Patient Religiosity and Postoperative Quality of Life in Surgical Oncology
Peter Potash, Vanderbilt University School of Medicine, Nashville, TN; Onur Orun, MS, Vanderbilt Critical Illness, Brain Dysfunction, and Survivorship Center, Nashville, TN; Rameela Raman, PhD, Vanderbilt Critical Illness, Brain Dysfunction, and Survivorship Center, Nashville, TN; and Myrick Shinall, MD, PhD, Vanderbilt University Medical Center and Vanderbilt Critical Illness, Brain Dysfunction, and Survivorship Center, Nashville, TN
Introduction
A growing body of research indicates that patient religiosity and spirituality may affect patient-reported health outcomes. Studies in medical oncology and heart failure demonstrated an association between higher levels of patient religiosity and increased patient quality of life (QoL). Surgical studies have not extensively explored this relationship.
Objectives
We aim to address this knowledge gap in the surgical field by examining the relationship between patient religiosity and self-reported QoL at 90 days postoperatively.
Methods
This was a retrospective cohort study completed as a secondary analysis of a randomized controlled trial that delivered a palliative care intervention to patients undergoing cancer surgery. The study population included adults (age >18) undergoing one of eight intra-abdominal procedures for treatment of cancer at a single academic referral center in the Southeastern United States from 2018-2021. Patient religiosity was measured preoperatively using the Duke University Religious Index (DUREL), a five-item survey consisting of three subscales representing religious service attendance, private religious activity, and intrinsic religiosity. Patient QoL was measured both preoperatively and at 90 days postoperatively using the Functional Assessment of Cancer Therapy – General (FACT-G). The FACT-G consists of four subscales representing physical, functional, emotional and social/family QoL. Statistical analysis was completed using proportional odds logistic regression on a sample of 215 patients, controlling for baseline QoL, age, sex, education and income levels, cancer type, and the palliative intervention.
Results
The adjusted median FACT-G for patients in the 25th percentile of DUREL scores was not significantly different from the adjusted median FACT-G for patients in the 75th percentile of DUREL scores (OR: 0.90 (95% CI: 0.49, 1.66); p-value: 0.92). Higher levels of overall DUREL were not significantly associated with physical/functional QoL, emotional QoL, or social/family QoL. Higher levels of religious service attendance, private religious activity, and intrinsic religiosity were not significantly associated with higher levels of overall postoperative FACT-G. While not statistically significant, there was a trend of lower postoperative FACT-G scores in patients with higher reported levels of private religious activity (p-value: 0.06).
Conclusions
Higher religiosity levels were not found to be associated with comparatively higher patient QoL in the postoperative period. Due to the limited generalizability of our study, future studies should confirm these results in other surgical populations before exploring differences in surgical and non-surgical populations. These empirical results contribute to a growing literature exploring the relationship between patient religiosity and patient-reported quality of life.
A growing body of research indicates that patient religiosity and spirituality may affect patient-reported health outcomes. Studies in medical oncology and heart failure demonstrated an association between higher levels of patient religiosity and increased patient quality of life (QoL). Surgical studies have not extensively explored this relationship.
Objectives
We aim to address this knowledge gap in the surgical field by examining the relationship between patient religiosity and self-reported QoL at 90 days postoperatively.
Methods
This was a retrospective cohort study completed as a secondary analysis of a randomized controlled trial that delivered a palliative care intervention to patients undergoing cancer surgery. The study population included adults (age >18) undergoing one of eight intra-abdominal procedures for treatment of cancer at a single academic referral center in the Southeastern United States from 2018-2021. Patient religiosity was measured preoperatively using the Duke University Religious Index (DUREL), a five-item survey consisting of three subscales representing religious service attendance, private religious activity, and intrinsic religiosity. Patient QoL was measured both preoperatively and at 90 days postoperatively using the Functional Assessment of Cancer Therapy – General (FACT-G). The FACT-G consists of four subscales representing physical, functional, emotional and social/family QoL. Statistical analysis was completed using proportional odds logistic regression on a sample of 215 patients, controlling for baseline QoL, age, sex, education and income levels, cancer type, and the palliative intervention.
Results
The adjusted median FACT-G for patients in the 25th percentile of DUREL scores was not significantly different from the adjusted median FACT-G for patients in the 75th percentile of DUREL scores (OR: 0.90 (95% CI: 0.49, 1.66); p-value: 0.92). Higher levels of overall DUREL were not significantly associated with physical/functional QoL, emotional QoL, or social/family QoL. Higher levels of religious service attendance, private religious activity, and intrinsic religiosity were not significantly associated with higher levels of overall postoperative FACT-G. While not statistically significant, there was a trend of lower postoperative FACT-G scores in patients with higher reported levels of private religious activity (p-value: 0.06).
Conclusions
Higher religiosity levels were not found to be associated with comparatively higher patient QoL in the postoperative period. Due to the limited generalizability of our study, future studies should confirm these results in other surgical populations before exploring differences in surgical and non-surgical populations. These empirical results contribute to a growing literature exploring the relationship between patient religiosity and patient-reported quality of life.