Spiritual interventions for cancer pain: a systematic review and narrative synthesis

BMJ Support Palliat Care. 2022 Mar;12(1):1-9. doi: 10.1136/bmjspcare-2021-003102. Epub 2021 Oct 19.

Abstract

BackgroundPain is a common and debilitating cancer-related symptom. In palliative care, physical, psychological, social and spiritual factors are thought to contribute to individual experience of pain. Consequently, spiritual care interventions are advocated in the management of cancer-related pain.

Aim: To systematically review the published literature concerning spiritual interventions in the management of cancer-related pain.

Methodology: Seven databases (Medline, CINAHL, EMBASE, PsycINFO, Cochrane, Scopus and Web of Science) were searched for quantitative studies of pain in patients with cancer receiving spiritual care interventions, with additional reference and citation searches. Research quality and relevance was appraised using Gough's 'Weight of Evidence' framework prior to narrative synthesis.

Results: The search identified 12 822 articles, of which 11 were included in the synthesis. Few studies have investigated spiritual interventions in the management of cancer pain: a minority of these demonstrate statistical benefit. Some evidence suggests spiritual care may aid in coping with pain, rather than altering pain intensity. Spiritual interventions are well received by patients with cancer and do not appear to cause harm.

Conclusion: Current evidence provides limited support for the use of spiritual care interventions in the management of cancer pain. The paucity and heterogeneity of literature points to a need for high-quality research with judgements of spiritual intervention efficacy made on an individual basis.

Prospero registration number: CRD42020190194.

Keywords: cancer; pain; spiritual care; terminal care.

Publication types

  • Systematic Review

MeSH terms

  • Cancer Pain* / therapy
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / psychology
  • Neoplasms* / therapy