Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T12:02:26.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Exploring the relationship between spiritual well-being and quality of life among patients newly diagnosed with advanced cancer

Published online by Cambridge University Press:  03 July 2014

Mei Bai ,
Mark Lazenby ,
Sangchoon Jeon ,
Jane Dixon  and
Ruth McCorkle
Mei Bai*
Affiliation:
Yale University, School of Nursing, New Haven, Connecticut
Mark Lazenby
Affiliation:
Yale University, School of Nursing, New Haven, Connecticut
Sangchoon Jeon
Affiliation:
Yale University, School of Nursing, New Haven, Connecticut
Jane Dixon
Affiliation:
Yale University, School of Nursing, New Haven, Connecticut
Ruth McCorkle
Affiliation:
Yale University, School of Nursing, New Haven, Connecticut
*
Address correspondence and reprint requests to: Ruth McCorkle, Yale School of Nursing, Yale University, West Campus, P.O. Box 27399, West Haven, Connecticut 06516-7399. E-mail: ruth.mccorkle@yale.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

In our context, existential plight refers to heightened concerns about life and death when people are diagnosed with cancer. Although the duration of existential plight has been proposed to be approximately 100 days, evidence from longitudinal studies raises questions about whether the impact of a diagnosis of advanced cancer may require a longer period of adjustment. The purpose of our study was to examine spiritual well-being (SpWB) and quality of life (QoL) as well as their interrelationship in 52 patients with advanced cancer after 100 days since the diagnosis at one and three months post-baseline.

Method:

The study was designed as a secondary data analysis of a cluster randomized clinical trial involving patients with stage 3 or 4 cancer undergoing treatment. SpWB was measured using the 12-item Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp–12); common factor analyses revealed a three-factor pattern on the FACIT–Sp–12. Quality of life was measured with the Functional Assessment of Cancer Therapy–General (FACT–G). We limited our sample to participants assigned to the control condition (n = 52).

Results:

SpWB and QoL remained stable between one and three months post-baseline, which were a median of 112 and 183 days after diagnosis, respectively. SpWB was found to be associated with QoL more strongly than physical and emotional well-being. Peace and Meaning each contributed unique variance to QoL, and their relative importance shifted over time. Faith was positively related to QoL initially. This association became insignificant at three months post-baseline.

Significance of results:

This study underscores the significance of SpWB for people newly diagnosed with advanced cancer, and it highlights the dynamic pattern of Peace, Meaning, and Faith in association with QoL. Our results confirm that patients newly diagnosed with advanced cancer experience an existential crisis, improve and stabilize over time. Future studies with larger samples over a longer period of time are needed to verify these results.

Keywords

Spiritual well-beingQuality of lifeAdvanced cancerNewly diagnosedExistential plight
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 927 - 935
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bai, M. & Dixon, J.K. (2014). Exploratory factor analysis of the 12-item Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp–12) in people newly diagnosed with advanced cancer. Journal of Nursing Measurement. In press.CrossRefGoogle ScholarPubMed
Brady, M.J., Peterman, A.H., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psycho-Oncology, 8, 417–428.Google Scholar
Breitbart, W., Poppito, S., Rosenfeld, B., et al. (2012). Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology, 30, 1304–1309.CrossRefGoogle ScholarPubMed
Canada, A.L., Murphy, P.E., Fitchett, G., et al. (2008). A 3-factor model for the FACIT–Sp. Psycho-Oncology, 17, 908–916.CrossRefGoogle ScholarPubMed
Caplan, G. (1974). Support systems and community mental health. New York: Behavioral Publications.Google Scholar
Cella, D.F. & Tulsky, D.S. (1993). Quality of life in cancer: Definition, purpose, and method of measurement. Cancer Investigation, 11, 327–336.CrossRefGoogle ScholarPubMed
Cella, D.F., Tulsky, D.S., Gray, G., et al. (1993). The Functional Assessment of Cancer Therapy Scale: Development and validation of the general measure. Journal of Clinical Oncology, 11(3), 570–579.Google Scholar
Cohen, S.R., Mount, B.M., Strobel, M.G., et al. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability. Palliative Medicine, 9(3), 207–219.Google Scholar
Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., et al. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429–438.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Courtens, A.M., Stevens, F.C., Crebolder, H.F., et al. (1996). Longitudinal study on quality of life and social support in cancer patients. Cancer Nursing, 19, 162–169.Google Scholar
de Haes, J.C. & van Knippenberg, F.C. (1985). The quality of life of cancer patients: A review of the literature. Social Science & Medicine, 20, 809–817.CrossRefGoogle ScholarPubMed
Edmondson, D., Park, C.L., Blank, T.O., et al. (2008). Deconstructing spiritual well-being: Existential well-being and HRQoL in cancer survivors. Psycho-Oncology, 17, 161–169.Google Scholar
Ercolano, E., Bai, M., Lazenby, M., et al. (2013). Emotional distress in patients newly diagnosed with late-stage cancers. Journal of Palliative Care & Medicine, S3: 002. doi: 10.4172/2165-7386.S3-002. Available at http://omicsgroup.org/journals/emotional-distress-in-patients-newly-diagnosed-with-late-stage-cancers-2165-7386.S3-002.pdf.Google Scholar
Fitchett, G., Peterman, A.H. & Cella, D.F. (1996). Spiritual beliefs and quality of life in cancer and HIV patients. Paper presented at the Society for Scientific Study of Religion, Nashville, Tennessee.Google Scholar
Jacobsen, P.B., Donovan, K.A., Trask, P.C., et al. (2005). Screening for psychological distress in ambulatory cancer patients. Cancer, 103, 1494–1502.CrossRefGoogle ScholarPubMed
Koenig, H.G. (2008). Concerns about measuring “spirituality” in research. The Journal of Nervous and Mental Disease, 196, 349–355.CrossRefGoogle ScholarPubMed
Lazenby, M. & Khatib, J. (2012). Associations among patient characteristics, health-related quality of life, and spiritual well-being among Arab Muslim cancer patients. Journal of Palliative Medicine, 15, 1321–1324.Google Scholar
Lazenby, M., Khatib, J., Al-Khair, F., et al. (2013). Psychometric properties of the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT–Sp) in an Arabic-speaking, predominantly Muslim population. Psycho-Oncology, 22, 220–227.CrossRefGoogle Scholar
McCorkle, R. & Quint-Benoliel, J. (1983). Symptom distress current concerns and mood disturbance after diagnosis of life-threatening disease. Social Science & Medicine, 17, 431–438.Google Scholar
McCorkle, R., Benoliel, J.Q., Donaldson, G., et al. (1989). A randomized clinical trial of home nursing care for lung cancer patients. Cancer, 64, 1375–1382.Google Scholar
Nunnally, J. & Bernstein, I. (1994). Psychometric theory. New York: McGraw-Hill.Google Scholar
Peterman, A.H., Fitchett, G., Brady, M.J., et al. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp). Annals of Behavioral Medicine, 24, 49–58.CrossRefGoogle ScholarPubMed
Roberts, K.T. & Fitzgerald, L. (1991). Serenity: Caring with perspective. Scholarly Inquiry for Nursing Practice, 5, 127–142.Google ScholarPubMed
Roberts, K.T. & Messenger, T.C. (1993). Helping older adults find serenity. Geriatric Nursing, 14, 317–322.CrossRefGoogle ScholarPubMed
Rose, J.H., Kypriotakis, G., Bowman, K.F., et al. (2009). Patterns of adaptation in patients living long term with advanced cancer. Cancer, 115, 4298–4310.CrossRefGoogle ScholarPubMed
Salsman, J.M., Yost, K.J., West, D.W., et al. (2011). Spiritual well-being and health-related quality of life in colorectal cancer: A multi-site examination of the role of personal meaning. Supportive Care in Cancer, 19, 757–764.Google Scholar
Sawatzky, R., Ratner, P.A. & Chiu, L. (2005). A meta-analysis of the relationship between spirituality and quality of life. Social Indicators Research, 72, 153–188.Google Scholar
Schultz, A.A. & Winstead-Fry, P. (2001). Predictors of quality of life in rural patients with cancer. Cancer Nursing, 24, 12–19.Google Scholar
Visser, A., Garssen, B. & Vingerhoets, A. (2010). Spirituality and well-being in cancer patients: A review. Psycho-Oncology, 19, 565–572.CrossRefGoogle ScholarPubMed
Wang, Y., Shen, J. & Xu, Y. (2011). Symptoms and quality of life of advanced cancer patients at home: A cross-sectional study in Shanghai, China. Supportive Care in Cancer, 19, 789–797.Google Scholar
Weisman, A.D. (1979). Coping with cancer. New York: McGraw-Hill.Google ScholarPubMed
Weisman, A.D. (1984). A model for psychosocial phasing in cancer. In Coping with Physical Illness. Moos, R.H. (ed.), pp. 107–122. New York: Plenum Publishing.CrossRefGoogle Scholar
Weisman, A.D. & Worden, J.W. (1976). The existential plight in cancer: Significance of the first 100 days. International Journal of Psychiatry in Medicine, 7, 1–15.Google Scholar
Whitford, H.S. & Olver, I.N. (2011). The multidimensionality of spiritual well-being: Peace, meaning, and faith and their association with quality of life and coping in oncology. Psycho-Oncology, 21, 602–610.CrossRefGoogle ScholarPubMed
Whitford, H.S., Olver, L.N. & Peterson, M. (2008). Spirituality as a core domain in the assessment of quality of life in oncology. Psycho-Oncology, 17, 1121–1128.Google Scholar
Wilson, I.B. & Cleary, P.D. (1995). Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. The Journal of the American Medical Association, 273, 59–65.Google Scholar
Yancik, R., Havlik, R.J., Wesley, M.N., et al. (1996). Cancer and comorbidity in older patients: A descriptive profile. Annals of Epidemiology, 6, 399–412.CrossRefGoogle ScholarPubMed
Yanez, B., Edomondson, D., Stanton, A.L., et al. (2009). Facets of spirituality as predictors of adjustment to cancer: Relative contributions of having faith and finding meaning. Journal of Consulting and Clinical Psychology, 77, 730–741.Google Scholar
Zavala, M.W., Maliski, S.L., Kwan, L., et al. (2009). Spirituality and quality of life in low-income men with metastatic prostate cancer. Psycho-Oncology, 18, 753–761.Google Scholar