Spirituality in Decision-Making in Patients in Oncology Settings: A Scoping Review

Spirituality is a source of meaning, comfort, hope, and resilience for oncology patients, influencing how they cope with diagnosis and treatment. It is embedded within systems of beliefs and values that can shape decision-making, including acceptance or refusal of treatments. The aim of this review is to map the knowledge on the influence of spirituality in decision-making among oncology patients in healthcare settings.

This scoping review followed JBI methodology and PRISMA-ScR guidelines. Searches were conducted in March 2025 across electronic databases, including MEDLINE and CINAHL. MedicLatina, LILACS, PubMed, ProQuest, Scopus, and SciELO. Grey literature sources included the Repositório Científico de Acesso Aberto de Portugal. Inclusion criteria involved oncology patients of any age, cancer type, disease stage, or treatment context and studies conducted in oncology-related settings, such as hospitals, palliative care, hospice care, oncology clinics, or community-based contexts. Eligible study designs included qualitative, quantitative, and mixed-methods research, as well as reviews, opinion pieces, and theoretical papers. Two reviewers independently screened studies using Rayyan, and data were extracted using JBI's standardised tool. Findings were tabulated and synthesised narratively. The search yielded 1,358 records; 578 duplicates were removed, leaving 780 for screening. A total of 53 articles were selected for full-text review after applying the eligibility criteria.

A total of 15 studies were included in this review. Three major themes emerged: (1) Spirituality reduces decisional conflict and regret, (2) Spirituality influences preferences for treatment goals, and (3) Integration of spirituality in shared decision-making.

Spirituality is a substantial factor in shaping treatment preferences and decisions, and patient engagement in shared decision-making. Understanding the role of spirituality in decision-making can support oncology healthcare professionals in providing holistic, patient-centred care. Integrating spiritual care and assessment into clinical practice may improve communication, align treatment goals with patients' values, reduce decisional conflict, and enhance overall care satisfaction.