Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care
Menée aux Etats-Unis auprès de 883 patients atteints de cancer et traités à l'extérieur de l'hôpital (âge moyen : 65, 5 ans), cette étude rétrospective évalue l'association entre leur bien-être spirituel, des symptômes liés à la maladie (dépression, anxiété, fatigue, douleur, etc) et l'efficacité du traitement anti-cancer et des soins palliatifs concomitants
Purpose : Spiritual well-being is threatened by cancer, but its correlation with other illness symptoms and the efficacy of palliative care (PC) to ameliorate spiritual suffering are not well understood. Methods : We conducted a retrospective study using a convenience sample of oncology patients at a comprehensive cancer center who received concurrent oncologic and palliative care between 2008 and 2011 and completed ESAS, QUAL-E, and Steinhauser Spiritual well-being survey questions was conducted. Descriptive, correlation, and t test statistics. Results : Eight hundred eighty-three patients surveyed had an average age of 65.6 years, with 54.1 % female, 69.3 % white, and 49.3 % married. Half (452, 51.2 %) had metastatic disease. Religious affiliation was reported as Christian by 20.3 %, Catholic by 18.7 %, and “none” by 39.0 %. Baseline spiritual well-being was not significantly correlated with age, gender, race, cancer stage, marital status, insurance provider, or having a religious affiliation. Greater spiritual well-being was correlated with greater quality of life (<p = 0.001) and well-being (<p = 0.001), and with less depression (<p = 0.001), anxiety (<p = 0.001), fatigue (p = 0.005), and pain (p = 0.01). In multiple regression analysis, the associations persisted between spiritual well-being and anxiety, depression, fatigue, and quality of life (R 2 = 0.677). Spiritual well-being improved comparing mean scores immediately prior to initial PC consultation with those at first follow-up (2.89 vs. 3.23 on a 1–5 scale, p = 0.005). Conclusions : Among patients with cancer receiving concurrent oncologic and palliative care, spiritual well-being was not associated with patient age, gender, or race, or disease stage. It was correlated with physical and emotional symptoms. Spiritual well-being scores improved from just prior to the initial PC consultation to just prior to the first PC follow-up visit