196936 Spirituality and quality of life in low-income men with metastatic prostate cancer

Monday, November 9, 2009: 2:35 PM

Mary Wassel Zavala, MA , Department of Urology, UCLA, Los Angeles, CA
Sally L. Maliski, RN, PhD , Nursing, UCLA, Los Angeles, CA
Lorna Kwan, MPH , Division of Cancer Prevention Control and Research, Jonsson Comprehensive Cancer Center, School of Public Health, UCLA, Los Angeles, CA
Arlene Fink, PhD , Division of General Internal Medicine; Department of Health Services, UCLA, Pacific Palisades, CA
Mark S. Litwin, MD, MPH , Urology and Health Services, David Geffen School of Medicine at UCLA, Los Angeles, CA
Little in human experience is more difficult than a disease for which there is no cure. It undoubtedly raises existential concerns of mortality and purpose. This leads many patients to seek comfort in their spirituality, which may improve their ability to cope with their disease.

While a positive relationship between spirituality and the quality of life (QOL) of chronically-ill patients has been established in the literature, a study of this relationship in men with metastatic prostate cancer was noticeably absent. This presentation describes the association between spirituality and health-related quality of life (HRQOL) in an ethnically-diverse cohort of low-income men with metastatic prostate cancer. Following a diagnosis of metastatic disease, 86 uninsured, low-income men enrolled in a state-funded program providing free prostate cancer treatment completed a survey containing validated measures of spirituality and general and disease-specific HRQOL. Multivariate analyses were used to assess the effect of spirituality and its two subscales, faith and meaning/peace. Greater spirituality was associated with better HRQOL and psychosocial function. When assessing spirituality subscales, meaning/peace closely tracked with HRQOL. In the absence of high meaning/peace scores, higher faith scores were negatively associated with HRQOL.

This study confirms the positive association between spirituality and HRQOL and provides insight as to how religious faith and life meaning/peace may relate differently to HRQOL. Based on our findings, we encourage clinicians to be mindful of the relationship between spirituality and HRQOL, utilize techniques that may improve patients' spirituality, and recognize potential barriers to working with spirituality in clinical settings.

Learning Objectives:
1. Describe the association between spirituality and health-related quality of life among low-income, uninsured men treated for prostate cancer. 2. Compare the differing associations of the two spirituality subscales, faith and meaning/peace, with psychosocial and health-related quality of life. 3. Discuss implications for clinical practice, including barriers to working with spirituality and successful interventions for improving spirituality in chronically-ill patients.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed, conducted and authored the study being evaluated for presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.