Table 5.
Impact of Spiritual Pain in Latin American Advanced Cancer Patients
| aWith spiritual pain median (IQR) | Without spiritual pain median (IQR) | p b | |
|---|---|---|---|
| Spirituality/religiosity questionsc | |||
| Do you consider yourself a spiritual person? | 7 (5, 9) | 7 (5, 10) | 0.7925 |
| Do you consider yourself a religious person? | 6 (5, 9) | 6 (3, 9) | 0.1853 |
| How important is spirituality in your life? | 10 (8, 10) | 10 (9, 10) | 0.0746 |
| How important is religion in your life? | 10 (8, 10) | 10 (9, 10) | 0.0226 |
| Is spirituality/religiosity a source of strength and comfort to you? | 10 (8, 10) | 10 (9, 10) | 0.0127 |
| Does spirituality/religiosity help you cope with your illness? | 10 (8, 10) | 10 (8, 10) | 0.0582 |
| Have you ever experienced spiritual pain any time in your life? | 7 (5, 10) | 0 (0, 6) | <0.0001 |
| Does your spiritual pain make your physical symptoms (pain, fatigue, drowsiness, appetite, or insomnia) worse? | 5 (1, 8) | 0 (0, 3) | <0.0001 |
| Does your spiritual pain make your emotional symptoms (anxiety and/or depression) worse? | 7 (4, 8) | 0 (0, 3) | <0.0001 |
| ESAS-FSd symptoms | |||
| Pain | 6 (3, 8) | 5 (1, 8) | 0.1390 |
| Fatigue | 6 (3, 8) | 4 (2, 7) | 0.0059 |
| Nausea | 1 (0, 5) | 0 (0, 4) | 0.0125 |
| Depression | 5 (2, 7) | 0 (0, 5) | <0.0001 |
| Anxiety | 5 (0, 7) | 0 (0, 4) | <0.0001 |
| Drowsiness | 5 (0, 7) | 2 (0, 5) | 0.0029 |
| Shortness of breath | 1 (0, 5) | 0 (0, 2) | 0.0021 |
| Appetite | 4 (0, 7) | 2 (0, 6) | 0.0211 |
| Sleep | 5 (0, 7) | 2 (0, 5) | 0.0068 |
| Well-being | 5 (2, 7) | 3 (0, 5) | <0.0001 |
| Financial distress | 6 (0, 8) | 1 (0, 6) | 0.0003 |
| Worry | 7 (4, 9) | 3 (0, 7) | <0.0001 |
| CES-De | 19 (11, 27) | 11 (4, 19) | <0.0001 |
| Spiritual well being/QOL (FACIT-Sp-Ex)f | 74 (64, 84) | 78 (68, 86) | 0.0002 |
| Meaning and peace | 25 (20, 28) | 27 (22, 30) | 0.0027 |
| Faith | 13 (10, 16) | 15 (12, 16) | 0.0035 |
| COPE behaviors/activities | |||
| Denial | 4 (2, 6) | 4 (2, 6) | 0.0337 |
| Behavioral disengagement | 3 (2, 4) | 2 (2, 3) | 0.0106 |
| Venting | 4 (2, 6) | 2 (2, 4) | <0.0001 |
| Positive reframing | 4 (3, 6) | 5 (4, 7) | 0.0157 |
| Religion | 7 (5, 8) | 8 (6, 8) | <0.0001 |
| Self-blame | 4 (2, 5) | 2 (2, 4) | 0.0085 |
| Positive religious COPE | 20 (16, 22) | 21 (18, 25) | 0.0012 |
| Negative religious COPE | 12 (10, 15) | 10 (7, 13) | 0.0001 |
a
Spiritual pain was scored from 0 to 10 (0 = “none” and 10 = “worst”). Spiritual pain was defined as any response ≥1.
b
Kruskal-Wallis test. Bold indicates statistical significance at p < 0.05.
c
Participants rated items on a scale of 0 to 10 (0 = not at all and 10 = very much, the most important).
d
ESAS-FS items were assessed on a scale from 0 to 10 (0 = “no symptom” and 10 = “worst possible symptom”).
e
A score of 16 or higher was used as the cutoff point for high depressive symptoms.
f
FACIT-Sp-Ex. Higher scores indicate greater importance of spiritual/religious aspects of QOL.