Abstract
PurposeCaring affects carers’ psychological and physical health, mortality, and quality of life (QoL) negatively. Lower spiritual QoL is associated with anxiety and depression, but the spiritual dimension is rarely investigated in carers. The present study aimed to explore which patient- and carer-related characteristics were associated with spiritual QoL in carers of patients with advanced cancer.MethodsSecondary analyses were conducted using data from a prospective study investigating integration between oncology and palliative care. Adult patients with advanced cancer and their carers were included, and baseline data considering demographics, clinical characteristics, symptoms, social support, and religious meaning-making were registered. Spiritual QoL was measured using the Functional Assessment of Chronic Illness Therapy - Spiritual well-being (FACIT-Sp-12) questionnaire. Associations to spiritual QoL were explored by bivariate and multivariate regression models.ResultsIn total, 84 carers were included, median age was 62.5 years, 52 (62%) were female, and the average spiritual QoL score was 23.3. In bivariate analyses, higher education, social support, and lower patients’ symptom burden were significantly associated with higher spiritual QoL. The multivariate regression model (n=77) had an explained variance (R2) = 0.34 and showed a significant association for social support, higher education, having children < 18 years living at home, and patient’s age.ConclusionThe study indicates that spiritual QoL in carers were low and were negatively affected by several factors related to both carers and patients. However, there could be other important factors not yet described. Health care professionals should be aware of the known associated factors, as carers who hold these may need extra support.
Highlights
Caregivers have been defined as follows: “Carers, who may or may not be family members, are lay people in a close supportive role who share in the illness experience of the patient and who undertake vital care work and emotion management” [1]
Due to missing data in one or more of the variables included in the multivariate analysis, another seven carers were excluded, resulting in a final analysis sample of 77 carers included in the multivariate analysis (Fig. 2)
In bivariate analyses (Table 4), higher education, higher social support, and lower patient symptom burden were significantly associated with higher spiritual quality of life (QoL) in carers
Summary
Caregivers (hereafter: carers) have been defined as follows: “Carers, who may or may not be family members, are lay people in a close supportive role who share in the illness experience of the patient and who undertake vital care work and emotion management” [1]. The burden of caring often exceeds carers’ coping abilities [3] and has been reported to negatively affect the carers’ psychological and physical health, mortality, social life, and quality of life (QoL) [4, 5]. The World Health Organization (WHO) includes spirituality in its four-dimensional palliative care definition (physical, psychological, social, and spiritual dimension) [6]. Puchalski et al stated that chaplains, or other spiritual experts, should be integrated in the health care team and recognized and referred to as the spiritual experts. They stated that all professions must share the responsibility for assessment and treatment of spiritual suffering [7]
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