Relationship between spirituality, meaning in life, psychological distress, wish for hastened death, and their influence on quality of life in palliative care patients
Journal Paper/Review - Jul 14, 2017
Bernard Mathieu, Strasser Florian, Gamondi Claudia, Braunschweig Giliane, Forster Michaela, Kaspers-Elekes Karin, Veri Silvia Walther, Borasio Gian Domenico
Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic underlying these components is essential for the development of interventions tailored to the palliative context.
The aims were to explore (i) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients, and (ii) the extent to which these non-physical determinants influence QOL.
A cross-sectional study involving face-to-face interviews with Swiss palliative patients was performed, including the Schedule for Meaning in Life Evaluation (SMILE), the Spiritual Subscale of the Functional Assessment of Chronic Illness Therapy (FACIT-Sp), the Idler Index of Religiosity (IIR), the Hospital Anxiety and Depression Scale (HADS) and the Schedule of Attitudes toward Hastened Death (SAHD). QOL was measured with a single item visual analogue scale (0-10).
206 patients completed the protocol (51.5% female; mean age=67.5 yrs). The results indicated a significant negative relationship between FACIT-Sp/SMILE and HADS total scores (p=.000). The best model for QOL explained 32.8 % of the variance (p=.000) and included the FACIT-Sp, SMILE, and SAHD total scores, the IIR "private religiosity" subscale, as well as the HADS "depression" score.
Both spiritual well-being and meaning in life appear to be potential protective factors against psychological distress at the end of life. Since non-physical determinants play a major role in shaping QOL at the end of life, there is a need for the development of meaning-oriented and spiritual care interventions tailored to the fragility of palliative patients.