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Cited by 330Religion, Spirituality, and PsychologyPalliative Care and End-of-Life IssuesPalliative and Oncologic Care

Support of cancer patients' spiritual needs and associations with medical care costs at the end of life

Open access
Balboni, Tracy, Balboni, Michael, Paulk, M. Elizabeth, Phelps, Andrea, Wright, Alexi, Peteet, John, Block, Susan, Lathan, Chris +2 more·2011·Cancer
DOI 10.1002/cncr.26221PMC PMC3177963
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Abstract

BACKGROUND: Although spiritual care is associated with less aggressive medical care at the end of life (EOL), it remains infrequent. It is unclear if the omission of spiritual care impacts EOL costs. METHODS: A prospective, multisite study of 339 advanced cancer patients accrued subjects from September 2002 to August 2007 from an outpatient setting and followed them until death. Spiritual care was measured by patients' reports that the health care team supported their religious/spiritual needs. EOL costs in the last week were compared among patients reporting that their spiritual needs were inadequately supported versus those who reported that their needs were well supported. Analyses were adjusted for confounders (eg, EOL discussions). RESULTS: Patients reporting that their religious/spiritual needs were inadequately supported by clinic staff were less likely to receive a week or more of hospice (54% vs 72.8%; P = .01) and more likely to die in an intensive care unit (ICU) (5.1% vs 1.0%, P = .03). Among minorities and high religious coping patients, those reporting poorly supported religious/spiritual needs received more ICU care (11.3% vs 1.2%, P = .03 and 13.1% vs 1.6%, P = .02, respectively), received less hospice (43.% vs 75.3% ≥1 week of hospice, P = .01 and 45.3% vs 73.1%, P = .007, respectively), and had increased ICU deaths (11.2% vs 1.2%, P = .03 and 7.7% vs 0.6%, P = .009, respectively). EOL costs were higher when patients reported that their spiritual needs were inadequately supported ($4947 vs $2833, P = .03), particularly among minorities ($6533 vs $2276, P = .02) and high religious copers ($6344 vs $2431, P = .005). CONCLUSIONS: Cancer patients reporting that their spiritual needs are not well supported by the health care team have higher EOL costs, particularly among minorities and high religious coping patients. Cancer 2011;. © 2011 American Cancer Society.

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  • Poor coping has adverse effects on medical outcomes, both in terms of lengthening hospital stay and increasing mortality.

    “Poor coping has adverse effects on medical outcomes, both in terms of lengthening hospital stay and increasing mortality [583].”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [583]

    The Methods (Baseline Measures; page unavailable) discuss religious coping, but do not link poor coping to longer hospital stays or increased mortality. The Abstract (Results; page unavailable) reports associations between inadequately supported spiritual needs and ICU care or place of death—not hospital-stay duration or mortality risk. Searches for poor coping, hospital stay, and mortality found no passage establishing the attributed claim. (LLM, conf=0.75)

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  1. [6]Brady MJ Peterman AH Fitchett G Mo M Cella D A case for including spirituality in quality of life measurement in oncology Psychooncology 1999 8 5 417 28 10559801

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Authors
Balboni, T., Balboni, M., Paulk, M. E., Phelps, A., Wright, A., Peteet, J., Block, S., Lathan, C., VanderWeele, T., & Prigerson, H.
Affiliations
  • Harvard University (US)
  • The University of Texas Southwestern Medical Center (US)
  • Brigham and Women's Hospital (US)
  • Dana-Farber Cancer Institute (US)
Corresponding author
Balboni, Tracy
ORCID
Venue
Cancer
Publisher
Wiley
Published
2011-05-11
Volume
117
Issue
23
Pages
5383-5391
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
DOI
10.1002/cncr.26221
PMC
PMC3177963
OpenAlex
W2005036109
Cited by
330
References
38
Citations by year
2026: 8 · 2025: 13 · 2024: 16 · 2023: 59 · 2022: 13 · 2021: 20 · 2020: 30 · 2019: 27 · 2018: 25 · 2017: 22 · 2016: 15 · 2015: 17 · 2014: 27 · 2013: 22 · 2012: 12
FWCI
20.74
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Public Health Service (MHJ63892)
  • National Institute of Mental Health (R01MH063892)
  • National Cancer Institute (R01CA106370, CA106370, T32CA009172)
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
spiritual care, religious and spiritual needs, end-of-life care, advanced cancer, health care costs, hospice care, ICU mortality, religious coping, minority patients
MeSH terms
Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Prospective Studies, Religion, Terminal Care, Health Care Costs, Spirituality

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