Spirituality may benefit patients with a diagnosis of prostate cancer
1. In this systematic review, most articles reported a positive association between spirituality and better health outcomes in prostate cancer patients.
2. In addition, more than 90% of prostate cancer survivors believed that prayer could help their fight against prostate cancer.
Evidence Rating Level: 1 (Excellent)
Prostate cancer may have significant physical and mental consequences due in part to the unpredictability of the disease. Spirituality may improve quality of life during these periods of uncertainty; however, access to spiritual care for prostate cancer patients is often more difficult compared to other forms of cancer. As a result, the objective of the present study was to review the impact of spirituality on men who have prostate cancer and its possible integration into the overall treatment plan.
Of 250 identified records, 30 (n=13 cross-sectional) studies were included from various databases from inception to August 2021. Studies were included if they evaluated the association between prostate cancer and spirituality in patients or their families and caregivers. Studies were excluded if there wasn’t a clear link between spirituality and prostate cancer. The review was performed using PRISMA guidelines. The primary outcome was the impact of spirituality on various health outcomes in prostate cancer patients.
The results demonstrated that overall there was a positive effect of spirituality on various mental health outcomes in prostate cancer patients, including coping with the prognosis, decreasing adverse mental health outcomes, and increasing union with family. Furthermore, spirituality was positively associated with increased prostate cancer screening and improved patient quality of life. In addition, more than 90% of prostate cancer survivors believed that prayer could help them in their fight against prostate cancer. Despite these results, the study was limited by the fact that most included studies were conducted in developed countries, which may have affected the generalizability of the results. Nonetheless, the present study highlighted the importance of spirituality in the management of prostate cancer.
End-of-life experiences tend to have a positive impact on the dying process
1. In this scoping and systematic review, it was found that end-of-life experiences (ELEs) positively impacted the dying process.
2. In addition, the most common ELEs were visions and dreams of deceased relatives or friends.
Evidence Rating Level: 1 (Excellent)
End-of-life experiences (ELEs) are thought to impact the quality of the dying experience. ELEs consist of spiritual or transcendent experiences in patients, relatives, and healthcare professionals around the dying process. Unlike near-death experiences, which have been studied more extensively, ELEs remain poorly understood. As a result, the present scoping review and mixed-methods systematic review aimed to synthesize the current understanding of ELEs and describe their impact on the dying process.
Of 2,440 identified records, 115 studies were included from various databases from inception to 2021. Studies were included if they investigated ELEs that had a religious, sacred, or transcendent nature experienced either by the dying patient, their relatives, or associated healthcare providers. Studies were excluded if they did not answer the research question or were found in book reviews or letters to the editor. The review was performed using PRISMA Scoping Review (PRISMA-ScR) guidelines. The study quality was assessed using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. The data was analyzed using a meta-aggregation approach and using narrative form. The primary outcome was the impact of ELEs on the experience of dying.
The results demonstrated that overall, ELEs were seen as generally positive experiences that had a positive impact on the dying process. In addition, the most common ELEs identified were visions and dreams of deceased friends or relatives. Despite these results, the study was limited by the lack of a clear definition for ELEs, which may have limited comparisons between studies. Nonetheless, the present study added evidence suggesting that ELEs may be important in the dying experience, both for patients and those involved in their care.
Across several countries, nursing knowledge of palliative care may be insufficient
1. In this systematic review and meta-analysis, pooled scoring on a palliative care-nursing quiz demonstrated that many nurses had insufficient knowledge of palliative care.
2. However, male nurses and nurses with palliative care training had higher levels of palliative care knowledge.
Evidence Rating Level: 1 (Excellent)
Nurses often spend the most time in direct contact with patients and are a valuable asset concerning palliative care services. Currently, there is a lack of understanding regarding nurses’ level of knowledge of palliative care. As a result, the objective of the present study was to analyze the existing evidence about nurses’ knowledge of palliative care to improve its quality.
Of 4,645 identified records, 40 (n=22,980 participants) studies from 12 countries were included from various databases from 2010 to 2021. Studies were included if they were observational and assessed the palliative care knowledge of nursing staff using the Palliative Care Quiz for Nursing (PCQN). Studies were excluded if they used the adjusted PCQN to evaluate palliative care knowledge. A PCQN score <10 indicated low/insufficient knowledge, whereas a score ≥10 indicated high/sufficient knowledge. The review was performed using PRISMA guidelines. The risk of bias was assessed using funnel plots and Egger’s regression test. The primary outcome was nurses’ knowledge of palliative care, as determined by their PCQN scores.
The results demonstrated that overall, nurses who completed the PCQN had scores that correlated with low/insufficient knowledge of palliative care. Furthermore, the average scores for each of the three main dimensions of the PCQN, Philosophy and Principles of Palliative Care, Pain and Other Symptom Control, and Psychological, Spiritual, and Social Care, were below the respective cut-off values for high/sufficient knowledge. However, male nurses and nurses with palliative care training demonstrated higher levels of expertise in subgroup analyses. Despite these results, the study was limited by the cross-sectional designs of the included studies and the use of convenience sampling. Nonetheless, the present study provided evidence to suggest that additional palliative care training may be beneficial for nurses.
Several factors contribute to patients’ perception of a good death from cancer
1. In this systematic review, seven core elements of a good death among cancer patients were identified, including being aware of cancer, pain and symptom management, dying well, being remembered after death, individual perspectives of a good death, individual behaviors leading to a good death, and culture and religion.
2. In addition, a framework was proposed which may be used to promote having a good death for patients.
Evidence Rating Level: 1 (Excellent)
At the end of life, patients with cancer often experience significant physical and psychological distress – making the experience of a “good death” of clinical importance. Although a good death has been evaluated in the literature in other heterogeneous groups, these experiences may not be as applicable to patients with cancer. As a result, the objective of the present study was to further understand how cancer patients perceive having a good death.
Of 1,432 identified records, 5 studies were included from various databases from inception to March 2022. Studies were included if they explored the perception of a good death among patients with cancer in any setting. Studies were excluded if they focused on the certificate of death or if participants were a heterogeneous group of the terminally ill. The review was performed using PRISMA guidelines. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Qualitative Research (JBI CACQR). The primary outcome was elements comprising a good death in cancer patients.
The results demonstrated that seven main factors were associated with a good death, including being aware of cancer, pain and symptom management, dying well, being remembered after death, individual perspectives of a good death, individual behaviors leading to a good death, and culture and religion. Furthermore, the authors proposed a framework combining external and internal factors that may support patients seeking a good death. Despite these results, the study was limited by the exclusion of studies involving a heterogenous population, which may have eliminated some perspectives of cancer patients. Nonetheless, the present study added considerable evidence to suggest that a good death for cancer patients may be achieved through the interplay of both internal and external factors.
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