Discussion:
To the best of our knowledge, this is the first study to assess spiritual well-being in subjects with CU. We found that subjects with not controlled CU appeared to experience spiritual well-being on a level worst to that of those with controlled CU. Shenefelt & Shenefelt suggest that reactions to skin disorders have had and continue to have extensive spiritual aspects. They mention modern understandings of skin disorders and how to treat them have brought important advances, but in fact, healing of the skin continues to have a spiritual aspect and sometimes even today healing is hindered until the spiritual aspect is adequately addressed.22
Our study measured QoL and SpWB concurrently. We found that not controlled CU subjects present negatively associated with SpWB and QoL. This is in accordance with recent research which mostly demonstrated emotional distress affect CU and other skin disease patients QoL, leading them to have a low SpWB.9, 23-24 Therefore, providing spiritual care might improve QoL among such patients.
As well as Brady et al study on the evaluation of spirituality impact in quality of life of oncology patients we found that the faith subscale evidenced significantly smaller correlations with QoL than did the meaning/peace subscale.25 Meaning/ Peace was the best predictor of QoL in the CU patients´ evaluated.
In line with the UCT development study there was a strong correlation between UCT scores and CU-Q2oL.12 In this study we found that UCT scores didn´t well correlate with FACIT-Sp-12 subscales, indicating that SpWB were not associated with CU patients´ control status.
Current literature suggests several potential interventions intended to help individuals engage in positive spiritual coping. Life review has been suggested as a potential intervention. This intervention is targeted at helping individuals work through the meaning-making process to achieve a positive view of past and present life events.26
The literature indicates some patient-generated suggestions for interventions. Regarding spiritually related needs, they suggested provider home visits, visits from volunteers, and that health care providers should generally offer a supporting attitude.27