Exploring the spiritual detriments of the quality of life among patients with advanced cancers undergoing palliative chemotherapy

Background: Cancers account for 28.7% of total deaths, with the leading cause of death, and this trend is steadily increasing. In South Korea, cancer survival rates have also consistently improved, from 45.2% to 72.9% between 1991 and 2022. As 7 out of 10 cancer patients now survive more than five years, the interest of healthcare providers has shifted beyond merely improving survival rates to enhancing quality of life (QoL). QoL is recognized as an essential indicator in cancer treatment and recovery processes. Especially in patients with advanced cancer, improving QoL during their remaining life span becomes a key therapeutic goal, requiring continuous assessment and interventions. Although existing cumulative evidence for QoL in the cancer population, understanding the spiritual determinants of QoL among patients with advanced cancers undergoing palliative chemotherapy is still limited. This study aimed to explore the spiritual detriments of the QoL among patients with advanced cancers undergoing palliative chemotherapy. Methods: This cross-sectional, descriptive study utilized convenience sampling to recruit participants undergoing palliative chemotherapy at a university hospital between September 2023 and March 2025. Uncertainty, Cancer coping, Spiritual well-being, and QoL were measured by the Korean version of the Mishel Uncertainty in Illness Scale - Adult Form, the Cancer Coping Questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale, and the Cancer-Specific Quality of Life scale, respectively. Demographic and Clinical data were obtained from electronic health records or demographic questionnaires. Multiple regression analysis was performed using SPSS version 30.0. Results: Among a total of 165 participants, 88 (53.3%) were males; the mean age was 54.86 (SD = 8.34) years; 62(37.6%) were diagnosed with colorectal cancers. The average number of chemotherapy sessions was 17.16 (SD =17.03). Pain (beta=-.221, p=.001), uncertainty (beta=-.250, p=<.001), and spiritual well-being (beta=.316, p=<.001), Colorectal cancer (beta=.250, p=.002) explained 37.2% of the variance (adjusted R² of .372) in QoL. Conclusion: To improve the QoL of patients with advanced cancers undergoing palliative chemotherapy, maintaining spiritual well-being is crucial. Holistic assessment of QoL, including spiritual components and management of pain, providing treatment information in a timely manner to reduce uncertainty, should be included in the intervention strategy to improve QoL in patients with advanced cancers.