精神上的痛苦加剧了癌症患者的痛苦。然而，目前不清楚照顾疗法以外的患者是否会报告精神痛苦及其与症状负担的关系。本研究旨在探讨报告精神痛苦的患者特征，以及精神痛苦与症状负担的关联，以及如何影响Edmonton症状评估系统(ESAS)的因素结构。 本研究进行了回顾性病历审查，研究了完成PROMIS10和修改的ESAS-FS(包括财务困难和精神痛苦)的整合肿瘤学患者的报告的病例。使用多重逻辑回归分析人口统计学与精神痛苦之间的关系。T检验比较了表达精神痛苦(0 vs. ≥1)的患者ESAS-FS症状和总体健康状况。主成分分析(交联旋转)也用于确定ESAS-FS症状簇。 样本(n=1662)主要是女性(65%)，39%表示至少≥1精神疼痛。男性和年龄较大的个体较不可能表达精神痛苦(ps<.05)。精神疼痛的出现与ESAS-FS和全局健康的症状恶化有关(ps<.001)。ESAS-FS有两个症状群，其中心理因素包括抑郁、焦虑、幸福感、睡眠、财务困难和内心的精神痛苦(克伦巴赫α为0.78)。 评估精神痛苦并了解其出现或缺失在其他身体和心理症状的背景下的影响可能为防止症状恶化、提高生活质量和增强整体护理体验提供额外的机会。在整合肿瘤学门诊评估中，有大部分患者表达内心的精神痛苦。表达精神痛苦的患者也表现出更严重的情绪症状、身体症状和全局健康。精神痛苦与心理压力症状一起聚集。Copyright © 2023. Elsevier Inc. 发行。

Spiritual pain contributes to the suffering of cancer patients. However, it is unclear whether patients seen outside of palliative care report spiritual pain and its relationship with symptom burden.Characteristics of patients reporting spiritual pain were examined, as well as the association of spiritual pain with symptom burden and how spiritual pain affected the factor structure of the Edmonton Symptom Assessment System (ESAS).A retrospective chart review was conducted of integrative oncology patients who completed the PROMIS10 and a modified ESAS (ESAS-FS) including financial distress and spiritual pain (pain deep in your soul/being that is not physical). Multiple logistic regression was used to assess associations between demographics and spiritual pain. T-tests compared ESAS-FS symptoms and global health for patients endorsing spiritual pain (0 vs. ≥1). Principal component analyses (oblique rotation) was also used to determine ESAS-FS symptom clusters.The sample (N = 1662) was mostly women (65%) and 39% endorsed spiritual pain at least ≥1. Men and older individuals were less likely to endorse spiritual pain (ps < .05). Presence of spiritual pain was associated with worse symptoms on the ESAS-FS and global health (ps < .001). The ESAS-FS had two symptom clusters, with the psychological factor including depression, anxiety, wellbeing, sleep, financial distress, and spiritual pain (Cronbach's alpha 0.78).Assessing spiritual pain and understanding the effects of its presence or absence in the context of other physical and psychosocial symptoms may provide additional opportunities for preventing exacerbation of symptoms, improving quality of life, and enhancing overall experience of care.Spiritual pain is endorsed in a significant portion of patients assessed in an integrative oncology clinic. Patients endorsing spiritual pain also endorse worse emotional symptoms, physical symptoms, and global health. Spiritual pain clusters together with psychological distress symptoms.Copyright © 2023. Published by Elsevier Inc.