{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:32:53Z","timestamp":1790299973356,"version":"4.1.0"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"unspecified","delay-in-days":111,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1478951525000409_sec1a\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period.<\/jats:p>\n\t    <jats:p><jats:bold>Objectives.<\/jats:bold> This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000409_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy \u2013 Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1\u00a0week, and 1\u00a0month. Data were analyzed using quantitative methods and thematic analysis.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000409_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1\u00a0month (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01). Symptoms such as shortness of breath (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u20131.19, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), drowsiness (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u20131.27, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01), and anxiety (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u20130.60, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.26, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000409_sec4d\">\n\t    <jats:title>Significance of results<\/jats:title>\n\t    <jats:p>Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1478951525000409","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T06:29:52Z","timestamp":1745303392000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approach"],"prefix":"10.1017","volume":"23","author":[{"given":"Er-Jung","family":"Hsueh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Chun","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Hung","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Yu","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-1153","authenticated-orcid":false,"given":"Tsai-Wei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Made Satya Nugraha","family":"Gautama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"S1478951525000409_ref5","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1037\/amp0000418","article-title":"A challenge for psychocardiology: Addressing the causes and consequences of patients\u2019 perceptions of enduring somatic threat","volume":"73","author":"Edmondson","year":"2018","journal-title":"The American Psychologist"},{"key":"S1478951525000409_ref2","doi-asserted-by":"publisher","DOI":"10.1177\/070674370404900605"},{"key":"S1478951525000409_ref19","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2020.1725932"},{"key":"S1478951525000409_ref12","first-page":"1411","article-title":"The mediating role of spirituality (meaning, peace, faith) between psychological distress and mental adjustment in cancer patients","volume":"26","author":"Jimenez-Fonseca","year":"2018","journal-title":"Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer"},{"key":"S1478951525000409_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-016-3417-6"},{"key":"S1478951525000409_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951517000785"},{"key":"S1478951525000409_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000298"},{"key":"S1478951525000409_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6374"},{"key":"S1478951525000409_ref26","unstructured":"World Health Organization (2024) The Global Health Observatory: Health and Well-Being. https:\/\/www.who.int\/data\/gho\/data\/major-themes\/health-and-well-being (accessed 9 August 2024 )"},{"key":"S1478951525000409_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199909\/10)8:5<417::AID-PON398>3.0.CO;2-4"},{"key":"S1478951525000409_ref11","doi-asserted-by":"crossref","DOI":"10.1038\/s41585-021-00491-z","article-title":"Incorporating palliative care principles to improve patient care and quality of life in urologic oncology","volume":"18","author":"Hugar","year":"2021","journal-title":"Nature Reviews Urology"},{"key":"S1478951525000409_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2019.05.007"},{"key":"S1478951525000409_ref9","doi-asserted-by":"publisher","DOI":"10.1177\/20551029221121526"},{"key":"S1478951525000409_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.07.016"},{"key":"S1478951525000409_ref6","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1200\/JCO.2016.70.1474","article-title":"Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update","volume":"35","author":"Ferrell","year":"2017","journal-title":"Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology"},{"key":"S1478951525000409_ref13","first-page":"1022","article-title":"Psychospiritual and existential distress. The challenge for palliative care","volume":"29","author":"Kissane","year":"2000","journal-title":"Australian Family Physician"},{"key":"S1478951525000409_ref20","doi-asserted-by":"publisher","DOI":"10.3390\/rel12110914"},{"key":"S1478951525000409_ref16","doi-asserted-by":"publisher","DOI":"10.1188\/13.ONF.E119-E125"},{"key":"S1478951525000409_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2011.00632.x"},{"key":"S1478951525000409_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/CNJ.0000000000000400"},{"key":"S1478951525000409_ref14","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2019.7837"},{"key":"S1478951525000409_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.5866"},{"key":"S1478951525000409_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.1.101"},{"key":"S1478951525000409_ref10","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1177\/02692163211022179","article-title":"Factors related to spiritual well-being in the last days of life in three East Asian countries: An international multicenter prospective cohort study","volume":"35","author":"Hiratsuka","year":"2021","journal-title":"Palliative Medicine"},{"key":"S1478951525000409_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/42.suppl_3.24"},{"key":"S1478951525000409_ref24","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3943"},{"key":"S1478951525000409_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/sjop.12339"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951525000409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T06:29:56Z","timestamp":1745303396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951525000409\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":27,"alternative-id":["S1478951525000409"],"URL":"https:\/\/doi.org\/10.1017\/s1478951525000409","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e95"}}