The Influence of Spirituality on Quality of Life and Pain in the Terminally Ill: An exploratory study of the patient perspective to develop an empirical model


Colleen Nordstrom, PhD
Department of General Practice
University of Melbourne, Australia


Spirituality has recently become the subject of empirical health research. Although spirituality has long been recognized as a key component of palliative care, there remains little understanding of how terminally ill patients describe their spirituality and view its impact upon their quality of life and experience of pain. The purpose of this study is to determine how dying patients understand and define the term spirituality, in order to develop a model that offers both clinical and conceptual explanatory powers.

A cross-sectional design using semi-structured qualitative interviews will explore how individuals living with an advanced cancer diagnosis describe aspects of spirituality that influence their quality of life, in particular their management experience of pain. Theoretical and convenience sampling methods will be used to select participants with a primary diagnosis of cancer receiving either domiciliary or inpatient palliative care services. Sample size will be determined by theoretical saturation. First level of data analysis will involve a three-fold approach:

  1. individual narrative analysis;
  2. thematic analysis; and
  3. content analysis of the three key concepts: spirituality, quality of life, and pain.

The spiritual Needs Model of Palliative Care Patients, proposed by Kellehear, will be used to undertake the second order data analysis to enable patterns of spiritual need, quality of life, and pain to be captured. This dimensional approach to researching spirituality enables aspects of the construct to be identified that may compound physical pain. The significance of this research lies in the clinical contribution that may result in improved quality of life, and potentially decreased pain, by identifying aspects of spirituality that can be employed as therapeutic interventions.