Jurnal Keperawatan Muhammadiyah 6 (1) 2021

Jurnal Keperawatan Muhammadiyah

Alamat Website: http://journal.um-surabaya.ac.id/index.php/JKM

Pemenuhan Spiritual Pada Pasien Kanker : Literature Review

Marti Husen 1, Iman Permana 2

1
Master of Nursing post graduate program, Universitas Muhammadiyah Yogyakarta, Bantul, Yogyakarta
2
Lecture Master of Nursing, Universitas Muhammadiyah Yogyakarta, Bantul, Yogyakarta

INFORMASI ABSTRACT
Korespondensi: Background: Cancer treatment can not only focus on the quantity or physicality of the
Martihusen96@gmail.com patient, but also pay attention to factors of quality of life, pain, stress, anxiety, fatigue,
fear of death, and depression in patients who are often missed in the treatment of cancer
patients. Spiritual needs are important needs to be met in patients with cancer in addi-
tion to other aspects of the need, because this disease can affect all aspects of the sufferer’s
life both physical, psychological and spiritual.

Objective:this study aims to determine the spiritual fulfillment in cancer patients.

Method : This research is a literature review with the process of collecting data through
3 databases namely Pubmed , EBSCO and Proquest . Search Literature with the word
key “ Spiritual experience Spiritual meaning OR AND Cancer Patients” article pub-
lished in the 5 years of the last is from the year 2015 to 2019 with the criteria of inclu-
sion.
Results: The literature search results found 169,139 journals, Pubmed found 583,
Ebsco 12,582, Proquest 155,974, the entire database was categorized with inclusion
Keywords: criteria and only 14 articles met the criteria.
Spiritual experience,
Spiritual meaning, Cancer Conclusion: spiritual fulfillment can improve the quality of life of cancer patients, by
patient increasing spiritual aspects can provide peace, comfort for cancer patients. So the impor-
tance of spiritual needs in health care.

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 Jurnal Keperawatan Muhammadiyah 6 (1) 2021

PENDAHULUAN dipenuhi pada pasien dengan penyakit kanker selain

Penyakit kanker merupakan salah satu penyebab ke- aspek kebutuhan lainnya, karena penyakit ini dapat
matian utama diseluruh dunia. Pada tahun 2012, berdampak terhadap seluruh aspek kehidupan pen-
kanker menjadi penyebab kematian sekitar 8,2 juta deritanya baik fisik, psikologis maupun spiritual.
orang. Berdasarkan data GLOBOCAN, Internation- Namun pelayanan keperawatan masih terfokus pada
al Agency for Research on Cancer (IARC), diketahui aspek fisik. Sehingga data mengenai kebutuhan spiri-
bahwa pada tahun 2012 terdapat 14.067.894 kasus tual pasien kanker di Indonesia belum komprehensif.
baru kanker dan 8.201.575 kematian akibat kanker Kebutuhan spiritual sangat dibutuhkan oleh pasien
diseluruh dunia (Kemenkes RI, 2018). kanker.
Angka kejadian kanker di wilayah Indonesia bagian
barat lebih besar jika dibandingkan wilayah Indone- METODE
sia tengah dan makin menurun hingga wilayah In- Metode yang digunakan dalam penelitian ini adalah
donesia timur. Pulau Jawa merupakan pulau dengan Literature review yang merupakan desain non-eksperi-
jumlah kanker paling tinggi, Sedangkan Jawa Tengah mental dimana para peneliti secara objektif mengkriti-
merupakan provinsi dengan kejadian kanker tertinggi si, meringkas dan membuat kesimpulan tentang suatu
(Dewi, 2017). subjek melalui pencarian sistematis, kategorisasi dan
Data terbaru yang dikeluarkan oleh The International analisis tematis (Christmals, 2018).
Agency for Research on Cancer (IARC) dan World Health Literature review penting untuk dilakukan karena
Organization (WHO) menunjukkan pertumbuhan merangkum literature yang tersedia pada satu topic
jumlah penderita kanker di dunia semakin meningkat tertentu, menggunakan langkah ilmiah dan menya-
sekitar 18,1 juta kasus baru, dan berdasarkan jumlah jikan analisis literature sehingga pembaca tidak harus
kasus tersebut 9,6 juta pasien kanker meninggal dunia mengakses setiap laporan penelitian individu yang ter-
(Bray, 2018). masuk dalam ulasan literature (Cultural Awareness in
Pengobatan kanker kanker tidak bisa hanya berfokus Nursing and Health Care, Second Edition, 2010).
terhadap kuantitas atau fisik pasien, akan tetapi juga Pada prinsipnya prinsipnya Literature review ini mer-
memperhatikan faktor kualitas hidup, nyeri, stres, upakan metode penelitian yang dilakukan dengan
kecemasan, fatigue, rasa takut kematian, dan depresi merangkum hasil artikel penelitian primer sebagai tu-
pada pasien yang sering terlewatkan dalam penanga- juan untuk menyajikan data lebih komprehensif dan
nan pasien kanker (Singh & Chaturvedi, 2015). berimbang.
Menurut penelitian Subu et al., (2019) Agama mer-
upakan salah satu yang paling dibutuhkan untuk pa-
sien dengan kanker. Dsouza dkk (2017) yang menya-
takan bahwa seiring dengan berjalannya pengobatan,
individu meningkatkan doa dan keyakinan kepada
Tuhan.
Spiritual merupakan seperangkat pengalaman dan
perasaan batin yang dialami seseorang mencari makna
dan tujuan secara batin serta hubungan dengan diri,
keluarga. Orang lain, masyarakat, dan alam (Baum-
steiger & Chenneville, 2015). Peningkatan dukun-
gan spiritual merupakan strategi untuk meningkat-
kan kualitas hidup pasien dengan kanker (Forouzi et
al., 2017). Spiritualitas dan religiusitas merupakan
dua komponen yang penting dalam perawatan pali-
atif pada pasien kanker, karakter holistik yang dapat
mempengaruhi dalam peningkatan kualitas hidup,
well-being, dan mengurangi distres pada pasien kank-
er (Ahmadi, 2015).
Menurut Nuraeni et al., (2015) Kebutuhan spiritu-
alitas merupakan kebutuhan yang penting untuk

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 Jurnal Keperawatan Muhammadiyah 6 (1) 2021

Literature review ini dilakukan dengan menggunakan dengan kategori dukungan sosial (Sheppard et al.,
4 (empat) tahapan, yaitu: (1) Menentukan kriteria ke- 2018; Paredes & Pereira, 2018).
layakan, kriteria kelayakan literature dilakukan den-
gan kriteria inklusi, yaitu: dimana artikel yang dit- PEMBAHASAN
injau merupakan hasil riset asli yang telah dikaji dan Literature review ini mengidentifikasi empat belas ar-
dipublikasikan dalam bahasa inggris, serta tujuan ar- tikel yang memenuhi kriteria inklusi. Sebagian besar
tikel yang ditinjau harus memuat data mengenai aspek makalah membahas tentang kebutuhan spiritual pada
spiritual pasien kanker; (2) Menentukan sumber in- pasien kanker. Beberapa penelitian telah dilakukan
formasi, Pencarian literatur dilakukan dengan meng- untuk mengetahui pemenuhan spiritual terhadap
gunakan 3 (tiga) data base online yaitu: Pubmed, EB- kualitas hidup. Berdasarkan hasil review dari 14 jur-
SCO, dan Proquest; (3) Pemilihan literature, Kriteria nal didapatkan 4 tema besar yaitu 1) kekuatan dalam
dalam pemilihan literatur review ini dilakukan dengan keyakinan, Menurut Barton et al., (2018) spiritu-
menentukan kata kunci berupa kunci “Spiritual expe- al sebagai sumber kekuatan yang dapat membantu
rience” OR “Spiritual meaning” AND cancer patients” meningkatkan kualitas dan makna hidup pasien kank-
Limitasi yang dilakukan untuk pencarian artikel yang er. Al-Natour et al., (2017) spiritual sebagai aspek ma-
terkait dengan aspek spiritual pasien kanker yaitu 5 nusia yang penting, karena dapat berkontribusi pada
tahun terakhir diantara tahun 2015 sampai dengan ta- peningkatan kesejahteraan fungsional, social, fisik,
hun 2019; (4) Data selection and analysis, Pengumpu- dan dapat meningkatkan kualitas hidup pasien yang
lan data literatur review ini dilakukan secara manual didiagnosa kanker. Bhatnagar et al., (2017) menga-
dengan cara mengekstrasi data sesuai dengan kriteria takan pasien dengan perawatan paliatif sebagian ser-
inklusi. kata kunci yang digunakan “Spiritual Expe- ing percaya dan yakin pada tuhan sehingga member-
rience” OR “Spiritual meaning” AND Cancer patients. ikan kekuatan dalam diri mereka. 2) kedamaian dan
Pencarian Jurnal di Pubmed, EBSCO dan Proquest. harapan, penelitian yang dikemukakan oleh Bai et al.,
Dari keyword yang dimasukkan didapatkan hasil (2015) pentingnya meningkatkan kesejahteraan spir-
dari beberapa database yaitu Pubmed (N=583) Ebsco itual pada pasien yang baru didiagnosis kanker stadi-
(N=12.582) dan Proquest (N=155.974). um lanjut dapat mempengaruhi pola dinamis seperti
makna perdamaian, dan iman yang berkaitan dengan
kualitas hidup. Forouzi et al., (2017) pemenuhan ke-
HASIL butuhan spiritual dapat meningkatkan kualitas hidup
Fokus utama dari literatur review ini adalah kebutuhan pasien kanker. Sehingga pentingnya kebutuhan spiri-
spiritual pasien kanker. Jurnal yang digunakan dalam tual dalam perawatan kesehatan. Walker et al., (2017)
Literature review ini sejumlah 14 jurnal yang keseluru- kesejahteraan spiritual dan pasikologis sangat erat da-
hannya merupakan penelitian dengan metode kualita- lam konteks keimanan. Spiritual memiliki hubungan
tif, kuantitatif, dan mixed methode bertujuan untuk yang kuat antara kedamaian dan kualitas hidup pa-
mengetahui pemenuhan kebutuhan spiritual pada sien kanker. Hasil penelitian Bai et al., (2016) menga-
pasien kanker. Hasil review menunjukan secara garis takan hubungan kesejahtraan spiritual terhadap iman
besar membahas tentang pemenuhan spiritual dengan dan kualitas hidup dapat menurunkan angka depresi
kualitas hidup pasien yang meliputi 4 tema besar yaitu dan memberikan kedamaian pada pasien kanker. 3)
1) kekuatan dalam keyakinan; 2) kedamaian dan hara- makna hidup dan tujuan, pada penelitian Garssen
pan; 3) makna hidup dan tujuan; 4) koneksi (dukun- et al., (2015) Spiritual membantu pasien kanker da-
gan sosial). Untuk mengoptimalkan interpretasi ini, lam mengatasi penyakit mereka atau penyusuaian
pertama-tama kita akan mengklarifikasi hasil temuan terhadap penyakit. Perilaku spiritual juga membantu
penelitian dari review 14 jurnal. Pada hasil tema yang orang mengekspresikan perasaan negative dan dapat
pertama tentang kekuatan dalam keyakinan (Barton menciptakan keheningan dan ketenangan pikiran.
et al., 2018; Al-Natour et al., 2017; Bhatnagar et al., menurut Caldeira et al., (2017) kesejahteraan spiritual
2017). Spiritual dengan kedamainan dan harapan (Bai lebih rendah pada pasien yang mengatakan diri mer-
et al., 2015; Forouzi et al., 2017; Walker et al., 2017; eka dalam tekanan spiritual. Phenwan et al., (2019)
Bai et al., 2016). Makna hidup dan tujuan (Garssen et mengatakan bahwa spiritualitas merupakan salah satu
al., 2015; Caldeira et al., 2017; Phenwan et al., 2019; komponen kunci dari manusia dan perawatan pali-
Rassouli et al., 2015; Nuraini et al., 2018. Koneksi atif yang mempengaruhi kualitas hidup secara fisik,

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 Jurnal Keperawatan Muhammadiyah 6 (1) 2021

dan psikologis pasien. Rassouli et al., (2015) dengan Not a Spiritual Person.” How Hope Might Fa-
meningkatkan spiritual, pasien dapat menerima dan cilitate Conversations About Spirituality Among
mengatasi penyakit mereka. Dan menurut Nuraini et Teens and Young Adults With Cancer. Jour-
al., (2018) perawatan paliatif adalah pendekatan yang nal of Pain and Symptom Management, 55(6),
terfokus pada peningkatan kualitas hidup pasien dan 1599–1608. https://doi.org/10.1016/j.jpainsym-
keluarga saat menghadapi penyakit yang mengancam man.2018.02.001
jiwa. Spiritualitas pada perawatan paliatif adalah kun- Baumsteiger, R., & Chenneville, T. (2015). Challeng-
ci untuk meningkatkan kenyamanan pada pasien yang es to the Conceptualization and Measurement
mengalami nyeri. 4) koneksi dengan kategori dukun- of Religiosity and Spirituality in Mental Health
gan social, menurut Paredes & Pereira, (2018) peran Research. Journal of Religion and Health, 54(6),
dukungan social sangat penting untuk memahami 2344–2354. https://doi.org/10.1007/s10943-
penyesuaian terhadap kanker. Sheppard et al., (2018) 015-0008-7
mengatakan spiritualitas dapat mempromosikan kual- Bhatnagar, S., Gielen, J., Satija, A., Singh, S., Noble,
itas hidup yang baik bagi pasien kanker melalui pen- S., & Chaturvedi, S. (2017). Signs of spiritual
ingkatan koping dan dukungan sosial. distress and its implications for practice in In-
dian Palliative Care. Indian Journal of Palliative
Care, 23(3), 306. https://doi.org/10.4103/IJPC.
KESIMPULAN
IJPC_24_17
Tinjauan dalam literature review penelitian ini
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L.,
mendapatkan hasil Pemenuhan spiritual dapat
Torre, L. A., & Jemal, A. (2018). Global cancer
meningkatkan kualitas hidup pasien kanker. Selain itu
statistics 2018: GLOBOCAN estimates of inci-
hasil dari penelitian menunjukan bahwa dengan pe-
dence and mortality worldwide for 36 cancers in
menuhan spiritual dapat memberikan kedamaian, dan 185 countries. CA: a cancer journal for clinicians.
kenyamanan pada pasien kanker. Sehingga penting- Caldeira, S., Timmins, F., de Carvalho, E. C., & Vie-
nya kebutuhan spiritual dalam perawatan kesehatan. ira, M. (2017). Spiritual Well-Being and Spiritu-
al Distress in Cancer Patients Undergoing Che-
DAFTAR PUSTAKA motherapy: Utilizing the SWBQ as Component
Ahmadi, Z., Darabzadeh, F., Nasiri, M., & Askari, M. of Holistic Nursing Diagnosis. Journal of Reli-
(2015). The effects of spirituality and religiosity gion and Health, 56(4), 1489–1502. https://doi.
on well-being of people with cancer: A literature org/10.1007/s10943-017-0390-4
review on current evidences. Jundishapur Journal Christmals, C. (2018). An integrative literature review
of Chronic Disease Care, 4(2). framework for postgraduate nursing research reviews.
Al-Natour, A., Al Momani, S. M., & Qandil, A. M. Cultural Awareness in Nursing and Health Care, Second
A. (2017). The Relationship Between Spiritu- Edition: An Introductory Text. (2010). Routledge.
ality and Quality of Life of Jordanian Women https://doi.org/10.1201/b13655
Diagnosed with Breast Cancer. Journal of Reli- Dewi, M. (2017). Sebaran Kanker di Indonesia, Riset
gion and Health, 56(6), 2096–2108. https://doi. Kesehatan Dasar 2007. 11(1), 8.
org/10.1007/s10943-017-0370-8 Forouzi, M., Tirgari, B., Safarizadeh, M., & Jahani,
Bai, M., Dixon, J., Williams, A., Jeon, S., Lazenby, M., Y. (2017). Spiritual needs and quality of life of
& McCorkle, R. (2016). Exploring the individu- patients with cancer. Indian Journal of Palliative
al patterns of spiritual well-being in people newly Care, 23(4), 437. https://doi.org/10.4103/IJPC.
diagnosed with advanced cancer: A cluster analy- IJPC_53_17
sis. Quality of Life Research, 25(11), 2765–2773. Garssen, B., Uwland-Sikkema, N. F., & Visser, A.
https://doi.org/10.1007/s11136-016-1328-0 (2015). How Spirituality Helps Cancer Patients
Bai, M., Lazenby, M., Jeon, S., Dixon, J., & McCork- with the Adjustment to their Disease. Journal of
le, R. (2015). Exploring the relationship between Religion and Health, 54(4), 1249–1265. https://
spiritual well-being and quality of life among doi.org/10.1007/s10943-014-9864-9
patients newly diagnosed with advanced cancer. Kemenkes RI. (2018)
Palliative and Supportive Care, 13(4), 927–935. Nuraeni, A., Nurhidayah, I., Hidayati, N., Sari, C. W.
https://doi.org/10.1017/S1478951514000820 M., & Mirwanti, R. (2015). Kebutuhan Spiritual
Barton, K. S., Tate, T., Lau, N., Taliesin, K. B., Wald- pada Pasien Kanker. 3, 10.
man, E. D., & Rosenberg, A. R. (2018). “I’m Nuraini, T., Andrijono, A., Irawaty, D., Umar, J., &
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Gayatri, D. (2018). Spirituality-focused palliative

care to improve indonesian breast cancer patient
comfort. Indian Journal of Palliative Care, 24(2),
196. https://doi.org/10.4103/IJPC.IJPC_5_18
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ty, Distress and Posttraumatic Growth in Breast
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57(5), 1606–1617. https://doi.org/10.1007/
s10943-017-0452-7
Phenwan, T., Peerawong, T., & Tulathamkij, K.
(2019). The Meaning of Spirituality and Spiritual
Well‑Being among Thai Breast Cancer Patients:
A Qualitative Study. Indian Journal of Palliative
Care, 25(1), 6.
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V., Xu, H., Cabling, M. L., He, J., Sutton, A.
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& Nurdin, E. A. (2019). Spiritual Experience
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Table 1. karakteristik jurnal

Peneliti/ (Tujuan) Hasil

No Judul Design penelitian
tahun
1. Barton et al., 2018 “I’m Not a Spiritual describe spiritual narratives Methods: mixed-methods, pro- Those who endorsed religiousness tended to cite faith
Person.” How Hope among AYAs based on their spective, longitudinal cohort study, as a source of strength, whereas many who declined
Might Facilitate Conver- self-identification as religious, AYAs (14-25 years-old) with newly this self-identity explicitly questioned their pre-existing
sations About Spirituality spiritual, both, or neither; and. diagnosed cancer. One-on-one, beliefs. Regardless of self-identified “religiousness” or
Among Teens and Young identify language to support AYA semi-structured interviews were “spirituality,” most participants endorsed quests for
Adults With Cancer spiritual needs in keeping with conducted at 3 time-points (with- meaning, purpose, and/or legacy, and all included con-
their self-identities. in 60 days of diagnosis, 6-12, and structs of hope in their narratives.
12-18 months later), and included
queries about spirituality, God/prayer,
meaning from illness, and evolving
self-identity.
2. Bai et al., 2015 Exploring the relation- The purpose of our study was to The study was designed as a secondary Our results confirm
ship between spiritual examine spiritual well-being and data analysis of a cluster random- that patients newly diagnosed with advanced
well-being and quality of quality of life as well as their ized clinical trial involving patients cancer experienced an existential crisis, improved,
life among patients newly interrelationship in 52 patients with stage 3 or 4 cancer undergoing and then stabilized over time
diagnosed with advanced with advanced cancer after 100 treatment.
cancer days since the diagnosis at one
and three months post-baseline
3. Garssen et al., 2015 How Spirituality Helps the aim of the present study was Consensual Qualitative Research The results of the present study indicate that the role of
Cancer Patients with to unravel the spiritual mecha- method for the analysis of semi-struc- spirituality in emotion regulation deserves attention in
the Adjustment to their nisms that help people in their tured interviews understanding how spirituality helps cancer patients to
Disease adjustment to the disesase adjust to their disease.

4. Caldeira et al., 2017 Spiritual Well-Being and This research aimed to analyze Kuantitaitf, cross-sectional study, The This research aimed to analyze spiritual well-being and
Spiritual Distress in Can- spiritual well-being and spiritual sample comprised 169 patients spiritual distress in cancer patients
cer Patients Undergoing distress in cancer patients undergoing chemotherapy and through this means to
Chemotherapy: Utilizing undergoing chemotherapy and proffer a reliable assessment that
the SWBQ as Compo- through this means to proffer a would contribute to the accuracy of the nursing diagno-
nent of Holistic Nursing reliable assessment that sis of spiritual distress in patients by
Diagnosis would contribute to the accuracy nurses.
of the nursing diagnosis of spiri-
tual distress in patients by
nurses.
5. Phenwan et al., 2019 The Meaning of Spir- The aim of the study is to assess Design: Descriptive qualita-tive phe- Three themes emerged with five subthemes: (1) feeling
ituality and Spiritual the meaning of spirituality and nomenology design. life worthwhile, (2) sense of belonging in the commu-
Well‑Being among Thai SWB in Thai breast cancer Subjects and Methods: In‑depth nity, and (3) feeling connected to the nature. Conclu-
Breast Cancer Patients: A patients in Southern Thailand interview with stratified purposive sions: For Thai women, who have breast cancer, their
Qualitative Study where people have more diverse sampling method. spirituality focuses on family, mainly their children.
cultural and religious back-
ground

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6. Sheppard et al., 2018 Spirituality in Afri- the aims of this study were to: Descriptive analysis was conducted Results:
can-American Breast describe levels of spirituality. to assess demographic, clinical, and Overall levels of spirituality were high and ranged from
Cancer Patients: Impli- identify patient-level sociocultur- psychosocial characteristics for African 11 to 36. participants endorsed that they were aware of
cations for Clinical and al correlates of spirituality; and Black patients. Wald Chi-square test the presence of God in their life
Psychosocial Care test for associations between spir- was used to examine theassociation (98.5% agreed/strongly agreed) and that they had a
ituality and women’s treatment between each variable and the out- personal relationship with God (97.5%
attitudes and healthcare ratings come variable, religiosity score. agree/strongly agree).
or health care.
7. Al-Natour et al., 2017 The Relationship Be- The aim of the study was to Descriptive crosssectional design. Par- highest of correlation was seen between spirituality and
tween Spirituality and investigate the relationship be- ticipants of the study are women who the functional domain/ Spiritual intervention could
Quality of Life of Jorda- tween spirituality and quality of were seeking care and treatment at contribute to increased functional, social, and physical
nian Women Diagnosed life (QoL) of Jordanian women the outpatient clinics of King Hussein well-being and enhance the total health and QoL of
with Breast Cancer diagnosed with breast cancer Cancer Center (KHCC) at Jordan. A women diagnosed with breast cancer.
total of 150 women diagnosed with
breast cancer, on active treatment, and
are stable physically as perceived by
them.

8. Bhatnagar et al., 2017 Signs of spiritual distress The aim of the current study, Data from 300 adult cancer patients Most participants believed in God or a higher power .
and its implications for First, to describe the most com- who had completed a question- Women were more likely to consider illness their fate,
practice in Indian Pallia- mon signs of spiritual distress . naire with 36 spirituality items were be worried about the future of their children or spouse
tive Care As part of that aim, we planned analyzed. We calculated frequencies and be angry about what was happening to them.
to explore gender differences and percentages, and we compared
in spirituality. Second, we responses of male and female partici-
wanted to formulate concrete pants using Chi‑squared tests.
recommendations to empower
palliative care professionals and
volunt- eers in India to more
efficiently address spiritual
distress.
9. Forouzi et al., 2017 Spiritual needs and qual- This study was conducted to de- This correlational study, sample of The results of the present study suggest that information
ity of life of patients with termine the relationship between 150 eligible cancer patients . Using about the relationship between spiritual needs and QoL
cancer spiritual needs and QoL among two questionnaires; the spiritual needs in patients with cancer. It should be improve QoL to
cancer patients in Iran. survey and the European Organiza- meet spiritual need of these patients.
tion for Research and Treatment of
Cancer QoL Questionnaire

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10. Rassouli et al., 2015 Spiritual needs of cancer This study was conducted to qualitative using to purposive sam- 4 themes :
patients: A qualitative explain spiritual needs of cancer pling. Participants were Connection
study patients in Iran. patients with diagnosis of cancer, Seeking peace
Data were collected using semi‑struc- Meaning and purpose
tured interviews.Interviews were Transcendence
recorded with permission of patients.

11. Nuraini et al., 2018 Spirituality-focused the aimed to develop a path cross-sectional study palliative care significantly improved breast cancer
palliative care to improve model of the relationships Participant : 308 breast cancer patient comfort by reducing anxiety and depression. a
indonesian breast cancer between the variables of nursing patients from 3 referral hospitals in Ja- significant positive relationship between spirituality and
patient comfort care (information, emotional karta, Indonesia. Kolcaba’s theory was emotional well-being.
support, technical support, and used to develop a theoretical model
palliative care),patient coping, estimating the path or relationships
family support, patient spirituali- between the key variables.
ty, and patient comfort

12. Paredes & Pereira, Spirituality, Distress and This study aimed to analyze the Data collection using questionnaire. Results showed an association between PTG, spiritu-
2018 Posttraumatic Growth in relationship between PTG, spir- Pearson correlation tests were used ality and distress. Women with a longer diagnosis and
Breast Cancer Patients ituality and emotional distress, to examine the relationship between recurrence showed more distress. Younger age, recurrent
and to determine the predictors variables. cancer and spirituality predicted higher PTG.
of PTG.

13. Walker et al., 2017 The Relationships Be- Findings in the current study Descriptive statistical analysis was Findings in the current study reflect a strong association
tween Spiritual Well-Be- reflect a strong association conducted for all measures and patient between patients’ subjective sense of Meaning/Peace and
ing, Quality of Life, and between patients’ subjective sense characteristics. Pearson’s correlation their quality of life.
Psychological Factors of Meaning / Peace and their coefficient was computed and tested
Before Radiotherapy for quality of life. to determine the strength of linear
Prostate Cancer association between the measured
constructs of interest.
14. Bai et al., 2016 Exploring the individ- This study aimed to examine analysis of a cluster randomized revealing contrasting relations of faith with QOL.
ual patterns of spiritual individual patterns of spiritual clinical trial with patients newly diag- Cluster 1, Cluster 3, and Cluster 4 represented high,
well-being in people well-being among patients newly nosedwith advanced cancer under- medium, and low levels of overall QOL, respectively,
newly diagnosed with diagnosed with advanced cancer. going treatment. Participants (46 % with correspondingly, medium, and low levels of peace,
advanced cancer: a cluster female) were predominantly white (89 meaning, and faith. Cluster 2 was distinguished from
analysis %), well-educated (73 % college edu- other clusters by its medium levels of overall QOL,
cation or more),and homogeneously peace, and meaning and low level of faith.
newly diagnosed with advanced cancer
(stage III or IV).

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