The Impact of Spirituality, Religiosity, and Spiritual Pain in Coping Strategies and Quality of Life (QOL) of Caregivers of Advanced Cancer Patients (CACP) in the Palliative Care (PC) Setting (717)

Abstract

1.Discuss the impact of spirituality, religiosity, and spiritual pain in caregivers of advanced cancer patients in the palliative care setting.2.Determine the importance of spiritual assessment in caregivers of advanced cancer patients in the palliative care setting. Background. Concerns about spiritual issues arise in the caregivers of advanced cancer patients (CACP). Caregivers could face physical, social, emotional distress, and spiritual-pain. Limited research has been done in oncology focusing on the spiritual-aspects of caregivers suffering. Research objectives. In this prospective cross-sectional study, we examined these associations and various factors, including quality of life (QOL) and coping. Methods. We interviewed 43 CACP in our palliative care (PC)-outpatient clinic. Self-rated spirituality, religiosity, and spiritual-pain were assessed using numeric-rating scales (0 = lowest, 10 = highest). They completed various validated questionnaires assessing sleep disturbances (PSQI), psychosocial distress (HADS), coping (Brief-COPE, Brief-R-COPE), and QOL (FACIT-Sp-Ex, SBI-15R, CGQOL). Results. The median age (range) was 52 years (21–83), 67% female. 78% were white, 17% African American, and 5% Hispanic. Ninety-one percent were Christians, 2% Jewish, and 2% Agnostic. Eighty-six percent were married and 42% were working full time. They were patients’ spouse (58%), friend (12%), and child (14%). Almost all CACP considered themselves spiritual (100%) and religious (98%), with a median score (0 to 10) of 8 (interquartile range 6-10) and 8 (4-9), respectively. The caregivers reported spirituality and religiosity help them cope with their patients’ illness (100%) and have a positive impact on their patients’ physical (58%) and emotional (76%) symptoms. Spiritual-pain was reported in 23/40 (58%) CACP, with a median score of 5 (2-8). Caregivers with spiritual pain expressed worse HADS-anxiety (median 10 versus 4, p = 0.002), worse HADS-depression (6 vs 2, p = 0.006), and expressed denial (3 vs 2, p = 0.01), behavioral disengagement (3 vs 2, p = 0.011), and dysfunctional coping strategies (19 vs 16, p = 0.02) and worse QOL (CGQOL: 70 vs 51, p < 0.001). There was no significant difference in religious coping strategies, FACIT-Sp-Ex, and PSQI. Conclusion. Majority of CACP considered themselves spiritual and religious. Spirituality, religiosity, and spiritual pain play an important role in their emotions and QOL. This supports the importance of spiritual assessment and support for CACP. Implications for research, policy, or practice. Highlight the importance of the spiritual assessment of caregivers of advanced cancer patients in the palliative care setting.