Predictors of spirituality at the end of life.

OBJECTIVE: To assess the relationship between spirituality and hopelessness, desire for hastened death, and clinical and disease-related characteristics among patients with advanced cancer, and to investigate predictors of spirituality. Spiritual well-being is thought to have a beneficial effect on patients' response to illness. DESIGN: Patients were asked to complete 4 questionnaires: the Greek version of the Spiritual Involvement and Beliefs Scale, the Greek version of the Schedule of Attitudes toward Hastened Death, the Beck Hopelessness Scale, and a questionnaire on demographics. SETTING: A palliative care unit in Athens, Greece. PARTICIPANTS: A total of 91 patients with advanced cancer. MAIN OUTCOME MEASURES: Associations between scores on the Spiritual Involvement and Beliefs scale and scores on the Schedule of Attitudes toward Hastened Death scale and the Beck Hopelessness scale, and demographic characteristics. RESULTS: Statistically significant associations were found between spirituality and sex of patients (P = .001) and spirituality and stronger hopelessness (r = 0.252, P = .016). In multivariate analyses, stronger hopelessness, male sex, younger age, and receiving chemotherapy were found to be the strongest predictors of being spiritual. CONCLUSION: Demographic and clinical characteristics and stronger hopelessness appeared to have statistically significant relationships with spirituality. Interventions to improve patients' spiritual well-being should take these relationships into account.

Cor triatriatum presenting as heart failure with reduced ejection fraction: a case report.

Cor triatriatum is a rare congenital cardiac malformation and it usually refers to the left atrium. We report an unusual case of cor triatriatum in a 33 - year old woman presented with congestive heart failure caused by left ventricular systolic dysfunction.