Spirituality and quality of life among caregivers of advanced cancer patients

Abstract

Background: Religion and/or spirituality (R/S) is important to most advanced cancer patients, and often upholds patient quality of life (QoL) within illness. However, the role of R/S within the caregiving experience has not been adequately studied. Methods: Data from 570 caregiver-patient dyads participating in the Coping with Cancer study were included. Caregivers completed R/S measures on R/S importance, positive and negative religious coping, and degree of spiritual support from medical teams and religious communities. The correlations of caregiver R/S variables to patient R/S were assessed. Multivariable models (MVA) were employed to assess relationships of caregiver R/S measures with their QoL (SF-36 questionnaire) and perceptions of care-giving experience, controlling for confounding factors (e.g., sociodemographic factors, self efficacy). Results: Caregivers (median age 53 years, 51% spouses) largely reported religion to be important (85%). Most (85%) endorsed at least some positive religious coping, and 31% endorsed at least some negative religious coping. Thirty-nine percent and 17% of caregivers reported being highly supported by R/S communities and medical system, respectively. Caregivers’ R/S variables were correlated with patient R/S, including religiosity (r=.24, p<.001), positive religious coping (r=.41, p<.001) and negative religious coping (r=.21, p<.001). In MVA assessing relationship of R/S variables to caregiver QOL, negative religious coping was significantly related to lower caregiver QoL (SF-36 mental component summary, β=-2.2, p<.001). In MVAs of the relationship of R/S to perceptions of care-giving experience, greater positive religious coping (OR 1.95, p=.04) and greater medical team spiritual support (OR 2.02, p=.01), were related to more positive perceptions of the caregiving experience. Conclusions: R/S is important to most caregivers and is correlated with patient R/S. Caregiver negative religious coping is associated with poorer QoL. Caregiver positive religious coping and spiritual support from medical teams are related to caregivers’ positive perceptions of caregiving experience. Results suggest approaches to improve caregiver QoL should involve intervention on R/S.