The influence of spirituality on end-of-life despair among terminally ill cancer patients

Document Type

Article

Disciplines

Psychology | Social and Behavioral Sciences

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.

Article Number

1252

Publication Date

2003

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