Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients Journal Article


Authors: McClain, C. S.; Rosenfeld, B.; Breitbart, W.
Article Title: Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients
Abstract: Background: The importance of spirituality in coping with a terminal illness is becoming increasingly recognised. We aimed to assess the relation between spiritual well-being, depression, and end-of-life despair in terminally-ill cancer patients. Methods: 160 patients in a palliative care hospital with a life expectancy of less than 3 months were interviewed with a series of standardised instruments, including the functional assessment of chronic illness therapy - spiritual well-being scale, the Hamilton depression rating scale, the Beck hopelessness scale, and the schedule of attitudes toward hastened death. Suicidal ideation was based on responses to the Hamilton depression rating scale. Findings: Significant correlations were seen between spiritual well-being and desire for hastened death (r=-0-51), hopelessness (r=-0.68), and suicidal ideation (r=-0.41). Results of multiple regression analyses showed that spiritual well-being was the strongest predictor of each outcome variable and provided a unique significant contribution beyond that of depression and relevant covariates. Additionally, depression was highly correlated with desire for hastened death in participants low in spiritual well-being (r=0.40, p<0.0001) but not in those high in spiritual well-being (r=0.20, p=0.06). Interpretation: Spiritual well-being offers some protection against end-of-life despair in those for whom death is imminent. Our findings have important implications for palliative care practice. Controlled research assessing the effect of spirituality-based interventions is needed to establish what methods can help engender a sense of peace and meaning.
Keywords: aged; functional assessment; major clinical study; cancer patient; neoplasms; cancer palliative therapy; palliative care; logistic models; terminally ill patient; prediction; medical assessment; social support; terminally ill; depression; correlation analysis; statistical analysis; clinical research; interview; psychologic test; patient attitude; religion; spirituality; life expectancy; wellbeing; attitude to death; psychologic assessment; multiple regression; humans; human; male; female; priority journal; article; suicide attempt
Journal Title: Lancet
Volume: 361
Issue: 9369
ISSN: 0140-6736
Publisher: Elsevier Science, Inc.  
Date Published: 2003-05-10
Start Page: 1603
End Page: 1607
Language: English
DOI: 10.1016/s0140-6736(03)13310-7
PUBMED: 12747880
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. William S Breitbart
    350 Breitbart