Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China

The physical and psychological condition of patients with gynaecological cancer has received much attention, but there is little research on spirituality in palliative care. This study aimed to investigate spiritual well-being and its association with quality of life, anxiety and depression in patients with gynaecological cancer. A cross-sectional study was conducted in China in 2019 with 705 patients diagnosed with primary gynaecological cancer. European Organisation for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-SWB32 and EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale were used to measure spiritual well-being, quality of life, anxiety and depression. Univariate and multiple linear regression analyses were performed to examine associations between spiritual well-being, quality of life, anxiety and depression. Functioning scales and global health status were positively correlated with spiritual well-being (P < .05). Anxiety and depression were negatively correlated with spiritual well-being (P < .05). Depression (-0.362, P < .001) was the strongest predictor of Existential score. Anxiety (-0.522, P < .001) was the only predictor of Relationship with self. Depression (-0.350, P < .001) and Global health (0.099, P = .011) were the strongest predictors of Relationship with others. Religion (-0.204, P < .001) and Depression (-0.196, P < .001) were the strongest predictors of Relationship with someone or something greater. Global health (0.337, P < .001) and Depression (-0.144, P < .001) were the strongest predictors of Global-SWB. Well spiritual well-being is associated with lower anxiety and depression, and better quality of life. Health providers should provide more spiritual care for non-religious patients and combine spiritual care with psychological counselling to help patients with gynaecological cancer, especially those who have low quality of life or severe symptoms, or experience anxiety or depression.