Spiritual Experience and Associated Factors Among Gynecological Cancer Patients in Turkey: A Cross-Sectional Study.

Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period.Objectives. This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1week, and 1month. Data were analyzed using quantitative methods and thematic analysis. Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1month (p<.01). Symptoms such as shortness of breath (β=-1.19, p<.001), drowsiness (β=-1.27, p=.01), and anxiety (β=-0.60, p=.03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (β=0.26, p<.001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support. Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.

Background/AimsResearch shows that low self-care ability and hopelessness are common in schizophrenia patients. Spirituality can be a key coping resource in managing mental illnesses. However, the mediating effect of spirituality on the relationship between self-care ability and hope in schizophrenia patients is unknown. This study aims to explore the mediating role of spiritual well-being in the relationship between self-care agency and hope in schizophrenia.MethodThis study is cross-sectional and correlational study with a descriptive design. The study was conducted with 116 schizophrenia patients who presented to the psychiatry outpatient clinic of a university hospital in eastern Turkey between 10.02. 2023 and 10.01. 2024. Descriptive Information Form, Self-Care Agency Scale, Herth Hope Index and Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale were used to collect the data. Structural equation modelling and bootstrapping method were used to analyse the data.ResultsIn this study, the effect of self-care agency on hope (β = 0.12) was positive but not significant. However, self-care agency positively influenced spiritual well-being (β = 0.47), and spiritual well-being had a significant positive effect on hope (β = 0.83). Spiritual well-being fully mediated the relationship between self-care agency and hope, with the total mediated effect on hope being significant (β = 0.52). The model explained 23% of the variance in spiritual well-being and 80% of the variance in hope.ConclusionIt was determined that self-care agency affected spiritual well-being positively and spiritual well-being affected hope positively in schizophrenia patients. It was also found that spiritual well-being mediated the relationship between self-care agency and hope. It is expected that this research model will be useful in formulating strategies to improve hope and self-care in schizophrenia patients.

Unmet needs for information and psychosocial support in relation to quality of life and emotional distress: A comparison between gynecological and breast cancer patients

The mediating role of hope in the effects of spiritual wellbeing on life satisfaction in elderly haematologic cancer patients in Turkey was investigated in the present study. The study was conducted in a descriptive, cross-sectional and correlational design. The study was conducted with 150 patients aged 65 and older who were diagnosed with haematologic cancer and who were referred to a university hospital haematology clinic and outpatient clinic. Research data were collected with Descriptive Information Form, Dispositional Hope Scale (DHS), Spiritual Well-being Scale (FACIT-Sp-12) and Satisfaction with Life Scale (SWLS). FACIT-Sp-12 score was 37.25 ± 7.29; DHS score was 40.42 ± 8.29, SWLS score was 16.24 ± 8.79. FACIT-Sp-12 (β = 0.668) and DHS (β = 0.226) were found to affect SWLS positively. In terms of the effect of FACIT-Sp-12 on SWLS, DHS has a mediating role and makes the positive effect of FACIT-Sp-12 on SWLS stronger (β = 0.771). Spiritual wellbeing levels of the participants in our study were found to be high, while their levels of satisfaction with life and hope were found to be moderate. It was also concluded that spiritual wellbeing had a direct effect on satisfaction with life and an indirect effect through the mediating role of hope.

Although gynecological cancers are among the most common cancers worldwide, these diagnoses are among the most traumatic experiences in women’s lives. This study aimed to examine the effects of logotherapy-based, nurse-guided meaning attribution conversations (MACs) on traumatic stress symptoms, post-traumatic growth, spiritual well-being, and life meaning attribution in gynecological cancer patients. This single-blind, randomized controlled trial consisted of face-to-face interviews with 68 women with gynecological cancer who received chemotherapy at Karadeniz Technical University Health Application And Research Center Farabi Hospital in 2019. Women in the intervention group underwent seven MAC sessions, whereas women in the control group only received routine nursing care. Data were collected using the Personal Information Form (PIF), the Traumatic Stress Symptom Scale (TSSS), the Post-Traumatic Growth Inventory (PTGI), the Meaning in Life Questionnaire (MLQ), and the Spiritual Well-Being Scale (SWBS). Descriptive statistics and parametric and nonparametric tests (Mann – Whitney U-test, Friedman test, Chi-squared test, and Fisher’s exact test) were used to analyze the data. The study was registered at ClinicalTrials.gov (NCT05246462). We observed statistically significant differences in the post-intervention and follow-up mean TSSS, PTGI, and MLQ scores (p = .000) between groups. However, mean total SWBS scores were not significantly different between groups (p = .145). This study demonstrated that MACs decreased the traumatic stress symptoms of women with gynecological cancer and increased their post-traumatic growth and ability to attribute meaning to life, but did not affect their spiritual well-being.

Advanced Cancer Patients' Prognostic Awareness and Its Association With Anxiety, Depression and Spiritual Well-Being: A Multi-Country Study in Asia

It is generally accepted that spiritual attitude may help one to cope better with the consequences of illness. For the progress of scientific and clinical research into the effects of spirituality a reliable and valid spirituality questionnaire is indispensable. Sessanna et al. (2011) have presented an excellent and critical review of available questionnaire. They evaluated the psychometric qualities of the scales, and – among other aspects – their clinical utility and practicality. Unfortunately one criterion was missing: the inclusion of well-being items in spirituality questionnaires. The inclusion of well-being items presents a problem when studying the relationship between spirituality and well-being. It seems self-evident that one should avoid tautology by refraining from a study into the relationship between spiritual well-being and ‘general well-being’. However, several studies investigate exactly this (Visser et al. 2010). Sessana et al. make no mention of this problem. It is obvious that scales on spiritual well-being include items on well-being, such as ‘I feel that life is a positive experience’ (Spiritual Well-Being Scale; SWBS). Sessana et al. name the following spiritual well-being scales: the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale (FACIT-sp), Spiritual Well-Being Scale (SWBS), Jarel Well-Being Scale (Jarel), and Spiritual Index of Well-Being (SIWB). However, well-being items can also be found in ‘general spirituality’ scales, such as the Daily Spiritual Experience Scale (DSES; ‘I feel deep inner peace or harmony’) and the Spiritual Scale (SS; ‘I am happy about the person I have become’). In our own review of spirituality scales (Jager Meezenbroek et al. 2010), we have used the criterion that these scales should include no or very few well-being items. Therefore, we value the quality of the FACIT-Sp lower than Sessanna et al., who gave this scale a high score. An attractive attribute of Sessanna et al.’s review is their item analysis (a term not used in their review). They make a distinction between: (i) items measuring spirituality; (ii) items referring to religiosity; (iii) items using terms as ‘spirit’ or ‘spirituality’; and (iv) non-spirituality items. In our view, items of the second, third and fourth category are not acceptable for spirituality questionnaires. People have different understandings of the words ‘spirit’, ‘spiritual’, or ‘spirituality’. Moreover, people find these words either ‘vague’ and ‘woolly’, or ‘sublime’ and ‘of ultimate importance’. Therefore, such words should be omitted. We agree with the recommendation that a spirituality questionnaire should be suitable for both religious and non-religious people and, therefore, should contain a limited number of religious items. As a consequence, the DSES and SWBS, which receive a high quality score in Sessanna et al.’s review, would be evaluated lower on the basis of their item analysis, which says that these scales include 50% religiosity items. Another example of a discrepancy is the SIWB. This scale received the highest quality score, but the item analysis showed that seven of the 12 items of this scale did not refer to spirituality or religiosity. Based on this, the SIWB should be disqualified as a measure of spirituality. In conclusion, we fully agree with the authors that practitioners and researchers should be ‘aware of the imperfections that currently exist in available measures assessing and evaluating spirituality’.

Effect of acupressure on chemotherapy-induced nausea and vomiting in gynecologic cancer patients in Turkey

Reminiscence therapy (RT) is a common nursing care program to ameliorate psychological disorders, while its application in stroke patients and their spouse caregivers is rare. Thus, this randomized, controlled study intended to investigate the influence of RT on anxiety, depression, and spiritual well-being in these individuals. Totally, 162 couples of stroke patients and their spouse caregivers were randomly assigned to receive RT (N = 81) and control care (CC) (N = 81) by pairs 4 times per month for 6months. Hospital Anxiety and Depression Scale for anxiety (HADS-A) and depression (HADS-D), Functional Assessment of Chronic Illness Therapy - Spiritual Well-being scale (FACIT-Sp) were evaluated at month (M)0, M1, M3, and M6. In stroke patients, RT reduced HADS-A score at M3 (P = 0.043) and M6 (P = 0.020), and HADS-D score at M6 (P = 0.034), while increased FACIT-Sp score at M1 (P = 0.023), M3 (P = 0.010), and M6 (P = 0.004) compared to CC. Meanwhile, RT induced greater ameliorations in HADS-A (P = 0.049) and FACIT-Sp (P < 0.001) scores from M0 to M6 versus CC, but less in HADS-D score (P = 0.076). In the aspect of spouse caregivers, RT deceased HADS-A score at M1 (P = 0.042), M3 (P = 0.001), and M6 (P < 0.001), lowered HADS-D score at M3 (P = 0.015) and M6 (P = 0.001), but elevated FACIT-Sp score at M1 (P = 0.042), M3 (P < 0.001), and M6 (P < 0.001) compared to CC. Noteworthily, RT facilitated the improvements of HADS-A (P < 0.001), HADS-D (P = 0.010), and FACIT-Sp (P < 0.001) scores from M0 to M6 versus CC. RT relieves anxiety, depression and boosts spiritual well-being in both stroke patients and their spouse caregivers.

The inclusion of spiritual well-being in healthcare assessments can provide insight into patients' needs and coping resources. This study explored the relationship between spiritual well-being and quality of life (QOL) in gynecologic oncology patients in an attempt to clarify the significance of spiritual well-being in the assessment process. Eighteen women with gynecologic cancer completed a self-administered questionnaire that obtained sociodemographic, medical, spiritual, and functional information. The Spiritual Well-being Scale was used to assess spiritual well-being, and the Functional Living Index: Cancer (FLIC) measured QOL. Data were analyzed using descriptive statistics, comparison of means, and analysis of variance. Patients with gynecologic cancers other than ovarian reported a better QOL and a higher degree of spiritual, existential, and religious well-being. Older patients consistently reported higher degrees of spiritual well-being and QOL than did younger patients. Married patients consistently reported higher degrees of spiritual well-being than patients who were not married (never married or separated). Catholic patients scored higher in degrees of religious and spiritual well-being as well as in FLIC scores than other patients. Health professionals do not generally assess spiritual well-being in their evaluations of patients' needs. The findings from this study support the inclusion of spirituality as part of routine patient assessment and intervention. Clinical intervention that would increase a patient's level of spiritual awareness and his or her level of comfort associated with a personal perspective on death could help decrease the patient's level of psychosocial distress. Despite the medical establishment's bias to the contrary, religion and spirituality are positively associated with both physical and mental health and may be particularly significant to terminally ill patients. The curricula of medical, nursing, and other health schools should be redesigned appropriately.

This study aimed to examine the correlation between post-traumatic growth (PTG), spiritual well-being (SWB), perceived social support (PSS), and demographic and clinical factors in Chinese gynecological cancer patients. Through convenience sampling, we conducted a cross-sectional study of 771 adult patients with gynecological cancer. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Spiritual Well-being 32 (EORTC QLQ-SWB32), Post-traumatic Growth Inventory (PTGI), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure SWB, PTG, and PSS. A Multiple Linear Regression Model was used to determine the possible factors contributing to PTG. The subscale with the highest centesimal score in the PTGI was the Appreciation of Life Scale, and the lowest was New Possibility. Gynecologic cancer patients with younger ages (B = − 0.313, P = 0.002), perceived more family support (B = 1.289, P < 0.001), had more existential (B = 0.865, P = 0.010), and had religious belief (B = 5.760, P = 0.034) may have more PTG. Spiritual well-being, perceived social support, younger age, and religious beliefs are associated with post-traumatic growth in gynecological cancer patients. Healthcare staff could provide more professional support to younger patients with religious beliefs. Promoting social support and spiritual well-being could potentially serve as effective interventions for boosting PTG among gynecological cancer.

The Functional Assessment of Chronic Illness Therapy ? Spiritual Well-Being scale (FACIT-Sp-12) is a 12-item questionnaire designed to assess spiritual well-being in individuals diagnosed with cancer and other chronic illnesses. The main goals of the present study were twofold: (1) to examine the factor structure of the FACIT-Sp-12 in a Serbian sample of oncology patients, (2) to investigate the external validity of FACIT-Sp-12 by examining the relationship with positive and negative affect (The Scale for Positive and Negative Experiences; SPANE), and depression, anxiety, and stress (Depression, Anxiety, and Stress Scale; DASS-21). A sample consisted of 215 female oncology patients, with a mean age of 50.41 years (age range: 24?81 years). The data were analyzed using confirmatory factor analysis. The results supported the FACIT-Sp-12 modified three-factor structure and its subscales achieved statistically significant correlations with external measures. The meaning and peace subscales achieved somewhat stronger correlations with all the external variables compared to the faith subscale. This study demonstrates that the FACIT-Sp-12 is a valid and reliable three-factor measure of spiritual well-being in a sample of female cancer patients in Serbia.

Gynaecological cancer is a women’s disease with a high incidence. Problems that occur in gynaecological cancer patients include physical, psychosocial, and spiritual aspects. However, spiritual well-being in gynaecological cancer patients is ignored so that it is not clearly seen how the condition of patients’ spiritual well-being. This study aimed to describe the spiritual well-being of gynaecological cancer patients in a referral hospital in Bandung. The design of this study used quantitative descriptive with a total sample method. The number of samples was 41 patients. The study was conducted for one month from June to July, the sampling technique used was accidental sampling. The instrument in this study used the Spiritual Index of Well-being (SIWB). Data were analysed using frequency distributions, averages, and percentages. The results showed that 68.29% of respondents had a high level of spiritual well-being, and 21.79% had a low level of spiritual well-being. The self-efficacy sub-variable had an average value of 19.46 lower than the life-scheme sub-variable of 22.29. The item that has the highest value is "In this world, I don't know where I feel comfortable" and the item that has the lowest value is "There's not much I can do to help myself". The conclusion of the results of this study is that most respondents have a high level of spiritual well-being. Self-efficacy is a sub-variable with the lowest average value.Keywords: gynaecological cancer, life-scheme, self-efficacy, spiritual

Effects of family-oriented dignity therapy on dignity, depression and spiritual well-being of patients with lung cancer undergoing chemotherapy: A randomised controlled trial

Objective: To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members. Design: Prospective cross-sectional observational data were analyzed by structural equation modelling. Setting: Inpatient and community services at one rehabilitation hospital. Subjects: Individual with spinal cord injury (n = 50) and family member (n = 50) dyads. Interventions: Standard rehabilitation, both inpatient and community. Main measure(s): Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale. Results: Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members. Conclusion: Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.