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Is spirituality related to survival in advanced cancer inpatients in Korea?

Published online by Cambridge University Press:  21 December 2017

Dong Wook Shin ,
Sang-Yeon Suh Open the ORCID record for Sang-Yeon Suh [Opens in a new window] ,
Sun-Hyun Kim ,
Jeanno Park ,
Seok Joon Yoon ,
Yu Jung Kim ,
Beodeul Kang ,
Jung Hye Kwon ,
Youngmin Park  and
Kwonoh Park
...Show all authors
Dong Wook Shin
Affiliation:
Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Seoul, South Korea
Sang-Yeon Suh*
Affiliation:
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea Department of Medicine, School of Medicine, Dongguk University, Seoul, South Korea
Sun-Hyun Kim
Affiliation:
Department of Family Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, South Korea
Jeanno Park
Affiliation:
Department of Internal Medicine, Bobath Memorial Hospital, Seongnam, South Korea
Seok Joon Yoon
Affiliation:
Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, South Korea
Yu Jung Kim
Affiliation:
Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea
Beodeul Kang
Affiliation:
Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea
Jung Hye Kwon
Affiliation:
Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University, Seoul, South Korea
Youngmin Park
Affiliation:
Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
Kwonoh Park
Affiliation:
Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan, South Korea
David Hui
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Hyeon Jeong Kim
Affiliation:
Department of Statistics, Dongguk University, Seoul, South Korea
Sanghwa Himchak
Affiliation:
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea
Sanghee Shiny Lee
Affiliation:
Department of Cancer Control and Population Health, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, South Korea
Hong-Yup Ahn
Affiliation:
Department of Statistics, Dongguk University, Seoul, South Korea
*
Author for correspondence: Sang-Yeon Suh, Department of Medicine, School of Medicine, Dongguk University, Seoul, South Korea. E-mail: lisasuhmd@hotmail.com
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Abstract

Objective

Spirituality is what gives people meaning and purpose in life, and it has been recognized as a critical factor in patients’ well-being, particularly at the ends of their lives. Studies have demonstrated relationships between spirituality and patient-reported outcomes such as quality of life and mental health. Although a number of studies have suggested that spiritual belief can be associated with mortality, the results are inconsistent. We aimed to determine whether spirituality was related to survival in advanced cancer inpatients in Korea.

Method

For this multicenter study, we recruited adult advanced cancer inpatients who had been admitted to seven palliative care units with estimated survival of <3 months. We measured spirituality at admission using the Korean version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-sp), which comprises two subscales: meaning/peace and faith. We calculated a Kaplan-Meier curve for spirituality, dichotomized at the predefined cutoffs and medians for the total scale and each of the two subscales, and performed univariate regression with a Cox proportional hazard model.

Result

We enrolled a total of 204 adults (mean age: 64.5 ± 13.0; 48.5% female) in the study. The most common primary cancer diagnoses were lung (21.6%), colorectal (18.6%), and liver/biliary tract (13.0%). Median survival was 19.5 days (95% confidence interval [CI95%]: 23.5, 30.6). Total FACIT-sp score was not related to survival time (hazard ratio [HR] = 0.981, CI95% = 0.957, 1.007), and neither were the scores for its two subscales, meaning/peace (HR = 0.969, CI95% = 0.932, 1.008) and faith (HR = 0.981, CI95% = 0.938, 1.026).

Significance of results

Spirituality was not related to survival in advanced cancer inpatients in Korea. Plausible mechanisms merit further investigation.

Keywords

Spiritualitymeaningpeacesurvivaladvanced cancerpalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 6 , December 2018 , pp. 669 - 676
Copyright
Copyright © Cambridge University Press 2017 

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References

Allison, PJ, Guichard, C, Fung, K, et al. (2003) Dispositional optimism predicts survival status 1 year after diagnosis in head and neck cancer patients. Journal of Clinical Oncology 21(3), 543–548.Google Scholar
Baek, YJ, Shin, DW, Choi, JY, et al. (2011) Late referral to palliative care services in Korea. Journal of Pain Symptom Management 41(4), 692–699.Google Scholar
Bai, M and Lazenby, M (2015) A systematic review of associations between spiritual well-being and quality of life at the scale and factor levels in studies among patients with cancer. Journal of Palliative Medicine 18(3), 286–298.Google Scholar
Balboni, TA, Balboni, M, Enzinger, AC, et al. (2013) Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Internal Medicine 173(12), 1109–1117.Google Scholar
Balboni, T, Balboni, M, Paulk, ME, et al. (2011) Support of cancer patients' spiritual needs and associations with medical care costs at the end of life. Cancer 117(23), 5383–5391.Google Scholar
Breitbart, W, Rosenfeld, B, Pessin, H, et al. (2015) Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology 33(7), 749–754.Google Scholar
Carey, MS, Bacon, M, Tu, D, et al. (2008) The prognostic effects of performance status and quality of life scores on progression-free survival and overall survival in advanced ovarian cancer. Gynecology and Oncology 108(1), 100–105.Google Scholar
Daugherty, CK, Fitchett, G, Murphy, PE, et al. (2005) Trusting God and medicine: Spirituality in advanced cancer patients volunteering for clinical trials of experimental agents. Psychooncology 14(2), 135–146.Google Scholar
El Nawawi, NM, Balboni, MJ, and Balboni, TA (2012) Palliative care and spiritual care: The crucial role of spiritual care in the care of patients with advanced illness. Current Opinion in Supportive and Palliative Care 6(2), 269–274.Google Scholar
Fielding, R and Wong, WS (2007) Quality of life as a predictor of cancer survival among Chinese liver and lung cancer patients. European Journal of Cancer 43(11), 1723–1730.Google Scholar
Frost, MH, Novotny, PJ, Johnson, ME, et al. (2013) Spiritual well-being in lung cancer survivors. Supportive Care in Cancer 21(7), 1939–1946.Google Scholar
Fu, WW, Popovic, M, Agarwal, A, et al. (2016) The impact of psychosocial intervention on survival in cancer: A meta-analysis. Annals of Palliative Medicine 5(2), 93–106.Google Scholar
Giese-Davis, J, Collie, K, Rancourt, KM, et al. (2011) Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: A secondary analysis. Journal of Clinical Oncology 29(4), 413–420.Google Scholar
Green McDonald, P, O'Connell, M, Lutgendorf, SK (2013) Psychoneuroimmunology and cancer: A decade of discovery, paradigm shifts, and methodological innovations. Brain, Behavior, and Immunity 30 Suppl, S1–S9.Google Scholar
Holland, JC, Passik, S, Kash, KM, et al. (1999) The role of religious and spiritual beliefs in coping with malignant melanoma. Psychooncology 8(1), 14–26.Google Scholar
Hsiao, AF, Wong, MD, Miller, MF, et al. (2008) Role of religiosity and spirituality in complementary and alternative medicine use among cancer survivors in California. Integrative Cancer Therapies 7(3), 139–146.Google Scholar
Ironson, G, Kremer, H, and Lucette, A (2016) Relationship between spiritual coping and survival in patients with HIV. Journal of General Internal Medicine 31(9), 1068–1076.Google Scholar
Johansson, M, Ryden, A, and Finizia, C (2011) Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - a longitudinal study. BMC Cancer 11, 283.Google Scholar
Kang, J, Shin, DW, Choi, JY, et al. (2012) Addressing the religious and spiritual needs of dying patients by healthcare staff in Korea: Patient perspectives in a multi-religious Asian country. Psychooncology 21(4), 374–381.Google Scholar
Koenig, HG (2012) Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry 2012, 278730.Google Scholar
Kruse, BG, Ruder, S, and Martin, L (2007). Spirituality and coping at the end of life. Journal of Hospice & Palliative Nursing 9(6), 296–304.Google Scholar
Lau, F, Downing, GM, Lesperance, M, et al. (2006) Use of Palliative Performance Scale in end-of-life prognostication. Journal of Palliative Medicine 9(5), 1066–1075.Google Scholar
Lee, YJ, Kim, CM, Linton, JA, et al. (2013) Association between spiritual well-being and pain, anxiety and depression in terminal cancer patients: A pilot study. Korean Journal of Hospice and Palliative Care 16(3), 175–182.Google Scholar
Lee, YJ, Suh, SY, Choi, YS, et al. (2014) EORTC QLQ-C15-PAL quality of life score as a prognostic indicator of survival in patients with far advanced cancer. Supportive Care in Cancer 22(7), 1941–1948.Google Scholar
Lissoni, P, Messina, G, Parolini, D, et al. (2008) A spiritual approach in the treatment of cancer: Relation between faith score and response to chemotherapy in advanced non-small cell lung cancer patients. In Vivo 22(5), 577–581.Google Scholar
Lo, C, Zimmermann, C, Rydall, A, et al. (2010) Longitudinal study of depressive symptoms in patients with metastatic gastrointestinal and lung cancer. Journal of Clinical Oncology 28(18), 3084–3089.Google Scholar
Luoma, ML, Hakamies-Blomqvist, L, Sjostrom, J, et al. (2003). Prognostic value of quality of life scores for time to progression (TTP) and overall survival time (OS) in advanced breast cancer. European Journal of Cancer 39(10), 1370–1376.Google Scholar
McClain, CS, Rosenfeld, B, and Breitbart, W (2003) Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet 361(9369), 1603–1607.Google Scholar
Montazeri, A (2009). Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health and Quality of Life Outcomes 7, 102.Google Scholar
Park, CL, Aldwin, CM, Choun, S, et al. (2016) Spiritual peace predicts 5-year mortality in congestive heart failure patients. Health Psychology 35(3), 203–210.Google Scholar
Pereira, DB, Christian, LM, Patidar, S, et al. (2010). Spiritual absence and 1-year mortality after hematopoietic stem cell transplant. Biology of Blood and Marrow Transplantation 16(8), 1171–1179.Google Scholar
Peteet, JR and Balboni, MJ (2013) Spirituality and religion in oncology. CA: A Cancer Journal for Clinicians 63(4), 280–289.Google Scholar
Peterman, AH, Fitchett, G, Brady, MJ, 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(1), 49–58.Google Scholar
Puchalski, CM (2012) Spirituality in the cancer trajectory. Annals of Oncology 23 Suppl 3, 49–55.Google Scholar
Rabow, MW and Knish, SJ (2015) Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care. Supportive Care in Cancer 23(4), 919–923.Google Scholar
Rodin, G, Lo, C, Mikulincer, M, et al. (2009) Pathways to distress: The multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients. Social Science & Medicine 68(3), 562–569.Google Scholar
Schofield, PE, Stockler, MR, Zannino, D, et al. (2016) Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer. Supportive Care in Cancer 24(1), 401–408.Google Scholar
Shin, DW, Choi, JE, Miyashita, M, et al. (2011) Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care. Journal of Pain Symptom Management 41(2), 478–484.Google Scholar
Silvestri, GA, Knittig, S, Zoller, JS, et al. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology 21(7), 1379–1382.Google Scholar
Spiegel, D, Bloom, JR, Kraemer, HC, et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 2(8668), 888–891.Google Scholar
Spinale, J, Cohen, SD, Khetpal, P, et al. (2008) Spirituality, social support, and survival in hemodialysis patients. Clinical Journal of the American Society of Nephrology 3(6), 1620–1627.Google Scholar
Steel, JL, Geller, DA, Robinson, TL, et al. (2014) Health-related quality of life as a prognostic factor in patients with advanced cancer. Cancer 120(23), 3717–3721.Google Scholar
Temel, JS, Greer, JA, Muzikansky, A, et al. (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine 363(8), 733–742.Google Scholar
Van Ness, PH, Kasl, SV, and Jones, BA (2003) Religion, race, and breast cancer survival. International Journal of Psychiatry in Medicine 33(4), 357–375.Google Scholar
Vigano, A, Donaldson, N, Higginson, IJ, et al. (2004). Quality of life and survival prediction in terminal cancer patients: A multicenter study. Cancer 101(5), 1090–1098.Google Scholar
Visser, A, Garssen, B, and Vingerhoets, A (2010). Spirituality and well-being in cancer patients: A review. Psychooncology 19(6), 565–572.Google Scholar
Watson, M, Haviland, JS, Greer, S, et al. (1999). Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet 354(9187), 1331–1336.Google Scholar
Watson, M, Homewood, J, Haviland, J, et al. (2005). Influence of psychological response on breast cancer survival: 10-year follow-up of a population-based cohort. European Journal of Cancer 41(12), 1710–1714.Google Scholar
Winkelman, WD, Lauderdale, K, Balboni, MJ, et al. (2011) The relationship of spiritual concerns to the quality of life of advanced cancer patients: Preliminary findings. Journal of Palliative Medicine 14(9), 1022–1028.Google Scholar
Woradet, S, Songserm, N, Promthet, S, et al. (2016). Health-related quality of life and survival of cholangiocarcinoma patients in Northeastern Region of Thailand. PLoS One 11(9), e0163448.Google Scholar
Zavala, MW, Maliski, SL, Kwan, L, et al. (2009). Spirituality and quality of life in low-income men with metastatic prostate cancer. Psychooncology 18(7), 753–761.Google Scholar