Spiritual wellbeing and psychiatric comorbidity among patients with advanced-stage solid tumor cancer.

Abstract

Background: The physical and psychological suffering of advanced-stage cancer patients has received attention recently, but the role of spiritual wellbeing (SpWB) in psychiatric morbidity is not adequately explored in the Indian context. Understanding this dimension may improve the quality of care among these patients.

Aim: The present study aimed to identify the correlates of SpWB and its association with psychiatric comorbidity among patients with advanced-stage solid tumor cancer.

Methodology: This cross-sectional study was conducted in the Radiation-oncology department of a tertiary-care hospital after obtaining ethical approval. Patients with advanced-stage solid tumors (n = 102) were assessed with clinical interview and rating scales [Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing 12 Item Scale (FACIT-Sp-12)]. The Chi-square test, Spearman's correlation, and logistic regression were used to examine the association of SpWB with psychiatric morbidity.

Results: Out of 102 patients, 36.27% had a psychiatric diagnosis, the most frequent being adjustment disorder. SpWB had a significant negative correlation with anxiety (ρ = -0.78) and depressive symptoms (ρ = -0.70). The family income (U = 848; P = 0.012) and belief about cancer prognosis (χ² = 12.94, P = 0.002) were associated with psychiatric morbidity. In logistic regression, SpWB (OR = 0.834) was significantly associated with psychiatric comorbidity, and among its domains, only 'Meaning' was significantly associated.

Conclusion: A higher level of SpWB is linked with lesser depressive and anxiety symptoms and is associated with psychiatric morbidity among advanced-stage cancer patients. The finding suggests a possible role of interventions facilitating spirituality and meaning in preventing psychiatric morbidity.