During end-of-life care, cancer patients who utilized spiritual, psychology, and social work services received different oncologic treatment, according to research published in The Oncologist.

The researchers noted that there is a lack of understanding about the impact of spiritual caregivers, psychologists, and social workers on end-of-life medical outcomes in oncology, such as reduced use of aggressive care in the final 2 weeks of life, having more time between the last active cancer treatment and death, and increased hospice use.

To gain some insight, the researchers studied 180 cancer patients treated at a hospital in Israel from November 2018 to March 2020. These patients had a life expectancy less than 6 months, their mean age was 63 years, and 52% were men.

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The patients utilized social work (n=154), spiritual (n=99), psychology (n=41), both social work and spiritual (n=84), social work and psychology (n=41), and psychology and spiritual (n=30) services.

Women were more likely to use psychology and spiritual care than men. Patients with Jewish parents born in Israel were more likely to receive spiritual care. Older patients were more likely to receive spiritual care sooner after a diagnosis of metastatic disease. Patients who were less calm were more likely to use social work services.

There were 10 predictors associated with a reduction in aggressive treatment at end of life (adjusted odds ratio [aOR] range, 1.20-4.56). The greatest predictors were having a palliative care conversation with a physician more than 1 week before death and viewing illness as part of life’s randomness.

There were 18 predictors associated with increased time from active treatment to end of life (aOR range, 1.001-2.28). The greatest predictors were discussing interpersonal relationships with a psychologist, spending more with family since the patient’s first spiritual care visit, and having a palliative care conversation more than 1 month before  end of life.

“This study potentially demonstrates the direct impact of social workers, spiritual caregivers, and psychologists on patients’ palliative medical outcomes, beyond generally reducing suffering and improving QOL [quality of life],” the study authors wrote.


Schultz M, Baziliansky S, Mitnik I, et al. Associations between psycho-social-spiritual interventions, fewer aggressive end-of-life measures, and increased time after final oncologic treatment. Oncologist. Published online April 10, 2023. doi:10.1093/oncolo/oyad037

This article originally appeared on Oncology Nurse Advisor