Spiritual care for cancer patients

Spiritual care for cancer patients: the role of assisted structured reflection on ultimate life goals to improve quality of life and empowerment

“Spiritual care for cancer patients” (2010-2014) investigated whether an assisted structured reflection on one’s ultimate life goals and resources to deal with contingency improves the quality of life of cancer patients.

Project team

• Principal investigators: prof.dr. H.W.M. van Laarhoven (Amsterdam UMC), prof.dr. M. Scherer-Rath (Radboud University), prof.dr. J.B.A.M. Schilderman (Radboud University)
• Other team members: dr. R. Kruizinga, prof.dr. P. Verschuren, prof.dr. C. Hermans, prof.dr. K. Vissers, dr. P. Ottevanger, prof.dr. J. Prins, prof.dr. C. van Weel, dr. W. Smeets, drs. J. van der Loos, prof.dr. D. Richel, prof.dr. M. Sprangers. P. Verschuren, prof.dr. C. Hermans, prof.dr. K. Vissers, dr. P. Ottevanger, prof.dr. J. Prins, prof.dr. C. van Weel, dr. W. Smeets, drs. J. van der Loos, prof.dr. D. Richel, prof.dr. M. Sprangers.

An increasing body of literature suggests that spirituality plays an important role in physical and psychosocial wellbeing of cancer patients. In fact, patients report spiritual care that should be addressed in health care. Spirituality may be defined as the personal expression of ultimate life goals. Ultimate life goals are the most important goals in life that people strive for. These goals give direction to other personal goals that one may have. In fact, ultimate life goals provide unity and stability to one’s course of life.

During life, one is confronted with life events that touch one’s personal goals. The diagnosis and treatment of cancer may be such a life event. The confrontation with a life event may result in the experience of contingency: the experience that something is neither a necessity, nor an impossibility. Contingency may be experienced when it’s problematic to incorporate a life event into one’s story of life. In confrontation with a contingent situation, such as the diagnosis and treatment of cancer, an extra narrative effort is required to construct a new framework of interpretation which fits with one’s ultimate life goals. Religious and non-religious philosophies of life provide resources to structure and incorporate experiences of contingency in one’s life.

Spiritual care may help patients to (re)access their own resources to come to terms with the contingent aspects of life, thereby improving patient’s quality of life and empowerment. This project analysed whether an assisted structured reflection on one’s ultimate life goals and resources to deal with contingency improves the quality of life of cancer patients. It departed from the question: does an assisted structured reflection on one’s ultimate life goals and resources to deal with contingency improve quality of life of cancer patients?

In phase 1, an interview model was elaborated based on previous research, to allow spiritual care givers to explore, explicate, and discuss ultimate life goals and experiences of contingency with cancer patients. In phase 2, patients (Dutch-speaking and with a Karnofsky performance score of at least 60) with advanced cancer not amenable to curative treatment options were included in a randomised controlled trial. The control group received care as usual, whereas the intervention group had two consultations with a spiritual counsellor using the interview model developed in phase 1. Throughout the research, patients filled out questionnaires regarding quality of life, empowerment, depression, anxiety and hopelessness, and health care consumption.

This project was a collaboration between the departments of the Amsterdam Medical Centre and the Radboud University Nijmegen Medical Centre (Dr. H. van Laarhoven, Prof. Dr. D. Richel, Dr. P.B. Ottevanger), Empirical Studies in Religion of the Radboud University Nijmegen (Dr. M. Scherer-Rath, Prof. Dr. J. Schilderman), and the Department of Medical Psychology of the Radboud University Nijmegen Medical Centre (Prof. Dr. J. Prins).

For research outcomes, please visit the Research Line Culture, Contingency, and Oncology Publications page.