Spirituality plays a significant role in the lives of individuals facing life-threatening illnesses. As patients approach the end of their lives, questions about the meaning of suffering and the existence of an afterlife become more pressing. Palliative care, with its focus on comprehensive patient care, recognizes the importance of addressing patients’ spiritual needs to enhance their quality of life. To effectively integrate spirituality into palliative care, it is crucial to assess patients’ spiritual wellbeing and understand their concepts of spirituality.
The present study aimed to explore the relationship between spiritual wellbeing, images of God, and attitudes towards death and afterlife in Dutch palliative cancer patients. The study utilized the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group’s provisional spiritual wellbeing (SWB) measure, which was validated in multiple countries, including the Netherlands. Additionally, the study examined patients’ images of God and attitudes towards death using specific questionnaires.
Fifty-two patients, consisting of 28 females and 24 males, participated in the study. The majority of patients had no religious affiliation, and their median scores on the SWB scales indicated higher spiritual wellbeing in the domains of relationship with others, relationship with self, and existential wellbeing. Most patients adhered to an unknowable image of God, believing that God or something higher surpasses human imagination. The study also revealed that patients predominantly held an agnostic/atheistic attitude towards death and afterlife.
Limitations of the study include its relatively small sample size, which restricts generalizability, and the single-site recruitment, which limits the external validity of the findings. Future research should validate these results in larger and more diverse patient populations and explore spiritual experiences and connections to higher beings beyond traditional religious frameworks.
The study’s results shed light on the impact of different images of God on spiritual wellbeing. An unknowable image of God, representing a distant and elusive relationship with the divine, was found to have a negative influence on SWB. Patients adhering to this image of God may face challenges in finding meaning, peace, and comfort in their lives. In contrast, personal and non-personal images of God showed weak associations with SWB, suggesting a nuanced influence on specific domains of spiritual wellbeing.
These findings contrast with studies conducted in the United States that predominantly reported positive relationships between belief in a personal God and spiritual wellbeing. The secularized society of the Netherlands may contribute to a decline in the influence of traditional religious beliefs, resulting in fewer individuals having a vividly helpful relationship with a personal God. However, despite the decline in religious salience, patients in the study demonstrated high scores in the SWB domains, indicating that spiritual wellbeing surpasses traditional religious views. This aligns with the growing population identifying as “spiritual but not religious” in Western societies.
The study contributes valuable insights into the complex concept of spiritual wellbeing in palliative cancer patients. The findings suggest that an unknowable image of God negatively impacts spiritual wellbeing, while personal and non-personal images of God exhibit weak associations with specific domains of spiritual wellbeing. The results emphasize the need for the development of a new language or imagery that better captures diverse spiritual experiences in secularized societies. By expanding the understanding of spirituality beyond traditional religious concepts, healthcare providers can better address patients’ spiritual needs and enhance their overall wellbeing.
Title: Images of God and attitudes towards death in relation to spiritual wellbeing: an exploratory side study of the EORTC QLQ-SWB32 validation study in palliative cancer patients
Authors: Renske Kruizinga, Michael Scherer-Rath, Johannes B. A. M. Schilderman, Mariëtte Weterman, Teresa Young, and Hanneke W. M. van Laarhoven
Journal: BMC Palliative Care
Year: 2017
Volume: 16
Page: 67
DOI: 10.1186/s12904-017-0251-7