Nursing care of patients with advanced cancer is challenging because it touches many dimensions of a patient’s life. The study of spiritual pain is relatively new although potentially very important in understanding how to help patients with advanced cancer achieve a sense of well-being. The purpose of this pilot study was to increase scientific knowledge from the participants‟ perspectives about experiences of spiritual pain and physical pain, and identify correlates of well-being from the participants‟ own perspectives in the context of advanced cancer. Four research questions were examined in this study: 1. What is the relationship between physical pain and spiritual pain, as perceived by participants who have advanced cancer? 2. What is the relationship between spiritual pain and existential well-being, as perceived by participants who have advanced cancer? 3. What is the relationship between spiritual pain and physical pain in the context of the demographic and health-related variables of age, gender, years of education, and months since diagnosis? 4. What factors do participants with advanced cancer identify as important to their existential well-being? A descriptive correlational design was used to study the research questions in a convenience sample of 30 adult participants from an outpatient oncology clinic in Southern Arizona. Quantitative data were obtained through interviews using the Providence Saint Vincent Medical Center Pastoral staff’s Spiritual Pain Assessment Tool and Paloutzian and Ellison’s (2009) Existential Well-Being Scale, and a Physical Pain Rating scale along with a demographic and health-related form. Qualitative data were also obtained from the participants. Descriptive, correlational, and content analyses generated results of a significant relationship between Spiritual Pain and Existential Well-Being, and a non-significant relationship between Physical Pain and Spiritual Pain. The following themes (with the first three being most frequently mentioned) were identified as important to the participants‟ well-being during their experience of advanced cancer: Meaningful activity, family and friends, and spiritual aspects, followed by health/nutrition, symptom management, and finances. Results warrant continued research into spiritual pain as it relates to existential well-being in persons with advanced cancer

Face à l’adversité, les individus semblent se diriger vers la spiritualité et l’utiliser comme une ressource personnelle pour s’ajuster aux événements de vie difficiles. Complexe à analyser, la spiritualité est un domaine de recherche, relativement récent, qui montre un intérêt croissant dans la littérature scientifique outre-Atlantique. En France, cet objet d’étude ayant été peu exploré, il est important d’apporter une meilleure compréhension de son effet sur la santé.L’objectif de cette recherche est d’examiner les effets potentiels de la spiritualité en lien avec des indicateurs de la santé tels que les troubles anxio-dépressifs et la qualité de vie, et d’identifier les ressources spirituelles pouvant jouer un rôle sur la qualité de vie.Une double méthodologie a été utilisée. Le volet qualitatif est constitué de trois études : la première concerne une population d’étudiants (n=219), la seconde est formée d’une population souffrant d’un cancer (n=42) et la troisième vise une population cardiaque (n=46).Les instruments de recherche comprenaient l’évaluation de la spiritualité (DSES, IWSRI, SWBS), les troubles anxio-dépressifs (HADS) et la qualité de vie (WHOQOL-bref). Le volet quantitatif se base sur des entretiens semi-directifs menés auprès d’une population d’étudiants(n=14) et de malades cardiaques (n=9).De manière générale, les résultats montrent que la spiritualité, mesurée par le bien-être existentiel, indique une relation à la détresse psychologique et à la qualité de vie, et ce, dans nos trois populations. La spiritualité semble également, au travers de certains indicateurs, influencer la qualité de vie, soit seule, soit en combinaison avec la détresse psychologique. Il est à noter que la spiritualité peut influencer la qualité de vie de manière positive mais aussi de manière négative.La spiritualité indique un potentiel thérapeutique par son influence sur la qualité de vie et soulève l’importance de son étude et de son rôle dans le cadre de la santé. / Facing with adversity, individuals may turns to spirituality and use it as a personal resource to cope difficult life events. Complex to analyze, spirituality is an area of research, relatively recent across the Atlantic, revealing a growing interest in the scientific literature. In France, this matter’s being little explored, so it is worth to provide a better understanding of its effect on health.The aim of this study was to access the potential effect of spirituality in relation to health’s indicators, such as anxiety, depression and quality of life, and to identify spiritual resources that may have a role in the quality of life as well.A mixed methodology was used. The qualitative component consists in three studies: the first concerns a student population (n = 219), the second consists in a population suffering from cancer (n = 42) and the third is a cardiac population (n = 46). Research instruments included assessment of spirituality (DSES, IWSRI and SWBS), anxiety and depression (HADS) and quality of life (WHOQOL-BREF). The quantitative component is based on semi-directive interviews conducted with both student population (n = 14) and cardiac patients (n = 9).Generally, results demonstrate that spirituality, as measured by the existential well-being, involve a relationship with psychological distress and quality of life with respect to those three populations. Spirituality also seems, through some indicators, to have an impact on the quality of life, either alone or in combination with psychological distress. It should be noted that spirituality may influence the quality of life positively but negatively as well.The spirituality reveals therapeutic potential by its influence on quality of life and raise the usefulness of studying spirituality in the context of health.

Bakgrund Den existentiella dimensionen av omvårdnad kan uppfattas som svår att både definiera, studera och utöva. I den palliativa vården, när livets slut blir en realitet, är de existentiella frågorna mer aktuella än någonsin och sjuksköterskan har en viktig roll i att bemöta de behov som uppstår. Syfte Syftet med litteraturöversikten är att sammanställa aktuell forskning kring faktorer som påverkar existentiellt välbefinnande hos patienter som vårdas palliativt. Metod Arbetet utfördes som en litteraturöversikt där 13 vetenskapliga artiklar undersöktes genom innehållsanalys. Artiklarna valdes ut genom systematiska databassökningar. Artiklar med kvalitativ, kvantitativ, samt mixad metod inkluderades. Resultat De mest betydelsefulla faktorerna för att främja existentiellt välbefinnande hos patienter som vårdas palliativt innefattar andligt stöd, religiös tro, förmåga att känna mening, fungerande copingstrategier, bibehållen känsla av kontroll och sociala relationer. Slutsats Bland de faktorer som påverkar existentiellt välbefinnande hos patienter som vårdas palliativt är både inre och yttre resurser representerade. Bland de yttre resurserna utmärkte sig goda nära relationer som en viktig skyddsfaktor. Inre resurser såsom andlighet, religiös tro, inre styrka, acceptans, samt förmåga att skapa mening, emotionell balans och harmoni, kunde alla bidra till ökat existentiellt välbefinnande. / Background The existential dimension of nursing can be hard to define, study and practice. In palliative care, when death is suddenly a reality, existential matters are more relevant than ever, and nurses have a vital role in meeting any needs that can arise. Aim The aim of this literary review is to compile research on factors influencing the existential well-being of patients receiving palliative care. Method The study was carried out as a literary review where 13 articles were studied through content analysis. The articles were selected through systematic database searches. Articles of qualitative, quantitative and mixed method were included. Results The most important factors in fostering existential well-being include spiritual support, religious faith, ability to find meaning, well-functioning coping strategies, maintained sense of control and social relations. Conclusions Among the factors influencing existential well-being in patients receiving palliative care,both internal and external resources are represented. Outer resources included close relationships which proved to be a protective factor. Internal resources such as spirituality, religious faith, inner strength, acceptance, as well as the ability to find meaning, emotional balance, and harmony, could all help increase existential well-being.

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