title: Spiritual well-being in long-term survivors with chronic graft-versus-host disease after hematopoietic stem cell transplantation.
abstract: Spiritual well-being (Sp-WB) is a resource that supports adaptation and resilience, strengthening quality of life (QOL) in patients with cancer or other chronic illnesses. However, the relationship between Sp-WB and QOL in patients with chronic graft-versus-host disease (cGVHD) remains unexamined. Fifty-two participants completed the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing (FACIT-Sp) questionnaire as part of a multidisciplinary study of cGVHD. Sp-WB was generally high. Those with the lowest Sp-WB had a significantly longer time since diagnosis of cGVHD (P = 0.05) than those with higher Sp-WB. There were no associations between Sp-WB and demographics, cGVHD severity, or intensity of immunosuppression. Participants with the lowest Sp-WB reported inferior physical (P = 0.0009), emotional (P = 0.003), social (P = 0.027), and functional well-being (P < 0.0001) as well as lower overall QOL (P < 0.0001) compared with those with higher Sp-WB. They also had inferior QOL relative to population norms. Differences between the group reporting the lowest Sp-WB and those groups who reported the highest Sp-WB scores consistently demonstrated a significant difference for all QOL subscales and for overall QOL. Controlling for physical, emotional, and social well-being, Sp-WB was a significant independent predictor of contentment with QOL. Our results suggest that Sp-WB is an important factor contributing to the QOL of patients with cGVHD. Research is needed to identify factors that diminish Sp-WB and to test interventions designed to strengthen this coping resource in patients experiencing the late effects of treatment.
authors.affiliation: Pain and Palliative Care Service, National Institutes of Health Clinical Center, National Cancer Institute, Bethesda, Maryland 20892, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Harris
authors.forename: Ann M
authors.initials: AM
authors.lastname: Berger
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: Karen L
authors.initials: KL
authors.lastname: Baker
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Handel
authors.forename: Jacques L
authors.initials: JL
authors.lastname: Bolle
authors.forename: Eric G
authors.initials: EG
authors.lastname: Bush
authors.forename: Daniele
authors.initials: D
authors.lastname: Avila
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: Pavletic
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000523:psychology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D029181:Spirituality; D017741:Survivors / Q000523:psychology*