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Is spirituality related to survival in advanced cancer inpatients in Korea?

Published online by Cambridge University Press:  21 December 2017

Dong Wook Shin
Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Seoul, South Korea
Sang-Yeon Suh*
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea Department of Medicine, School of Medicine, Dongguk University, Seoul, South Korea
Sun-Hyun Kim
Department of Family Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, South Korea
Jeanno Park
Department of Internal Medicine, Bobath Memorial Hospital, Seongnam, South Korea
Seok Joon Yoon
Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, South Korea
Yu Jung Kim
Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea
Beodeul Kang
Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea
Jung Hye Kwon
Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University, Seoul, South Korea
Youngmin Park
Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
Kwonoh Park
Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan, South Korea
David Hui
Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Hyeon Jeong Kim
Department of Statistics, Dongguk University, Seoul, South Korea
Sanghwa Himchak
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea
Sanghee Shiny Lee
Department of Cancer Control and Population Health, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, South Korea
Hong-Yup Ahn
Department of Statistics, Dongguk University, Seoul, South Korea
Author for correspondence: Sang-Yeon Suh, Department of Medicine, School of Medicine, Dongguk University, Seoul, South Korea. E-mail:



Spirituality is what gives people meaning and purpose in life, and it has been recognized as a critical factor in patients’ well-being, particularly at the ends of their lives. Studies have demonstrated relationships between spirituality and patient-reported outcomes such as quality of life and mental health. Although a number of studies have suggested that spiritual belief can be associated with mortality, the results are inconsistent. We aimed to determine whether spirituality was related to survival in advanced cancer inpatients in Korea.


For this multicenter study, we recruited adult advanced cancer inpatients who had been admitted to seven palliative care units with estimated survival of <3 months. We measured spirituality at admission using the Korean version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-sp), which comprises two subscales: meaning/peace and faith. We calculated a Kaplan-Meier curve for spirituality, dichotomized at the predefined cutoffs and medians for the total scale and each of the two subscales, and performed univariate regression with a Cox proportional hazard model.


We enrolled a total of 204 adults (mean age: 64.5 ± 13.0; 48.5% female) in the study. The most common primary cancer diagnoses were lung (21.6%), colorectal (18.6%), and liver/biliary tract (13.0%). Median survival was 19.5 days (95% confidence interval [CI95%]: 23.5, 30.6). Total FACIT-sp score was not related to survival time (hazard ratio [HR] = 0.981, CI95% = 0.957, 1.007), and neither were the scores for its two subscales, meaning/peace (HR = 0.969, CI95% = 0.932, 1.008) and faith (HR = 0.981, CI95% = 0.938, 1.026).

Significance of results

Spirituality was not related to survival in advanced cancer inpatients in Korea. Plausible mechanisms merit further investigation.

Original Article
Copyright © Cambridge University Press 2017 

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