Narrative-based study of spiritual health in advanced cancer patients: insights from Macao’s cultural context with broader implications for Asia and beyond

Background: Individuals with advanced cancer frequently have substantial physical, psychological, and spiritual obstacles. Spiritual health has garnered growing attention as a crucial element of palliative care, particularly in enhancing patients’ quality of life (QoL) and psychological resilience. Nevertheless, studies regarding the spiritual well-being of advanced cancer patients in Macao remain scarce. This study seeks to investigate the spiritual health and narrative experiences of advanced cancer patients in Macao, while comparing the results with worldwide perspectives to emphasize cultural particularities and implications for holistic care. Method: This study employed a qualitative narrative research approach to perform semi-structured interviews with five patients suffering from advanced cancer in a palliative care centre in Macao from March to May, 2025. Utilizing the FICA model (Faith, Importance, Community, and Address) as a framework. Themes were derived by story analysis, and the credibility of the findings was validated through collaborative developing between the researcher and the participants. Result: Five primary themes were identified in the study: (1) psychological adjustment and emotional transformation; (2) social connection; (3) family support; (4) spiritual practice and self-healing; and (5) life reflection and experience transmission. Culture-specific findings encompassed the significance of familial support, the amalgamation of traditional culture and spiritual practices (e.g., Buddhism beliefs), and the impact of nurse-patient narrative exchanges in addressing spiritual needs. Conclusion: Spiritual health is a critical component of the comprehensive treatment of patients with advanced cancer. Narrative research effectively elucidates patients’ spiritual demands and coping mechanisms. This study advocates for the use of spiritual therapies grounded in culture and narrative understanding into palliative care procedures.