Exploring the relationship between spiritual well-being and death anxiety in patients with gynecological cancer: a cross-section study

Abstract

Background In recent years, spiritual well-being has gradually gained the attention of health care providers in China, especially those in oncology departments, who have recognized the importance of improving spiritual well-being in cancer patients. Since most of the current research on spiritual well-being has been carried out in areas with religious beliefs, this study was conducted in the context of no development of formal religion. The purpose of this study was to explore the relationship between death anxiety and spiritual well-being and the related factors of spiritual well-being among gynecological cancer patients. Methods This cross-section study was conducted among 586 gynecological cancer patients. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-spiritual well-being32 (EORTC QLQ-SWB32) and Templer's Death Anxiety Scale (T-DAS) were used to measure spiritual well-being and death anxiety. The Multiple Linear Regression Model was used to determine the relationship between spiritual well-being and death anxiety. Results For all participants, the highest QLQ-SWB32 centesimal score was 75.13 on the Relationship with Other scale, and the lowest was 60.33 on the Relationship with Someone or Something Greater Scale. The mean Death Anxiety score was 5.31 (SD 3.18). We found that Relationship with Someone or Something Greater was the only scale not associated with death anxiety. Overall, patients with lower death anxiety have a higher level of spiritual well-being. Besides, a high Relationship with Other score was associated with living with a partner (B = 2.471, P < 0.001) and married (B = -6.475, P = 0.001). Patients with higher Global-SWB were retired (B = 0.387, P = 0.019). Conclusions Our study found that the spiritual well-being of patients with gynecological cancer in China was no worse than in other countries with religious beliefs and patients with lower death anxiety have a higher level of spiritual well-being. Clinical staff should pay attention to the spiritual health of cancer patients, and spiritual care should be regarded as an essential element in cancer care.

Spiritual Well-Being for Croatian Cancer Patients: Validation and Applicability of the Croatian Version of the EORTC QLQ-SWB32

“…The primary aim of our main study was to explore the structure and validity of a Croatian version of the SWB32 with patient participants in Croatia. We found that this measure was comprehensible and acceptable to all participants, with quantitative findings broadly equivalent to those found in the international study with palliative patients [8], Median values of scale scores in our study were mostly consistent with those in other published studies [8,12,13,19]. For each of the four multi-item scales, the Cronbach's alpha coefficient was above the threshold of 0.6.…”

“…For sex, women scored higher on RSG, EX, RG, and Global-SWB. In the validation study [8,19], and the two Chinese studies [12,13], female participants also scored significantly higher on RSG, EX, and Global-SWB. Studies using other measures of spirituality or SWB (the Spiritual Interests Related to Illness Tool (SpIRIT) [33] and the Spiritual Needs Inventory (SNI) [35]) have also found that women have greater SWB than men [33][34][35][36].…”

“…Our study engages with this observation and contributes to further understanding of the multiple facets of SWB, and its place and role in different clinical and cultural settings, providing additional insight by investigating the use of the measure with Croatian curative oncology patients of both sexes, and with a variety of cancers. As Feng et al [13] point out, understanding the role of spirituality and SWB for both curative and palliative patients is important in developing and delivering holistic and culturally appropriate patientoriented care.…”

“…Amongst other recommendations, Vivat et al [8] recommended exploring the use of the SWB32 with curative oncology patients. No such research has yet been conducted in Croatia, but two recent studies in China included curative patients [12,13] (it must however be noted that both these Chinese studies used a translation of the SWB32 which has not been validated by the EORTC Translation Unit). Following an initial small-scale study validating the Croatian translation of the SWB32, the primary aim of our project's main study was to evaluate and validate the psychometric characteristics of the Croatian version of the SWB32 with Croatian curative oncology patients, and assess its suitability as both a measurement and intervention tool for these patients.…”

Validation of the Revised Collett–Lester Fear of Death Scale in a French Population

“…Indeed, neuroticism (as a personality trait) is linked to generalized anxiety and preliminaries studies have demonstrated positive associations between neuroticism and death anxiety ( Loo, 1984 ; Frazier and Foss-Goodman, 1989 ; Pradhan et al, 2020 ). Elsewhere, it has also been demonstrated that people with high spiritual well-being have low death anxiety ( Routledge and Juhl, 2010 ; Lyke, 2013 ; MacLeod et al, 2019 ; Feng et al, 2021 ). Because spirituality offers sense of faith, meaning and purpose life and inner peace, people with high spirituality are less afraid of death and more prone to accept death.…”