Abstract
Background: Religious and spiritual beliefs can influence adjustment to medical treatments and outcomes. This mixed methods cross-sectional study examined spiritual quality of life (QOL) of long-term colorectal cancer survivors with permanent intestinal ostomies.
Methods: Men (n=88) and women (n=55) with ostomies whose total scores fell in the upper (n=71) or lower (n=72) quartiles of the validated City of Hope Quality-of-Life ostomy-specific (COHQOL-O) survey provided quantitative and qualitative data regarding spiritual dimensions of QOL. Analyses included chi-square and analysis of variance ± standard deviations with significances set at P<0.05. Content analysis was used to explicate meanings for spirituality items in survey narratives and focus groups.
Results: The high COHQOL-O group was significantly more likely to be older (74±9 vs. 70±1.3, P<0.01) and married or partnered (72% vs. 55%, P<0.03). Upper quartile subjects had more favorable scores for the spiritual items Sense of Inner Peace, Hopeful, Reason to be Alive, and support from spiritual (e.g., prayer) and religious (e.g., church) activities compared to the lower quartile (all P<0.0001). The two groups did not differ for the item Positive Changes in life related to having an ostomy. Qualitative comments made by participants reflected the meaning of their high or low spiritual QOL scores.
Conclusions: Spiritual dimensions of QOL are significantly influenced by an intestinal stoma. Qualitative comments provided insight into the meanings and live experiences related to the spirituality items. Persons with ostomies report less inner peace, feeling less hopeful, not having a reason to be alive, as well as fewer spiritual and religious activities for coping. An understanding of these factors will facilitate integration of holistic care and treatment in this population.
- Received September 11, 2008.
