The study results showed that the overall mean of spiritual needs of terminal ill cancer patients was at the moderate level. This can be explained that due to depending on medical devices to live because of incurable disease, terminal ill cancer patients are enduring physical, mental, social, and spiritual distress . Moreover, these patients are unable to communicate their needs. Thus, the physical conditions of them are mainly cared for; meanwhile, other dimensions of their needs are neglected3. Registered nurses are the health care provider playing an important role in the delivery of holistic care for terminal ill cancer patients to alleviate suffering for the patients and their families [12-15]. If terminal ill cancer patients have religious beliefs and faith, positive attitudes towards life, and love from family; the patients view life as more meaningful and have peace of mind .
In addition, explain: if end-of-life needs are fulfilled and terminal ill cancer patients feel that hope exists, their quality of life will get better. Also, they will leave this world in peace. Accordingly, registered nurses should provide preparation for end-of-life phase for terminal ill cancer patients and their families [17-19]. That is to enable the patients to understand the illness, accept the conditions of the disease, and accept death [17,20-21]. Thus, spiritual care is an important approach that all registered nurses should keep in mind and provide it for terminal ill cancer patients [22-23].
The study results showed that terminal ill cancer patients with varied marital status, number of family members, living with family, and spiritual anchor differed in spiritual needs at the statistical significance level of .05. This can be explained that due to the conditions of incurable diseases, terminal ill cancer patients are enduring physical, mental, social, and spiritual distress. Their spiritual needs are varied in relation to beliefs, customs, tradition and culture, and religions and spiritual anchor that the patients and families have practiced . The provision of holistic care for terminal ill cancer patients, especially the care related to the dimension of spirituality and beliefs of the patients and families is valuable and important in the area of palliative care for terminal ill cancer patients. That is to let the patient be happy at end-of-life phase and live this world with human dignity .
Considering the study results: (1) terminal ill cancer patients with married status had higher mean score of spiritual needs than those with widowed status. (2) terminal ill cancer patients with 3–4 family members had higher mean score of spiritual needs than those with 1-2 family members and 5 family members and over. (3) Terminal ill cancer patients who lived with family had higher mean score of spiritual needs than those who lived alone. It can be explained that terminal ill cancer patients feel happy when perceiving that they are valuable to others and families as well as able to perform behaviors that benefit others . These patients are happy with being useful for others, perceive life as valuable, have self-esteem, satisfy with current situation in life, and have better spiritual well-being [24-25].
In addition, (4) Terminal ill cancer patients with 1 spiritual anchor had higher mean score of spiritual needs than those who had none. It can be explained that terminal ill cancer patients who have faith in religions will perform behaviors in line with the principles of their religions. The patients will have faith in rules, custom, tradition, values or culture of the society/sacred objects . This will lead to living together in peace, find happiness in life, and have better spiritual well-being [5,24].
Moreover, spiritual needs of terminal ill cancer patients are varied depending on experience, culture, tradition, religion, and values. Therefore, having incurable disease is a major factor causing suffering in all areas, especially mental and spiritual distress. Some cases may be unable to accept death and end-of-life phase they are encountering, resulting in spiritual distress and no inner calm . On the contrary, if terminal ill cancer patients develop the perception and achieve good spirituality; they would have positive experience related to their current illness, resulting in better quality of life .
In summary, religious beliefs and faith directly influence quality of life of terminal ill cancer patients. Each individual patient has different religious beliefs and needs [27-28]. When these needs are fulfilled, the patients will have peaceful life be able to accept illness’ conditions and death better [26,29-30].
Limitations of the study
This study used data obtained only from Thai terminal ill cancer patients from Thai seven hospitals in northern, northeast, central, and southern regions who did not respond to the treatment. So, it may can’t be generalized to other Thai terminal ill cancer patients who did respond to the treatment.
Practical implications for nursing profession
Nursing professional should investigate about spiritual need and other variables related to spiritual needs of Thai terminal ill cancer patients that encourages Thai terminal ill cancer patients to achieve holistic care in the long term to alleviate suffering and promote good quality of life of patients.