Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approach

Background Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. Objectives. This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences. Methods This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1 week, and 1 month. Data were analyzed using quantitative methods and thematic analysis. Results Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1 month (p < .01). Symptoms such as shortness of breath (beta = -1.19, p < .001), drowsiness (beta = -1.27, p = .01), and anxiety (beta = -0.60, p = .03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (beta = 0.26, p < .001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support. Significance of results Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.