| Summary: | 碩士 === 臺北醫學大學 === 護理學研究所 === 98 === Abstract
Title of Thesis: Relationships between Spiritual Well-being and Symptoms in Advanced Cancer Patients
Institution: Graduate Institute of Nursing, Taipei Medical University
Author: Yin-Chih Wang
Thesis directed by: Chia-Chin Lin, Ph. D., Professor
Objectives: The purpose of current research is to explore the relationships between spiritual well-being and symptoms in advanced cancer patients, and also to clarify the mechanism how spiritual well-being reduce the impacts on quality of life, hopelessness and desire for hastened death caused by cancer-related symptoms as a buffer.
Methods:This is a cross-sectional designed study, Eighty five with mixed diagnoses advanced cancer patients have been recruited, and completed Taiwanese version of the M. D. Anderson Symptom Inventory (MADSI-T), the Functional Assessment of Chronic Illness Therapy－Spiritual Well-being (FACIT-Sp), the Beck hopelessness Scale (BHS) and the Schedule of Attitudes Toward hastened Death (SAHD).
Results: Spiritual well-being demonstrated a significant , negative with symptom severity (r=- .46) and symptom interfere(r=- .56); symptom severity and symptom interfere is also correlated with hopelessness(r= .51, r= .61) and desire for hastened death(r= .53, r= .53). A regression analyse assessed by generalized linear model showed spiritual well-being is a partial mediator to the three relations of symptom burden versus quality of life, hopelessness and desire for hastened death. However, spiritual well-being is a moderator to symptom burden versus quality of life only, but there is not a significance to symptom burden versus hopelessness and desire for hastened death.
Sleep problems are most annoying to terminally cancer patients, however, patients with high levels of spiritual well-being had lower symptom severity and interferece to daily life. After controlled symptom burdens and other confounders(e.g. age, sex, current job situation…), meaning/peace domain of spiritual well-being is more important to quality of life, hopelessness and desire for hastened death than faith domain.
Conclusion: The current study results lead further understand to the relationships between spiritual well-being and cancer related symptoms. As a mediator and moderator, spiritual well-being can reduce the negative impacts caused by cancer symptoms. It is concluded that these results support the move to biopsychosocialspiritual model for holistic palliative care.
Key words: cancer-related symptoms, spiritual well-being
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