Prevalence, predictors and correlates of religious and spiritual struggles in palliative cancer patients.

Annelieke Damen, Julie Exline, Kenneth Pargament, Yingwei Yao, Harvey Chochinov, Linda Emanuel, George Handzo, Diana Wilkie, George Fitchett

Research output: Contribution to journalArticleAcademic

Abstract

Context: Religion and spirituality (r/s) are important resources in coping with cancer. However, there are aspects of r/s, such as religious and spiritual struggles, found to be associated with poorer outcomes. A new measure has been adapted from the Religious and Spiritual Struggles Scale (RSS) to assess r/s struggles: the RSS-14. This concise measure allows for the assessment of multiple types of r/s struggles for people from different religious backgrounds or none. Objectives: The aim of the present study was to examine the prevalence, predictors and correlates of r/s struggles as measured by the RSS-14 and its subdomains in a cancer population receiving palliative care. Methods: Data were collected from six outpatient palliative care services across the US. Inclusion criteria for patients were age 55 or older with a cancer diagnosis. In addition to demographic and r/s characteristics, study measures included the Edmonton Symptom Assessment Scale (ESAS), the Patient Dignity Inventory (PDI) and the Quality of Life at the End of Life (QUAL-E). Results: The study included 331 participants. Some r/s struggle was reported by 66%, moderate to high struggle for at least one item was reported by 20% of the patients. In bivariate analyses, r/s struggle was associated with greater symptom burden, greater dignity-related problems and poorer quality of life; in multivariable analyses, dignity-related problems remained a predictor of total r/s struggle. Conclusion: R/S struggles may compromise well-being for cancer patients receiving palliative care. Clinicians should consider periodic screening for r/s struggles and referrals for spiritual care if indicated.
Original languageEnglish
Pages (from-to)e139-e147
JournalJournal of Pain and Symptom Management
Volume62
Issue number3
DOIs
Publication statusPublished - 1 Sep 2021

Keywords

  • Religion
  • cancer
  • negative religious coping
  • palliative care
  • religious/spiritual struggles
  • spirituality

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