Angústia espiritual em pessoas com cancro submetidas a quimioterapia
: estudo longitudional

Translated title of the thesis: Spiritual distress in cancer patients undergoing chemotherapy: a longitudinal study

Student thesis: Doctoral Thesis

Abstract

Introduction: Cancer is one of the world leading causes of morbidity and mortality worldwide. Cancer affects people in all human dimensions: physical, psychological, social and spiritual. The nursing diagnosis of spiritual distress is present in 40.8% of cancer patients undergoing chemotherapy. Nursing care is based on a holistic background in which the spiritual dimension must be considered and, as so, addressing patients’ spiritual needs is critical. However, there is still weak evidence on the profile of the spiritual distress diagnosis over time or over living a particular health condition. Objective: To determine the score of spiritual distress in cancer patients during chemotherapy. Methodology: Quantitative, observational, longitudinal panel and prospective study. The data collection process comprised five cuts over the entire course of chemotherapy. The population consisted of 332 cancer patients endergoing chemotherapy in an outpatient clinic in a hospital in southern Portugal. A simple random technique sampling was used based on the following inclusion criteria: aged over 18 years; able to read and write; undergoing chemotherapy (oral, subcutaneous, intravenous) in outpatient clinic at the selected setting; stage of the disease: I, II, III and IV; cancer patients before starting the first cycle of chemotherapy. The data collection was conducted during five cuts, specifically before starting chemotherapy, after three months, six months, nine months and 12 months after starting chemotherapy. The data was collected by a questionnaire, composed of five parts: (1) sociodemographic characterization; clinical status; (3) Belief into Action Scale, to assess the religious involvement of patients; (4) Spiritual Distress Scale and (5) defining characteristics of NANDA-International spiritual distress nursing diagnosis. Data collection took place between the February 2019 and the June of 2020. Data analysis was performed using the software Statistical Package for the Social Sciences. The study was approved by the ethics committee of the institution where the study was performed. Results: A total of 332 participants were enrolled in the initial phase, and in the last cutoff moment 274 participants remained, which resulted in attrition of 17.5%. The initial sample was composed mainly of women 56.60% (n = 188), mean age of 60.25 years (Standard Deviation (SD) = ± 11.73), and a range between 22-83 years. Majority had a religious affiliation (93.70%, n = 311). The most frequent type of cancer was breast cancer (27.70%, n = 92). Spiritual distress during the study reached the highest value in the three months after starting chemotherapy and decreased until 12 months, however a statistically significant difference between the values of spiritual distress has been identified, which are higher by the end of twelve months compared to the moment before starting chemotherapy. No difference on the spiritual distress score was identified between genders. In addition, a significant negative correlation has been established between spiritual distress and religious involvement. Conclusion: The diagnosis of spiritual distress is a reality in cancer patients, in which the most delicate period corresponds to the first three months after the start of chemotherapy, but the values of spiritual distress after twelve months of chemotherapy are higher than the beginning of the treatment. Religious involvement could be a positive strategy in managing spiritual distress or risk for spiritual distress. The knowledge about the nursing diagnosis spiritual distress in a longitudinal perspective may facilitate nurses in planning autonomous nursing interventions with the aim of promoting spiritual well-being and adequate to the human responses that are assessed.
Date of Award25 Jul 2022
Original languagePortuguese
Awarding Institution
  • Universidade Católica Portuguesa
SupervisorSílvia Caldeira (Supervisor)

Keywords

  • Spiritual distress
  • Cancer
  • Nursing
  • Longitudinal studies
  • Chemotherapy

Designation

  • Doutoramento em Enfermagem

Cite this

'