Meeting Terminal Patients' Spiritual Needs Improves Quality of Life

Dec. 19, 2009— -- When medical teams acknowledge a patient's spiritual needs as death approaches, that patient is more likely to receive hospice care and have a better quality of life in his or her remaining days, researchers say.

Those with advanced cancer who felt their spiritual needs were met by their medical team had more than a three-fold greater chance of getting hospice care than those who felt their needs weren't supported, according to Dr. Tracy Balboni of Dana Farber Cancer Institute in Boston.

They also had a better quality of life near the end, and those most at peace with their prognosis were less likely to receive futile aggressive care, she and colleagues wrote in the Journal Of Clinical Oncology.

"Other studies have suggested that patients' religiousness and or spirituality play an important role in end-of-life decision making and how they think of their illness," Balboni told MedPage Today. "That might play a role as far as impacting care at the end of life."

"It's also an important component of quality of life," she added. "So by addressing a patient's spiritual needs, the medical team and pastoral care services are helping to uphold patient quality of life even as they're facing the end of life."

Previous studies have found that the majority of patients with an advanced illness view religion or spirituality as personally important and have spiritual needs. As Balboni noted, patient spirituality has important implications for medical decision making.

Even though spiritual care has been incorporated into national care guidelines, Balboni said, it remains notably absent for most patients at the end of life. The paucity of data examining prospective associations of spiritual care on patient well-being just before death may be partially responsible.

So the researchers conducted the Coping with Cancer study, which investigates how psychosocial factors, including spiritual care, influence patients' end-of-life care and quality-of-life.

Patients' perception of spiritual care was assessed at baseline, with questions about satisfaction with spiritual care from both their medical team and pastoral services.