A case for including spirituality in quality of life measurement in oncology

Authors

  • Marianne J. Brady,

    Corresponding author
    1. Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, IL, USA
    2. Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL, USA
    • Institute for Health Services Research and Policy Studies, Northwestern University, 1000 Central Street, Suite 101, Evanston, IL 60201. USA. Tel.: +1 847 5701726; fax: +1 847 5701735
    Search for more papers by this author
  • Amy H. Peterman,

    1. Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, IL, USA
    2. Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL, USA
    Search for more papers by this author
  • George Fitchett,

    1. Department of Religion, Health, and Human Values, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA
    Search for more papers by this author
  • May Mo,

    1. Abbott Laboratories, Abbott Park, IL, USA
    Search for more papers by this author
  • David Cella

    1. Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, IL, USA
    2. Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL, USA
    Search for more papers by this author

Abstract

Most of the commonly used quality of life (QOL) instruments in oncology do not include spirituality as a core domain. However, previous research suggests that spirituality might be an important aspect of QOL for cancer patients and that it may, in fact, be especially salient in the context of life-threatening illness. This study used a large (n=1610) and ethnically diverse sample to address three questions relevant to including spirituality in QOL measurement: (1) Does spirituality demonstrate a positive association with QOL?; (2) Is this association unique?; and (3) Is there clinical utility in including spirituality in QOL measurement?

Spirituality, as measured by the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being (FACIT-Sp), was found to be associated with QOL to the same degree as physical well-being, a domain unquestioned in its importance to QOL. The significant association between spirituality and QOL was unique, remaining after controlling for core QOL domains as well as other possible confounding variables. Furthermore, spiritual well-being was found to be related to the ability to enjoy life even in the midst of symptoms, making this domain a potentially important clinical target. It is concluded that these results support the move to the biopsychosocialspiritual model for QOL measurement in oncology. Copyright © 1999 John Wiley & Sons, Ltd.

Ancillary