Factors influencing spiritual needs in patients with chronic diseases: A systematic literature review
DOI: https://doi.org/10.33024/minh.v9i4.3467
Cancer Cardiovascular Disease Chronic Diseases Chronic Kidney Disease Spiritual Needs Stroke
Abstract
Background: Spiritual needs are a critical component of holistic care for patients with life-threatening illnesses, yet their manifestation varies significantly across different disease pathways.
Purpose: To identify and synthesize the multifaceted factors influencing spiritual needs in patients with cancer, cardiovascular disease (CVD), chronic kidney disease (CKD), and stroke, while mapping how different clinical trajectories contribute to variations in spiritual experiences.
Method: Following PRISMA 2020 guidelines, a systematic search was conducted in Scopus and PubMed for primary empirical studies published between 2020 and 2026. A total of 398 records were identified, and after rigorous screening and quality assessment, 49 studies were included in the final synthesis.
Results: Spiritual needs among patients with chronic diseases: cancer, cardiovascular disease, chronic kidney disease, and stroke are associated with interconnected clinical, demographic, physical, psychological, psychosocial, socioeconomic, and cultural factors. Disease burden, physical symptoms, psychological distress, social support, and personal beliefs collectively shape spiritual well-being, highlighting its dynamic nature throughout the illness trajectory.
Conclusion: Spiritual needs among patients with chronic and life-threatening illnesses are associated with clinical, demographic, physical, psychological, psychosocial, socioeconomic, and spiritual-cultural factors. Integrating routine spiritual assessment and personalized spiritual care into healthcare practice may help improve coping, resilience, and quality of life.
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References
Albusoul, R. M., Hasanien, A. A., Razeq, N. M. A., & Al-Maharma, D. Y. (2024). Symptom Clusters and Their Impact on Spiritual Well-Being Among Women with Breast Cancer. International Journal of Women’s Health, 16, 961–970. Scopus. https://doi.org/10.2147/IJWH.S463840
Bacoanu, G., Poroch, V., Aniței, M.-G., Poroch, M., Froicu, E. M., Hanganu, B., & Ioan, B.-G. (2024). Spiritual Care for Cancer Patients at the End-of-Life. Healthcare (Switzerland), 12(16). Scopus. https://doi.org/10.3390/healthcare12161584
Benkel, I., Arnby, M., & Molander, U. (2020). Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situation. SAGE Open Medicine, 8, 2050312120910350. https://doi.org/10.1177/2050312120910350
Biswas, J., Islam, N., Afsar, N., Mroy, W. W., & Chandra Banik, P. (2024). Validation of Bengali version of EORTC QLQ-SWB32: A standalone measure of spiritual wellbeing for advanced cancer patients receiving palliative care. Heliyon, 10(9). Scopus. https://doi.org/10.1016/j.heliyon.2024.e29927
Bovero, A., Pesce, S., Botto, R., Tesio, V., & Ghiggia, A. (2023). Self-Transcendence: Association with Spirituality in an Italian Sample of Terminal Cancer Patients. Behavioral Sciences, 13(7). Scopus. https://doi.org/10.3390/bs13070559
Çakıcı, V., Oğuz, A., Can, S., Kahveci, G. B., Gür, H. B., Akgül, F., Yiğit, A., Topal, A., Peker, P., Özcan, E., Gökmen, İ., & Çırak, Y. (2026). Medication Adherence in Women with Early-Stage Breast Cancer and Active Parenting Responsibilities: The Mediating Role of Parenting Stress and Spiritual Well-Being. Medicina (Lithuania), 62(2). Scopus. https://doi.org/10.3390/medicina62020306
Çakmak, S., Demir Doğan, M., Selim, N., & Kalleci, G. N. (2024). Evaluation of Spiritual Care and Well-Being Levels of Individuals Diagnosed with Lung Cancer in Turkey. Journal of Religion and Health, 63(5), 3636–3659. Scopus. https://doi.org/10.1007/s10943-024-02088-3
Chang, T.-G., Hung, C.-C., Huang, P.-C., Hsu, C.-Y., & Yen, T.-T. (2022). Demoralization and Its Association with Quality of Life, Sleep Quality, Spiritual Interests, and Suicide Risk in Breast Cancer Inpatients: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 19(19). Scopus. https://doi.org/10.3390/ijerph191912815
Cheng, L., Chen, H., Lin, L., Li, H., & Zhang, F. (2023). Spiritual needs of older adults with cancer: A modified concept analysis. Asia-Pacific Journal of Oncology Nursing, 10(11), 100288. https://doi.org/10.1016/j.apjon.2023.100288
Cheng, S.-L., Yusuf, A., He, Y.-Y., Tang, W.-Z., & Sulaiman, N. A. B. S. (2024). Spiritual Needs and Influencing Factors of Postoperative Breast Cancer Women Undergoing Chemotherapy: A Cross-Sectional Study. Risk Management and Healthcare Policy, 17, 843–853. Scopus. https://doi.org/10.2147/RMHP.S453184
Cho, D., Kim, S., Durrani, S., Liao, Z., & Milbury, K. (2021). Associations Between Spirituality, Mindfulness, and Psychological Symptoms Among Advanced Lung Cancer Patients and Their Spousal Caregivers. Journal of Pain and Symptom Management, 61(5), 898-908.e1. Scopus. https://doi.org/10.1016/j.jpainsymman.2020.10.001
Ciria-Suarez, L., Calderon, C., Montes, A. F., Antoñanzas, M., Hernández, R., Rogado, J., Pacheco-Barcia, V., Asensio-Martínez, E., Palacín-Lois, M., & Jimenez-Fonseca, P. (2021). Correction to: Optimism and social support as contributing factors to spirituality in Cancer patients. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 29(6), 3375–3376. https://doi.org/10.1007/s00520-021-06079-y
Cruz, J. I. N., Cardozo, A. C. L., de Melo, E. V., Lira, J. M. C., Santos, G. V., Salazar, G. O., Oliveira, B., Reis, M. C. S., de Lima, D. M. B., Soares, P. S., Sousa, A. C. S., & Oliveira, J. L. M. (2023). Religiosity and Spirituality: The Relationship Between Psychosocial Factors and Cardiovascular Health. International Journal of Cardiovascular Sciences, 36. Scopus. https://doi.org/10.36660/ijcs.20220176
Dabo, I., Skočilić, I., Vivat, B., Belac-Lovasić, I., & Turina, I. S.-B. (2021). Spiritual well-being for croatian cancer patients: Validation and applicability of the croatian version of the eortc qlq-swb32. International Journal of Environmental Research and Public Health, 18(22). Scopus. https://doi.org/10.3390/ijerph182211920
Damen, A., Exline, J., Pargament, K., Yao, Y., Chochinov, H., Emanuel, L., Handzo, G., Wilkie, D. J., & Fitchett, G. (2021). Prevalence, Predictors and Correlates of Religious and Spiritual Struggles in Palliative Cancer Patients. Journal of Pain and Symptom Management, 62(3), e139–e147. Scopus. https://doi.org/10.1016/j.jpainsymman.2021.04.024
Damen, A., Raijmakers, N. J. H., van Roij, J., Visser, A., Beuken-Everdingen, M. V. D., Kuip, E., van Laarhoven, H. W. M., van Leeuwen-Snoeks, L., van der Padt-Pruijsten, A., Smilde, T. J., Leget, C., & Fitchett, G. (2022). Spiritual Well-Being and Associated Factors in Dutch Patients With Advanced Cancer. Journal of Pain and Symptom Management, 63(3), 404–414. Scopus. https://doi.org/10.1016/j.jpainsymman.2021.10.004
Daniels, J., Glover, E. T., & Kyei, K. A. (2025). The contribution of spirituality and religiousness to the quality of life of cancer patients treated with radiotherapy in Ghana: A cross-sectional study. Ecancermedicalscience, 19. Scopus. https://doi.org/10.3332/ecancer.2025.1858
De Luca, E., Sena, B., Butcher, K., & de Wal, L. J. (2025). Spirituality and palliative care: International models and new perspectives. Frontiers in Sociology, 10, 1523685. https://doi.org/10.3389/fsoc.2025.1523685
Delgado-Guay, M. O., Palma, A., Duarte, E., Grez, M., Tupper, L., Liu, D. D., & Bruera, E. (2021). Association between spirituality, religiosity, spiritual pain, symptom distress, and quality of life among latin american patients with advanced cancer: A multicenter study. Journal of Palliative Medicine, 24(11), 1606–1615. Scopus. https://doi.org/10.1089/jpm.2020.0776
Dewi, I. P., Gartika, N., Sanusi, S., & Suryatiningsih, D. (2024). Determinants of Spiritual Well-Being That Impact Breast Cancer Patients’ Quality of Life. Journal of Holistic Nursing, 42(2_suppl), S40–S46. Scopus. https://doi.org/10.1177/08980101231181272
Erdogan, T. K., Danacı, E., Kılıç, Y., & Akköse, A. (2026). Effect of health perception and spiritual well-being on rational drug use by individuals with cardiovascular disease diagnosis in Turkey. Current Psychology, 45(7). Scopus. https://doi.org/10.1007/s12144-026-09273-5
Farahani, A. S., Ashrafizadeh, H., Akbari, M. E., Motefakker, S., Khademi, F., Ebrahimloyi, S., Karami, M., Moghimian, R., Razmara, R., Abreu, W., & Rassouli, M. (2022). The Mediating Role of Spiritual Health in Adherence to Treatment in Patients with Cancer. International Journal of Cancer Management, 15(5). Scopus. https://doi.org/10.5812/ijcm-127820
Farahani, A. S., Kerdar, S. H., Ashrafizadeh, H., Büssing, A., Mehrnoush, N., Akbari, M. E., Karami, M., Tajalli, S., Mojen, L. K., & Rassouli, M. (2023). The predictors of spiritual dryness among Iranian cancer patients during the COVID-19 pandemic. Frontiers in Psychology, 13. Scopus. https://doi.org/10.3389/fpsyg.2022.1024009
Feng, Y., Liu, X., Lin, T., Luo, B., Mou, Q., Ren, J., & Chen, J. (2021). Exploring the relationship between spiritual well-being and death anxiety in patients with gynecological cancer: A cross-section study. BMC Palliative Care, 20(1). Scopus. https://doi.org/10.1186/s12904-021-00778-3
Feng, Y., Liu, X., Zhang, S., Lin, T., Guo, X., & Chen, J. (2024). Relationship among post-traumatic growth, spiritual well-being, and perceived social support in Chinese women with gynecological cancer. Scientific Reports, 14(1). Scopus. https://doi.org/10.1038/s41598-024-55605-5
Ghiggia, A., Pierotti, V., Tesio, V., & Bovero, A. (2021). Personality matters: Relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients. Supportive Care in Cancer, 29(12), 7775–7783. Scopus. https://doi.org/10.1007/s00520-021-06363-x
Heuschkel, G., von Weikersthal, L. F., Junghans, C., Zomorodbakhsch, B., Stoll, C., Prott, F.-J., Fuxius, S., Micke, O., Richter, A., Sallmann, D., Büntzel, J., Hoppe, C., & Huebner, J. (2024). Spirituality in Oncology: Relations between Spirituality, Its Facets, and Psychological and Demographic Factors in Cancer Patients in Germany. Oncology Research and Treatment, 47(4), 123–134. Scopus. https://doi.org/10.1159/000535919
Jetan, M., Daifallah, A., Rabayaa, M. K., Qadri, R., Nassorah, M., Nouri, A., & Al-Othaman, N. (2023). The Impact of Spiritual Well-Being on the Quality of Life of Cancer Patients: A Cross-Sectional Study. Integrative Cancer Therapies, 22. Scopus. https://doi.org/10.1177/15347354231210841
Kang, K.-A., & Choi, Y. (2020). Comparison of the Spiritual Needs of Terminal Cancer Patients and Their Primary Family Caregivers. Han’guk Hosup’isu Wanhwa Uiryo Hakhoe Chi = The Korean Journal of Hospice and Palliative Care, 23(2), 55–70. https://doi.org/10.14475/kjhpc.2020.23.2.55
Karakurt, N., Celik, H. C., & Erden, Y. (2025). The Relationship Between Spiritual Well-Being and Fear of COVID-19 Among Cancer Patients in Turkey. Journal of Religion and Health, 64(6), 4977–4991. Scopus. https://doi.org/10.1007/s10943-025-02303-9
Kebede, F. A., Tafesse, B. H., Moga, F., Haile, A., & Zerihun, E. (2024). Spiritual well-being and associated factor among adult cancer patients in Hawassa University Comprehensive Specialized Hospital, Oncology Center, Hawassa, Ethiopia. Frontiers in Oncology, 14. Scopus. https://doi.org/10.3389/fonc.2024.1357506
Khiyali, Z., Naderi, Z., Vakil, M., Ghasemi, H., Dehghan, A., & Bijani, M. (2023). A study of COVID anxiety, spiritual well-being and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic: A cross-sectional study in the south of Iran. BMC Psychology, 11(1). Scopus. https://doi.org/10.1186/s40359-023-01126-1
Kurt, B., & Sinan, O. (2025). An Investigation of Spiritual Well-Being of Individuals with Cancer in Türkiye. Journal of Religion and Health, 64(5), 3996–4009. Scopus. https://doi.org/10.1007/s10943-025-02356-w
Li, Z.-Y., Cao, X., Li, S., Huang, T.-J., Liu, Y.-X., & Qin, L.-H. (2024). Spiritual needs and influencing factors among people with stroke in China: A cross-sectional study. BMC Nursing, 23(1). Scopus. https://doi.org/10.1186/s12912-024-02182-7
Liu, Y., Zhang, M., Huang, X., Zheng, Y., Yu, X., Li, X., Zhang, M., Zhang, Y., & Hu, F. (2025). Global burden of disease analysis of stroke due to high systolic blood pressure in different regions, 1990–2021. BMC Public Health, 25(1), 3743. https://doi.org/10.1186/s12889-025-25026-8
Londoudi, A., Skampardonis, K., Alikari, V., Prapa, P.-M., Toska, A., Saridi, M., Lavdaniti, M., Zyga, S., & Fradelos, E. C. (2024). Assessment of the Relationship between Fear of Cancer Recurrence, Spiritual Well-Being, and Mental Health among Cancer Patients: A Cross-Sectional Study. Nursing Reports, 14(1), 317–327. Scopus. https://doi.org/10.3390/nursrep14010024
Malak, M. Z., Shehadeh, A., Ayed, A., & Abu Sharour, L. (2025). Quality of life and its association with spiritual well-being among Jordanian Muslim patients with chronic kidney disease undergoing hemodialysis: A cross-sectional study. Journal of Health Psychology, 13591053251392566. https://doi.org/10.1177/13591053251392566
Maria, R., Waluyo, A., & Khamarudin, K. (2024). Spiritual Care in Patient with Cancer Pain: Literature Review. Indonesian Journal of Global Health Research, 6(1), 9–18. https://doi.org/10.37287/ijghr.v6i1.2562
Melaku, Y. A., Bassil, M., Tayyem, R. F. A., ElObeid, T., Zhao, L., Manger, S., Eckert, D. J., Adams, R., & Shi, Z. (2025). The Impact of Unhealthy Lifestyle on the Burden of Non-Communicable Diseases in the State of Qatar: A Systematic Analysis of the Global Burden of Disease Study 2021. American Journal of Lifestyle Medicine, 15598276251405214. https://doi.org/10.1177/15598276251405214
Mihic-Gongora, L., Jiménez-Fonseca, P., Hernandez, R., Gil-Raga, M., Pacheco-Barcia, V., Manzano-Fernández, A., Hernando-Polo, S., Antoñanzas-Basa, M., Corral, M. J., Valero-Arbizu, M., & Calderon, C. (2022). Psychological distress and resilience in patients with advanced cancer during the Covid-19 pandemic: The mediating role of spirituality. BMC Palliative Care, 21(1), 146. https://doi.org/10.1186/s12904-022-01034-y
Noviana, C. M., & Zahra, A. N. (2022). Social Support and Self-Management among End-Stage Renal Disease Patients Undergoing Hemodialysis in Indonesia. Journal of Public Health Research, 11(2), jphr.2021.2733. https://doi.org/10.4081/jphr.2021.2733
Oliveira, S. S. W., Vasconcelos, R. S., Amaral, V. R. S., Pedrosa E Sousa, H. F., Dinis, M. A. P., Vidal, D. G., & Sá, K. N. (2021). Spirituality in coping with pain in cancer patients: A cross-sectional study. Healthcare (Switzerland), 9(12). Scopus. https://doi.org/10.3390/healthcare9121671
Pei, L., Zhou, M., Xu, J., & Hu, Y. (2026). Development and psychometric evaluation of the cancer bio-psycho-social-spiritual comprehensive assessment scale. BMC Psychology, 14(1). Scopus. https://doi.org/10.1186/s40359-025-03794-7
Rabitti, E., Cavuto, S., Iani, L., Ottonelli, S., De Vincenzo, F., & Costantini, M. (2020). The assessment of spiritual well-being in cancer patients with advanced disease: Which are its meaningful dimensions? BMC Palliative Care, 19(1). Scopus. https://doi.org/10.1186/s12904-020-0534-2
Roh, S., Lee, Y.-S., Hsieh, Y.-P., & Easton, S. D. (2021). Protective Factors against Depressive Symptoms in Female American Indian Cancer Survivors: The Role of Physical and Spiritual Well-Being and Social Support. Asian Pacific Journal of Cancer Prevention, 22(8), 2515–2520. Scopus. https://doi.org/10.31557/APJCP.2021.22.8.2515
Sadeghi, M. V., Tehrani, M. A. H., Pasha, H., Hamidia, A., Nabipour, M., Khafri, S., & Yadollahpour, M. H. (2025). Relationship between spiritual well-being with anxiety and depression among cancer patients. PLOS ONE, 20(6 June). Scopus. https://doi.org/10.1371/journal.pone.0322923
Saedi, F., Dehghan, M., Mohammadrafie, N., Xu, X., Hermis, A. H., & Zakeri, M. A. (2024). Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. BMC Nephrology, 25, 326. https://doi.org/10.1186/s12882-024-03768-8
Secinti, E., Wu, W., Krueger, E. F., Hirsh, A. T., Torke, A. M., Hanna, N. H., Adra, N., Durm, G. A., Einhorn, L., Pili, R., Jalal, S. I., & Mosher, C. E. (2022). Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making. Psycho-Oncology, 31(12), 2177–2184. Scopus. https://doi.org/10.1002/pon.6065
Shi, X., Wang, F., Xue, L., Gan, Z., Wang, Y., Wang, Q., & Luan, X. (2023a). Current status and influencing factors of spiritual needs of patients with advanced cancer: A cross-sectional study. BMC Nursing, 22(1). Scopus. https://doi.org/10.1186/s12912-023-01306-9
Shi, X., Wang, F., Xue, L., Gan, Z., Wang, Y., Wang, Q., & Luan, X. (2023b). Current status and influencing factors of spiritual needs of patients with advanced cancer: A cross-sectional study. BMC Nursing, 22, 131. https://doi.org/10.1186/s12912-023-01306-9
Stripp, T. A., Jensen, L. H., Wehberg, S., Ahrenfeldt, L. J., Balboni, T. A., Sangild, P. T., Søndergaard, J., & Hvidt, N. C. (2025). Spiritual needs following cancer diagnosis: A national cross-sectional survey of randomly selected adults and cancer patients linked to nationwide registers. Social Science and Medicine, 381. Scopus. https://doi.org/10.1016/j.socscimed.2025.118198
Tang, A., Li, F., He, B., Zheng, Y., Li, Q., Zhou, L., Wu, J., Zeng, H., Tang, N., Qiu, X., & Chen, X. (2025). Eating-related distress profiles and spiritual well-being in patients with advanced cancer receiving chemotherapy: A latent profile analysis. Asia-Pacific Journal of Oncology Nursing, 12. Scopus. https://doi.org/10.1016/j.apjon.2025.100814
Titi, I., & El Sharif, N. (2026). Spiritual well-being and quality of life among newly diagnosed Palestinian women with breast cancer: A prospective study. Scientific Reports, 16(1). Scopus. https://doi.org/10.1038/s41598-025-33745-6
Vatansever, E., & Ciydem, E. (2026). Intolerance of uncertainty and attitudes toward cancer as predictors of spiritual well-being in patients with cancer. Supportive Care in Cancer, 34(4). Scopus. https://doi.org/10.1007/s00520-026-10606-0
Wang, L., He, Y., Han, C., Zhu, P., Zhou, Y., Tang, R., & He, W. (2025). Global burden of chronic kidney disease and risk factors, 1990-2021: An update from the global burden of disease study 2021. Frontiers in Public Health, 13, 1542329. https://doi.org/10.3389/fpubh.2025.1542329
Wang, T., Badrin, S., & Badrin, S. (2026). Predictors of spiritual needs in Chinese cancer patients: The prominent roles of time since diagnosis, depression severity, and residential area. Eurasian Journal of Medicine and Oncology, 10(1), 279–295. Scopus. https://doi.org/10.36922/EJMO025380405
WHO. (2025). Noncommunicable diseases. WHO. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
WHO. (2026). Cancer. WHO. https://www.who.int/news-room/fact-sheets/detail/cancer
Xia, C., Zhao, X., Li, B., Qi, B., & Hong, Y. (2023). Loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients. Brazilian Journal of Medical and Biological Research, 56. Scopus. https://doi.org/10.1590/1414-431X2023e12915
Zhou, M., Zhang, Y., Yang, W., Wang, H. H. X., Park, S. M., Liu, S., & Piao, H. (2024). Analysis of Factors That Influence the Spiritual Care Needs of Patients with Advanced Cancer. European Journal of Cancer Care, 2024. Scopus. https://doi.org/10.1155/2024/5809074
Zhu, F., Wu, Z., Zhu, H., Liu, D., Yang, L., Lin, Y., Lin, J., & Ke, X. (2025). Factors influencing the spiritual needs of patients with terminal cancer: A multicenter study in southern China. BMC Palliative Care, 24(1). Scopus. https://doi.org/10.1186/s12904-025-01749-8
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