Spiritual Status and Quality of Life in Hospice Family Caregivers: A cross-sectional study.

Objectives: This study examines the association between spiritual status and quality of life (QoL) among family caregivers (FCs) of terminally ill cancer patients.

Materials and methods: A cross-sectional survey was conducted at nine hospice care units in South Korea (n=170 FCs). Spiritual status was addressed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being questionnaire (FACIT-Sp-12) and three self-rated questions that addressed spirituality, religiosity, and spiritual pain. QoL was measured using the Korean version of the Caregiver Quality of Life Index-Cancer(CQOLC-K) questionnaire. Multivariate regression analysis, adjusted for covariates via stepwise selection, was used to examine the associations between spiritual variables and CQOLC-K total and each subscale.

Results: In adjusted analyses, Positive Adaptation was the only CQOLC-K subscale associated with all spiritual measures, including Meaning/peace, Faith of FACIT-Sp-12, self-rated spirituality, religiosity, and spiritual pain. No consistent independent association was observed with the CQOLC-K total. In stratified models, these associations were confined to caregivers with a religious affiliation. Spiritual pain showed subgroup-specific patterns: among religious caregivers it coexisted with higher positive adaptation and greater burden, while among non-religious caregivers it was related to worse financial concerns.

Conclusion: In this cohort, spirituality aligned with domain-specific adaptation, and this linkage was limited to caregivers with a religious affiliation. Brief screening that records a single item for spiritual pain and the presence of religious affiliation may help identify caregivers with a religious affiliation who will benefit from meaning-focused spiritual support, while caregivers without a religious affiliation may benefit more from practical and financial assistance.