This study examined longitudinal associations between spirituality and quality of life (QoL) in women newly diagnosed with breast cancer and undergoing chemotherapy at a large tertiary cancer center.

Women (N = 114) completed measures of spirituality (3 subscales of the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale: Meaning, Peace, and Faith) and health-related QoL (36-Item Short Form Health Survey) at study entry and 3- and 15-months later. Bias-corrected bootstrap tests were used to examine whether baseline Faith was indirectly associated with mental and physical QoL 15 months later via Meaning and Peace at 3 months.

Baseline Faith was positively associated with Meaning (β = .31, p = .001) and Peace (β = .38, p < .001) at 3 months. Both Meaning [n = 94, effect = .07 (95% CI: .002, .17)] and Peace [n = 93, effect = .13 (95% CI: .02, .28)] mediated the association between Faith and mental QoL at 15 months. When baseline Meaning was controlled, the indirect effect of baseline Faith on mental QoL remained significant, [n = 94, effect = .07 (95% CI: .001, .18)], and increases in Meaning over the first 3 months became an even stronger predictor of later mental QoL (β = .36, p = .004), suggesting that change in meaning during active treatment is an especially important predictor of mental QoL.

Overall, findings demonstrate that Faith is indirectly associated with long-term QoL through early increases in Meaning and Peace. Because 90% of participants were within 6 weeks of diagnosis, the study provided a unique perspective on spirituality during the early treatment period. Clinically, results highlight the importance of early assessment of spiritual well-being and suggest that meaning-focused interventions may enhance long-term QoL for women undergoing chemotherapy.

Cancer-related fatigue (CRF) is a distressing symptom in terminally ill patients with cancer. While many studies have been conducted on the relationship between fatigue and quality of life (QOL) among patients undergoing treatment, only a few have been conducted to measure fatigue from multiple perspectives or clarify its impact on patients in advanced stages or those receiving palliative care.

To examine the impact of fatigue on QOL in terminally ill patients with cancer, using a questionnaire that measures CRF from 3 perspectives.

CRF and QOL were measured using the Cancer Fatigue Scale (CFS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative (EORTCQLQ-C15-PAL), respectively, and the correlation between them was evaluated. Web-based questionnaires were completed by patients receiving hospice and palliative care.

Twenty-nine participants provided valid responses. Median CFS and global health status/QOL scores were as follows: total fatigue 25.0, physical fatigue 11.0, affective fatigue 9.0, cognitive fatigue 5.0, and global health status/QOL 50.0. QOL showed significant correlations with total fatigue (rs = −0.44, p = 0.017, 95% CI: −0.70, −0.09) and physical fatigue (rs = −0.38, p = 0.038, 95% CI: −0.66, −0.02), but none with affective fatigue (rs = −0.02, p = 0.917, 95% CI: −0.38, 0.35) and cognitive fatigue (rs = −0.33, p = 0.074, 95% CI: −0.63, 0.03).

Of the 3 aspects of fatigue, physical fatigue may be most closely related to QOL; however, its accurate assessment may depend on the scale used. Therefore, it is necessary to select an appropriate scale for patients with terminal cancer.

To examine the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) in Mexican cancer patients, and to evaluate their utility as brief screening measures for depressive and anxiety symptoms in oncology care.

In this cross-sectional study, 357 adult patients receiving oncological treatment at a cancer hospital in Mexico completed the culturally adapted Spanish versions of the PHQ-9 and GAD-7. Exploratory and confirmatory factor analyses were conducted to assess the factorial structure of both instruments, and internal consistency was evaluated using Cronbach’s alpha. Concurrent validity was examined through correlations with related measures.

The PHQ-9 yielded a 2-factor structure with acceptable internal consistency (Cronbach’s α = 0.837), while the GAD-7 showed a 1-factor structure with good internal consistency (Cronbach’s α = 0.881). The PHQ-9 explained 55.3% of the variance and the GAD-7 explained 58.5%. Confirmatory factor analyses indicated adequate model fit for both instruments.

Findings suggest that the PHQ-9 and GAD-7 are brief, valid, and reliable tools for detecting depressive and anxiety symptoms in Mexican cancer patients. Their use may facilitate the early identification of symptoms of anxiety and depression in oncology settings and support both clinical care and psycho-oncology research.

Terminally ill immigrant patients may wish to return to their homeland to die. However, the challenges and repatriation experiences faced by terminally ill Latinx immigrants who return to their country of origin (COO) remain underexplored. This study examines bereaved caregiver accounts of end-of-life (EOL) care and repatriation experiences of Latinx immigrants who returned to their COO following a terminal diagnosis.

Bereaved caregivers were interviewed via telephone. Primary outcomes were patient repatriation prior to death and caregiver perceptions of patient quality of death (QOD). Secondary outcomes included repatriation barriers, symptom burden and management, health-care utilization, and location of death. Caregivers of deceased patients treated at a U.S. urban tertiary medical center from 2013 to 2020 who requested and returned to their COO for death were included. Deceased patient clinical and sociodemographic information was obtained from the chart review.

Nineteen caregivers of patients who returned to their COO were included, most (n = 15/19, 78.9%) from the Dominican Republic. Two patients experienced logistical challenges during travel to their COO. None received supplementary nutrition or ventilatory support. Most patients had well-controlled symptoms (12/19 had pain, 11/12 pain was controlled) and died peacefully with dignity (84.2%) at their preferred location (73.7%). Most caregivers reported that their loved one was happy with repatriation (89.5%) and that repatriation improved EOL quality of life (84.2%). QOD was rated favorably (average score of 4.2/5).

QOD was favorable after repatriation. Successful repatriation is feasible and an important component of QOD that should be included in goals of care discussions.

This mixed-method study examined whether the Integrated Palliative Outcome Scale (IPOS) can support the identification of palliative care needs and inform individualized care planning in hospice settings.

Thirty-eight terminally ill patients admitted to a hospice in Northern Italy completed the IPOS. Quantitative analyses described the frequency and intensity of physical, psychological, relational, spiritual, and practical needs at the first administration and, where available, compared scores across 2 administrations using non-parametric tests. Spearman correlations were used to explore associations between awareness of diagnosis/prognosis and symptom burden. In parallel, semi-structured interviews explored the subjective meaning of “being at peace with oneself”; responses were examined through thematic content analysis.

IPOS administration highlighted frequent needs related to constipation, oral discomfort, weakness, drowsiness, anxiety, and concerns about family members. Awareness of diagnosis and prognosis were positively correlated. Anxiety and not feeling at peace showed negative associations with awareness, particularly awareness of prognosis. Across administrations, most physical symptoms remained stable, while anxiety and depressive feelings increased. Qualitative findings showed that inner peace was mainly associated with calmness, satisfaction with life, relational fulfilment, not having harmed others, and acceptance of one’s condition.

The integration of IPOS into routine hospice care may help multidisciplinary teams identify patients’ evolving needs and translate them into more responsive individualized care plans. Combining structured IPOS scores with patient narratives can also make existential and psychosocial concerns more visible in clinical decision-making.

Meaning-Centered Psychotherapy (MCP) has shown significant promise in reducing existential distress and improving wellbeing in people with advanced cancer. Research is yet to explore the applicability and translation of MCP into an Indigenous Aotearoa New Zealand cultural context.

This research sought to explore the applicability of MCP within Aotearoa New Zealand. The objectives of this study were to investigate Indigenous patients’ experiences of an MCP trial and Indigenous therapists’ experiences of recruitment and MCP delivery within the trial.

Semi-structured interviews were conducted with 2 Indigenous patients with advanced cancer receiving MCP, 1 Indigenous support person, and 4 Indigenous health psychologists delivering MCP about their experience in the research trial. Participants were also asked their views on recruiting Indigenous populations into research trials, and on the applicability of MCP in Aotearoa New Zealand. Reflective thematic analysis was utilized to analyze interview transcripts.

This study showed that trust is central to recruiting Indigenous populations into research trials and contributed to the overall success of MCP delivery. Participants highlighted community trust and organizational mistrust as potential contributors toward recruitment challenges. Trust in the self, in others, and in culture was central to finding meaning through MCP. When conducted in a safe patient-centered therapeutic space, MCP concepts and meaning-making can integrate effectively into Te Ao Māori and an Indigenous context.

MCP concepts and delivery may integrate well into a Te Ao Māori framework. Care should be taken in future delivery of MCP within Aotearoa New Zealand, ensuring the patient-focused nature of the therapeutic modality is maintained, and the patient’s own connection with culture is the highest priority.

This study was conducted to determine the relationship between death anxiety, spiritual well-being, and social support in patients with gynecological cancer.

This descriptive study consisted of 519 patients with gynecological cancers. Data were collected using a “Personal Information Form,” the “Death Anxiety Scale,” the “Spiritual Well-Being Scale,” and the “Multidimensional Perceived Social Support Scale.”

The mean total score of the Death Anxiety Scale was 6.8 ± 2.95, the Spiritual Well-Being Scale was 31.16 ± 5.24, and the Multidimensional Perceived Social Support Scale was 62.46 ± 13.76. A positive correlation was found between the scores of the Multidimensional Perceived Social Support Scale and the Spiritual Well-Being Scale. However, death anxiety levels were not influenced by spiritual well-being or social support levels (p < 0.001). As the level of perceived social support increases, spiritual well-being also increases; however, no significant relationship was found between death anxiety and either spiritual well-being or perceived social support.

The findings of this study highlight the importance of social support as a key factor associated with higher levels of spiritual well-being in women with gynecological cancer. Strengthening patients’ support systems may contribute to better psychological and spiritual adjustment during cancer treatment. Although death anxiety was not significantly related to either spiritual well-being or perceived social support, this result suggests that death anxiety may be influenced by other clinical or personal factors beyond these psychosocial variables. These findings provide guidance for developing supportive care programs that prioritize social support enhancement to improve overall patient well-being.

The relationship between frailty, self-efficacy, and advance care planning (ACP) remains unclear in Asia. This study examined how frailty status relates to decisional self-efficacy, ACP engagement, and advance directive completion among older adults receiving home healthcare in Taiwan.

A cross-sectional analysis was conducted using baseline data from a nationwide cohort in Taiwan. Participants (N = 358) were categorized by Clinical Frailty Scale (CFS): mildly frail (CFS 4–5, n = 60), moderately frail (CFS 6, n = 83), severely frail (CFS 7, n = 147), and very severely frail (CFS 8–9, n = 68). ACP engagement and decision-making self-efficacy were assessed using Likert scales.

Patients with greater frailty had lower odds of high decisional self-efficacy (CFS: 8–9: odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.14–1.07) but higher odds of ACP engagement (CFS: 6: OR = 3.38, 95% CI = 1.40–8.17; CFS: 7: OR = 2.52, 95% CI = 1.08–5.89) compared with mildly frail individuals. However, this increase did not extend linearly to the very severely frail group. Advance directive completion remained low across all frailty levels (4.8–10.0%) and was not significantly associated with frailty status.

Frailty was associated with lower decisional self-efficacy but higher readiness for ACP, revealing a divergence between perceived confidence and planning motivation. Despite greater engagement, advance directive completion remained low. Stage-sensitive, values-based approaches may help bridge the gap between intention and documentation across the frailty spectrum.

Depression in cancer patients is a common condition that poses significant challenges for prognosis, treatment adherence, and quality of life. Its onset reflects the interplay of diverse biological, psychological, and social factors, which has been the focus of numerous studies.

We identified both systematic and non-systematic reviews examining cross-sectional or prospective studies reporting associations between DAFs and depression. We extracted data relative to DAFs, as well as the direction and statistical significance of the reported association. Consistency of findings was assessed by estimating the proportion of concordant studies (PCS) for each DAF. Methodological quality and risk of bias were assessed using a standardized tool.

We identified 73 reviews (26 systematic and/or meta-analyses, 47 narrative) encompassing 514 unique primary studies, reporting the associations between depression and 198 distinct DAFs. DAFs were grouped into six domains (sociodemographic, cancer-related, somatic, psychological, biological-genetic, and other). The strongest associations (PCS ≥ 75% and ≥5 studies) were observed for sociodemographic factors (e.g., high social support, being unmarried), inflammatory markers (IL-6, TNF-α, CRP), psychological factors (e.g., history of depression, distress, anxiety), and somatic factors (e.g., fatigue, low functional status, malnutrition). When restricting analyses to prospective studies, consistent associations emerged for cancer-related physical symptoms and time dedicated to patient communication.

Depression in cancer is multifactorial, with physical and psychosocial factors likely iteracting dynamically. Prospective studies are still greatly needed. Further research on risk and protective factors may facilitate risk stratification, early diagnosis and patient management.