The effect of spiritual care on anxiety about death in patients with gastrointestinal cancer undergoing chemotherapy: A randomized controlled trial

Abstract

IntroductionA cancer diagnosis may disrupt the existential dimension of a patient. Thus, holistic care of these patients and extra attention to their psycho-social needs is extremely important. The current study aimed at investigating the influence of spiritual care on anxiety about death in a group of Iranian cancer patients who had received chemotherapy. MethodsThis randomized controlled trial was conducted on 145 gastrointestinal cancer patients who were randomly allocated by block randomization to either usual care (73 patients) or a spiritual care intervention (72 patients) group. The intervention group received a 3-day spiritual care program. The level of anxiety about death level was assessed using the Templer’s Death Anxiety Scale (T-DAS) before and after the intervention. ResultsBefore the intervention, scores on anxiety about death in the intervention and control groups was moderate and not significantly different between the two groups (8.14 ± 1.54 vs. 8.03 ± 0.85; P = 0.429). After the intervention, mean scores were 7.86 ± 1.22 vs. 8.18 ± 0.79 (P = 0.029) respectively. According to the analysis of covariance, the null hypothesis was rejected at alpha = 0.05 level. However, Cohen’s effect size (d) revealed that the obtained effect was not clinically significant (d = 0.31). ConclusionsResults suggested that a spiritual care program delivered over a 3 day period had no effect on moderate death anxiety among cancer patients in Iran. Future studies should assess whether spiritual care is effective when provided to cancer patients over a longer time period, the type of care provided and whether there are variations depending for patients with different religious beliefs.