Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands.
Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio.
J Pain Symptom Manage. 2021 Sep;62(3):e139-e147. doi: 10.1016/j.jpainsymman.2021.04.024. Epub 2021 May 10.
Religion and spirituality (r/s) are important resources in coping with cancer. However, there are aspects of r/s, such as religious and spiritual struggles, found to be associated with poorer outcomes. A new measure has been adapted from the Religious and Spiritual Struggles Scale (RSS) to assess r/s struggles: the RSS-14. This concise measure allows for the assessment of multiple types of r/s struggles for people from different religious backgrounds or none.
The aim of the present study was to examine the prevalence, predictors and correlates of r/s struggles as measured by the RSS-14 and its subdomains in a cancer population receiving palliative care.
Data were collected from six outpatient palliative care services across the US. Inclusion criteria for patients were age 55 or older with a cancer diagnosis. In addition to demographic and r/s characteristics, study measures included the Edmonton Symptom Assessment Scale (ESAS), the Patient Dignity Inventory (PDI) and the Quality of Life at the End of Life (QUAL-E).
The study included 331 participants. Some r/s struggle was reported by 66%, moderate to high struggle for at least one item was reported by 20% of the patients. In bivariate analyses, r/s struggle was associated with greater symptom burden, greater dignity-related problems and poorer quality of life; in multivariable analyses, dignity-related problems remained a predictor of total r/s struggle.
R/S struggles may compromise well-being for cancer patients receiving palliative care. Clinicians should consider periodic screening for r/s struggles and referrals for spiritual care if indicated.
宗教和精神信仰（r/s）是应对癌症的重要资源。然而，宗教和精神信仰方面存在一些问题，如宗教和精神挣扎，这些问题与较差的预后相关。一种新的衡量标准是从宗教和精神挣扎量表（RSS）改编而来，用于评估 r/s 挣扎：RSS-14。这种简洁的衡量标准允许评估来自不同宗教背景或没有宗教背景的人的多种 r/s 挣扎。
本研究的目的是在接受姑息治疗的癌症患者中，使用 RSS-14 及其子量表评估 r/s 挣扎的患病率、预测因素和相关性。
数据来自美国六个门诊姑息治疗服务机构。患者纳入标准为年龄 55 岁或以上，患有癌症。除了人口统计学和 r/s 特征外，研究措施还包括埃德蒙顿症状评估量表（ESAS）、患者尊严量表（PDI）和生命末期生活质量（QUAL-E）。
该研究共纳入 331 名参与者。66%的患者报告存在某种程度的 r/s 挣扎，20%的患者报告至少有一项存在中度至高度挣扎。在单变量分析中，r/s 挣扎与更大的症状负担、更大的尊严相关问题和更差的生活质量相关；在多变量分析中，尊严相关问题仍然是 r/s 总挣扎的预测因素。
r/s 挣扎可能会影响接受姑息治疗的癌症患者的幸福感。临床医生应考虑定期筛查 r/s 挣扎，并在需要时转介进行精神关怀。
