Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer

Objective: To study the influence of spiritual well being (Sp WB) on symptoms of distress, depression, and other dimensions of quality of life in advanced cancer patients receiving palliative care.
Materials and Methods: The study was cross-sectional in nature. Fifty patients with advanced cancer from a hospice were assessed with the following instruments: the visual analog scale for pain (VAP), M.D. Anderson symptom inventory (MDASI), Hospital Anxiety Depression Scale (HADS), Functional assessment of cancer therapy - Palliative Care (FACT-pal), and Functional assessment of chronic illness therapy-spiritual well-being (FACIT-sp). We studied the correlations between spirituality and other variables on these scales.
Results: Depression and anxiety were negatively correlated with spiritual well-being (Sp WB). Sp WB was significantly correlated with fatigue (r = -0.423, P = 0.002), symptom distress (r = -0.717, P < 0.001), memory disturbance (r = -0.520, P < 0.001), loss of appetite (r = -0.399, P = 0.004), drowsiness (r = -0.400, P = 0.004), dry mouth (r = -0.381, P = 0.006), and sadness (r = -0.720, P < 0.001). Sp WB was positively correlated with all the other aspects of QOL measures. Predictors such as palliative care well-being (t = 2.840, P = 0.008), distress (t = -2.582, P = 0.015), sadness (t = -2.765, P = 0.010), mood (t = 2.440, P = 0.021), and enjoyment in life (t = -3.586, P = 0.001) were significantly correlated with Sp WB, after regression analysis.
Conclusions: This study suggests that spiritual well being is an important component of the quality of life of advanced cancer patients, and is closely related to the physical and psychological symptoms of distress. It should be addressed appropriately and adequately in palliative care settings.

Keywords
Advanced cancer, spirituality, spiritual well being, quality of life, depression, symptom distress