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Demoralization and spirituality in oncology: an integrative systematic review

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Abstract

Objective

To synthesize the scientific findings on demoralization and spirituality in the oncology context.

Methods

This is an integrative systematic review, in line with the PRISMA 2020 guidelines, as proposed by Whittemore and Knalf (2005). The MEDLINE via PubMed, Scopus, Web of Science, APA PsycNet, CINAHL, Cochrane Library, EMBASE, and LILACS databases were searched without limitations regarding language or year of publication. The studies were screened for inclusion according to the predefined eligibility criteria. Data extraction and evidence quality assessment were performed.

Results

Out of the 1587 articles evaluated, 10 studies were included in this review. In general, it was found that demoralization tends to increase with the proximity of death and seems to be inversely related to spirituality, with spiritual well-being being a protective factor against demoralization, while the non-fulfillment of spiritual needs is related to increased demoralization in people with cancer. Furthermore, even among caregivers of people with advanced cancer, demoralization seems to be associated, among other factors, with spiritual suffering. These results should be analyzed with caution, considering that the studies included in this review are all observational studies, which prevents establishing cause and effect relationships.

Conclusions

Demoralization tends to increase with growing frailty and the proximity of death in people with cancer, and it seems to be inversely related to spirituality, both in these patients and in their caregivers.

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Author information

Authors and Affiliations

  1. Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas (UNIFAL-MG), Gabriel Monteiro da Silva Street, 700, Centro, Alfenas, MG, 37130-001, Brazil

    Ana Cláudia Mesquita Garcia, Milena Schneiders, Kárita Santos da Mota & Vander Monteiro da Conceição

  2. University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, Brazil

    Kárita Santos da Mota

  3. Department of Nursing, Federal University of Fronteira Sul, Chapecó, Brazil

    Vander Monteiro da Conceição

  4. University of Notre Dame, Sydney, Australia

    David W. Kissane

  5. Cunningham Centre, St Vincent’s Hospital, Sydney, Australia

    David W. Kissane

  6. Szalmuk Family Psycho Oncology Research Unit, Cabrini Health and Monash Partner’s Comprehensive Cancer Centre, Melbourne, Australia

    David W. Kissane

Authors
  1. Ana Cláudia Mesquita Garcia
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  2. Milena Schneiders
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  3. Kárita Santos da Mota
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  4. Vander Monteiro da Conceição
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  5. David W. Kissane
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Contributions

Ana Cláudia Mesquita Garcia: conceptualization, methodology, formal analysis, interpretation, writing the original draft, writing, reviewing, editing, and supervision. Milena Schneiders and Karita Santos da Mota: methodology, database searching, and reviewing. Vander Monteiro da Conceição: methodology and reviewing. David W. Kissane: interpretation, reviewing, and editing.

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Correspondence to Ana Cláudia Mesquita Garcia.

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Garcia, A.C.M., Schneiders, M., da Mota, K.S. et al. Demoralization and spirituality in oncology: an integrative systematic review. Support Care Cancer 31, 259 (2023). https://doi.org/10.1007/s00520-023-07722-6

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