Factors influencing spiritual well-being in terminally ill cancer inpatients in Japan

Yusuke Hiratsuka, Sang Yeon Suh, Isseki Maeda, Tatsuya Morita, Masanori Mori, Satoko Ito, Tomohiro Nishi, Takayuki Hisanaga, Tetsuji Iriyama, Keisuke Kaneishi, Tomoo Ikari, Keita Tagami, Akira Inoue

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Purpose: Spiritual well-being is very important in patients undergoing palliative care. Although psychosocial factors have been suggested to be associated with spiritual well-being, the relationship between physical signs and spiritual well-being has not been fully elucidated. The aim of this study was to explore diverse factors associated with spiritual well-being among palliative care patients in Japan. Methods: This study is a secondary analysis of a multicenter prospective cohort study involving patients admitted to palliative care units in Japan. Physicians recorded all data prospectively on a structured sheet designed for the study. The spiritual well-being score was measured using the Integrated Palliative Outcome Scale after patients’ death in regard to symptoms over the previous 3 days. We classified each patient into “better” score (0–1) and “worse” score (2–4) groups and examined diverse factors associated with spiritual well-being. Results: Among the 1896 patients enrolled, 1313 were evaluated. In the multivariate analysis, seven variables were significantly associated with “worse” score: worse spiritual well-being on admission (2–4) (p < 0.0001), younger age (< 80) (p = 0.0001), hyperactive delirium over 3 days before death (mild/moderate/severe) (p = 0.0001), expressed wish for hastened death (yes) (p = 0.0006), worse communication among patients and families (Support Team Assessment Schedule score 2–4) (p = 0.0008), pleural effusion (present) (p = 0.037), and marital status (unmarried) (p = 0.0408). Conclusion: Recognizing factors associated with spiritual well-being is potentially useful for identifying high-risk groups with lower spiritual well-being at the end of life. Further study is required to investigate factors associated with patient-reported spiritual well-being.

Original languageEnglish
Pages (from-to)2795-2802
Number of pages8
JournalSupportive Care in Cancer
Issue number5
Publication statusPublished - 2021 May


  • Advanced cancer
  • End of life
  • Palliative care
  • Palliative care unit
  • Spirituality


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