A systematic review of spiritual distress and needs among patients with cancer

Abstract

Chronic illnesses such as cancer often lead to spiritual distress and unmet spiritual needs. These conditions cause patients to lose their sense of meaning in life and daily purpose. Furthermore, spiritual issues may have a significant impact on physical and psychosocial domains. However, reviews focusing on both aspects of spiritual distress and need are limited in the databases. Therefore, this project aims to synthesize quantitative evidence on the prevalence of spiritual distress and needs, and to identify its characteristics among patients with cancer. Of the various types of reviews, a systematic review was selected because it is well-suited to answer the review's objectives. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used during the process. The review involved four online databases, including PubMed, Scopus, Science Direct, and Taylor & Francis. Literature searches were conducted from August 2022 to June 2025. Two reviewers independently screened potentially eligible articles, and those meeting the eligibility criteria underwent quality appraisal using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Of 3745 potentially eligible studies, 17 were included in the review. Patients reported unmet spiritual needs that varied across geographic locations, including desires for prayer, inner peace, connection with significant others, and kindness. Spiritual needs were associated with psychological factors such as anxiety and depression. A high prevalence of spiritual distress was found among patients with cancer. Patients' spiritual distress and needs were influenced by demographic, clinical, and psychological variables. Therefore, establishing adequate assessment and appropriate spiritual care is fundamental for nurses working in the cancer area.

Keywords: Cancer, inner peace, prayer, religiosity, spiritual anguish, spiritual distress, spiritual need, spiritual pain