Spiritual Pain Is Associated with Decreased Quality of Life in Advanced Cancer Patients in Palliative Care: An Exploratory Study

Perez‐Cruz, Pedro Emilio; Langer, Paola; Carrasco, Cecilia Alejandra Marambio; Bonati, Pilar; Batic, Bogomila; Satt, Laura Tupper; Otaiza, Marcela Gonzalez

doi:10.1089/jpm.2018.0340

Cited by 31 publications

(33 citation statements)

References 28 publications

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“…The diagnosis of cancer frequently results in a complex set of issues that patients and their families must confront [10]. Alleviating the consequences of cancer and providing high-quality of care, including symptom management, handling side effects, as well as social, psychological, spiritual and emotional support are recognised as high priority aspects that should be taken into account [11]. These aspects are categorised under the PC umbrella [12,13].…”

Section: Introductionmentioning

confidence: 99%

Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews

2020

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Background: Despite the significant benefits of palliative care (PC) services for cancer patients, multiple challenges hinder the provision of PC services for these patients. Low-and middle-income countries (LMICs) are witnessing a sharp growth in the burden of non-communicable diseases. There is a significant gap between demand and supply of PC in LMICs in current health services. This review aims to synthesise evidence from previous reviews and deliver a more comprehensive mapping of the existing literature about personal, system, policy, and organisational challenges and possible facilitators on the provision of PC services for cancer patients in LMICs. Methods: A systematic review of reviews was performed following PRISMA guidelines. PubMed, EMBASE, SCOPUS, PsycINFO, Web of Sciences, CINAHL, and Cochrane Library databases were searched to identify review papers published between 2000 and 2018 that considered challenges and possible facilitators to PC provision. A modified socioecological model was used as a framework for analysing and summarising findings. Results: Fourteen reviews were included. The reviews varied in terms of aim, settings, and detail of the challenges and possible facilitators. The main challenges of personal and health care systems included knowledge deficits and misunderstandings from patients, families, the general public, and health care providers about PC; and inadequate number of trained workforce. Besides, limited physical infrastructure, insufficient drugs for symptom relief and lack of a comprehensive national plan for implementing PC were the core organisational and policy level challenges that were recognised. Furthermore, the main possible facilitators that were identified included provision of adequate training for health care providers and health education for patients, families and the general public to enhance their knowledge, beliefs, and attitudes to PC. Finally, involvement of policymakers and making drugs available for symptom relief should also be in place to improve the health care systems. Conclusions: Understanding challenges to the provision of PC for people with cancer could help in the development of a PC pathway in LMICs. This knowledge could be used as a guide to develop an intervention programme to improve PC. Political influence and support are also required to ensure the sustainability and the provision of high-quality PC.

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Section: Introductionmentioning

confidence: 99%

Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews

2020

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“…Consequently, the role of the medical oncologist is not only to provide best quality anti-cancer treatment, but also to address the impact of the disease and its treatment on a patient’s life, the lived illness experience [ 3 – 5 ]. Considering the uniqueness of patients’ illness experiences, medical oncologists should, as stated in the WHO definition of palliative care, not only pay attention to the somatic, but also to the social, psychological and spiritual aspects of being ill [ 6 , 7 ]. Knowing what matters most to the patient is a prerequisite for successful personalized care [ 5 , 8 , 9 ], and patients and their proxies confronted with a life-threatening disease highly value attention given by healthcare providers’ [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Oncologist responses to advanced cancer patients’ lived illness experiences and effects: an applied conversation analysis study

et al. 2022

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Background An advanced cancer patient’s life is often disturbed by fear of cancer recurrence, cancer progress, approaching suffering, and fear of dying. Consequently, the role of the medical oncologist is not only to provide best quality anti-cancer treatment, but also to address the impact of disease and treatment on a patient’s life, the lived illness experience. We aimed to gain insights into whether and how medical oncologists working at an outpatient clinic identify and explore lived illness experiences raised by patients with advanced cancer, and how this influences patients’ responses. Methods Conversation Analysis was applied to analyse 16 verbatim transcribed audio-recorded consultations. Results We identified 37 fragments in which patients expressed a lived experience from 11 of the 16 consultations. We found differing responses from different oncologists. Patients continued talking about their lived experiences if the listener produced a continuer such as humming or tried to capture the experience in their own words. In contrast, a response with optimistic talking or the presentation of medical evidence prevented patients from further unfolding the experience. In consultations in which the lived illness experience was most extensively unfolded, medical oncologists and patients could constantly see each other’s facial expressions. Conclusions When a patient with advanced cancer spontaneously introduces a lived illness experience, it helps to identify and explore it when the medical oncologist produces a continuer or tries to capture this experience in their own words. Our findings can be implemented in training sessions, followed by frequent reinforcement in daily care.

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“…2 Some studies of advanced cancer patients have assessed the spiritual distress or spiritual pain, which were found to be associated with poorer quality of life, being younger, lower Karnofsky performance status (KPS), higher physical distress, anxiety or depression, and decreased religiosity and religious coping. 3 Spiritual pain was found in more than 40% of advanced cancer patients and it was correlated with physical and psychological distress. 4 It has been reported that spirituality, religiosity, and spiritual pain may influence symptom distress, quality of life, and coping strategies of patients with advanced and terminal illness.…”

Section: Introductionmentioning

confidence: 99%

The Role of Religiosity in Symptom Expression of Advanced Cancer Patients

Mercadante

Adile

Ricci

et al. 2021

Am J Hosp Palliat Care

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Aim: The aim of this study was to assess the religious pattern and its impact on symptom expression in patients with advanced cancer. Methods: A consecutive sample of advanced cancer patients screened at admission to palliative care. Standard epidemiological data were recorded. Patients were asked about their religious beliefs, the degree of social relationship to existing religions, the role of religion in their life, and the frequency of their prayer. The Edmonton Symptom Assessment Scale (ESAS) and Hospital Anxiety Depression scale (HADS) were assessed. Results: Two-hundred-eighty-three patients were screened. Age and gender were found to be independently correlated with religious belief (p = 0.042 and p = 0.016, respectively). Gender (females, p = 0.026), age (p = 0.003), lower Karnofsky performance status (KPS) (p = 0.022), and higher values of HADS-A (p = 0.003) were independently correlated with the degree of social relationship to existing religions. Gender (females, p = 0.002), lower KPS (p = 0.005), and higher values of HADS-A (p = 0.04) were independently correlated with a more relevant role of religiosity. Gender (females, p < 0.0005), lower KPS (p = 0.001), and drowsiness (p = 0.05) were independently correlated with frequency of prayer. Conclusion: The more the patients have demanding religious issues, the greater the state of anxiety, particularly in older and female patients with a lower KPS. The religious pattern did not have relevant role in the expression of other symptoms included in the ESAS.

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Spiritual Pain Is Associated with Decreased Quality of Life in Advanced Cancer Patients in Palliative Care: An Exploratory Study

Cited by 31 publications

References 28 publications

Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews

Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews

Oncologist responses to advanced cancer patients’ lived illness experiences and effects: an applied conversation analysis study

The Role of Religiosity in Symptom Expression of Advanced Cancer Patients

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