Spirituality, symptom burden and palliative care needs assessed by the Palliative Outcome Scale in those with cancer:...

Understanding symptom prevalence and palliative care needs is essential to advancing palliative care research in South America. This study aimed to assess these outcomes using the Palliative Outcome Scale (POS) and explore their relationship with the self-rated importance of spirituality.

A cross-sectional study was conducted among adult persons with cancer receiving palliative care at an outpatient clinic in a Brazilian public hospital. Data were collected through structured interviews using the POS, which assesses physical and psychosocial symptoms, communication, practical concerns and information received. Spirituality was measured using a self-rated single-item question. Associations between symptom burden and spirituality were analysed using t-tests and logistic regression was used to examine the relationship between spirituality importance and inadequate pain control, adjusting for potential confounders. Statistical significance was set at p < 0.05.

Sixty-seven patients (mean age 60 ± 13.8 years; 68.6% female) participated. Pain (77.6%), nausea (27%), weakness/fatigue (20.9%) and psychological distress (19.4%) were the most prevalent symptoms. Most had metastatic cancer (62.7%), and 32.8% were undergoing chemotherapy. Patients rating spirituality as highly important had significantly lower pain scores (mean 1.4 ± 1.4 versus 2.6 ± 0.9, p = 0.006) and were over ten times less likely to report inadequate pain control (odds ratios = 10.74, 95% confidence intervals: 1.87-203.82, p = 0.028).

Our findings underscore the high prevalence of physical, psychological and social challenges among persons with cancer receiving palliative care. Symptom patterns aligned with global data, suggesting a universal burden. The strong association between spirituality and pain highlights the protective role of spiritual well-being in mitigating suffering, reinforcing the need to integrate spiritual care into palliative frameworks. These results offer valuable insights for guiding clinical practice, shaping international policy and informing future research to optimise care delivery and patient outcomes.