Spiritual coping and psychological symptoms as the end approaches: a closer look on ambulatory palliative care patients

ABSTRACT

Palliative care providers must seek to improve quality of life despite their patients’ life-threating diseases, based on the concept of total pain, which includes physical, psychological and spiritual pain. Understanding the relationship between spiritual coping and psychological symptoms (especially depressive symptoms) could help healthcare teams better address patients’ needs. Across-sectional survey with aconvenient sample of ambulatory palliative care patients investigated their psychological pain through the Hospital Anxiety and Depressive (HAD) scale and their use of spirituality using the Brief Religious/spiritual coping (BriefRCOPE) scale. Alinear regression model, using the HADS-depression as outcome variable and the BriefRCOPE as the independent variable, adjusting for confounding variables, investigated the possible association between these variables. Due to methodological limitations, just 40 out 130 potential participants were assessed, with 40percent showing depressive symptoms. In regression model, depressive and anxiety symptoms were significantly associated with each other (p = 0.037 and 0.015, respectively) and negative religious/spiritual coping was associated with depressive symptoms (p = 0.033). This study found asignificant relationship between psychological pain and negative spiritual coping mechanisms. Palliative care professionals should be trained to address patients’ total pain and spiritual needs, supporting their ability to cope with their suffering.

KEYWORDS:

• Adaptation
• psychological
• anxiety
• depression
• palliative care
• ambulatory care
• spirituality

Acknowledges

This article is based on the Masters` research of GG;

Pain Management and Palliative Care Service at the Botucatu Medical School, State University of São Paulo, Brazil, its team and patients, for the permission and collaboration for the data collecting;

Fernanda Bono Fukushima, PhD, MD for her full support during the project discussion and data collecting;

Thanks for the support, incentive, and resources on this manuscript preparation:

• Programa de Pós-Graduação em Ensino em Saúde/Clínica Médica, UNICAMP, Campinas, Brazil;

• CAPES – MEC/Brazil for scholarship to GG;

• Palliative Care Institute Liverpool, University of Liverpool;

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by CAPES – MEC, Brazil under Grant 88881.188776/2018-01 (PSDE – Edital n.47/2017)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [PSDE 88881.188776/2018-01].