Cancer is becoming a leading cause of morbidity and mortality in low, middle and high-income countries, with increasing incidence globally [1, 2]. Cancer is often seen as a death sentence in the African context, and as a result, accepting cancer diagnosis, informing patients and family members about the disease and associated side effects with varied treatment options, most often than not, cause psychological distress to patients [3, 4].
Several psychosocial strategies have been developed to decrease cancer-related psychological morbidity thus enhancing the daily functioning and enhancing the quality of life of cancer patients [5, 6]. Such interventions/strategies include exercise programs, cognitive behavioral therapy, peer support etc. [7, 8]. Spiritual care has been found to improve cancer patients and primary care giver’s quality of life in cancer setting [9]. While all these psychosocial intervention reduction strategies have been extensively researched, little is known about spiritual care assessment of cancer patients in Nigeria [10].
Spiritual caring has been recognized as an integral component of holistic nursing care [11]. While much is known about spiritual care in the dying, little attention has been given to spiritual care needs of patients with cancer in clinical setting in Nigeria. Spiritual caring interventions such as prayers, referral services to spiritual services, support persons could improve quality of life of cancer patients, although these options have been minimally explored [12, 13]. Existing cancer survivorship programs basically focuses on therapies such as exercise programs, dietary/nutritional therapy etc. of patients with cancer in order to improve their quality of life, with little or no emphasis on spiritual care, particularly in the study setting where this research was carried out.
According to [14], the assessment of spiritual/religious needs, which can be considered the first step in devising needs-tailored interventions, should be included in cancer care beyond simply caring for the person's body. Spirituality, according to Florence Nightingale's philosophy of care, is inherent in humans and is the deepest and most powerful source of healing. Thus, one of the nurses' responsibilities is to pay attention to spiritual aspects of care and to provide a healing environment for patients [15]. Spiritual well-being, which includes faith, meaning, and peace, is an important component of overall life quality [16].
Spiritual well-being has been found to be more strongly associated with quality of life than physical and emotional well-being, indicating that spiritual care needs should become a formalized and standardized procedure rather than an ancillary service used on a consult basis [17]. When spiritual care was provided in the cancer setting, both patients' and primary caregivers' quality of life improved significantly [18]. Spiritual needs are now routinely mentioned as an important component of holistic healthcare assessment [19]. Although this has not been fully implemented clinical practice in Nigeria particularly relating to the care of cancer patients. Most of than not, spiritual caring practices have been limited to praying with the clients with the exclusion of all other components knowingly or unknowingly [20].
Spiritual care will undoubtedly aid cancer patients in improving their quality of life. However, misinformation, poor integration, and a lack of full acceptance among Nigerian health professionals and institutions continue to plague spiritual caring practices [21]. Each year, 100,000 new cancer cases are reported in Nigeria, with a high case fatality rate. Because the country is still dealing with infectious diseases and has limited data on cancer epidemiology, Nigeria has a significant cancer burden [22, 23]. A review of Nigerian-based literature revealed that there has been little progress in the field of spiritual care in nursing in Nigeria. If nurses, clinicians, and other healthcare stakeholders are not discussing spirituality, then people should raise concerns about it because patients' perceptions of illness and underpinning health beliefs in most Nigerians are that illness has a primary supernatural cause and requires spiritual solutions.
Over the years, Ilorin, the capital of Kwara State, has cancer registries with numerous cases of the disease [25]. According to Afolayan et al. [26], 1187 new cancer cases were registered at the University of Ilorin Teaching Hospital Cancer Registry, Department of Pathology, between 1999 and 2003, with approximately 40% males and 60% females. The top five most common cancers at this center were breast cancer, cervical cancer, hepatocellular carcinoma, malignant lymphoma, and prostate carcinoma. Males were more likely to develop cancers of the liver, prostate, and colorectal tract, whereas females were more likely to develop cancers of the breast, cervix, and hepatocellular carcinoma [27.] Lung cancer is rare in both sexes. Children accounted for 6% of all cases, with malignant lymphoma being the most common [28].
It can be difficult to determine a patient's spiritual needs. This issue derives in part from the ambiguity and complexity of the concept of spirituality, which makes it difficult to discern between religious concepts and assessing spirituality in non-religious persons [29]. In cancer patients, spiritual well-being reduces symptom severity, hopelessness, and the desire for hastened death [30]. However, spiritual care remains underserved in the medical setting, despite the fact that patients, particularly those nearing the end of their lives, would like their spiritual needs to be addressed as part of their overall care [18].
Assessment of spiritual care needs of cancer patients is paramount as this may substantially improve quality of life (QoL) of these patients [31]. This study therefore assessed spiritual care needs of cancer patients and their quality of life. Additionally, this study determined the relationships between these 2 concepts and their sub-concepts in one of the foremost tertiary health Institution in Nigeria.