Spiritual needs following cancer diagnosis: A national cross-sectional survey of randomly selected adults and cancer patients linked to nationwide registers

Background: Diagnosis of cancer affects patients at physical, psychological, social, and spiritual levels. The psychosocial effects of cancer diagnosis are well-established, but observational evidence elucidating spiritual needs is limited. Methods: The study is a national cross-sectional survey linked to longitudinal national registers. The primary outcome was spiritual needs (measured by the Spiritual Needs Questionnaire), analysed by weighted linear regression (WLR) and case-control matching. Results: We included 6,871 cancer and 19,548 non-cancer individuals (response rate: 32.1 %). Most substantially, we found an ∼8 % increase in overall spiritual needs in the first six months following diagnosis (WLR: 0.23 [0.12; 0.35]). We found no evidence in our data that the severity of the cancer affect spiritual needs. Both cancer and non-cancer individuals share the most frequently reported spiritual needs. However, several needs were reported as strong or very strong twice as often in recently diagnosed cancer individuals in a matched analysis: to find meaning in suffering (44 % vs. 19 %), to talk about fears (33 % vs. 14 %), to clarify open aspects of life (31 % vs. 14 %), and to talk about life after death (12 % vs. 6 %). Conclusions: Spiritual needs were elevated in recently diagnosed cancer individuals, although most pronounced within the first half year following diagnosis. This knowledge could be valuable in guiding holistic care plans tailored to the spiritual well-being of cancer patients. Future research in this area should focus on the link between reported need and wanted care and test potentially effective spiritual care interventions.