Impact of Spiritual Care Nursing Based on the “Four-full Framework” on Liver Cancer Patients
Download PDF
$currentUrl="http://$_SERVER[HTTP_HOST]$_SERVER[REQUEST_URI]"

Keywords

Four-full framework
Spiritual care nursing
Liver cancer
Spiritual status
Psychological distress
Quality of life

DOI

10.26689/jcnr.v9i6.10951

Submitted : 2025-06-03
Accepted : 2025-06-18
Published : 2025-07-03

Abstract

Objective: To explore the impact of spiritual care nursing based on the “Four-full Framework” (whole-person, whole-process, whole-department, whole-society) on the spiritual status, psychological distress, and quality of life of liver cancer patients. Methods: A total of 120 terminally ill liver cancer patients admitted to the hospital from January 2022 to December 2023 were divided into a control group (60 cases, receiving routine nursing) and an observation group (60 cases, receiving routine nursing plus spiritual care nursing based on the four-full framework) according to their admission order. Both groups were intervened for 4 consecutive weeks. The two groups were compared in terms of death attitude, spiritual status, psychological distress, and quality of life. Results: After intervention, the observation group had lower scores in death avoidance, death fear, escape acceptance, and psychological distress, while higher scores in natural acceptance, approach acceptance, all dimensions of spiritual status, psychological resilience, and all aspects of quality of life compared with the control group, with statistically significant differences (P < 0.05). Conclusion: Spiritual care nursing based on the four-full framework can effectively help terminally ill liver cancer patients face death positively, improve their spiritual status, reduce psychological distress, and enhance their quality of life.

References

Cao G, 2024, Epidemiological Characteristics and Precision Prevention and Control of Primary Liver Cancer. Journal of Guangxi Medical University, 41(11): 1455–1463.

Yang F, Cao M, Li H, et al., 2022, Analysis and Prediction of Epidemiological Trends of Liver Cancer in Chinese Population From 1990 to 2019. Chinese Journal of Digestive Surgery, 21(1): 106–113.

Chen Q, Rui F, Ni W, et al., 2024, Research Progress on Epidemiology and Risk Factors of Primary Liver Cancer. Chinese General Practice, 27(6): 637–642.

Li G, 2024, Research Progress on Immunotherapy for Pre-Liver Transplantation Treatment of Liver Cancer. Electronic Journal of Liver Cancer, 11(1): 47–49.x

Guo Y, Su J, Chen B, et al., 2024, Application of Mindfulness Intervention Combined With Spiritual Care in Terminally Ill Cancer Patients. China Medicine and Pharmacy, 14(20): 102–105.

Zeng J, Wang Y, Li H, et al., 2024, Case Management of “Four Wholes Care” for a Patient With Advanced Breast Cancer and a Large Wound. Shanghai Nursing, 24(3): 69–71.

Zha L, Mao W, 2023, Application of Physical-Psychological-Social-Spiritual Four Wholes Care in Cervical Cancer Patients Undergoing Chemotherapy. Today’s Nurse, 30(24): 94–97.

Chen Y, Cai T, Song B, 2023, Influence of Spiritual Care Based on the IMB Model on Spiritual Health and Quality of Life of Advanced Cancer Patients. Journal of Qilu Nursing, 29(19): 45–49.

Medical Administration Bureau of the National Health Commission of the People’s Republic of China, 2020, Standards for Diagnosis and Treatment of Primary Liver Cancer (2019 Edition). Journal of Clinical Hepatology, 36(2): 277–292.

Zhu H, Shi B, 2011, Reliability and Validity Study of the Chinese Version of the Death Attitude Description Scale-Revised. Chinese Journal of Practical Nursing, 27(8): 51–53.

Xu S, Yuan Z, Cheng X, et al., 2023, Revision of the Chinese Version of the Functional Assessment of Chronic Illness Therapy–Spiritual Scale and Its Application in Maintenance Hemodialysis Patients. Nursing Research, 37(11): 2001–2005.

Roth A, Kornblith A, Batel‐Copel L, et al., 1998, Rapid Screening for Psychologic Distress in Men With Prostate Carcinoma: A Pilot Study. Cancer: Interdisciplinary International Journal of the American Cancer Society, 82(10): 1904–1908.

Zhang D, Xiong M, Li Y, 2018, Reliability and Validity Test of the Short Version of the Psychological Resilience Scale in Community-Dwelling Elderly. Chinese Journal of Behavioral Medicine and Brain Science, 27(10): 942–946.

Du Y, Fang J, 2000, Introduction and Instructions for Use of the Chinese Version of the World Health Organization Quality of Life Assessment Scale. Modern Rehabilitation, 4(8): 1127–1129, 1145.

Xu W, Zhen C, Chen X, et al., 2022, Application Effect of Traditional Chinese Medicine Appropriate Technology Combined With Hospice Care in Nursing Terminally Ill Cancer Patients. Chinese Journal of Clinical Oncology and Rehabilitation, 29(5): 573–576.

Ying J, Chen L, Zhu S, et al., 2024, Application of the Self-Management-Oriented 5A Nursing Model in Patients Undergoing Liver Resection for Liver Cancer. Health Medicine Research and Practice, 21(5): 143–148.

Liao R, Zhu H, Chen J, et al., 2022, Influence of the Physical-Psychological-Social-Spiritual Integrated Whole-Person Model on Lung Cancer Patients. Chinese Journal of Health Psychology, 30(9): 1310–1314.

Ye P, Mao X, 2021, Influence of Palliative Care on Self-Perceived Burden, Attitude Toward Life, and Quality of Life in Terminally Ill Cancer Patients. Journal of Clinical Research, 38(4): 625–627.

Snapp M, Hare L, 2021, The Role of Spiritual Care and Healing in Health Management. Advances in Mind-Body Medicine, 35(1): 4–8.

Zhang L, Wang R, 2023, Analysis of the Influence of Physical-Psychological-Social-Spiritual Nursing on the Quality of Life of Terminally Ill Malignant Tumor Patients. Clinical Research, 31(5): 149–151.