title: Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care.
abstract: OBJECTIVE
  Spiritual well-being is threatened by cancer, but its correlation with other illness symptoms and the efficacy of palliative care (PC) to ameliorate spiritual suffering are not well understood.
  
  
  METHODS
  We conducted a retrospective study using a convenience sample of oncology patients at a comprehensive cancer center who received concurrent oncologic and palliative care between 2008 and 2011 and completed ESAS, QUAL-E, and Steinhauser Spiritual well-being survey questions was conducted. Descriptive, correlation, and t test statistics.
  
  
  RESULTS
  Eight hundred eighty-three patients surveyed had an average age of 65.6 years, with 54.1 % female, 69.3 % white, and 49.3 % married. Half (452, 51.2 %) had metastatic disease. Religious affiliation was reported as Christian by 20.3 %, Catholic by 18.7 %, and "none" by 39.0 %. Baseline spiritual well-being was not significantly correlated with age, gender, race, cancer stage, marital status, insurance provider, or having a religious affiliation. Greater spiritual well-being was correlated with greater quality of life (<p = 0.001) and well-being (<p = 0.001), and with less depression (<p = 0.001), anxiety (<p = 0.001), fatigue (p = 0.005), and pain (p = 0.01). In multiple regression analysis, the associations persisted between spiritual well-being and anxiety, depression, fatigue, and quality of life (R (2) = 0.677). Spiritual well-being improved comparing mean scores immediately prior to initial PC consultation with those at first follow-up (2.89 vs. 3.23 on a 1-5 scale, p = 0.005).
  
  
  CONCLUSIONS
  Among patients with cancer receiving concurrent oncologic and palliative care, spiritual well-being was not associated with patient age, gender, or race, or disease stage. It was correlated with physical and emotional symptoms. Spiritual well-being scores improved from just prior to the initial PC consultation to just prior to the first PC follow-up visit.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA, mrabow@medicine.ucsf.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Rabow
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Knish
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012068:Religion and Medicine; D012189:Retrospective Studies; D029181:Spirituality