A systematic review of associations between spiritual well-being and quality of life at the scale and factor levels in studies among patients with cancer

J Palliat Med. 2015 Mar;18(3):286-98. doi: 10.1089/jpm.2014.0189. Epub 2014 Oct 10.


Objective: The purpose of this systematic review was to examine the literature for associations between spiritual well-being and quality of life (QOL) among adults diagnosed with cancer.

Methods: A systematic literature search was conducted in the PubMed and CINAHL databases on descriptive correlational studies that provided bivariate correlations or multivariate associations between spiritual well-being and QOL. A total of 566 citations were identified; 36 studies were included in the final review. Thirty-two studies were cross-sectional and four longitudinal; 27 were from the United States. Sample size ranged from 44 to 8805 patients.

Results: A majority of studies reported a positive association (ranges from 0.36 to 0.70) between overall spiritual well-being and QOL, which was not equal among physical, social, emotional, and functional well-being. The 16 studies that examined the Meaning/Peace factor and its association with QOL reported a positive association for overall QOL (ranges from 0.49 to 0.70) and for physical (ranges from 0.25 to 0.28) and mental health (ranges from 0.55 to 0.73), and remained significant after controlling for demographic and clinical variables. The Faith factor was not consistently associated with QOL.

Conclusions: This review found consistent independent associations between spiritual well-being and QOL at the scale and factor (Meaning/Peace) levels, lending support for integrating Meaning/Peace constituents into assessment of QOL outcomes among people with cancer; more research is needed to verify our findings. The number of studies conducted on spiritual well-being and the attention to its importance globally emphasizes its importance in enhancing patients' QOL in cancer care.

Publication types

  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Cross-Sectional Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / psychology*
  • Palliative Care / psychology*
  • Quality of Life / psychology*
  • Socioeconomic Factors
  • Spirituality*
  • Survivors / psychology*