Spirituality, religiosity, spiritual pain, and quality of life among Latin American patients with advanced cancer (LAAdCa): A multicenter study.

246 Background: The associations between spirituality (S), religiosity (R), spiritual pain (SP), symptom, coping and quality of life (QOL) have not been well characterized in LAAdCa. The main purpose of this Multicenter study was to analyze these associations.

METHODS: We interviewed 325 LAAdCa at a Palliative Care clinic in Chile, Guatemala, and USA. They completed FICA (S/R assessment), ESAS-FS (including SP), PSWQ (Worry), B-COPE and B-R-COPE (coping), FACIT-sp-ex (Spiritual Well-being).

RESULTS: Median age 58 (range: 19-85), 60% women, 62% Catholic, 30% Christian not Catholics, and 2% with no religion. 97% of LAAdCa considered themselves spiritual and 89% religious, median 7(IQR: 5-10) and 7(5-9) respectively. Median Importance of S/R in life (score 0 = none, 10 = very important) was 10 (IQR:8-10). The frequency and associations among the importance of S/R and different items were: helps them to cope with their illness (98%, r = 0.73; p < 0.0001), is a source of strength and comfort (99%, r = 0.79; p < 0.0001), and has a positive effect in physical symptoms (81%, r = 0.40; p < 0.0001), emotional symptoms (84%, r = 0.42, p < 0.0001), and helps to their caregivers to cope with pts' illness (100%, r = 0.66, p < 0.0001). 60% of LAAdCa reported that their S/R needs had not been supported by the medical team. 24% had received pastoral attention inside the hospital. 162/311 (52%) of LAAdCa reported spiritual pain (median 6; IQR: 5-8). Spiritual pain significantly correlated with worse pain (p = 0.02), fatigue (p = 0.0002), depression (p < 0.0001), anxiety (p < 0.0001), Financial distress (p < 0.0001), worry (p < 0.001), behavioral disengagement (p = 0.01), FACIT-sp-Ex (p = 0.0002), negative religious coping strategies (p < 0.0001), caregiver's SP (p = 0.02), caregiver's depression (p < 0.0001), caregiver's anxiety (p = 0.0007), and worse caregiver's QOL (p = 0.001).

CONCLUSIONS: Majority of LAAdCa considered themselves spiritual and religious. S/R help to deal with their illness and correlates with less emotional distress, positive coping strategies and QOL. Still more than 50% LAAdCa reported SP and their S/R needs are not totally supported by the medical team. More research is needed.