Improve Cancer Patient and Caregiver Well-Being with Spiritual Care
By John M. de Castro, Ph.D.
“Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.” – National Cancer Institute
Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.
Not only the patient but also the caregivers have difficult issues to cope with. Providing care for cancer patients can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Caregiving comes at a cost to the caregiver. It exacts an economic toll in lost work hours, income, and even the opportunity to take a promotion or relocate for a better position. But, more significantly, it exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.
Obviously, there is a need to both care for the cancer patients and also for the caregivers. Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer and also for their caregivers. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens of cancer or on the quality of life of cancer patients and their caregivers. Hence, there is a need to study the effects of spiritual care on the cancer patient and their caregivers.
In today’s Research News article “Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/
Sankhe and colleagues recruited adult cancer patients undergoing surgery whose life expectancy exceeded 6 months and one of their caregivers. This was a pilot study without a control group in which all patients and caregivers were provided with spiritual care consisting of 90 minutes daily counseling, reading and chanting. They were measured at the baseline, discharge and 2, 4, and 6 months following the surgery, for spiritual well-being and quality of life, including physical well-being, social/family well-being, emotional well-being and functional well-being.
They found that both the cancer patients and their caregivers had large and significant improvements in spiritual well-being and in all quality of life domains. These improvements were maintained 6 months after discharge. These are impressive effects of spiritual care but, because of the lack of a control condition, any conclusions must be tempered with the understanding that there are a myriad of possible confounding factors. The results do though provide strong evidence for the conduct of a randomized controlled clinical trial of providing spiritual care for cancer patients and their caregivers.
So, improve cancer patient and caregiver well-being with spiritual care.
“Spirituality and religion can be important to the well-being of people who have cancer, enabling them to better cope with the disease. Spirituality and religion may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.” – National Comprehensive Cancer Network
CMCS – Center for Mindfulness and Contemplative Studies
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Sankhe, A., Dalal, K., Agarwal, V., & Sarve, P. (2017). Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study. Journal of Religion and Health, 56(2), 725–731. http://doi.org/10.1007/s10943-016-0324-6
Spiritual care is still in infancy stage all over the globe including India. The present study was an original study evaluating the role of spiritual care in cancer patients and their primary caregivers regarding their spiritual and general well-being. The study was a prospective, non-randomized single-group study involving cancer patients undergoing surgery and their primary caregivers. Functional assessment of cancer therapy—general and functional assessment of chronic illness therapy-spiritual care was evaluated during the admission and at the time of discharge, two, four and 6 months following discharge from the hospital. Descriptive statistics was used for demographic details and repeated measure ANOVA with Dunn’s test was used for analysis of changes in the scores. A total of 107 (63 males and 44 females) patients with a mean (SD) of age 51 (13) years were recruited in the study. Similarly, for each patient one of their primary caregivers was recruited with their mean (SD) age of 39.4 (12.7) years. A total of 11/107 (10.3%) patients died and nine out of 107 (8.4%) were lost to follow-up eventually during the study period. There was a statistically significant (P < 0.0001) increase in the scores at all the follow-up periods in both the patient and their relative groups. To conclude, we found out that spiritual care on the basis of MATCH guideline improved the level of not only spiritual well-being but general well-being also in both the patients and their primary caregivers. Control group could have improved scientific validity of study in accessing effect of spiritual care. Authors believe that more robust comparative study on each principle against all five MATCH principles in future will add scientific validity and clear the various ambiguities in spiritual care.