Spiritual Care in Oncology: A Twelve-Month Cohort of Three Hundred and Twenty-Four Patients Across Cancer Types and Care Phases Spiritual Distress Patterns, Intervention Outcomes, and Modifiable Determinants

Abstract

Spirituality represents a domain of patient experience long recognised as important in cancer care yet inconsistently integrated into structured oncology practice. The International Consensus Conference on Spiritual Care in Cancer recommended structured spiritual screening, assessment, and care across cancer care settings. We undertook a 12-month prospective cohort study of 324 cancer patients across five tumour categories with integrated spiritual care service availability and structured engagement measurement. Spiritual concerns at baseline differed substantially by tumour type: lung cancer patients showed highest meaning/purpose concerns (52%) and haematological cancer patients showed highest fear/anxiety concerns (52%). Spiritual care intervention produced measurable benefits across multiple outcome domains with largest effect sizes for spiritual wellbeing (Cohen's d 1.84), existential meaning (1.62), and faith integration (1.48), and smaller but meaningful effects for depression, anxiety, pain, and quality of life. 12-month quality-of-life maintenance was achieved by 62% of high-engagement patients versus 32% of low-engagement patients. Strongest predictors of spiritual care benefit included pre-existing religious practice, active treatment, recent diagnosis, existential distress, family caregiver participation, trained spiritual provider availability, and multilingual/multifaith service infrastructure.

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