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Spiritual Well-being Could Lessen Despair In Terminally Ill People (p 1603)

May 07, 2003

US research published in this week's issue of THE LANCET suggests that feelings of deep despair and a desire to hasten death among terminally ill people can be tempered by strong feelings of spiritual well-being.

There is growing research which suggests that spiritual well-being (broadly defined as having an understanding of the meaning and purpose of life, which is not necessarily restricted to organised religion) might help to bolster psychological functioning and adjustment to illness. Barry Rosenfeld and colleagues from Fordham University and Memorial Sloan-Kettering Cancer Center, New York City, USA, assessed the association between spiritual well-being and end-of-life despair in a large sample of terminally ill cancer patients.

160 patients from a palliative-care hospital in New York City (Calvary Hospital) who had a life expectancy of less than 3 months were studied. Various scales (including a standard depression scale, and a measure of spiritual well-being) were used to identify patients' attitude to death. Patients who scored high on the scale for spiritual well-being were less likely to desire a hastened death, to have strong feelings of hopelessness, and to be suicidal. The importance of spiritual well-being was also emphasised by the finding that patients scoring high on the depression scale were only likely to be suicidal if they scored low on the scale for spiritual well-being.

Barry Rosenfeld comments: "Our findings have important implications for palliative-care practice. Addressing spiritual needs and existential questions among the dying is generally neglected in palliative-care practice, but could be a crucial aspect of psychological functioning. Mental-health care for the terminally ill would probably benefit from a more thorough incorporation of pastoral-care principals and practices. Our findings show the importance of an interdisciplinary approach to palliative care."

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