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Predictors of spirituality at the end of life

Eleni Tsilika, MSc
Ms Tsilika is a health psychologist

Efi Prapa, MA
Ms Parpa is a clinical psychologist

Marilena Smyrnioti
Ms Smyrnioti is a graduate student in psychology

Anna Pagoropoulou, PhD
Dr Pagoropoulou is an Assistant Professor in psychology, all at the University of Athens in Greece

Vlahos Lambros, MD PhD
Dr Lambros is a Professor of Radiology and Director of the Radiology Department at Areteion University Hospital in Athens

Correspondence Dr Kyriaki Mystakidou, Department of Radiology, School of Medicine, University of Athens, 27 Korinthias St, Athens 115 26, Greece; telephone 30210 770766; fax 30210 7488437; e-mailmistakidou{at}yahoo.com references

OBJECTIVE To assess the relationship between spirituality and hopelessness, desire for hastened death, and clinical and disease-related characteristics among patients with advanced cancer, and to investigate predictors of spirituality. Spiritual well-being is thought to have a beneficial effect on patients’ response to illness.

DESIGN Patients were asked to complete 4 questionnaires: the Greek version of the Spiritual Involvement and Beliefs Scale, the Greek version of the Schedule of Attitudes toward Hastened Death, the Beck Hopelessness Scale, and a questionnaire on demographics.

SETTING A palliative care unit in Athens, Greece.

PARTICIPANTS A total of 91 patients with advanced cancer.

MAIN OUTCOME MEASURES Associations between scores on the Spiritual Involvement and Beliefs scale and scores on the Schedule of Attitudes toward Hastened Death scale and the Beck Hopelessness scale, and demographic characteristics.

RESULTS Statistically significant associations were found between spirituality and sex of patients (P = .001) and spirituality and stronger hopelessness (r = 0.252, P = .016). In multivariate analyses, stronger hopelessness, male sex, younger age, and receiving chemotherapy were found to be the strongest predictors of being spiritual.

CONCLUSION Demographic and clinical characteristics and stronger hopelessness appeared to have statistically significant relationships with spirituality. Interventions to improve patients’ spiritual well-being should take these relationships into account.