Spiritual Well-being May Reduce the Negative Impacts of Cancer Symptoms on the Quality of Life and the Desire for Hastened Death in Terminally Ill Cancer Patients

BACKGROUND:: Spirituality is a central component of the well-being of terminally ill cancer patients. OBJECTIVE:: The aim of this study was to examine the mediating or moderating role of spiritual well-being in reducing the impact of cancer-related symptoms on quality of life and the desire for hastened death in terminally ill cancer patients. METHODS:: Eighty-five terminally ill cancer patients were assessed using the Taiwanese version of the M. D. Anderson Symptom Inventory, the Functional Assessment of Cancer Therapy–General, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-being, the Beck Hopelessness Scale, and the Schedule of Attitudes Toward Hastened Death. RESULTS:: Spiritual well-being was significantly negatively correlated with symptom severity (r = −0.46, P <.01). Symptom severity negatively correlated with quality of life (r = −0.54) and positively correlated with hopelessness (r = 0.51, P <.01) and the desire for hastened death (r = 0.61, P <.01). Spiritual well-being was a partial mediator and moderator between symptom severity and quality of life. Spiritual well-being was a partial mediator between symptom severity and the desire for hastened death. The meaning subscale of spiritual well-being was a more significant predictor of the desire for hastened death and quality of life than the faith subscale was. CONCLUSION:: Spiritual well-being may reduce the negative impacts of cancer on quality of life and the desire for hastened death. IMPLICATIONS FOR PRACTICE:: Appropriate spiritual care may reduce the negative impact of severe cancer symptoms on quality of life and the desire for hastened death in terminally ill cancer patients.