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Objectives The purposes of this study were to describe and compare the spiritual needs and spiritual well-being among terminally ill patients receiving care in different palliative care settings and to investigate the differences in spiritual well-being in relation to the level of Buddhist practices. Methods A cross-sectional multicenter study was carried out that included community/home-based care (Home), a faith-based organization for patients with AIDS (FB_AIDS), a faith-based organization for patients with cancer (FB_CA), and a hospice ward (Hospice). Descriptive statistics were used to analyze the participants’ demographics, Buddhist practices, spiritual needs, and spiritual well-being. The analysis was performed using analysis of variance and Kruskal–Wallis tests to compare the spiritual needs and the spiritual well-being in the different settings. The Kruskal–Wallis test was used to investigate the differences in spiritual well-being in relation to the level of Buddhist practices. Results A total of 170 patients with a terminal illness (30 Home, 33 FB_AIDS, 64 FB_CA, and 43 Hospice) participated. Patients with a terminal illness receiving care at the FB_CA and Home had significantly higher mean scores for spiritual needs than those in the other settings. Patients with a terminal illness receiving care at the FB_CA had a significantly higher mean score for spiritual well-being than those receiving care in the other settings. Participants having a higher frequency of Buddhist practice had significantly higher mean scores for spiritual well-being. Significance of results Spiritual needs and spiritual well-being differed significantly among participants in different palliative care settings. The more the patients engaged in Buddhist practices, the higher their scores were for spiritual well-being. Thus, religious-based strategies should be integrated into palliative care and should be more emphasized.

Background End-stage renal disease (ESRD) patients undergoing hemodialysis have to face many symptoms from disease progression and treatment. These symptoms cause suffering and affect physical, psychological, emotional, social, and spiritual of the patients, resulting in decreased quality of life and might increase the death rate of these patients. Therefore, the study of symptoms in ESRD patients undergoing hemodialysis will lead to effective symptom management and maximize benefits for the patients. The purpose of this study was to explore the symptom clusters of ESRD patients undergoing hemodialysis. Materials and methods The sample of this descriptive study consisted of 150 ESRD patients undergoing hemodialysis from two dialysis centre of the university hospital and specialized kidney hospital in Bangkok. The instruments consisted of Personal Information Questionnaire (PIQ) and Dialysis Symptom Index-THAI (DSI-THAI). The data were analyzed by exploratory factor analysis. Results The 8 clusters of symptoms were found: 1) gastrointestinal, 2) musculoskeletal and fluid volume 3) neurological 4) irritation of the mucous membranes and skin 5) depression 6) sleep disturbance 7) sexual 8) anemic. Conclusion The results of this study can be raised awareness and used as the information for the health-care provider to develop the intervention to manage unpleasant symptoms which lead to improving the quality of life.

Background End-stage renal disease (ESRD) patients undergoing hemodialysis have to face many symptoms from disease progression and treatment. These symptoms cause suffering and affect physical, psychological, emotional, social, and spiritual of the patients, resulting in decreased quality of life and might increase the death rate of these patients. Therefore, the study of symptoms in ESRD patients undergoing hemodialysis will lead to effective symptom management and maximize benefits for the patients. The purpose of this study was to explore the symptom clusters of ESRD patients undergoing hemodialysis. Materials and Methods The sample of this descriptive study consisted of 150 ESRD patients undergoing hemodialysis from two dialysis centre of the university hospital and specialized kidney hospital in Bangkok. The instruments consisted of Personal Information Questionnaire (PIQ) and Dialysis Symptom Index-THAI (DSI-THAI). The data were analyzed by exploratory factor analysis. Results The 8 clusters of symptoms were found: 1) gastrointestinal, 2) musculoskeletal and fluid volume 3) neurological 4) irritation of the mucous membranes and skin 5) depression 6) sleep disturbance 7) sexual 8) anemic. Conclusion The results of this study can be raised awareness and used as the information for the health-care provider to develop the intervention to manage unpleasant symptoms which lead to improving the quality of life.

Objective: The purpose of this study was to investigate the psychometric properties of themodified Thai Spiritual Well-Being Scale in patients with advanced cancer.Method: This cross-sectional study was employed to investigate psychometric properties.Some 196 participants from three tertiary hospitals in Bangkok and suburban Thailand wereasked to complete a Personal Information Questionnaire (PIQ), The Memorial SymptomAssessmentScale(MSAS),andtheSpiritualWell-BeingScale(SWBS).Validitywasdeterminedby known-group, concurrent, and constructs validity. Reliability was estimated using internalconsistency by Cronbach’s acoefficients.Results: Three factors were extracted: so-called existential well-being, religious well-being,and peacefulness accounted for 71.44% of total variance. The Cronbach’s acoefficients for totalSWB, EWB, RWB, and peacefulness were 0.96, 0.94, and 0.93, respectively.Significance of Results: These findings indicate that the Thai SWBS is a valid and reliableinstrument, and it presented one more factor than the original version.KEYWORDS: Spiritual Well-Being Scale, Thai, Advanced cancerINTRODUCTIONSpiritual well-being is an essential dimension of hu-manlifeandisrecognizedasacriticalfactorintermsof health and well-being (Puchalski, 2012). It is alsoanimportantcomponentofqualityoflifeforpatientswithcancer(Lucette,2014)andpatientsattheendoflife (Balboni et al., 2010). Previous studies haveshown that spiritual well-being impacts physical(Campbell et al., 2010: Park et al., 2011) and psycho-logical well-being (Nelson et al., 2009; Dein et al.,2010; Breitbart et al., 2010), as well as quality oflife(Vallurupalli etal., 2011). Ithasalsobeen report-ed to be a significant predictor of the effectiveness ofpalliative care in patients with advanced cancer(Chaiviboontham, 2014).Although the concept of spiritual well-being stilllacks a consensus definition and conceptualization(Vivat et al., 2013), Edwards and colleagues (2010)proposed that it offers a sense of purpose, peace,meaning, and relationship. From the Thai perspec-tive, spiritual well-being can be defined as a multidi-mensional concept of wisdom, or a mental state, inrelationtoareligiousviewthatleadstopeace,happi-ness, and enlightenment. It also can be definedwithin a humanistic context as the compassionaterelationship of an individual with other people andwith their environment, and it includes religiousfaith and compliance with religious principles intheir interests of self and society (Kunsongkeit,2004). Similarly, Paloutzian and Ellison (1982) sug-gested that it is comprised of two dimensions, withbothverticalandhorizontaldimensions.Theverticaldimensionreferstoasenseofwell-beinginrelationtoGod,whilethehorizontaldimensionreferstoasenseof life purpose and life satisfaction, with noreferenceto anything specifically religious. These two