• Mpho Ratshikana-Moloko, Oluwatosin Ayeni, Jacob M Tsitsi, Michelle L Wong, Judith S Jacobson, Alfred I Neugut, Mfanelo Sobekwa, Maureen Joffe, Keletso Mmoledi, Charmaine L Blanchard, Witness Mapanga, Paul Ruff, Herbert Cubasch, Daniel S O'Neil, Tracy A Balboni, and Holly G Prigerson.
• Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; Centre for Palliative Care, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium (Pty) Ltd, Johannesburg, South Africa. Electronic address: mpho.ratshikana-moloko@wits.ac.za.
• J Pain Symptom Manage. 2020 Jul 1; 60 (1): 37-47.

ContextWhen religious and spiritual (R/S) care needs of patients with advanced disease are met, their quality of life (QoL) improves. We studied the association between R/S support and QoL of patients with cancer at the end of life in Soweto, South Africa.ObjectivesTo identify R/S needs among patients with advanced cancer receiving palliative care services and to assess associations of receipt of R/S care with patient QoL and place of death.MethodsA prospective cohort study conducted from May 1, 2016 to April 30, 2018 at a tertiary hospital in Soweto, South Africa. Nurses enrolled patients with advanced cancer and referred them to the palliative care multidisciplinary team. Spiritual counselors assessed and provided spiritual care to patients. We compared sociodemographic, clinical, and R/S factors and QoL of R/S care recipients and others.ResultsOf 233 deceased participants, 92 (39.5%) had received R/S care. Patients who received R/S care reported less pain (2.82 ± 1.23 vs. 1.93 ± 1.69), used less morphine, and were more likely to die at home than patients who did not (57.5% compared with 33.7%). On multivariate logistic regression analysis, adjusting for significant confounding influences and baseline African Palliative Care Association Palliative care Outcome Scale scores, receipt of spiritual care was associated with reduced pain and family worry (odds ratio 0.33; 95% CI 0.11-0.95 and odds ratio 3.43; 95% CI 1.10-10.70, respectively).ConclusionPatients with cancer have R/S needs. R/S care among our patients appeared to improve their end-of-life experience. More research is needed to determine the mechanisms by which R/S care may have improved the observed patient outcomes.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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