Factors influencing spiritual wellbeing among pancreatic ductal adenocarcinoma patients receiving chemotherapy

Table 1 Questionnaire results for pancreatic ductal adenocarcinoma patients treated with chemotherapy (n = 143)

Item	Score range	Scale score	mean item score
FACIT-Sp-12	0-48	32.16 ± 10.06	2.68 ± 0.84
Faith	0-16	10.85 ± 3.76	2.71 ± 0.94
Meaning	0-16	10.55 ± 3.42	2.64 ± 0.86
Peace	0-16	10.76 ± 4.00	2.69 ± 1.00
SAS	0-100	45.59 ± 6.44	2.28 ± 0.32
Anxiety	0-20	5.48 ± 1.96	1.37 ± 0.49
Vegetative disorder	0-40	11.01 ± 2.90	1.38 ± 0.36
Exercise-induced anxiety	0-30	15.43 ± 2.40	2.57 ± 0.40
Concurrent symptoms of anxiety and vegetative disorder	0-10	4.54 ± 1.27	2.27 ± 0.64
EORTC QLQ-C30	0-100	83.74 ± 2.85	5.58 ± 0.19
Body	0-100	18.46 ± 15.52	3.69 ± 3.10
Role functioning	0-100	16.32 ± 19.33	8.16 ± 9.67
Emotion	0-100	14.74 ± 18.65	3.69 ± 4.67
Cognition	0-100	19.35 ± 19.74	9.67 ± 9.87
Social function	0-100	28.79 ± 24.80	14.39 ± 12.40
QLQ-C30 global health status	0-100	74.01 ± 21.41	37.00 ± 10.70
QLQ-C30 symptom domain	0-11	8.88 ± 1.79	0.68 ± 0.14
Fatigue	0-100	75.76 ± 21.04	25.25 ± 7.01
Nausea and vomiting	0-100	89.04 ± 17.48	44.52 ± 8.74
Pain	0-100	82.63 ± 21.29	41.32 ± 10.65
Shortness of breath	0-100	85.32 ± 21.89
Insomnia	0-100	76.46 ± 27.07
Loss of appetite	0-100	76.22 ± 27.59
Constipation	0-100	86.71 ± 20.98
Diarrhea	0-100	86.71 ± 20.98
Economic difficulty	0-100	85.55 ± 25.50

FACIT-Sp-12: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale; SAS: Zung’s Self-rating Anxiety Scale; EORTC QLQ-C30: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30.

Table 2 Differences in spiritual wellbeing among demographic and clinical subgroups of pancreatic ductal adenocarcinoma patients on chemotherapy (n = 143)

Item		No. of cases, n (%)	Spiritual wellbeing score	T/F	P value
Sex	Male	93 (65.0)	32.89 ± 10.54	1.187	0.024
	Female	50 (35.0)	30.80 ± 9.06
Age (yr)	18–44	18 (12.6)	29.67 ± 10.32	0.4951	0.687
	45–59	79 (55.2)	32.39 ± 10.16
	60–74	36 (25.2)	32.39 ± 10.52
	75–89	10 (7.0)	32.16 ± 10.06
Education level	Primary school or below	37 (25.9)	26.03 ± 10.48	12.3991	< 0.001
	Middle and high school	62 (43.4)	32.19 ± 9.33
	Technical and further education	20 (14.0)	33.6 ± 7.00
	Undergraduate degree or above	24 (16.8)	40.33 ± 7.10
Occupation	Farmer	73 (51.0)	32.49 ± 10.55	1.0471	0.374
	Retired	34 (23.8)	32.21 ± 10.23
	Full-time employment	20 (14.0)	28.90 ± 9.99
	Other	16 (11.2)	34.63 ± 6.86
Household monthly income	> 1000 Yuan	35 (24.5)	31.03 ± 11.09	2.6851	0.049
	1000–3000 Yuan	30 (21.0)	29.37 ± 10.65
	3000-5000 Yuan	56 (39.2)	35 ± 8.64
	5000 Yuan plus	22 (15.4)	30.55 ± 9.80
Spouse	Yes	124 (86.7)	31.59 ± 10.05	-1.749	0.082
	No	19 (13.3)	35.89 ± 9.57
Religious belief	Yes	3 (2.1)	35 ± 14.73	0.493	0.623
	No	140 (97.9)	32.1 ± 10.01
Number of offspring	0	4 (2.8)	39 ± 4.24	1.6541	0.180
	1	65 (45.5)	33.42 ± 9.37
	2	58 (40.6)	31.10 ± 10.37
	3 or more	16 (11.2)	29.19 ± 11.77
Type of health insurance	Employee Health Insurance	62 (43.4)	35.68 ± 7.80	11.2821	< 0.001
	New rural pension scheme	63 (44.1)	30.98 ± 9.65
	Urban medical insurance	6 (4.2)	33.67 ± 10.35
	Other	12 (8.4)	19.42 ± 11.87
Time after diagnosis	≤ 6 mo	69 (48.3)	33.42 ± 8.44	1.2781	0.284
	7–12 mo	40 (28.0)	30.95 ± 11.11
	13–24 months	17 (11.9)	28.76 ± 13.26
	≥ 24 mo	17 (11.9)	33.29 ± 9.76
Recurrence	Yes	28 (19.6)	26.18 ± 12.19	-3.035	< 0.001
	No	115 (80.4)	32.16 ± 10.06

¹F test.

Table 3 Correlations among spiritual wellbeing, anxiety, and quality of life scores (n = 143)

Item	Spiritual wellbeing	Faith	Meaning	Peace
SAS	-0.357b	-0.329b	-0.345b	-0.293b
Anxiety	-0.371b	-0.366b	-0.319b	-0.316b
Vegetative disorder	-0.466b	-0.420b	-0.469b	-0.378b
Exercise-induced anxiety	0.053	0.067	0.047	0.030
Concurrent symptoms of anxiety and vegetative disorder	0.092	0.061	0.079	0.106
EORTC QLQ-C30	0.421b	0.381b	0.437b	0.329b
Body	0.292b	0.302b	0.266b	0.225b
Role functioning	0.181a	0.177a	0.223b	0.100
Emotion	0.436b	0.387b	0.436b	0.362b
Cognition	0.324b	0.275b	0.335b	0.271b
Social function	0.301b	0.229b	0.368b	0.229b
QLQ-C30 global health status	0.464b	0.362b	0.435b	0.456b
QLQ-C30 symptom domain	-0.322b	-0.320b	-0.331b	-0.226b
Fatigue	-0.264b	-0.294b	-0.245b	-0.177a
Nausea and vomiting	-0.169a	-0.210a	-0.144	-0.105
Pain	-0.275b	-0.278b	-0.294b	-0.180a
Shortness of breath	-0.214a	-0.231b	-0.183a	-0.166a
Insomnia	-0.281b	-0.229b	-0.302b	-0.234b
Loss of appetite	-0.309b	-0.295b	-0.323b	-0.225b
Constipation	-0.189a	-0.213a	-0.183a	-0.119
Diarrhea	-0.199a	-0.162	-0.242b	-0.143
Economic difficulty	-0.098	-0.042	-0.156	-0.074

^aP < 0.05.

^bP < 0.01. SAS: Zung’s Self-rating Anxiety Scale; EORTC QLQ-C30: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30.

Table 4 Default values of independent variables for multivariable regression

Independent variable	Default value
Sex	Male = 1; female = 2
Education level	Primary school or below = 1; middle and high school = 2; technical and further education = 3; bachelor degree and above = 4
Household monthly income (Yuan)	< 1000 = 1; 1000-3000 = 2; 3000-5000 = 3; > 5000 = 4
Type of health insurance	Workers’ medical insurance = 1; new rural pension scheme = 2; urban medical insurance = 3; other = 4
Recurrence	Yes = 1; No = 2

Table 5 Multiple linear regression analysis of factors independently influencing spiritual wellbeing (n = 143)

Item	FACIT-Sp-12
	b	sb	b’	t value	P value
(Constant)	-74.696	42.693	-	-1.750	0.082
Sex	0.518	1.397	0.025	0.371	0.711
Education level	3.297	0.639	0.332	5.156	< 0.001
Household monthly income	0.013	0.65	0.001	0.020	0.984
Type of health insurance	-3.02	0.798	-0.263	-3.786	< 0.001
recurrence	2.198	1.739	0.087	1.264	0.209
SAS anxiety	-0.214	0.12	-0.137	-1.786	0.076
C30 global health status	0.988	0.416	0.279	2.371	0.019
C30 symptom domain	0.152	0.037	0.323	4.117	< 0.001
C30 functional domain	1.647	0.643	0.293	2.559	0.012

F = 14.902, P = 0.000, R = 0.709, R² = 0.502. FACIT-Sp-12: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale.