Quality of life among oncology patients with distinct spiritual well-being profiles.

Abstract

12102 Background: Individuals undergoing treatment for cancer experience multiple symptoms moderated by stress/resilience that impact quality of life (QOL). Spiritual well-being (SWB) is an understudied QOL component that may influence outcomes. Purpose: Identify SWB profiles and associations with symptoms, stress, resilience, and QOL. Methods: Patients with breast, gastrointestinal, gynecologic and lung cancer undergoing chemotherapy were enrolled in a symptom clusters study. Assessments included: SWB subscale of theMultidimensional Quality of Life Scale-Patient Version (MQOLS); Lee Fatigue Scale (LFS), Attentional Function Index (AFI), Spielberger State-Trait Anxiety Inventory (STAI), Center for Epidemiological Studies-Depression scale (CESD), General Sleep Disturbance Scale (GSDS); Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CDRS) and MQOLS. Latent profile analysis (LPA) was used to identify the distinct SWB profiles. Differences among latent classes were evaluated using analysis of variance, Kruskal-Wallis, or Chi Square tests with a Bonferroni corrected p-value of <0.008. Results: Among 1324 patients, four distinct SWB profiles were identified (Table). Patients in the Low SWB class were older, better educated, and more likely to be male and White compared to other groups (all p< 0.008). Low SWB patients reported greater fatigue, anxiety, and depression, poorer general health and mental health, and greater stress. Compared to High and Very High classes, patients in the Low and Moderate classes had lower resilience scores. Low SWB patients reported poorer QOL. Conclusions: Four distinct SWB profiles were identified. Patients with lower SWB reported higher symptom burden, higher levels of stress and poorer QOL. An evaluation of patients’ SWB may assist clinicians to identify a modifiable condition that warrants targeted interventions. Differences in symptoms, stress, resilience, and QOL scores among SWB classes. Characteristics Low (1)n=188 (14.2%) Moderate (2)n=450 (34.0%) High (3)n=421 (31.8%) Very High (4)n=265 (20.0%) Statistics Evening fatigue (>5.6) 5.5 (2.1) 5.4 (2.1) 5.6 (2.0) 4.8 (2.3) F = 8.61, p <.0011, 2, and 3 > 4 AFI (<5.0 = Low, 5 to 7.5 = Moderate, >7.5 = High) 6.2 (1.7) 6.3 (1.8) 6.4 (1.8) 6.8 (1.8) F = 6.40, p <.0011, 2, and 3 < 4 STAI (>32.2) 38.2 (13.5) 34.4 (12.0) 33.4 (12.4) 30.6 (11.1) F = 14.51, p <.0011 > 2, 3, and 42 and 3 > 4 CESD (>16.0) 15.4 (10.9) 13.2 (9.8) 12.4 (9.4) 11.0 (8.6) F = 7.95, p <.0011 > 3 and 42 > 4 GSDS (>43.0) 55.5 (18.6) 54.1 (19.6) 51.0 (20.5) 50.0 (21.4) F = 4.47, p = .0041 and 2 > 4 PSS total (0 to 56) 20.8 (8.7) 19.2 (8.3) 18.1 (8.1) 16.3 (7.2) F = 12.89, p <.0011, 2, and 3 > 41 > 3 CDRS total (0 to 40) 28.1 (6.4) 29.2 (6.4) 30.7 (6.1) 32.0 (6.0) F = 18.06, p <.0011 and 2 < 3 and 4 MQOLS: Psychological well-being 4.8 (1.8) 5.4 (1.8) 5.6 (1.9) 6.0 (1.9) F = 15.50, p <.0011, 2, and 3 < 42 and 3 < 4 MQOLS: Social well-being 5.6 (2.0) 5.9 (2.0) 5.5 (2.0) 5.9 (2.0) F = 2.60, p = .051