Spirituality as a core domain in the assessment of quality of life in oncology

Objectives: This study investigated including spiritual wellbeing as a core domain in the assessment of quality of life (QOL) in an Australian oncology population. Methods: Four hundred and ninety consecutive cancer patients with mixed diagnoses completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) and the Mental Adjustment to Cancer (MAC) scale. Results: Overall, 449 patients completed assessments. Spiritual wellbeing demonstrated a significant, positive association with QOL (r = 0.59), fighting spirit (r =0.49) and a significant, negative relationship with helplessness/hopelessness (r = -0.47) and anxious preoccupation (r = -0.26). A hierarchical multiple regression showed spiritual wellbeing to be a significant, unique contributor to QOL beyond the core domains of physical, social/family, and emotional wellbeing (R-2 change = 0.08, p = 0.000). However, high levels of meaning/peace or faith did not appear to significantly impact patients' ability to enjoy life despite chronic symptoms of pain or fatigue, making the current results inconsistent with other findings. Conclusion: Results lend further support to the biopsychosocialspiritual model. By failing to assess spiritual wellbeing, the 'true' burden of cancer is likely to be miscalculated. However, at this stage, the exact clinical utility of spirituality assessment is unclear. Copyright (C) 2008 John Wiley & Sons, Ltd.