To review which are the most influential variables in achieving levels of psychological well-being at the end of life and to verify whether, as certain studies suggest, spirituality, resilience and social support are the pillars on which the psychological well-being construct is based.
Method
A systematic search through the Scopus, Pubmed and PsycInfo electronic databases was carried out using keywords such as: “wellbeing” OR “psychological-well-being” AND “resilience” AND “spirituality” AND “social support” AND “palliative care” and their multiple combinations.
Results
Eleven studies were selected, in which terms such as spiritual well-being, absence of discomfort and quality of life were used in substitution of psychological well-being and a certain consensus was found regarding whether resilience, spirituality and social support are predictive variables of psychological well-being.
Conclusions
Resilience, social support and spirituality are highly relevant variables at the end of life and contribute decisively towards psychological well-being.
Arrebola-MorenoA. L.Garcia-RetameroR.CatenaA.Marfil-ÁlvarezR.Melgares-MorenoR.Ramírez-HernándezJ. A. (2014). On the protective effect of resilience in patients with acute coronary syndrome. International Journal of Clinical and Health Psychology, 14(2), 111–119. https://doi.org/10.1016/S1697-2600(14)70044-4
BarretoP.FombuenaM.DiegoR.GalianaL.OliverA.BenitoE. (2015). Bienestar emocional y espiritualidad al final de la vida [Emotional and spiritual well-being at the end of life]. Medicina Paliativa, 22(1), 25–32. http://doi.org/10.1016/j.medipa.2013.02.002
4.
BenitoE., &; BarberoJ. (2014). El sufrimiento en clínica. Incorporando las tradiciones de sabiduría. In E. Benito, J. Barbero, & M. Dones (Eds.), Espiritualidad en clínica. Una propuesta de evaluación y acompañamiento espiritual en Cuidados Paliativos (pp. 45-58). http://www.secpal.com//Documentos/Blog/Monografia%20secpal.pdf
5.
BonnanoG. A. (2004). Loss, trauma and human resilience: Conceptual and empirical connections and separateness. American Psychologist, 59(1), 20–28. https://doi.org/10.1037/0003-066X.59.1.20
6.
BoveroA.BottoR.AdrianoB.OpezzoM.TesioV.TortaR. (2019). Exploring demoralization in end-of-life cancer patients: Prevalence, latent dimensions, and associations with other psychosocial variables.Palliative & Supportive Care, 17(5), 596–603. https://doi.org/10.1017/S1478951519000191
7.
BoveroA.LeombruniP.MiniottiM.RoccaG.TortaR. (2016). Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice.European Journal of Cancer Care, 25(6), 961–969. https://doi.org/10.1111/ecc.12360
ChibnallJ. T.VideenS. D.DuckroP. N.MillerD. K. (2002). Psychosocial—Spiritual correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16(4), 331–338. https://doi.org/10.1191/0269216302pm544oa
11.
Costa-RequenaG.SalameroM.Gil MoncayoF. (2007). Validación del cuestionario MOS-SSS de apoyo social en pacientes con cáncer (Validity of the questionnaire MOS-SSS of social support in neoplastic patients). Medicina Clínica, 128, 687–691. https://doi.org/10.1157/13102357
12.
Cowlishaw, S., Niele, S., Teshuva, K., Browning, C., & Kendig, H. (2013). Older adults' spirituality and life satisfaction: a longitudinal test of social support and sense of coherence as mediating mechanisms. Ageing & Society, 33(7), 1243–1262.
13.
De la RevillaL.FleitasL. (1991). El apoyo social y la atención primaria de salud.Atención primaria: Publicación oficial de la Sociedad Española de Familia y Comunitaria, 8(9), 664–666.
14.
DienerE.LucasR.OishiS. (2002). Subjective well-being: The science of happiness and life satisfaction. In SnyderC. R. ?0026; LopezS. J. (Eds.), Handbook of positive psychology (pp. 63–73). Oxford University Press.
FombuenaM.GalianaL.BarretoP.OliverA.PascualA.Soto-RubioA. (2016). Spirituality in patients with advanced illness: The role of symptom control, resilience and social network.Journal of Health Psychology, 21(12), 2765–2774. https://doi.org/10.1177/1359105315586213
17.
Galiana, L., Oliver, A., & Barreto, P. (2014). Recursos en evaluación y acompañamiento espiritual. Revisión de medidas y presentación del cuestionario GES. In E. Benito, J. Barbero, & M. Dones (Eds.), Espiritualidad en cica. Una propuesta de evaluación y acompañamiento espiritual en Cuidados Paliativos (pp. 131–146). Retrieved from: http://www.secpal.com//Documentos/Blog/Monografia%20secpal.pdf
18.
GalianaL.OliverA.BarretoP. (2014). Recursos en evaluación y acompañamiento espiritual. Revisión de medidas y presentación del cuestionario GES. En: Benito, E., Barbero, J., & Dones, M. Espiritualidad en clínica. Madrid, SECPAL, Monografías, n°6, Cap.11, 131–146.
19.
García-Maroto FernándezS.López DelgadoM. L.Latorre PostigoJ. M. (2015). Ansiedad, resiliencia e inteligencia emocional percibida en un grupo de mujeres con cáncer de mama.Ansiedad y estrés, 21. http://hdl.handle.net/10578/10072
20.
García- Maroto, S., Latorre, J.M., y López, M.L. (2015). Ansiedad, resiliencia einteligencia emocional percibida en un grupo de mujeres con cîcer de mama. Ansiedad y Estrés , 21(2-3), 115–125.
21.
Garcia-RuedaN.Carvajal-ValcárcelA.Saracibar-RazquinM.Arantzamendi-SolabarrietaM. (2016). The experience of living with advanced‐stage cancer: A thematic synthesis of the literature. European Journal of Cancer Care, 25(4), 551–569. https://doi.org/10.1111/ecc.12523
22.
Gheihman, G., Zimmermann, C., Deckert, A., Fitzgerald, P., Mischitelle, A., Rydall, A., Schimmer, A., Gagliese, L. & Rodin, G. (2016). Depression and hopelessness in patients with acute leukemia:The psychological impact of an acute and life-threatening disorder. Psycho-Oncology, 25(8), 979–989. https://doi.org/10.1002/pon.3940
23.
GheihmanG.ZimmermannC.DeckertA.FitzgeraldP.MischitelleA.RydallA., … RodinG. (2016). Depression and hopelessness in patients with acute leukemia: The psychological impact of an acute and life‐threatening disorder. Psycho‐Oncology, 25(8), 979–989. https://doi.org/10.1002/pon.3940
24.
GranéJ.ForésA. (2008). La Resiliencia, crecer desde la adversidad. Plataforma.
25.
HiewC. C.MoriT.ShimizuM.TominagaM. (2000). Measurement of resilience development: Preliminary results with a State-Trait resilience inventory. Journal of Learning and Curriculum Development, 1, 111–117.
26.
HutaV. (2013). Eudaimonia. In DavidS.BoniwellI.AyersA. C. (Eds.), Oxford handbook of happiness (pp. 201–213). Oxford University Press.
27.
Jim, H. S., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., Merluzzi, T. V., Mu oz, A. R., George, L., Snyder, M. A. & Salsman, J. M. (2015). Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer, 121(21), 3760–3768. https://doi.org/10.1002/pon.3940
28.
JimH. S.PustejovskyJ. E.ParkC. L.DanhauerS. C.ShermanA. C.FitchettG., … SalsmanJ. M. (2015). Religion, spirituality, and physical health in cancer patients: A meta‐analysis. Cancer, 121(21), 3760–3768. https://doi.org/10.1002/cncr.29353
29.
JohnsonK. S.TulskyJ. A.HaysJ. C.ArnoldR. M.OlsenM. K.LindquistJ. H.SteinhauserK. E. (2011). Which domains of spirituality are associated with anxiety and depression in patients with advanced illness?Journal of General Internal Medicine, 26(7), 751–758. https://doi.org/10.1007/s11606-011-1656-2
30.
KashdanT. B.Biswas-DienerR.KingL. A. (2008). Reconsidering happiness: The costs of distinguishing between hedonics and eudaimonia. The Journal of Positive Psychology, 3(4), 219–233. https://doi.org/10.1080/17439760802303044
31.
Kavak, F., Özdemir, A., & Dural, G. (2019). The Relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer. Current Psychology, 40, 1788–1794
32.
KavakF.ÖzdemirA.DuralG. (2019). The relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer. Current Psychology, 40, 1788-1794. https://doi.org/10.1007/s12144-018-0116-0
33.
KeyesC. L. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health.American Psychologist, 62(2), 95. https://doi.org/10.1037/0003-066X.62.2.95
LimoneroJ. T.BayésR. (1995). Bienestar en el ámbito de los enfermos en situación terminal. Medicina Paliativa, 2(2), 53–59.
36.
LimoneroJ. T.Gómez-RomeroM. J. G.MateoD. (2016). Evaluación psicológica en cuidados paliativos. In BarberoJ.Gómez-BatisteX.Maté.J.OrtegaD. (Coords.). Manual para la atención psicosocial y espiritual a personas con enfermedades avanzadas: intervención psicológica y espiritual (pp. 119–134). La Caixa.
37.
MatéJ.JuanE. (2008). ¿Qué dicen los expertos sobre las necesidades espirituales?: revision bibliográfica. In BenitoE.BarberoJ.PayásA. (Eds.), El acompañamiento espiritual en cuidados paliativos. Una introducción y una propuesta (pp. 57–81). Disponible en. http://www.secpal.com//Documentos/Blog/archivo_9.pdf
38.
McClainC. S.RosenfeldB.BreitbartW. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. The Lancet, 361(9369), 1603–1607. https://doi.org/10.1016/S0140-6736(03)13310-7
39.
MinJ. A.YoonS.LeeC. U.ChaeJ. H.LeeC.SongK. Y.KimT. S. (2013). Psychological resilience contributes to low emotional distress in cancer patients. Supportive Care in Cancer, 21(9), 2469–2476. http://doi.org/10.1007/s00520-013-1807-6
40.
MorenoP. I.StantonA. L. (2013). Personal growth during the experience of advanced cancer: A systematic review.The Cancer Journal, 19(5), 421–430. https://doi.org/10.1097/PPO.0b013e3182a5bbe7
41.
MystakidouK.TsilikaE.PrapaE.SmyrniotiM.PagoropoulouA.LambrosV. (2008). Predictors of spirituality at the end of life. Canadian Family Physician, 54(12), 1720–1721.
42.
National Collaborating Centre for Methods and Tools. (2008). Quality assessment tool for quantitative Studies. McMaster University.
43.
NelsonC. J.RosenfeldB.BreitbartW.GaliettaM. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43(3), 213–220. https://doi.org/10.1176/appi.psy.43.3.213
44.
PayàsA. (2002). Espiritualidad en la última etapa de la vida. Labor Hospitalaria, 35(268), 7–14.
45.
Payàs, A. (2003). Espiritualidad en la última etapa de la vida. Labor Hospitalaria, 35(268), 7–14.
46.
Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., Chochinov, H., Handzo, G., Nelson-Becker, H., Prince-Paul, M., Pugliese, K. & Sulmasy, D. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. Journal of Palliative Medicine, 12(10), 885–904. https://doi.org/10.1089/jpm.2009.0142
47.
PuchalskiC.FerrellB.ViraniR.Otis-GreenS.BairdP.BullJ., … SulmasyD. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference.Journal of Palliative Medicine, 12(10), 885–904. https://doi.org/10.1089/jpm.2009.0142
48.
Vinaccia, S., & Quiceno, J. M. (2011). Calidad de vida relacionada con la salud y factores psicológicos: un estudio desde la enfermedad pulmonar obstructiva crónica-EPOC. Terapia psicolca, 29(1), 65–75.
49.
Radbruch, L., Payne, S. & Bercovitch, M. (2009). White paper on standards and norms for hospice and palliative care in Europe: Part 1. European Journal of Palliative Care, 16(6), 278–289.
50.
RadbruchL.PayneS. (2009). White paper on standards and norms for hospice and palliative care in Europe: Part 1. European Journal of Palliative Care, 16(6), 278–289.
51.
Reig-Ferrer, A., Ferrer-Cascales, R., Fernádez-Pascual, M. D., Albaladejo-Blúquez, N., & Valladares, M. P. (2015). [Assessment of spiritual well-being in palliative care patients]. Medicina Paliativa, 22(2), 60–68.https://doi.org/10.1016/j.medipa.2013.03.008
52.
Reig-FerrerA.Ferrer-CascalesR.Fernández-PascualM. D.Albaladejo-BlázquezN.ValladaresM. P. (2015). Evaluación del bienestar espiritual en pacientes en cuidados paliativos. Medicina Paliativa, 22(2), 60–68. https://doi.org/10.1016/j.medipa.2013.03.008
53.
RippentropA. E.AltmaierE. M.BurnsC. P. (2006). The relationship of religiosity and spirituality to quality of life among cancer patients. Journal of Clinical Psychology in Medical Settings, 13(1), 29. https://doi.org/10.1007/s10880-005-9000-9
54.
Rodin, G., Walsh, A., Zimmermann, C., Gagliese, L., Jones, J., Shepherd, F. A., Moore, M., Braun, M., Donner, A, & Mikulincer, M. (2007). The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer. Psycho-Oncology, 16(12),1080–1091. https://doi.org/10.1089/jpm.2009.0142
55.
RodinG.WalshA.ZimmermannC.GaglieseL.JonesJ.ShepherdF. A., … . MikulincerM. (2007). The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer.Psycho‐Oncology, 16(12), 1080–1091. https://doi.org/10.1002/pon.1186
56.
RudillaD.GalianaL.OliverA.BarretoP. (2016). Comparing counselling and dignity therapies in home care patients: A pilot study.Palliative & Supportive Care, 14(4), 321. https://doi.org/10.1017/S1478951515001182
57.
RyffC. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069. https://doi.org/10.1037/0022-3514.57.6.1069
58.
RyffC. D.KeyesC. L. M. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719–727. https://doi.org/10.1037/0022-3514.69.4.719
59.
SalmonP.ManziF.ValoriR. M. (1996). Measuring the meaning of life for patients with incurable cancer: The life evaluation questionnaire (LEQ). European Journal of Cancer, 32(5), 755–760.
Sharif, S. P., Lehto, R. H., Amiri, M., Ahadzadeh, A. S., Nia, H. S., Haghdoost, A. A., Fomani, F. K. & Goudarzian, A. H. (2021). Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment. Palliative & Supportive Care, 19(1), 55–61.
62.
SharifS. P.LehtoR. H.AmiriM.AhadzadehA. S.NiaH. S.HaghdoostA. A., … . GoudarzianA. H. (2020). Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment.Palliative & Supportive Care, 1–7. https://doi.org/10.1017/S1478951520000383
SiebertA. (2007). La resiliencia: Construir en la adversidad. Alienta.
65.
SinclairV. G.WallstonK. A. (2004). The development and psychometric evaluation of the Brief Resilient Coping Scale.Assessment, 11, 94–101. https://doi.org/10.1177/1073191103258144
66.
SolanoJ. P. C.da SilvaA. G.SoaresI. A.AshmawiH. A.VieiraJ. E. (2016). Resilience and hope during advanced disease: A pilot study with metastatic colorectal cancer patients. BMC Palliative Care, 15(1), 70. http://doi.org/10.1186/s12904-016-0139-y
67.
Soto-RubioA.Perez-MarinM.Tomas MiguelJ.Barreto MartinP. (2018). Emotional distress of patients at end-of-life and their caregivers: Interrelation and predictors.Frontiers in Psychology, 9, 2199. https://doi.org/10.3389/fpsyg.2018.02199
68.
TardyC. H. (1985). Social support measurement. American Journal of Community Psychology, 13(2), 187–202.
69.
Thoits, P. (1982). Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress. Journal of Health and Social Behavior, 23(2), 145–159. https://doi.org/10.2307/2136511
70.
ThoitsP. A. (1982). Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress. Journal of Health and Social Behavior, 145–159. https://doi.org/10.2307/2136511
71.
ThompsonG. N.ChochinovH. M.WilsonK. G.McPhersonC. J.CharyS.O'SheaF. M.MacmillanK. A. (2009). Prognostic acceptance and the well-being of patients receiving palliative care for cancer. Journal of Clinical Oncology, 27(34), 5757–5762. https://doi.org/10.1200/JCO.2009.22.9799
72.
ThorntonA. A.PerezM. A.OhS.CrocittoL. (2012). Optimism and prostate cancer-specific expectations predict better quality of life after robotic prostatectomy. Journal of Clinical Psychology in Medical Settings, 19(2), 165–176. https://doi.org/10.1007/s10880-011-9270-3
73.
UngarM. (2011). The social ecology of resilience: Addressing contextual and cultural ambiguity of a nascent construct. American Journal of Orthopsychiatry, 81(1), 1–17. https://doi.org/10.1111/j.1939-0025.2010.01067.x
74.
VázquezC.HervásG. (2008). Salud positiva: del síntoma al bienestar. Psicología Positiva Aplicada, 17–39.
75.
VicuñaM. N.SalesJ. P. I.FarreC. N.TrotaR. A.SánchezA. T. (2002). Cuidados Paliativos (III): el valor de la calidad de vida y los factores psicosociales. Medicina paliativa, 9(3), 134–138.
76.
Viel SiritoS., (2016). Familia y entorno afectivo. In BarberoJ.X. Gómez-BatisteMaté., J.Ortega (Coords.)D.Manual para la atención psicosocial y espiritual a personas con enfermedades avanzadas: intervención psicológica y espiritual (pp. 323–336). La Caixa.
77.
WangZ. Y.LiuL.ShiM.WangL. (2016). Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: A cross-sectional study.Psychology, Health & Medicine, 21(5), 571–582.
78.
WatsonM.LucasC.HoyA.WellsJ. (2019). Oxford handbook of palliative care. Oxford University Press.
79.
World Health Organization. (2005). Promoting mental health: Concepts, emerging evidence, practice.
80.
ZysbergL.HaiS.DallyN. (2019). A new take on a resource-based model of quality of life in hemato-oncological patients: Demographic, personal, and social factors. Journal of Clinical Psychology in Medical Settings, 26(4), 430–439.
