Saneta Maiko1, Shelley A Johns2, Paul R Helft3, James E Slaven4, Ann H Cottingham5, Alexia M Torke6. 1. Indiana University Health, The Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indianapolis, Indiana, USA; The John Templeton Transforming Chaplaincy Research Fellow and Affiliate Research Scientist, Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, Indiana, USA. Electronic address: smaiko@iuhealth.org. 2. Indiana University School of Medicine, Regenstrief Institute, Indianapolis, Indiana, USA; Charles Warren Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis, Indiana, USA; Research in Palliative and End-of-Life Communication and Training (RESPECT) Center, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA. 3. Indiana University Cancer Center, Charles Warren Fairbanks Center for Medical Ethics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 4. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 5. Regenstrief Institute, Inc, Indiana University School of Medicine, Indianapolis, Indiana, USA. 6. The Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, Indiana, USA.
Abstract
CONTEXT: Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of patients with advanced cancer will help guide the provision of high-quality spiritual care. OBJECTIVES: To qualitatively describe advanced cancer patients' spiritual experiences of illness. METHODS: We conducted semistructured qualitative interviews at a single cancer center with 21 patients with stage IV solid malignancies who had a prognosis of less than 12 months, as estimated by each patient's medical oncologist. Five investigators conducted a thematic analysis of the transcribed interviews. RESULTS: We found 31 patients who were eligible for enrollment, and 21 (67.7%) participated in interviews to thematic saturation. Using a thematic-analysis approach, five major themes emerged. Relationships with family and friends was the most important theme among all 21 patients irrespective of their religious or spiritual identity. Relationship with God and faith community was frequently identified by those who considered themselves spiritually religious. Cancer often led to reflection about the meaning of life and the nature of existential suffering. Patients addressed the extent to which identity was changed or maintained through the cancer experience, and some expressed acceptance as a way of coping with illness. CONCLUSIONS: Spiritual care for dying cancer patients should always include the exploration of relationships with family and friends, as well as God and faith community for some patients. Relationships with family, friends, and God can be a source of strength for many. Making meaning, addressing identity concerns, supporting acceptance as a resource for coping with illness, and acknowledging existential suffering will often arise for these patients.
CONTEXT: Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of patients with advanced cancer will help guide the provision of high-quality spiritual care. OBJECTIVES: To qualitatively describe advanced cancerpatients' spiritual experiences of illness. METHODS: We conducted semistructured qualitative interviews at a single cancer center with 21 patients with stage IV solid malignancies who had a prognosis of less than 12 months, as estimated by each patient's medical oncologist. Five investigators conducted a thematic analysis of the transcribed interviews. RESULTS: We found 31 patients who were eligible for enrollment, and 21 (67.7%) participated in interviews to thematic saturation. Using a thematic-analysis approach, five major themes emerged. Relationships with family and friends was the most important theme among all 21 patients irrespective of their religious or spiritual identity. Relationship with God and faith community was frequently identified by those who considered themselves spiritually religious. Cancer often led to reflection about the meaning of life and the nature of existential suffering. Patients addressed the extent to which identity was changed or maintained through the cancer experience, and some expressed acceptance as a way of coping with illness. CONCLUSIONS: Spiritual care for dying cancerpatients should always include the exploration of relationships with family and friends, as well as God and faith community for some patients. Relationships with family, friends, and God can be a source of strength for many. Making meaning, addressing identity concerns, supporting acceptance as a resource for coping with illness, and acknowledging existential suffering will often arise for these patients.
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