Spiritual-Religious Profiles and Psychological Distress in Romanian Patients with Cancer

Background/Objectives: Religious engagement may coexist with low existential well-being. We identified spiritual-religious profiles in Romanian patients with cancer, assessed their associations with distress and quality of life, and evaluated spirituality's incremental predictive value. Methods: This single-centre cross-sectional study included 175 adults with cancer. Latent profile analysis used FACIT-Sp Meaning, Peace, and Faith, Religious Commitment Inventory-10, and service attendance. Clinically significant distress was defined as Hospital Anxiety and Depression Scale anxiety or depression scores ≥8. Adjusted regression and a six-predictor logistic model with bootstrap internal validation were used. Results: Three profiles emerged: low spiritual-religious resource (n = 61), religiously engaged but existentially unsettled (n = 52), and integrated spiritual-religious resource (n = 62). Distress prevalence was 68.9%, 61.5%, and 25.8%, respectively (p < 0.001). Compared with the low-resource profile, the integrated profile had lower adjusted odds of distress (OR 0.19, 95% CI 0.08-0.44), higher global quality of life (adjusted difference 14.1 points, 95% CI 4.4-23.8), and lower symptom burden (-11.8 points, 95% CI -18.6 to -5.0). The full model had an apparent AUC of 0.816 (95% CI 0.748-0.875) and an optimism-corrected AUC of 0.789. Its AUC exceeded that of the clinical-only model by 0.064 (95% CI 0.008-0.12; p = 0.023). Conclusions: Religious involvement alone did not indicate resolved spiritual needs. Inner peace may improve distress risk assessment, although prospective external validation is required.