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Predictors of spirituality at the end of life.

OBJECTIVE
To assess the relationship between spirituality and hopelessness, desire for hastened death, and clinical and disease-related characteristics among patients with advanced cancer, and to investigate predictors of spirituality. Spiritual well-being is thought to have a beneficial effect on patients' response to illness.


DESIGN
Patients were asked to complete 4 questionnaires: the Greek version of the Spiritual Involvement and Beliefs Scale, the Greek version of the Schedule of Attitudes toward Hastened Death, the Beck Hopelessness Scale, and a questionnaire on demographics.


SETTING
A palliative care unit in Athens, Greece.


PARTICIPANTS
A total of 91 patients with advanced cancer.


MAIN OUTCOME MEASURES
Associations between scores on the Spiritual Involvement and Beliefs scale and scores on the Schedule of Attitudes toward Hastened Death scale and the Beck Hopelessness scale, and demographic characteristics.


RESULTS
Statistically significant associations were found between spirituality and sex of patients (P = .001) and spirituality and stronger hopelessness (r = 0.252, P = .016). In multivariate analyses, stronger hopelessness, male sex, younger age, and receiving chemotherapy were found to be the strongest predictors of being spiritual.


CONCLUSION
Demographic and clinical characteristics and stronger hopelessness appeared to have statistically significant relationships with spirituality. Interventions to improve patients' spiritual well-being should take these relationships into account.