Cancer patients report more spiritual needs than their nurses perceive

Patients with cancer rate their spiritual needs substantially higher than the nurses caring for them, according to a comparative cross-sectional study published in BMC Nursing. Researchers surveyed 120 patients with cancer and 120 nurses using the same 20-item questionnaire covering four domains of spiritual need: Religious Needs, Inner Peace, Existential Needs, and Active Giving. Patients recorded an overall mean score of 1.83 (standard deviation 0.19), while nurses reported a mean of 1.50 (standard deviation 0.20), leaving a measurable gap between what patients expressed and what nursing staff perceived.

The pattern held across the individual domains, but not in the same order. Among patients, Religious Needs scored highest at 2.14 (standard deviation 0.34), followed by Existential Needs at 1.97 (standard deviation 0.33), Inner Peace at 1.84 (standard deviation 0.34), and Active Giving at 1.38 (standard deviation 0.34). The nurses produced a different ranking: Inner Peace came first at 1.77 (standard deviation 0.35), followed by Religious Needs at 1.55 (standard deviation 0.33), Existential Needs at 1.45 (standard deviation 0.36), and Active Giving at 1.24 (standard deviation 0.34). In every domain, patients’ mean scores exceeded the nurses’, with the largest absolute differences appearing in the religious and existential categories.

To identify what shapes these perceptions, the researchers ran multiple linear regression analyses on the overall spiritual-needs scores in each group. Among patients, none of the examined demographic and clinical characteristics showed a significant association with the overall score. In other words, the level of spiritual need patients reported did not vary measurably with any of the factors the study assessed, which the authors read as support for assessing spirituality directly with every patient rather than targeting particular subgroups.

Among nurses, one factor did stand out: greater work experience was inversely associated with the overall spiritual-needs score they perceived. More experienced nurses, on average, attributed lower spiritual needs to their patients than less experienced colleagues did. The study did not examine why this pattern emerged, and its cross-sectional design cannot establish causation, but the association raises questions about how perceptions of spiritual care may shift over the course of a nursing career.

Spiritual needs are described in the nursing literature as an important but often overlooked component of holistic cancer care, and nurses occupy a central position in identifying and addressing them. The present findings add quantitative weight to that concern by showing, within a single paired comparison, that the people receiving care reported greater spiritual needs than the people providing it perceived, particularly on religious and existential items.

The authors conclude that the discrepancy underscores the value of direct, patient-centred spiritual assessment rather than reliance on staff judgement alone. They also suggest that nursing education should be strengthened so that nurses are better equipped to recognize and respond to the diverse spiritual needs of patients with cancer.

As a cross-sectional study, the research captures perceptions at a single point in time and cannot track how spiritual needs, or nurses’ assessments of them, change over the course of illness or treatment. The sample comprised 120 patients and 120 nurses, and because the regression models found no significant patient-level predictors, the observed gap should be interpreted as a group-level difference rather than a personalized risk profile.

Even with those limitations, the study offers a concrete, measurable demonstration of a persistent challenge in oncology nursing: the spiritual dimension of patient care may be more demanding than the professionals closest to it tend to assume, and closing that perception gap is a practical target for training and bedside assessment alike.

Subject of Research: Differences between cancer patients' reported spiritual needs and nurses' perceptions in a comparative cross-sectional study

Article Title: Differences in perceived spiritual needs between nurses and patients with cancer: a comparative cross-sectional study

Article References: Shoorvazdi, Z., Salimi, P., Fard, M. M. S., Tabatabaei, M. S., & Rozveh, A. K. (2026). Differences in perceived spiritual needs between nurses and patients with cancer: a comparative cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05581-0

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05581-0

Keywords: cancer care, spiritual needs, nursing, cross-sectional study, oncology nursing, religious needs, existential needs, holistic care, nursing education, patient-centred care, BMC Nursing, Differences