Faith among patients with advanced cancer. A pilot study on patients offered "no more than" palliation

Spiritual wellbeing is an important topic in cancer care. Being religious i s reported by patients facing dilemmas concerning the quality and meaning o f life to be potentially helpful. However, the fear of death may be close t o the surface and easily stimulated. The aim of this study was to clarify p atients' attitudes to faith. Between February 1998 and February 1999, 20 pa tients aged 37-74 years and suffering from ten different incurable cancers were enrolled in the study. An interview technique focusing on the topic by way of an open question about faith was employed. The topic was only conti nued if the patient signalled a clear wish for this. Half the patients had a close relative present during the conversation, and an oncology nurse was present in all cases. Most patients (18, or 90%) intimated that the topic was of interest: 85% responded by saying they believed in God, and 75% repo rted that they prayed. A quarter (25%) mentioned that they had visited thei r local Lutheran pastor before their admission to hospital. One patient rep orted being a Jehovah's Witness and one, a member of the Norwegian Humanist ically Ethical Association (HEA). Following the conversation, 4 patients re quested a visit from the hospital chaplain, 1 asked for contact with the Sa lvation Army to be arranged, and 1 wanted to talk to the local leader of HE A. Following the conversation all patients were observed by a nurse, and no raised level of anxiety was reported. Sixteen of the patients died within a median of 18 (1-180) days after the conversation. In conclusion, most pat ients responded positively to a question about faith. The topic should be a ddressed in the treatment of patients with advanced disease. However, care must be taken to avoid frightening the patients. Patients' attitudes with r egard to what death brings deserve respect.