Understanding Patient Priorities for Religious and Spiritual Needs During Radiation Therapy for Gynecological Malignancies

Purpose: Addressing religion and spirituality (R/S) in the patient care setting has shown associations with health care outcomes and quality of life. Patients with gynecologic malignancies demonstrate increased distress and fear following treatment. The Faith or belief, Importance and Influence of spirituality, spiritual Community; and interventions to Address spiritual needs (FICA) Spiritual History Tool outlines 4 domains of assessment. Using the FICA Spiritual History Tool, we sought to evaluate the importance of R/S for patients with gynecologic cancer who had undergone external beam radiation therapy or brachytherapy and assess the most meaningful questions from the FICA Spiritual History Tool that best facilitate conversation. Methods and Materials: Eleven patients with gynecologic malignancy treated with external beam radiation therapy and/or brachytherapy were interviewed with the FICA Spiritual History Tool to assess each question as helpful or unhelpful, and to select 1 or 2 questions they perceived to best open the conversation with providers. Results: Average age was 59 years old (range, 37-74). Religious identities included Christian denominations, Buddhist, Jewish, Muslim, and Hindu. Nine of 11 patients (82%) rated the importance of their faith as 5/5. On average, 9.5 of 11 questions (range, 7-11) were thought to be helpful if asked. All patients reported the same 6 questions as helpful, ranging across all domains. The two most common questions identified to best facilitate conversation were related to alleviating stress: “Do you have spiritual beliefs that help you cope with stress?” and “Have your beliefs influenced you in how you handle stress?” Conclusions: Among gynecological cancer patients who underwent radiation therapy, conversations regarding R/S are highly coveted across a spectrum of demographics and ethnic identities. How R/S helps patients cope with stress was identified as the most meaningful question to open this conversation with providers. Furthermore, engaging patients on their R/S invites further conversation and understanding regarding stress, coping, and anxiety surrounding treatment, findings that should be explored in larger cohorts.