Previous presentation: Initial results presented at the Palliative Care Congress, Bournemouth, UK, March 2010. Further results presented at the European Palliative Care Conference, Lisbon, Portugal, May 2011.
Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care†
Article first published online: 17 JUN 2013
© 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Volume 22, Issue 11, pages 2505–2512, November 2013
How to Cite
King, M., Llewellyn, H., Leurent, B., Owen, F., Leavey, G., Tookman, A. and Jones, L. (2013), Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care. Psycho-Oncology, 22: 2505–2512. doi: 10.1002/pon.3313
- Issue published online: 24 OCT 2013
- Article first published online: 17 JUN 2013
- Manuscript Accepted: 26 APR 2013
- Manuscript Revised: 25 APR 2013
- Manuscript Received: 27 AUG 2012
Despite growing research interest in spirituality and health, and recommendations on the importance of spiritual care in advanced cancer and palliative care, relationships between spiritual belief and psychological health near death remain unclear. We investigated (i) relationships between strength of spiritual beliefs and anxiety and depression, intake of psychotropic/analgesic medications and survival in patients with advanced disease; and (ii) whether the strength of spiritual belief changes as death approaches.
We conducted a prospective cohort study of 170 patients receiving palliative care at home, 97% of whom had a diagnosis of advanced cancer. Data on strength of spiritual beliefs (Beliefs and Values Scale [BVS]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), psychotropic/analgesic medications, daily functioning, global health and social support were collected at recruitment then 3 and 10 weeks later. Mortality data were collected up to 34 months after the first patient was recruited.
Regression analysis showed a slight increase in strength of spiritual belief over time approaching statistical significance (+0.16 BVS points per week, 95% CI [−0.01, 0.33], p = 0.073). Belief was unrelated to anxiety and depression (−0.15 points decrease in HADS for 10 points increased in BVS (95% CI [−0.57, 0.27], p = 0.49) or consumption of psychotropic medication). There was a non-significant trend for decreasing analgesic prescription with increasing belief. Mortality was higher over 6 months in participants with lower belief at recruitment.
Results suggest that although religious and spiritual beliefs might increase marginally as death approaches, they do not affect levels of anxiety or depression in patients with advanced cancer. © 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.