Spirituality and associated factors among cancer patients undergoing chemotherapy.

AIM: Patients' spirituality, the relationship between spirituality and physical pain, and the association between spirituality and quality of life (QOL) among patients undergoing cancer chemotherapy were examined. Spirituality was defined as a sense of meaning in one's existence and life, peace of mind, and the strength and comfort drawn from faith. METHODS: A cross-sectional questionnaire survey was distributed to 176 adult cancer patients who received chemotherapy in May-September 2011 at an outpatient clinic in rural Japan. Spirituality was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12). Demographic data were collected for performance status, cancer stage, age, marital status, occupational status, persons in household, pain intensity, and other troubling symptoms. The relationship between the patients' spirituality subscale score and QOL was assessed in a structural equation model. RESULTS: Two FACIT-Sp-12 subscales, meaning/peace and faith, were moderately to strongly associated with age, appetite, and QOL scores. Although physical pain was significantly related to the QOL score (P = .002), it was not related to the FACIT-Sp-12 score (P = .427). These results indicated that the patients with higher spiritual scores and severe pain were enjoying life more than the patients with lower spiritual scores and severe pain. Moreover, two subscales of the FACIT-Sp-12 had a direct effect on QOL. CONCLUSIONS: Spirituality was strongly associated with QOL. Younger patients (<50 years old) and stage I cancer patients need additional assistance to meet their spiritual needs. To maintain cancer patients' spiritual well-being, nursing interventions should facilitate patients' nutrition support and appropriately address their spirituality.

Cost information of chemotherapy for cervical and endometrial cancer in Japan.

AIM: Treatment cost is one of the biggest concerns for cancer patients. Providing information to cancer patients about treatment cost and available financial support contributes to high-quality care. The aim of this study was to determine chemotherapy costs and other medical care expenditures for patients with cervical and endometrial cancer. METHODS: Data from the Diagnosis Procedure Combination system, which is the Japanese version of the Diagnosis-related Group system, were used to identify 179 patients with cervical cancer and 244 patients with endometrial cancer who received chemotherapy from 2008-2010 at a specialized cancer hospital. The costs of chemotherapy per bolus, various protocols, and other medical care expenditures were investigated. RESULTS: The cost per bolus of chemotherapeutic agents varied from ¥13,804-258,906 ($US 173-3236). The total medical cost for each course, including supportive care and treatment for chemotoxic symptoms, ranged ¥22,230-590,140 ($US 278-7377). Fourteen protocols were used in this population. Multiple regression analysis revealed that the factors related to the total medical care cost for cervical cancer were cost of chemotherapeutic agents, laboratory tests, oral medications, number of complications, and age. For endometrial cancer, cost of chemotherapeutic agents, laboratory tests, and oral medications were the factors related to the total medical care costs. CONCLUSION: The cost of various chemotherapy protocols and the total medical care was determined using the Diagnosis Procedure Combination system. Nurses should give the information about treatment cost and discuss the cost with patients to facilitate high-quality care.