Whitford Hayley S, Olver Ian N, Peterson Melissa J
Royal Adelaide Hospital Cancer Centre, Adelaide, SA, Australia.
Psychooncology. 2008 Nov;17(11):1121-8. doi: 10.1002/pon.1322.
This study investigated including spiritual wellbeing as a core domain in the assessment of quality of life (QOL) in an Australian oncology population.
Four hundred and ninety consecutive cancer patients with mixed diagnoses completed the Functional Assessment of Chronic Illness Therapy--Spiritual Well-Being (FACIT-Sp) and the Mental Adjustment to Cancer (MAC) scale.
Overall, 449 patients completed assessments. Spiritual wellbeing demonstrated a significant, positive association with QOL (r=0.59), fighting spirit (r=0.49) and a significant, negative relationship with helplessness/hopelessness (r=-0.47) and anxious preoccupation (r=-0.26). A hierarchical multiple regression showed spiritual wellbeing to be a significant, unique contributor to QOL beyond the core domains of physical, social/family, and emotional wellbeing (R(2) change=0.08, p=0.000). However, high levels of meaning/peace or faith did not appear to significantly impact patients' ability to enjoy life despite chronic symptoms of pain or fatigue, making the current results inconsistent with other findings.
Results lend further support to the biopsychosocialspiritual model. By failing to assess spiritual wellbeing, the 'true' burden of cancer is likely to be miscalculated. However, at this stage, the exact clinical utility of spirituality assessment is unclear.
本研究调查了将精神健康作为澳大利亚肿瘤患者生活质量（QOL）评估核心领域的情况。
490名连续入组的混合诊断癌症患者完成了慢性病治疗功能评估——精神健康（FACIT-Sp）和癌症心理适应（MAC）量表。
总体而言，449名患者完成了评估。精神健康与生活质量呈显著正相关（r = 0.59）、与斗志呈显著正相关（r = 0.49），与无助感/绝望感呈显著负相关（r = -0.47）以及与焦虑关注呈显著负相关（r = -0.26）。分层多元回归显示，除身体、社会/家庭和情感健康等核心领域外，精神健康是生活质量的一个显著且独特的影响因素（R²变化 = 0.08，p = 0.000）。然而，尽管存在慢性疼痛或疲劳症状，但高水平的意义/平和或信仰似乎并未显著影响患者享受生活的能力，这使得当前结果与其他研究结果不一致。
研究结果进一步支持了生物心理社会精神模型。若不评估精神健康，癌症的“真正”负担可能会被误算。然而，现阶段，精神性评估的确切临床效用尚不清楚。
