BACKGROUND Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients. METHODS A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one's perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients' definitions of spirituality was based on the interpretative phenomenological process. RESULTS Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one's decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones' values and beliefs. CONCLUSION The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients' spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

中文翻译：

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灵性对姑息治疗门诊患者决策的影响：一项横断面研究。

背景 由于不确定的预后和围绕决策的普遍恐惧，姑息治疗中的决策可能很复杂。姑息治疗的决策可能会受到精神和文化信仰或价值观的影响。决策过程的决定因素尚不完全清楚，灵性对于应对疾病至关重要。因此，本研究旨在探讨灵性对姑息治疗门诊患者医疗决策认知的影响。方法 开展了一项横断面研究。对 95 名姑息门诊患者进行了一系列测试，即：社会人口统计学问卷 (SQ)、决策冲突量表 (DCS)、慢性病治疗功能评估-精神健康量表 (FACIT-Sp) 和半结构化访谈（SSI）研究一个人对灵性和决策自主权的看法。统计分析涉及 SQ 和 SSI 的描述性统计。曼-惠特尼检验用于比较各组之间的量表分数，并且所有量表和子量表均使用相关性。对患者灵性定义的分析是基于解释现象学过程。结果 精神健康与更高水平的身体、情感和功能健康以及更好的生活质量显着相关。更大的精神健康与减少决策冲突、减少不确定性、获得更多信息和支持以及对自己的决定更加满意的感觉有关。大多数患者成功地执行了他们的决定，并认为自己有能力尽早做出决定。能够执行决定的患者决策冲突较少，精神健康和生活质量较高。在确定的 16 个主题中，灵性大多是通过家庭来描述的。接受过精神护理的患者表现出更好的精神健康分数、生活质量，并且表现出更少的决策冲突。患者认为患病期间的灵性很重要，并相信需要获得精神支持和专门护理，可以在考虑个人价值观和信仰的情况下做出决策。结论 精神健康对决策的影响是显而易见的。灵性是整体幸福的关键组成部分，它具有多维和独特的功能。促进参与决策并考虑患者精神需求的个性化护理对于促进患者赋权、自主和尊严至关重要。