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