Nursing Care for Spiritual Pain in Terminal Cancer Patients: A Non-Randomized Controlled Trial

Kaori Ichihara; Chika Nishiyama; Kosuke Kiyohara; Tatsuya Morita; Keiko Tamura

doi:10.1016/j.jpainsymman.2023.10.016

Nursing Care for Spiritual Pain in Terminal Cancer Patients: A Non-Randomized Controlled Trial

J Pain Symptom Manage. 2024 Feb;67(2):126-137. doi: 10.1016/j.jpainsymman.2023.10.016. Epub 2023 Oct 16.

Authors

Kaori Ichihara¹, Chika Nishiyama², Kosuke Kiyohara³, Tatsuya Morita⁴, Keiko Tamura⁵

Affiliations

¹ Department of Nursing (K.I.), Yodogawa Christian Hospital, Osaka, Japan; Department of Palliative Nursing (K.I., K.T.), Kyoto University Graduate School of Human Health Science, Kyoto, Japan. Electronic address: ichihara.kaori.62s@kyoto-u.jp.
² Department of Critical Care Nursing (C.N.), Kyoto University Graduate School of Human Health Science, Kyoto, Japan.
³ Department of Food Science (K.K.), Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan.
⁴ Department of Palliative and Supportive Care and Seirei Hospice (T.M.), Seirei Mikatahara General Hospital, Hamamatsu, Japan.
⁵ Department of Palliative Nursing (K.I., K.T.), Kyoto University Graduate School of Human Health Science, Kyoto, Japan; Division of Regional Medical Cooperation (K.T.), Center for Industrial Research and Innovation, Translational Research Institute for Medical Innovation, Osaka Dental University, Osaka, Japan.

PMID: 37852454
DOI: 10.1016/j.jpainsymman.2023.10.016

Abstract

Context: Spiritual well-being is important for terminal cancer patients; however, appropriate interventions remain to be established.

Objectives: To evaluate the effectiveness of nursing care to alleviate spiritual pain in daily clinical practice using a Spiritual Pain Assessment Sheet-based spiritual care program for nurses (SpiPas-SCP-N).

Methods: A nonrandomized controlled trial was conducted in five palliative care units in Japan. The intervention group received spiritual care based on SpiPas-SCP-N by ward nurses. The primary outcome was the Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp). Secondary outcomes included: Hospital Anxiety and Depression Scale (HADS), Comprehensive Quality of life Outcome (CoQoLo), and the Japanese version of the M.D. Anderson Symptom Inventory (MDASI-J). Propensity score matching was used for adjustment.

Results: Terminal cancer patients were assigned to the control and intervention groups (n = 140 and 157, respectively); of whom, 97 (69.8%) and 106 (68.0%), respectively, completed two weeks. Seventy-three patients were matched in each group. The total score of FACIT-Sp increased in the intervention group and decreased in the control group; however, there was no significant difference (95% CI, -3.98, 1.41, P = 0.347). HADS total score significantly increased (95% CI, 0.15, 3.87, P = 0.035), whereas there were no significant changes in CoQoLo and MDASI-J scores. The effect size of changes in FACIT-Sp subscales were 0.25 in the meaning/peace subscale and 0.04 in the faith subscale.

Conclusion: SpiPas-SCP-N for spiritual pain may have a positive impact on terminal cancer patients. Future research using larger samples, randomized design, and the meaning/peace subscale of FACIT-Sp as the primary outcome is necessary as well as supervision and continuous training in daily nursing practice.

Keywords: Spirituality; nursing care; palliative care; patient-reported outcomes; terminal cancer.

Publication types

Controlled Clinical Trial
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Neoplasms* / complications
Neoplasms* / therapy
Pain / complications
Quality of Life*
Spirituality
Surveys and Questionnaires