Predictive effect of symptom burden and spiritual well-being on patient empowerment in palliative care patients: a cross-sectional study

Abstract

Patient empowerment is central to high-quality palliative care, yet the factors influencing a patient’s sense of control remain poorly understood. While clinical practice often focuses on physical symptoms, the impact of spiritual well-being and prior illness experience on empowerment requires further exploration. This study examined how symptom burden and spiritual well-being relate to patient empowerment in individuals receiving palliative care. A descriptive, cross-sectional, and correlational design was employed. The study included 140 patients followed in a palliative care unit of a public hospital in Turkiye. Data were collected using the Edmonton Symptom Assessment Scale-Revised, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, and the Patient Empowerment Scale. Data analysis included descriptive statistics, Pearson correlation, and multiple linear regression analysis. The mean total symptom burden score was 50.95 ± 11.41, with pain, fatigue, anxiety, and depression being the most severe symptoms. Despite high symptom intensity, patients maintained moderate levels of spiritual well-being (24.25 ± 4.93) and empowerment (3.05 ± 0.48). Correlation analysis revealed a significant positive relationship between spiritual well-being and empowerment ( r = 0.520, p < 0.01). Regression analysis showed that the model explained 42.8% of the total variance in patient empowerment. Spiritual well-being (β = 0.484, p < 0.001) and the presence of other chronic diseases (β = 0.372, p < 0.001) were identified as the strongest significant predictors of empowerment, whereas symptom burden did not have a significant predictive effect ( p > 0.05). Spiritual resources are significantly associated with patient empowerment, even in the presence of a high symptom load. Nursing care can be enhanced by complementing physical symptom management with a holistic approach that incorporates spiritual support and acknowledges the experiential expertise of patients.