Relationships among depressive symptoms, spiritual well-being, and quality of life in primary liver cancer patients in Korea

Monday, 18 November 2013: 10:40 AM

Eunsuk Lee, PhD, RN
College of Nursing, Kent State University, Kent, OH
Joyce J. Fitzpatrick, PhD, RN, FAAN
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH

Learning Objective 1: The learner will be able to engage their clinical experiences into the evidence-based practice settings.

Learning Objective 2: The learner will be able to create and synthesize the body of knowledge in order to engage in collaboration across specialties and cultural diversities.

Primary liver cancer is the most common type of solid tumors affecting young to middle-aged individuals and the second leading cause of death in Korea. However, very little research has been conducted. The purpose of this study is to explore the relationships among depressive symptoms, spiritual well-being, and quality of life in primary liver cancer patients. A cross-sectional design was utilized and 96 patients were consecutively recruited. As for the theoretical framework, Fitzpatrick’s Live Perspective Rhythm Model was utilized.

To measure the study variables, the CES-D Scale for depressive symptoms (Cronbach’s α=.80), the Spiritual Well-Being Scale (Cronbach’s α=.89) for spiritual well-being, and the SF-12 (Cronbach’s α=.89) for QOL were used.

In conclusion, there were significant negative correlations: between depressive symptoms and spiritual well-being; between depressive symptoms and QOL-PCS (physical component summary); between depressive symptoms and QOL-MCS (mental component summary). There were significant positive correlations: between spiritual well-being and QOL-PCS; between spiritual well-being and QOL-MCS. In the QOL-PCS regression equation, spiritual well-being was the strongest predictor. In the QOL-MCS regression equation, the strongest predictor was depressive symptoms; spiritual well-being served as a moderator.

Based on the findings, the patients who showed critical spiritual distress or serious depressive symptoms and who needed immediate medical attention were referred to their doctors for further assessment. Findings from the analyses were important in capturing more detailed insight into the research models and in identifying areas of needed intervention for the vulnerable populations. The history of nursing highlights the compassionate care for dying patients using holistic approaches and postulates that human caring exists beyond the possibility of cure. Given the high vulnerability of the liver cancer patients, findings from this study may guide others to a wide range of possibilities for future nursing research, practice, and education.