Spiritual Well-being in Patients With Metastatic Colorectal Cancer Receiving Noncurative Chemotherapy: A Qualitative Study

BACKGROUND: Spiritual well-being (SWB) is an important quality-of-life dimension for cancer patients in the palliative phase. Therefore, it is important for healthcare professionals to recognize the concept of SWB from the patient’s point of view. A deeper understanding of how patients experience and reflect upon these issues might influence patient care. OBJECTIVES: The aim of this study was to explore SWB in colorectal cancer patients receiving chemotherapy in the palliative phase. METHODS: We used a qualitative method of in-depth interviews and a hermeneutic editing approach for the analyses and interpretations. RESULTS: Twenty colorectal cancer patients in the palliative phase, aged 34 to 75 years, were included: 12 patients were receiving first-line chemotherapy, and 8 patients were receiving second-line chemotherapy. Through empirical analyses, we identified subthemes according to the SWB dimensions defined by the European Organisation for Research and Treatment of Cancer quality-of-life group. Under the SWB dimension, (i) relationships with self and others, we identified the subthemes: (a) strategies for inner harmony and (b) sharing feelings with significant others. Under the dimension, (ii) existential issues, we identified the subtheme (c) coping with end-of-life thoughts. Under the dimension, (iii) specifically religious and/or spiritual beliefs and practices, we identified the subtheme (d) seeking faith as inner support. CONCLUSION: Knowledge about cancer patients’ use of different strategies to increase their SWB may help healthcare professionals to guide patients through this vulnerable phase. IMPLICATION FOR PRACTICE: Healthcare professionals need sufficient courage and willingness to share their patients’ thoughts, beliefs, and grief to be able to guide patients toward improving their SWB.