Spirituality and associated factors among cancer patients undergoing chemotherapy

Patients' spirituality, the relationship between spirituality and physical pain, and the association between spirituality and quality of life (QOL) among patients undergoing cancer chemotherapy were examined. Spirituality was defined as a sense of meaning in one's existence and life, peace of mind, and the strength and comfort drawn from faith.

A cross-sectional questionnaire survey was distributed to 176 adult cancer patients who received chemotherapy in May-September 2011 at an outpatient clinic in rural Japan. Spirituality was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12). Demographic data were collected for performance status, cancer stage, age, marital status, occupational status, persons in household, pain intensity, and other troubling symptoms. The relationship between the patients' spirituality subscale score and QOL was assessed in a structural equation model.

Two FACIT-Sp-12 subscales, meaning/peace and faith, were moderately to strongly associated with age, appetite, and QOL scores. Although physical pain was significantly related to the QOL score (P = .002), it was not related to the FACIT-Sp-12 score (P = .427). These results indicated that the patients with higher spiritual scores and severe pain were enjoying life more than the patients with lower spiritual scores and severe pain. Moreover, two subscales of the FACIT-Sp-12 had a direct effect on QOL.

Spirituality was strongly associated with QOL. Younger patients (<50 years old) and stage I cancer patients need additional assistance to meet their spiritual needs. To maintain cancer patients' spiritual well-being, nursing interventions should facilitate patients' nutrition support and appropriately address their spirituality.