Self-Transcendence: Association with Spirituality in an Italian Sample of Terminal Cancer Patients

In terminally ill cancer patients nearing the end of life, demoralization strongly undermines spiritual wellbeing, while self-transcendence and positive religious coping may protect it. Among 141 end-stage patients with a life expectancy of four months or less, demoralization was the strongest negative influence on spirituality, followed by self-transcendence (a protective factor) and positive religious coping (a smaller protective factor). These factors together predicted 67% of the variation in spiritual wellbeing. The findings suggest that supporting self-transcendence and positive religious coping could help preserve spiritual wellbeing and improve quality of life at the end of life.

Study at a glance

Abstract

Terminally ill cancer patients often experience demoralization and loss of dignity, which undermines their spiritual wellbeing, which could, however, be supported by the presence of other factors such as self-transcendence and religious coping strategies. To assess self-transcendence and religious coping strategies and how they influence spirituality, we studied 141 end-stage cancer patients (64.3% male; mean age 68.6 ± 14.6) with a Karnofsky Performance Status ≤ 50 and a life expectancy ≤ 4 months using the Self-Transcendence Scale, the Demoralization Scale, the Functional Assessment of Chronic Illness Therapy—Spiritual Wellbeing (FACIT-Sp-12), the Brief Religious COPE, and the Patient Dignity Inventory. To understand the effects of these variables on spirituality, hierarchical multiple regression was performed on FACIT-Sp-12. The final model predicted 67% of the variance in spiritual wellbeing. Demoralization was the strongest influencing factor (β = −0.727, p < 0.001), followed by self-transcendence (β = 0.256, p < 0.001), and positive religious coping (β = 0.148, p < 0.05). This study suggests that self-transcendence and positive religious coping may be protective factors for spirituality in terminal cancer patients. These factors should be considered in treatment to promote spiritual wellbeing and improve patients’ quality of life at the end of life.