Spiritual beliefs and preferences among patients with multiple myeloma

PURPOSE: Religion and spirituality are important dimensions of coping and supportive care for many patients with cancer, but their role in the longitudinal care of patients with multiple myeloma is less well characterized. We surveyed patients with multiple myeloma to characterize spirituality and religiosity, examine preferences for incorporating spiritual considerations into care, assess whether spiritual beliefs influence treatment decisions, and explore associations between spirituality or religiosity and myeloma-specific quality of life. PATIENTS AND METHODS: We developed an anonymous electronic survey incorporating 47 items from three validated survey instruments: the Centrality of Religiosity Scale (CRS), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12), and the EORTC QLQ-MY20, together with investigator-developed questions regarding spiritual beliefs, treatment experiences, and care preferences. Using convenience sampling, surveys were distributed via X/Twitter and within the University of Chicago myeloma patient population. Survey scores were calculated using validated scoring criteria. Group comparisons were performed with the Mann-Whitney U test, and associations between spirituality measures and QLQ-MY20 subscales were examined with Spearman's rank correlation. RESULTS: Of 281 respondents, 176 (63%) completed all survey components. Median age was 65 years; 64% were female and 85% were non-Hispanic White (NHW; 8.5% non-Hispanic Black, NHB). Most identified as Christian (70%), followed by atheist/agnostic (11%) and spiritual but not religious (10%). Overall, 80% believed clinicians should consider religious or spiritual factors when presenting treatment options and 42% wanted spiritual care services or resources, yet only 19% had discussed spirituality with their care team. Median FACIT-Sp12 and CRS scores were 33 and 3.73, respectively. NHB respondents had higher FACIT-Sp12 and CRS scores indicating higher spiritual well-being, whereas atheist/agnostic participants had lower scores and worse body image. Correlations between spirituality measures and QLQ-MY20 subscales were generally weak. CONCLUSION: Spirituality and religiosity vary widely among patients with multiple myeloma, with meaningful differences by race and belief group. Many patients wanted clinicians to consider relevant spiritual or religious factors during treatment discussions, whereas relatively few reported having discussed these beliefs with their oncology team. These descriptive, cross-sectional findings support future study and suggest opportunities to explore how individual spiritual care preferences might be identified and, when desired, met through referral to appropriate resources.