Spiritual Wellbeing of Cancer Patients: What Health-Related Factors Matter?

Abstract

This study aimed to determine the predictors of spiritual wellbeing of non-terminal stage cancer patients hospitalized in oncology units in Lithuania. An exploratory cross-sectional study design was employed. During structured face-to-face interviews, 226 cancer patients hospitalized in oncology units responded about their spiritual wellbeing, perception of happiness, satisfaction with life, pain intensity, levels of education and physical functioning, and length of inpatient stay. A set of standardized tools were used: spiritual wellbeing scale SHALOM, brief multidimensional life satisfaction scale, Oxford Happiness Questionnaire, Barthel Index questionnaire, and verbal pain intensity scale. Additionally, social- and health-related factors were included in data analyses. Structural equation modeling was adapted for a comprehensive assessment of the mediating effect of spiritual wellbeing on the relationship between different health- and value-related factors. The overall fit of the structural model was generally good: \(\chi_{(29)}^{2}\) = 66.94 (χ2/df = 2.31), CFI = 0.94, RMSEA = 0.08, and SRMR = 0.06. Data were analyzed using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 24.0 and Mplus version 8.2. Level of happiness, life satisfaction, and spiritual wellbeing scored in the moderate upper range. The communal domain of spiritual wellbeing rated with the highest mean score and transcendental domain with the lowest score. Education (b = 0.208, p = 0.004), physical functioning (b = 0.171, p = 0.025), and hospital duration (b = − 0.240, p = 0.001) were significant predictors of spiritual wellbeing. Happiness and life satisfaction were negatively influenced by pain intensity, which ranged from mild to moderate. Levels of education, physical functioning, and length of hospital stay predict spiritual wellbeing of non-terminally ill cancer patients. Happiness, as well as life satisfaction, was negatively predicted by pain intensity but had no direct influence on spiritual wellbeing of cancer patients. Spiritual wellbeing positively influences emotional wellbeing (happiness and life satisfaction), and its influence is stronger than the negative influence of physical pain has on emotional wellbeing.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. Alford, K. R. (2017). Spiritual wellbeing among older cancer patients and implications for Christians in social work. Social work & Christianity,4(3), 25–38.

    Google Scholar 

  2. Amirian, M. E., & Fazilat-Pour, M. (2016). Simple and multivariate relationships between spiritual intelligence with general health and happiness. Journal of Religion and Health,55, 1275. https://doi.org/10.1007/s10943-015-0004-y.

    Article  PubMed  Google Scholar 

  3. Bai, M., & Lazenby, M. (2015). A systematic review of associations between spiritual wellbeing and quality of life at the scale and factor levels in studies among patients with cancer. Journal of Palliative Medicine,18(3), 286–298. https://doi.org/10.1089/jpm.2014.0189.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bekelman, D. B., Rumsfeld, J. S., Havranek, E. P., Yamashita, T. E., Hutt, E., Gottlieb, S. H., et al. (2009). Symptom burden, depression and spiritual wellbeing: A comparison of heart failure and advanced cancer patients. Journal of General Internal Medicine,24(5), 592–598. https://doi.org/10.1007/s11606-009-0931-y.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bezzera, S. M. M. S., Gomes, E. T., Galvao, P. C. C., & Souza, K. V. (2018). Spiritual wellbeing and hope in the perioperative period of cardiac surgery. Revista Brasileira de Enfermagem,71(2), 398–405. https://doi.org/10.1590/0034-7167-2016-0642.

    Article  Google Scholar 

  6. Büssing, A., Fischer, J., Haller, A., Heusser, P., Ostermann, T., & Matthiessen, P. F. (2009). Validation of the brief multidimensional life satisfaction scale in patients with chronic diseases. European Journal of Medical Research,14, 171–177. https://doi.org/10.1186/2047-783X-14-4-171.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Chaar, E. A., Hallit, S., Hajj, A., Aaraj, R., Kattan, J., Jabbour, H., et al. (2018). Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: An observational transversal study. Supportive Care in Cancer,26(8), 2581–2590. https://doi.org/10.1007/s00520-018-4089-1.

    Article  PubMed  Google Scholar 

  8. Chan, C. L. W., Ng, S. M., Ho, R. T. H., & Chow, A. Y. M. (2006). East meets west: Applying eastern spirituality in clinical practice. Journal of Clinical Nursing,15(7), 822–832. https://doi.org/10.1111/j.1365-2702.2006.01649.x.

    Article  PubMed  Google Scholar 

  9. Cheng, Q., Liu, X., Li, X., Wang, Y., Mao, T., & Chen, Y. (2019). Improving spiritual wellbeing among cancer patients: Implications for clinical care. Supportive Care in Cancer. https://doi.org/10.1007/s00520-019-4636-4.

    Article  PubMed  Google Scholar 

  10. Chiang, Y. C., Lee, H. C., Chu, T. L., Han, C. Y., & Hsiao, Y. C. (2015). The impact of nurses’ spiritual health on their attitudes toward spiritual care, professional commitment, and caring. Nursing Outlook,64(3), 215–224. https://doi.org/10.1016/j.outlook.2015.11.012.

    Article  PubMed  Google Scholar 

  11. Cooper-Effa, M., Blount, W., Kaslow, N., Rothenberg, R., & Eckman, J. (2001). Role of spirituality in patients with sickle cell disease. Journal of the American Board of Family Practice,14(2), 116–122.

    CAS  PubMed  Google Scholar 

  12. Deb, S., Thomas, S., Bose, A., & Aswathi, T. (2019). Happiness, meaning, and satisfaction in life as perceived by Indian university students and their association with spirituality. Journal of Religion and Health. https://doi.org/10.1007/s10943-019-00806-w.

    Article  PubMed  Google Scholar 

  13. Dilmaghani, M. (2018). Religiosity and subjective wellbeing in Canada. Journal of Happiness Studies,19, 629–664. https://doi.org/10.1007/s10902-016-9837-7.

    Article  Google Scholar 

  14. Ellison, C. W. (1983). Spiritual wellbeing: Conceptualization and measurement. Journal of Psychology and Theology,11, 30–340.

    Google Scholar 

  15. Eslami, A. A., Rabiei, L., Khayri, F., Rashidi Nooshabadi, M. R., & Masoudi, R. (2014). Sleep quality and spiritual wellbeing in hemodialysis patients. Iranian Red Crescent Medical Journal,16(7), e17155. https://doi.org/10.5812/ircmj.17155.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fisher, J. (2010). Development and application of a spiritual wellbeing questionnaire called SHALOM. Religions,1, 105–121. https://doi.org/10.3390/rel1010105.

    Article  Google Scholar 

  17. Fisher, J. (2011). The four domains model: Connecting spirituality, health and well-being. Religions,2, 17–28. https://doi.org/10.3390/rel2010017.

    Article  Google Scholar 

  18. Fisher, J. (2012). Staff’s and family members’ spiritual wellbeing in relation to help for residents with dementia. Journal of Nursing Education and Practice,2, 77–85. https://doi.org/10.5430/jnep.v2n4p77.

    Article  Google Scholar 

  19. Flint, K. M., Fairclough, D. L., Spertus, J. A., & Bekelman, D. B. (2019). Does heart failure-specific health status identify patients with bothersome symptoms, depression, anxiety and/or poorer spiritual wellbeing? European Heart Journal-Quality of Care and Clinical Outcomes,1:5(3), 233–241. https://doi.org/10.1093/ehjqcco/qcy061.

    Article  PubMed  Google Scholar 

  20. Gomez, R., & Fisher, J. W. (2003). Domains of spiritual well-being and development and validation of the Spiritual Well-Being Questionnaire. Personality and Individual Differences,35(8), 1975–1991. https://doi.org/10.1016/S0191-8869(03)00045-X.

    Article  Google Scholar 

  21. Hills, P., & Argyle, M. (2002). The Oxford Happiness Questionnaire: A compact scale for the measurement of psychological wellbeing. Personality and Individual Differences,33(7), 1073–1082. https://doi.org/10.1016/S0191-8869(01)00213-6.

    Article  Google Scholar 

  22. Hooper, D., Coughlin, J., & Mullen, M. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods,6, 53–60. https://doi.org/10.21427/D7CF7R.

    Article  Google Scholar 

  23. Jacobs-Lawson, J. M., Schumacher, M. M., Hughes, T., & Arnold, S. (2010). Gender differences in psychosocial responses to lung cancer. Gender Medicine,7(2), 137–148. https://doi.org/10.1016/j.genm.2010.03.002.

    Article  PubMed  Google Scholar 

  24. Juškienė, V. (2016). Spiritual health as an integral component of human wellbeing. Applied Research In Health And Social Sciences: Interface And Interaction,13(1), 3–13. https://doi.org/10.1515/arhss-2016-0002.

    Article  Google Scholar 

  25. Kanis, S. (2002). Theobiology and gendered spirituality. American Behavioral Scientist,45(12), 1866–1874. https://doi.org/10.1177/0002764202045012009.

    Article  Google Scholar 

  26. Koyama, A., Matsuoka, H., Ohtake, Y., Makimura, C., Sakai, K., Sakamoto, R., et al. (2016). Gender differences in cancer-related distress in Japan: A retrospective observation study. BioPsychoSocial Medicine. https://doi.org/10.1186/s13030-016-0062-8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Lee, S., & Jirásek, I. (2019). Associations between screen-based activity, spiritual wellbeing, and life satisfaction among adolescents. Journal of Religion and Health,58, 795. https://doi.org/10.1007/s10943-017-0429-6.

    Article  PubMed  Google Scholar 

  28. Lim, C., & Putnam, R. D. (2010). Religion, social networks, and life satisfaction. American Sociological Review,75(6), 914–933. https://doi.org/10.1177/0003122410386686.

    Article  Google Scholar 

  29. Mahoney, F., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal,14, 61–65.

    CAS  PubMed  Google Scholar 

  30. Mashhadimalek, M., Jafarnia Dabanloo, N., & Gharibzadeh, S. (2019). Is it possible to determine the level of spiritual wellbeing by measuring heart rate variability during the reading of heavenly books? Applied Psychophysiology and Biofeedback,8, 1–9. https://doi.org/10.1007/s10484-019-09433-3.

    Article  Google Scholar 

  31. Mehdipoorkorani, L., Bahrami, M., & Mosavizade, R. (2019). Impact of a spiritual care program on spiritual wellbeing of oncology nurses: A randomized clinical trial. Iranian Journal of Nursing and Midwifery Research,24(1), 38–43. https://doi.org/10.4103/ijnmr.IJNMR_33_18.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Mihaljević, S., Vuksan-Ćusa, B., Marčinko, D., Koić, E., Kušević, Z., & Jakovljević, M. (2011). Spiritual wellbeing, cortisol, and suicidality in Croatian war veterans suffering from PTSD. Journal of Religion and Health,50(2), 464–473. https://doi.org/10.1007/s10943-010-9383-2.

    Article  PubMed  Google Scholar 

  33. Murray, S. A., Kendall, M., Grant, E., Boyd, K., Barclay, S., & Sheikh, A. (2007). Patterns of social, psychological and spiritual decline toward the end of life in lung cancer and heart failure. Journal of Pain and Symptom Management,34(4), 393–402. https://doi.org/10.1016/j.jpainsymman.2006.12.009.

    Article  PubMed  Google Scholar 

  34. Musa, A. S., Pevalin, D. J., & Shahin, F. I. (2016). Impact of spiritual wellbeing, spiritual perspective, and religiosity on the self-rated health of Jordanian Arab Christians. Journal of Transcultural Nursing,27(6), 550–557. https://doi.org/10.1177/1043659615587590.

    Article  PubMed  Google Scholar 

  35. Oxford Happiness Questionnaire. Available online at: http://www.meaningandhappiness.com/oxford‐happiness‐questionnaire/214/. Retrieved on 5 September, 2019.

  36. Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The meaning of spirituality and spiritual well-being among Thai breast cancer patients: A qualitative study. Indian Journal of Palliative Care,25(1), 119–123. https://doi.org/10.4103/IJPC.IJPC_101_18.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Phillips, K. D., Mock, K. S., Bopp, C. M., Dudgeon, W. A., & Hand, G. A. (2006). Spiritual wellbeing, sleep disturbance, and mental and physical health status in HIV-infected individuals. Issues in Mental Health Nursing,27(2), 125–139. https://doi.org/10.1080/01612840500436917.

    Article  PubMed  Google Scholar 

  38. Piderman, K. M., Lapid, M., Stevens, S. R., Ryan, S. M., Somers, K. J., Kronberg, M. T., et al. (2011). Spiritual wellbeing and spiritual practices in elderly depressed psychiatric inpatients. Journal of Pastoral Care and Counseling,65(1–2), 1–11.

    PubMed  Google Scholar 

  39. Pilger, C., Santos, R. O. P. D., Lentsck, M. H., Marques, S., & Kusumota, L. (2017). Spiritual wellbeing and quality of life of older adults in hemodialysis. Revista Brasileira de Enfermagem,70(4), 689–696. https://doi.org/10.1590/0034-7167-2017-0006.

    Article  PubMed  Google Scholar 

  40. Riklikienė, O., Kaselienė, S., & Fulton, J. (2018). Translation and validation of spiritual wellbeing questionnaire SHALOM in Lithuanian language, culture and health care practice. Religions,9, 156. https://doi.org/10.3390/rel9050156.

    Article  Google Scholar 

  41. Rowold, J. (2011). Effects of spiritual wellbeing on subsequent happiness, psychological wellbeing, and stress. Journal of Religion and Health,50(4), 950–963. https://doi.org/10.1007/s10943-009-9316-0.

    Article  PubMed  Google Scholar 

  42. Scheffold, K., Philipp, R., Vehling, S., Koranyi, S., Engelmann, D., Schulz-Kindermann, F., et al. (2019). Spiritual wellbeing mediates the association between attachment insecurity and psychological distress in advanced cancer patients. Supportive Care in Cancer. https://doi.org/10.1007/s00520-019-04744-x.

    Article  PubMed  Google Scholar 

  43. Shor, E., & Roelfs, D. J. (2013). The longevity effects of religious and nonreligious participation: A meta-analysis and meta-regression. Journal of Scientific Study of Religion,52, 120–145. https://doi.org/10.1111/jssr.12006.

    Article  Google Scholar 

  44. Tamutienė E. (2009). Relation of nurses’ happiness and personality traits with the subjective assessment of mental health [In Lithuanian]. Master thesis, Vytautas Magnus University, Lithuania. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2009~D_20091222_084140-59191. Assessed 15 Oct 2018.

  45. Unterrainer, H. F., Lukanz, M., Pilch, M., Scharf, S., Glawischnig-Goschnik, M., Wutte, N., et al. (2016). The influence of religious/spiritual wellbeing on quality of life in dermatological disease. British Journal of Dermatology,174(6), 1380–1383. https://doi.org/10.1111/bjd.14359.

    CAS  Article  PubMed  Google Scholar 

  46. Wade, J. B., Hayes, R. B., Wade, J. H., Bekenstein, J. W., Williams, K. D., & Bajaj, J. S. (2018). Associations between religiosity, spirituality, and happiness among adults living with neurological illness. Geriatrics (Basel).,3(3), 35. https://doi.org/10.3390/geriatrics3030035.

    Article  PubMed Central  Google Scholar 

  47. Wang, C. W., Chow, A. Y. M., & Chan, C. L. W. (2017). The effects of life review interventions on spiritual wellbeing, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials. Palliative Medicine,31(10), 883–894. https://doi.org/10.1177/0269216317705101.

    Article  PubMed  Google Scholar 

  48. Yong, J., Kim, J., Park, J., Seo, I., & Swinton, J. (2011). Effects of a spirituality training program on spiritual and psychosocial wellbeing of hospital middle manager nurses in Korea. Journal of Continuing Education in Nursing,42(6), 280–288. https://doi.org/10.3928/00220124-20101201-04.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The authors acknowledge final-year BSN student nurses Akvile Pukaite and Ieva Paskeviciute who participated in data collection conducting face-to-face interviews with patients. The authors also acknowledge Richard S. Feinn, Associate Professor of Medical Sciences from Quinnipiac University, Hamden, CT, USA, for his assistance with statistical interpretation in this paper.

Author information

Affiliations

Authors

Contributions

The study was financially supported by The Research Council of Lithuania Grant for Young Scientists through the project ‘Spirituality in Nursing: Spiritual wellbeing and Spiritual Needs of Non-terminally-ill oncology patients—mixed methods study (SPIRITcare)’ [Grant number S-MIP-17-95].

Corresponding author

Correspondence to Olga Riklikienė.

Ethics declarations

Ethical Approval

The Lithuanian Regional Committee on Bioethics issued permission to conduct the study (December 5, 2017, No. BE-2-84). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

We have full control over our data, there is no conflict of interest and we allow the journal access to our data if requested.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Riklikienė, O., Kaselienė, S., Spirgienė, L. et al. Spiritual Wellbeing of Cancer Patients: What Health-Related Factors Matter?. J Relig Health (2020). https://doi.org/10.1007/s10943-020-01053-0

Download citation

Keywords

  • Spiritual wellbeing
  • Cancer patients
  • Happiness
  • Life satisfaction
  • Pain
  • Lithuania