Tracy Balboni, MD, MPH
In a new study of terminally ill cancer patients, researchers at
Dana-Farber Cancer Institute found support of patients' spiritual needs
by the medical team is associated with greater use of hospice, less
aggressive care and greater quality of life near death.
The study is published by the Journal of Clinical Oncology on its web site and later will be published in a print edition.
"Recent research has shown that religion and spirituality are major
sources of comfort and support for patients confronting advanced
disease," says the study's senior author, Tracy Balboni, MD, MPH, of Dana-Farber.
"Our findings indicate that patients whose spiritual needs are
supported by their medical team, including doctors, nurses and
chaplains, have better quality of life near death and receive less
aggressive medical care at the end of life."
The study involved 343 incurable cancer patients at hospital and
cancer centers around the country. Participants were interviewed about
their means of coping with their illness, the degree to which their
spiritual needs were met by the medical team and their preferences
regarding end-of-life treatment.
Investigators then tracked each patient's course of care during the remainder of his or her life.
The researchers found that patients whose spiritual needs were
largely or completely supported by the medical team were likely to
transition to hospice care at the end of life.
Additionally, among patients relying on their religious beliefs to
cope with their illness, spiritual support reduced their risk of
receiving aggressive medical interventions at the end of life.
Support of patients' spiritual needs by the medical team was also
associated with better patient well-being at the end of life, with
scores on average being 28 percent higher among those receiving
"Our findings suggest that spiritual care from the medical system
has important ramifications for patients at the end of life, including
helping them transition to comfort-focused care and improving their
well-being near death," said Balboni.
"Furthermore, they highlight the need to educate medical caregivers
in being attentive to the frequent role of religion and spirituality in
patients' coping with advanced illness and importance of integrating
pastoral care into multidisciplinary medical teams."
Financial support for the study was provided by grants from the
National Cancer Institute, the National Institute of Mental Health, the
American Society of Clinical Oncology, and the Fetzer Institute.
Holly Prigerson, PhD., Director of the Dana-Farber Center for
Psycho-oncology and Palliative Care Research is the study's senior
author and principal investigator. The study's co-authors include Alexi
A.Wright, MD, Elizabeth Trice Loggers, MD, PhD, Michael J. Balboni,
M.Div, PhD, Eldrin F. Lewis, MD, Andrea C. Phelps, MD, of Dana-Farber;
John Peteet, MD, and Susan D. Block, MD of Dana-Farber and Brigham and
Women's Hospital (BWH); and Mary Elizabeth Paulk, MD, of the University
of Texas Southwestern Medical Center, Dallas.