Abstract
OBJECTIVES: Spiritual well-being (SpWB) is a critical yet often underexplored component of holistic care for patients with advanced cancer. This study aimed to assess the SpWB and quality of life (QOL) levels and examine their correlation among patients receiving palliative care at a tertiary cancer centre in Kerala, India. DESIGN: Institution-based cross-sectional observational study among patients with advanced cancer conducted between August 2023 and December 2024. SETTING: The outpatient department of a major tertiary-level, autonomous cancer centre under the Government of Kerala, India. PARTICIPANTS: 398 patients with advanced cancer aged 18 and above. MEASURES: SpWB and QOL were measured using validated Malayalam versions of the Functional Assessment of Chronic Illness Therapy-Spiritual well-being Expanded Version and European Organisation for Research and Treatment of Cancer, Quality of Life Core 30 questionnaires, respectively. Data collection included patient self-reports or assistance by a medical social worker. RESULTS: The median (IQR) age of participants was 59 (51-65) years; most were married (94.5%) and from an upper-lower socioeconomic background (55%). Hinduism was the predominant religion (67.1%). Almost all patients (99%) were aware of their diagnosis, but only 62.3% knew their prognosis. The median (IQR) SpWB score was 67.5 (57-76), significantly higher in females (p=0.02). The median (IQR) QOL score was 50 (41.7-66.7). SpWB was positively correlated with QOL (r=0.766, p<0.01) and negatively correlated with symptoms like constipation, fatigue, nausea, pain, insomnia and appetite loss. CONCLUSIONS: SpWB showed a strong positive correlation with QOL among patients with advanced cancer. Enhancing SpWB may play a pivotal role in improving overall QOL in palliative care settings.