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Cited by 812Religion, Spirituality, and PsychologyPalliative and Oncologic CarePalliative Care and End-of-Life Issues

Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients

McClain, Colleen S, Rosenfeld, Barry, Breitbart, William·2003·The Lancet
DOI 10.1016/s0140-6736(03)13310-7
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Abstract

Background The importance of spirituality in coping with a terminal illness is becoming increasingly recognised. We aimed to assess the relation between spiritual well-being, depression, and end-of-life despair in terminally-ill cancer patients.Methods 160 patients in a palliative care hospital with a life expectancy of less than 3 months were interviewed with a series of standardised instruments, including the functional assessment of chronic illness therapy-spiritual well-being scale, the Hamilton depression rating scale, the Beck hopelessness scale, and the schedule of attitudes toward hastened death. Suicidal ideation was based on responses to the Hamilton depression rating scale.Findings Significant correlations were seen between spiritual well-being and desire for hastened death (r=-0.51), hopelessness (r=-0.68), and suicidal ideation (r=-0.41). Results of multiple regression analyses showed that spiritual well-being was the strongest predictor of each outcome variable and provided a unique significant contribution beyond that of depression and relevant covariates. Additionally, depression was highly correlated with desire for hastened death in participants low in spiritual well-being (r=0.40, p<0.0001) but not in those high in spiritual well-being (r=0.20, p=0.06).Interpretation Spiritual well-being offers some protection against end-of-life despair in those for whom death is imminent. Our findings have important implications for palliative care practice. Controlled research assessing the effect of spirituality-based interventions is needed to establish what methods can help engender a sense of peace and meaning.

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  • As symptoms worsen, many CHF patients become dependent on carers, which adversely affects their sense of identity and will to live.

    “As symptoms worsen, many CHF patients become dependent on carers, which adversely affects their sense of identity and will to live. 6 , 15”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [15]

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Authors
McClain, C. S., Rosenfeld, B., & Breitbart, W.
Affiliations
  • Fordham University (US)
  • Memorial Sloan Kettering Cancer Center (US)
Corresponding author
Rosenfeld, Barry
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2003-05
Volume
361
Issue
9369
Pages
1603-1607
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(03)13310-7
OpenAlex
W2137699706
Cited by
812
References
32
Citations by year
2026: 11 · 2025: 21 · 2024: 26 · 2023: 24 · 2022: 27 · 2021: 26 · 2020: 45 · 2019: 30 · 2018: 38 · 2017: 38 · 2016: 52 · 2015: 38 · 2014: 44 · 2013: 30 · 2012: 48
FWCI
38.05
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
National Institute of Nursing Research (R01NR005183, NR-05183)
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
spiritual well-being, terminal cancer patients, palliative care, depression, hopelessness, suicidal ideation
MeSH terms
Aged, Attitude to Death, Female, Humans, Male, Neoplasms, Palliative Care, Social Support, Logistic Models, Terminally Ill, Spirituality

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