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Status and influential factors of spiritual well-being in cancer patients with drug clinical trials: a cross-sectional study

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Abstract

Purpose

The purpose of this study was to investigate the spiritual well-being status of cancer patients in drug clinical trials and its influencing factors, and to provide theoretical support for the spiritual health intervention of clinical trial cancer patients.

Methods

This cross-section study was conducted among 244 cancer patients in clinical trials. The Memorial Symptom Assessment Scale Short Form (MSAS-SF), Connor-Davidson Resilience Scale 10 (CD-RISC 10), and Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-SP-12) were used to measure symptom burden, psychological resilience, and spiritual well-being. The Multiple Linear Regression Model was used to determine the influencing factors of patients’ spiritual health.

Results

The overall spiritual health level of cancer patients with clinical trials was high (36.87 ± 11.0), and the spiritual health level was positively correlated with psychological resilience (r = 0.872, P < 0.001). Religious belief, nationality, treatment regimen, and resilience were independent risk factors for the spiritual health of cancer patients in clinical trials. Patients with religious beliefs (β = 0.097, P = 0.012), ethnic minorities (β = 0.087, P = 0.023), and high resilience scores (β = 0.874, P < 0.001) had higher levels of spiritual health. Patients who received single antineoplastic therapy (β =  − 0.079, P = 0.028) had lower levels of spiritual health.

Conclusion

Our study found that the spiritual health of cancer patients in clinical trials was at a high level, superior to cancer patients receiving conventional anti-tumor therapy. Religious belief, nationality, treatment regimen, and psychological resilience were the influential factors of spiritual health.

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Data availability

The datasets used and analyzed in this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.

Code availability

Not applicable.

References 

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians 71:209–249

    PubMed  Google Scholar 

  2. **a C, Dong X, Li H, Cao M, Sun D, He S, Yang F, Yan X, Zhang S, Li N, Chen W (2022) Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J 135:584–590

    Article  PubMed  PubMed Central  Google Scholar 

  3. Zeng H, Chen W, Zheng R, Zhang S, Ji JS, Zou X, **a C, Sun K, Yang Z, Li H, Wang N, Han R, Liu S, Li H, Mu H, He Y, Xu Y, Fu Z, Zhou Y, Jiang J, Yang Y, Chen J, Wei K, Fan D, Wang J, Fu F, Zhao D, Song G, Chen J, Jiang C, Zhou X, Gu X, ** F, Li Q, Li Y, Wu T, Yan C, Dong J, Hua Z, Baade P, Bray F, Jemal A, Yu XQ, He J (2018) Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health 6:e555–e567

    Article  PubMed  Google Scholar 

  4. Li N, Huang HY, Wu DW, Yang ZM, Wang J, Wang JS, Wang SH, Fang H, Yu Y, Bai Y, Yan Z, Cao Y, Jiang M, Liu YF, Li KY, Xu BH, Sun Y, He J (2019) Changes in clinical trials of cancer drugs in mainland China over the decade 2009–18: a systematic review. Lancet Oncol 20:e619–e626

    Article  PubMed  Google Scholar 

  5. Jain R, Coss C, Whooley P, Phelps M, Owen DH (2020) The role of malnutrition and muscle wasting in advanced lung cancer. Curr Oncol Rep 22:54

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mizukami T, Piao Y (2021) Role of nutritional care and general guidance for patients with advanced or metastatic gastric cancer. Future oncology (London, England) 17:3101–3109

    Article  CAS  PubMed  Google Scholar 

  7. Okuyama T, Akechi T, Mackenzie L, Furukawa TA (2017) Psychotherapy for depression among advanced, incurable cancer patients: a systematic review and meta-analysis. Cancer Treat Rev 56:16–27

    Article  PubMed  Google Scholar 

  8. Kandasamy A, Chaturvedi SK, Desai G (2011) Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer. Indian J Cancer 48(1):55–9.https://doi.org/10.4103/0019-509X.75828

  9. Byrne M (2007) Spirituality in palliative care: what language do we need? Learning from pastoral care. Int J Palliat Nurs 13:118–124

    Article  PubMed  Google Scholar 

  10. Klimasiński M, Baum E, Praczyk J, Ziemkiewicz M, Springer D, Cofta S, Wieczorowska-Tobis K (2022) Spiritual distress and spiritual needs of chronically ill patients in Poland: a cross-sectional study. Int J Environ Res Public Health 19(9):5512. https://doi.org/10.3390/ijerph19095512

  11. O’Brien MR, Kinloch K, Groves KE, Jack BA (2019) Meeting patients’ spiritual needs during end-of-life care: a qualitative study of nurses’ and healthcare professionals’ perceptions of spiritual care training. J Clin Nurs 28:182–189

    Article  PubMed  Google Scholar 

  12. Santos Carmo BD, de Camargos MG, Santos Neto MFD, Paiva BSR, Lucchetti G, Paiva CE (2023) Relationship between religion/spirituality and the aggressiveness of cancer care: a sco** review. J Pain Symptom Manag 65:e425–e437

    Article  Google Scholar 

  13. Cannon AJ, Dokucu ME, Loberiza FR Jr (2022) Interplay between spirituality and religiosity on the physical and mental well-being of cancer survivors. Support Care Cancer 30:1407–1417

    Article  PubMed  Google Scholar 

  14. Evangelista CB, Lopes ME, Costa SF, Batista PS, Batista JB, Oliveira AM (2016) Palliative care and spirituality: an integrative literature review. Rev Bras Enferm 69:591–601

    Article  PubMed  Google Scholar 

  15. Lei A, You H, Luo B, Ren J (2021) The associations between infertility-related stress, family adaptability and family cohesion in infertile couples. Sci Rep 11(1):24220

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L et al (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer (Oxford, England : 1990) 30:1326–1336

    Article  Google Scholar 

  17. Chang VT, Hwang SS, Feuerman M, Kasimis BS, Thaler HT (2000) The memorial symptom assessment scale short form (MSAS-SF). Cancer 89:1162–1171

    Article  CAS  PubMed  Google Scholar 

  18. Fu L, Hu Y, Lu Z, Zhou Y, Zhang X, Chang VT, Yang Y, Wang Y (2018) Validation of the simplified Chinese version of the Memorial Symptom Assessment Scale-Short Form among cancer patients. J Pain Symptom Manag 56:113–121

    Article  Google Scholar 

  19. Cheng C, Dong D, He J, Zhong X, Yao S (2020) Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese undergraduates and depressive patients. J Affect Disord 261:211–220

    Article  PubMed  Google Scholar 

  20. Connor KM, Davidson JR (2003) Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 18:76–82

    Article  PubMed  Google Scholar 

  21. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    Article  CAS  PubMed  Google Scholar 

  22. Liu X, Wei D, Chen Y, Cheng Q, Liang S, Xu X, Zhang M (2016) Reliability and validity of the Chinese version of the functional assessment of chronic illness therapy spiritual well-being in cancer patients. Chin J Nurs 51(9):1085–1090

    Google Scholar 

  23. Fu L, Hu Y, Lu Z, Zhou Y, Zhang X, Chang VT, Yang Y, Wang Y (2018) Validation of the simplified Chinese version of the Memorial Symptom Assessment Scale-Short Form among cancer patients. J Pain Symptom Manag 56(1):113–121

    Article  Google Scholar 

  24. Huang X, **e M, Zhao S, Chen Y, Wu L, Zeng X (2022) Benefits of an online multimodal nursing program among patients with peripherally inserted central catheter-related thrombosis. Front Public Health 10:971363

    Article  PubMed  PubMed Central  Google Scholar 

  25. Yang Y, Cui M, Zhao X, Wang S, Wang Y, Wang X (2023) Association of pain management and positive expectations with psychological distress and spiritual well-being among terminally ill cancer patients admitted to a palliative care unit. BMC Nurs 22:96

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Scheffold K, Philipp R, Vehling S, Koranyi S, Engelmann D, Schulz-Kindermann F, Härter M, Mehnert-Theuerkauf A (2019) Spiritual well-being mediates the association between attachment insecurity and psychological distress in advanced cancer patients. Supportive Care Cancer 27:4317–4325

    Article  Google Scholar 

  27. Ghiggia A, Pierotti V, Tesio V, Bovero A (2021) Personality matters: relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients. Support Care Cancer 29:7775–7783

    Article  PubMed  PubMed Central  Google Scholar 

  28. Zhang Y, Xue G, Chen Y, An K, Chen L (2020) Factors related to spiritual health in Chinese haemodialysis patients: a multicentre cross-sectional study. Nurs Open 7:1536–1543

    Article  PubMed  PubMed Central  Google Scholar 

  29. Yang CT, Narayanasamy A, Chang SL (2012) Transcultural spirituality: the spiritual journey of hospitalized patients with schizophrenia in Taiwan. J Adv Nurs 68:358–367

    Article  PubMed  Google Scholar 

  30. Tian W, Ma W (2021) Who am I”: a study of the identity of Chinese elders in the U.S.: an anthropological study of Chinese elders in Michigan. J XIAMEN Univ (Arts & Social Sciences) 5:132–142

    Google Scholar 

  31. Turan GB, Dural G (2022) Does spiritual well-being affect death anxiety and psychological resilience in cancer patients? Omegahttps://doi.org/10.1177/00302228221129948

  32. Mihic-Gongora L, Jiménez-Fonseca P, Hernandez R, Gil-Raga M, Pacheco-Barcia V, Manzano-Fernández A, Hernando-Polo S, Antoñanzas-Basa M, Corral MJ, Valero-Arbizu M, Calderon C (2022) Psychological distress and resilience in patients with advanced cancer during the Covid-19 pandemic: the mediating role of spirituality. BMC Palliat Care 21:146

    Article  PubMed  PubMed Central  Google Scholar 

  33. Calderon C, Lorenzo-Seva U, Ferrando PJ, Sorribes E, Rodríguez-González A, Obispo BM, Mihic-Góngora L, Corral MJ, Rogado J, Cruz-Castellanos P, Jiménez-Fonseca P (2022) Measurement properties of the Spanish version of the brief resilient co** scale (BRCS) in cancer patients. Int J Clin Health Psychol 22:100313

    Article  PubMed  PubMed Central  Google Scholar 

  34. Tamura S, Suzuki K, Ito Y, Fukawa A (2021) Factors related to the resilience and mental health of adult cancer patients: a systematic review. Support Care Cancer 29:3471–3486

    Article  PubMed  Google Scholar 

  35. Breitbart W, Pessin H, Rosenfeld B, Applebaum AJ, Lichtenthal WG, Li Y, Saracino RM, Marziliano AM, Masterson M, Tobias K, Fenn N (2018) Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: a randomized controlled trial in patients with advanced cancer. Cancer 124:3231–3239

    Article  PubMed  Google Scholar 

  36. Hanfstingl B.(2013) Ego and spiritual transcendence: relevance to psychological resilience and the role of age. Evid Based Complement Alternat Med https://doi.org/10.1155/2013/949838

  37. Green MR, Emery CF, Kozora E, Diaz PT, Make BJ (2011) Religious and spiritual co** and quality of life among patients with emphysema in the National Emphysema Treatment Trial. Respir Care 56:1514–1521

    Article  PubMed  Google Scholar 

  38. Ibrahim MA, Isa KQ, Haji-Idris HA, Nawi SH, Teo YC, Abdul Rahman H, Abdul-Mumin KH (2020) Spiritual co** with stress among emergency and critical care nurses: a cross-sectional study. Community Ment Health J 56:287–293

    Article  PubMed  Google Scholar 

  39. Li X, Lin H, Jiang L, Chen X, Chen J, Lu F (2022) Low serum vitamin D is not correlated with myopia in Chinese children and adolescents. Front Med 9:809787

    Article  Google Scholar 

  40. Sepúlveda C, Marlin A, Yoshida T, Ullrich A (2002) Palliative care: the World Health Organization’s global perspective. J Pain Symptom Manag 24:91–96

    Article  Google Scholar 

  41. Chen C, Sun X, Liu Z, Jiao M, Wei W, Hu Y (2023) The relationship between resilience and quality of life in advanced cancer survivors: multiple mediating effects of social support and spirituality. Front Public Health 11:1207097

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the study participants and the research assistants for their contributions to this study.

Author information

Authors and Affiliations

  1. Department of Biotherapy Research, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Sichuan Province, 37 Guo Xue Rd, Chengdu, 610041, China

    Xue Hu, Jiaying Gao, Zhiying Yue & Rujun Zheng

  2. Divison of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China

    Shiqi Liang

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  1. Xue Hu
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Contributions

XH and RZ contributed to the conception and design of the study. XH and JG collected the data. SL and XH analyzed and interpreted the data. SL and XH were the major contributor in writing the manuscript. ZY and RZ revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rujun Zheng.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study was approved by the Medical Ethics Committee of West China Hospital, Sichuan University (2020–1198).

Consent to participate

All participants were informed of the purpose and type of the study and the confidentiality of the study data was ensured. Individuals who provided informed consent would be included in the study.

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Hu, X., Gao, J., Liang, S. et al. Status and influential factors of spiritual well-being in cancer patients with drug clinical trials: a cross-sectional study. Support Care Cancer 31, 646 (2023). https://doi.org/10.1007/s00520-023-08112-8

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