The Effects of Spiritual Needs on Spiritual Well-being in Patients with Brain Tumors: A Structural Equation Modeling Approach

Abstract

Background: For patients living with the diagnosis of a brain tumor, the extent of unmet supportive care needs is high as brain tumors are perceived as a devastating source of morbidity and mortality. Patients with cancer often find spirituality to be valuable in coping with uncertainty from their illness. The integration of spiritual care for patients with cancer has proven its values in promoting patients’ positive experiences across the cancer trajectory; therefore, it is imperative to inquire about patient spirituality regardless of patient’s religious preference. Purpose: This study was designed to examine how spirituality is interconnected with other important dimensions of patient care. The primary objective of this study was to test a theoretical model of spiritual strength that explains how spiritual well-being (SWB) of patients with brain tumors is affected by symptom burden, psychological distress, spiritual needs, and spirituality. Methods: This study was conducted with a cross-sectional online survey design using standardized questionnaires and reviewing a participant’s electronic medical records for data collection. A structural equation model (SEM) tested the theory on SWB and explained how SWB is affected by symptom burden, psychological distress, spiritual needs, and spirituality. A multigroup analysis (MGA) examined the impacts of demographic and clinical moderators. Results: The SEM analysis found that symptom burden (r= -.365) had significant negative influence on SWB and significant positive influence on spiritual needs (r = .378). Spirituality and spiritual needs had a significant influence on SWB (r = .429, r = -.204, respectively). The predictors accounted for 47.2% of the variance of SWB with spirituality contributing the most to SWB. The MGA found a higher tendency of moderating effects on above relationships if patients, compared to their counterparts, were aged <50; newly diagnosed (< 1year); primary brain tumor. The moderating effects of gender and religious affiliation/preference were minimal. Conclusion: Increased symptom burden, psychological distress, and spiritual needs are key factors in explaining low spiritual well-being. However, elevating spirituality and early screening for high-risk patients could alleviate such negative impacts. The findings of this research support the applicability of Eriksson’s theory of spiritual well-being in care of patients with brain tumors.