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Dew K, Chamberlain K, Egan R, Broom A, Dennett E, Cunningham C. Disruption, discontinuity and a licence to live: Responding to cancer diagnoses. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38813846 DOI: 10.1111/1467-9566.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/02/2024] [Indexed: 05/31/2024]
Abstract
Although a diagnosis of a life-limiting cancer is likely to evoke emotions, such as fear, panic and anxiety, for some people it can also provide an opportunity to live life differently. This article is based on research undertaken in Aotearoa New Zealand on the topic of exceptional cancer trajectories. Eighty-one participants who had been identified as living with a cancer diagnosis longer than clinically expected were interviewed, along with 25 people identified by some of the participants as supporters in their journey. For some participants the diagnosis provided the opportunity to rethink their lives, to undertake lifestyle and consumption changes, to be culturally adventurous, to take up new skills, to quit work and to change relationships with others. The concepts of biographical disruption and posttraumatic growth are considered in relation to these accounts, and it is argued that the event of a cancer diagnosis can give license for people to breach social norms.
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Affiliation(s)
- Kevin Dew
- School of Social and Cultural Studies, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Kerry Chamberlain
- School of Social and Cultural Studies, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Richard Egan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Alex Broom
- Sydney Centre for Healthy Societies, University of Sydney, Sydney, New South Wales, Australia
| | | | - Chris Cunningham
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
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Dominguez LJ, Veronese N, Barbagallo M. The link between spirituality and longevity. Aging Clin Exp Res 2024; 36:32. [PMID: 38341843 PMCID: PMC10859326 DOI: 10.1007/s40520-023-02684-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/21/2023] [Indexed: 02/13/2024]
Abstract
We are facing an inverted demographic pyramid with continuously growing aged populations around the world. However, the advances that prolong physical life not always contemplate its psychological and social dimensions. Longevity is a complex outcome influenced by a wide range of factors, including genetics, lifestyle choices, access to healthcare, socio-economic conditions, and other environmental factors. These factors have been generally considered in the compelling research that seeks the determinants of longevity, particularly those concerning personal lifestyle choices, socioeconomic conditions, and molecular mechanisms proposed to mediate these effects. Nonetheless, fundamental aspects that can affect health and well-being, such as spirituality and religiosity, have been somehow left aside despite numerous epidemiological studies showing that higher levels of spirituality/religiosity are associated with lower risk of mortality, even after adjusting for relevant confounders. Because spirituality/religiosity are dimensions of great value for patients, overlooking them can leave them with feelings of neglect and lack of connection with the health system and with the clinicians in charge of their care. Integrating spirituality and religiosity assessment and intervention programs into clinical care can help each person obtain better and complete well-being and also allowing clinicians to achieve the highest standards of health with holistic, person-centered care. The present narrative review aims to explore the available evidence of a relationship between spirituality/religiosity and longevity and discusses the possible mechanisms that can help explain such relationship.
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Affiliation(s)
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90127, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90127, Palermo, Italy.
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Wenham J, Best M, Kissane DW. An Online Survey of Australian Medical Students' Perspectives on Spiritual History Taking and Spiritual Care. JOURNAL OF RELIGION AND HEALTH 2024; 63:257-273. [PMID: 37725268 PMCID: PMC10861599 DOI: 10.1007/s10943-023-01897-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/21/2023]
Abstract
It is reported that little spiritual care communication skills training occurs in Australian medical schools. This survey explored the experience of final year students in this domain in order to inform the construction of a new curriculum. Medical students in their final year at four Australian medical schools were invited to participate in an online survey, which included questions about demographic details, exposure to spiritual history taking, perceived learning needs, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being 12 item Non-Illness score. Two-hundred and sixty students from a cohort of 766 responded (34%). One in nine students had witnessed spiritual history taking, and one in ten students had been given the opportunity to do so. Barriers and enablers were identified. Two-thirds of the students reported no recollection of any training in spiritual care. When it did occur, it was limited in scope and structure. Final year medical students recognise that spiritual care deserves a place in the modern, broad-based medical school curriculum. This supports the argument for inclusion of spiritual care training as part of all medical student curricula in Australia.
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Affiliation(s)
- John Wenham
- Broken Hill Department of Rural Health, Sydney Medical School, Corrindah Court, PO Box 457, Broken Hill, NSW, 2880, Australia.
| | - Megan Best
- Institute for Ethics and Society, The University of Notre Dame Australia, 104 Broadway, PO Box 944, Broadway, NSW, 2007, Australia
| | - David W Kissane
- Palliative Medicine Research, The University of Notre Dame Australia, Broadway, NSW, 2007, Australia
- The Cunningham Centre for Palliative Care Research, St Vincent's Hospital, Sydney, NSW, Australia
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Salsman JM, Awao S, George JR, Batt S, Park CL. Placing the US Federal Investment in Religion, Spirituality, and Health Research in Context: A Systematic Review and Comparison with Social Support and Optimism Funding Levels. JOURNAL OF RELIGION AND HEALTH 2024; 63:393-409. [PMID: 38169027 DOI: 10.1007/s10943-023-01973-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 01/05/2024]
Abstract
Religion and spirituality (R/S) have been linked to better physical and mental health. The US government has funded several research studies that include a focus on R/S but the amount of support over the last several years appears to be declining. To better understand these funding trends for R/S and health research, we chose relevant comparisons from projects that include a focus on social support and optimism. We identified total amount of funding, change in funding patterns over time, and characteristics of funded projects from a large database of US research projects (Federal RePORTER). We reviewed 5093 projects for social support and 6030 projects for optimism before narrowing the number of eligible studies to 170 and 13, respectively. Social support projects received the largest investment of $205 million dollars. Funded awards for social support and optimism remained stable over time while R/S decreased (p = 0.01), intervention research was more characteristic and studies of African-American/Black participants were less characteristic of funded projects in social support than of R/S (ps < 0.001). Future research for R/S and health would likely benefit from continued focus on minority communities and on identifying and developing appropriate interventions to support individual and community health and well-being.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Sayaka Awao
- Department of Psychology, University of Maryland College Park, College Park, MD, USA
| | - Jamilah R George
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Steven Batt
- Hartford Campus Library, University of Connecticut, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Lebowa W, Prusak J, Leśniak M, Wasiewicz J, Jurczyszyn A. The Influence of Religiosity and Spirituality on the Quality of Life of Patients With Multiple Myeloma. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:889-896. [PMID: 37739869 DOI: 10.1016/j.clml.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/17/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION The majority of patients with advanced neoplasms have religious/spiritual needs, and for most of them religion and/or spirituality is important. The psychology of religion and spirituality is one the forms of support offered to patients with advanced cancer. R/S are factors which impact health-related quality of life (HRQoL). The aim of this paper was to assess the influence of R/S on the HRQoL of patients diagnosed with MM. MATERIALS AND METHODS The patients filled out anonymous questionnaires about R/S and the HRQoL scale. The clinical data were collected from medical records. RESULTS The study sample consisted of 83 patients with MM (51.8% women), with a mean age of 64.9 years. The leading denomination among the respondents was Catholic (N = 83, 100%): 36% described themselves as deep believers (N = 30), 53% as believers (N = 44), and 11% as nonpracticing believers (N = 9). Most patients were receiving ongoing treatment (59.8%), while 40.2% were in remission from the disease. Patients in remission declared a significantly higher interest in R/S issues than patients in active treatment and had a higher rate of intrapsychic R/S struggles dominated by anxiety and guilt. A moderate negative correlation between interest in R/S issues and unfavorable assessment of physical functioning and role functioning was observed. Anger towards God positively correlated with a negative assessment of emotional functioning. CONCLUSIONS The findings highlight the importance of R/S for the HRQoL of MM patients and show that their QoL depends on the types of R/S coping used.
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Affiliation(s)
- Weronika Lebowa
- Department of Hematology, University Hospital, Jagiellonian University Medical College, Cracow, Poland; Jagiellonian University Medical College, Doctoral School of Medical and Health Sciences, Faculty of Medicine, Cracow, Poland.
| | - Jacek Prusak
- Institute of Psychology, Jesuit University Ignatianum, Cracow, Poland
| | - Marlena Leśniak
- Department of Hematology, University Hospital, Jagiellonian University Medical College, Cracow, Poland
| | - Jakub Wasiewicz
- Institute of Psychology, Pedagogical University of Cracow, Cracow, Poland
| | - Artur Jurczyszyn
- Department of Hematology, University Hospital, Jagiellonian University Medical College, Cracow, Poland
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Chen C, Sun X, Liu Z, Jiao M, Wei W, Hu Y. The relationship between resilience and quality of life in advanced cancer survivors: multiple mediating effects of social support and spirituality. Front Public Health 2023; 11:1207097. [PMID: 37701908 PMCID: PMC10493315 DOI: 10.3389/fpubh.2023.1207097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Background While previous studies have revealed a positive association between resilience and quality of life in advanced cancer survivors, the mechanisms of the relationship is still unclear. This study aimed to explore the relationships between resilience, social support, spirituality, and quality of life and determine the multiple mediation effects of social support and spirituality on the relationship between resilience and quality of life. Methods With 286 advanced cancer survivors, a cross-sectional, correlational survey was adopted using convenience sampling. Resilience, social support, spirituality, and quality of life were evaluated by self-report questionnaires. The PROCESS macro for SPSS was used to test the multiple mediation model. Results The scores for resilience, social support, spirituality and quality of life were positively correlated with one another. Resilience was found to be directly impact quality of life. Meanwhile, the relationship between resilience and quality of life was mediated by social support (effect = 0.067, 95% CI [0.019, 0.120]) and by spirituality (effect = 0.221, 95% CI [0.134, 0.332]), respectively, and by these two serially (effect = 0.036, 95% CI [0.015, 0.067]). Conclusion Social support and spirituality played multiple mediating roles in the relationship between resilience and quality of life. Interventions aimed at increasing resilience, and then boosting social support and spirituality may be beneficial for promoting quality of life of advanced cancer survivors.
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Affiliation(s)
- Cancan Chen
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China
| | - Xiaofei Sun
- Department of Publicity, Zhengzhou Vocational University of Information and Technology, Zhengzhou, Henan, China
| | - Zhenya Liu
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China
| | - Miaorui Jiao
- Department of Traditional Chinese Medicine, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wanhong Wei
- School of Nursing and Rehabilitation, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanli Hu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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Shi X, Wang F, Xue L, Gan Z, Wang Y, Wang Q, Luan X. Current status and influencing factors of spiritual needs of patients with advanced cancer: a cross-sectional study. BMC Nurs 2023; 22:131. [PMID: 37076918 PMCID: PMC10116731 DOI: 10.1186/s12912-023-01306-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/16/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Spiritual needs have been associated with better physical health outcomes and provide a context for patients to gain hope and significance in coping with disease. This study aimed to understand the status of spiritual needs of patients with advanced cancer and conducted a quantitative study on the relationship between patient-reported physical, psychological, and social influencing factors and spiritual needs based on a biopsychosocial-spiritual model. METHODS In this study, 200 oncology inpatients from Shandong Province were recruited using a convenience sampling method to conduct a cross-sectional survey using general data from December 2020 to June 2022. Correlation analysis was used to analyze the correlation between spiritual needs and cancer-related fatigue, anxiety and depression, the family care index, and social support. Multiple regression analysis was used to analyze the relationship between spiritual needs and the influencing factors. RESULTS The spiritual needs score of the patients with advanced cancer was high. Multiple regression analysis revealed that cancer-related fatigue, social support, and religious beliefs influenced the spiritual needs of patients with advanced cancer. Compared with married patients, widowed or divorced patients scored 8.531 points higher on spiritual needs. Cancer-related fatigue, social support, religious beliefs, and marital status (divorced or widowed) explained 21.4% of the total variation in the spiritual needs of patients with advanced cancer. CONCLUSION The spiritual needs of patients with advanced cancer were significantly correlated with cancer-related fatigue, depression, social support, and other factors. Religious beliefs, marital status, cancer-related fatigue, and social support were the main factors influencing the spiritual needs of patients with advanced cancer. This is a quantitative study, and medical staff can provide targeted spiritual care for patients with cancer based on the above influencing factors.
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Affiliation(s)
- Xin Shi
- Department of Oncology, Fourth People's Hospital of Jinan City, Shandong, China
- School of Nursing and Rehabilitation, Shandong University, Jinan City, Shandong Province, China
| | - Fengxia Wang
- Department of Oncology, Zaozhuang Municipal Hospital, Shandong, China
| | - Lixin Xue
- Department of Oncology, Fourth People's Hospital of Jinan City, Shandong, China
| | - Zhaohong Gan
- Department of Oncology, Fourth People's Hospital of Jinan City, Shandong, China
| | - Yan Wang
- Department of Oncology, Fourth People's Hospital of Jinan City, Shandong, China
| | - Qian Wang
- Department of Oncology, Shandong Cancer Hospital and Institute, Shandong, China
| | - Xiaorong Luan
- School of Nursing and Rehabilitation, Shandong University, Jinan City, Shandong Province, China.
- Department of Infection Control, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China.
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Merluzzi TV, Salamanca-Balen N, Philip EJ, Salsman JM. "Letting go" - Relinquishing control of illness outcomes to God and quality of life: Meaning/peace as a mediating mechanism in religious coping with cancer. Soc Sci Med 2023; 317:115597. [PMID: 36535230 PMCID: PMC9962851 DOI: 10.1016/j.socscimed.2022.115597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Relinquishing control (RC) of outcomes to God is a long-standing form of religious coping with serious illness. Placing cancer outcomes "in God's hands" has been positively related to coping and quality of life (QOL). However, the mechanisms involved in this relationship have not been established. A serial mediation model [i.e., RC (X)-Meaning/Peace (M1)-Coping Efficacy (M2)-Symptoms, Physical QOL, Functional QOL (Ys)] tested the hypothesis that Meaning/Peace alone and in conjunction with coping would mediate the RC-QOL relationship. METHOD 548 persons with a cancer diagnosis completed the Religious Problem-Solving Scale (RPSS), FACIT-Sp Meaning and Peace Scales, Cancer Behavior Inventory (coping efficacy), and measures of Physical Quality of Life (PQOL), Functional Quality of Life (FQOL) and Symptoms. RESULTS As hypothesized, the single mediation effects of Meaning/Peace were significant [Indirect Effects: PQOL: .23 (95% CI: 0.15, 0.34); FQOL: 0.46 (95% CI: 0.33, 0.61); Symptoms: -0.18 (95% CI: -0.27, -0.10)]. In addition, mediation was confirmed for the serial mediation model (i.e., Meaning/Peace - Coping Efficacy as serial mediators) with significant indirect effects [Indirect Effects: PQOL: 0.37 (95% CI: 0.27, 0.48); FQOL: 0.57 (95% CI: 0.42, 0.72); Symptoms: -0.25 (95% CI: -0.35, -0.17)]. CONCLUSIONS In the mediation models tested, the RC-QOL and RC-Symptoms relationships were mediated by the confluence of a sense of peace perhaps due to patients' feelings that outcomes were "in God's hands" and a sense of coherence between their current situation and a spiritually-based meaning system. Meaning/Peace was also related to coping efficacy, suggesting that these mediating constructs could be used to inform evidence-based interventions, such as Meaning-Centered therapies, that are sensitive to the belief systems of cancer patients and enhance QOL.
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Affiliation(s)
| | | | - Errol J Philip
- University of Notre Dame, Department of Psychology, United States
| | - John M Salsman
- Wake Forest University College of Medicine, Social Sciences and Health Policy, United States
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Davari S, Boogar IR, Talepasand S, Evazi MR. The Effect of Religious-Spiritual Psychotherapy on Illness Perception and Inner Strength among Patients with Breast Cancer in Iran. JOURNAL OF RELIGION AND HEALTH 2022; 61:4302-4319. [PMID: 35690697 DOI: 10.1007/s10943-022-01594-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
Women diagnosed with breast cancer often suffer from illness-related issues, which negatively impact their illness perception and inner strength following diagnosis and/or during treatment. An investigation of the effectiveness of religious-spiritual psychotherapy based on the Twelver Shia Sects of Islam (RSP-TSS) was conducted among hospitalized cancer patients to determine whether it improved their disease perception and inner strength. Forty-five women (ages 31-58) diagnosed with breast cancer in Iran were randomly assigned to RSP-TSS (n = 15), attention control (n = 15) and untreated control groups (n = 15). To meet the needs of hospitalized participants, the manualized RSP-TSS protocol was adapted to consist of ten sessions, each lasting 90 min. Sessions were conducted once weekly for 10 weeks. Primary outcome measures were the Revised Illness Perception Questionnaire (IPQ-R) and the Inner Strength Questionnaire (ISQ). Data were collected in pre-intervention, post-intervention, and 4 months following the intervention. Repeated MANOVA measures showed that, as compared with the attention control and untreated control groups, the RSP-TSS group achieved significant improvements in illness perception and inner strengths, and those gains were maintained during the 4-month follow-up. By reframing illness perception and building inner strength, spiritual and religious-based interventions may improve patients coping with cancer and improve the quality of life for women hospitalized with breast cancer. These promising results warrant further investigation into the efficacy of spiritual and religious-based interventions to remediate illness perception and inner strength problems in women diagnosed with serious medical illnesses.
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Affiliation(s)
- Safoora Davari
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, 356411156, Mahdishahr, Semnan, Iran
| | - Isaac Rahimian Boogar
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, 356411156, Mahdishahr, Semnan, Iran.
| | - Siavash Talepasand
- Department of Educational Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran
| | - Mohamad Reza Evazi
- Department of Internal Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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What Aspects of Religion and Spirituality Affect the Physical Health of Cancer Patients? A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10081447. [PMID: 36011104 PMCID: PMC9408220 DOI: 10.3390/healthcare10081447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, the literature on the relationship between religion and spirituality (R/S) and the health of cancer patients has been flourishing. Although most studies focus on mental health, many study the physical health of these individuals. In order to summarize the findings of these studies, we reviewed the most recent research on this subject using the PubMed and PsycInfo databases. The objective of this systematic review was to recognize the primary R/S variables studied in research on physical health in cancer contexts. We found that spiritual well-being was the most-researched variable in studies of these characteristics, followed by R/S struggles and other variables such as religious coping; religious commitment or practice; or self-rated R/S. In general, R/S seems to have a positive association with the physical health of cancer patients, although the results are quite heterogeneous, and occasionally there are no relationships or the association is negative. Our results may assist in improving interventions that include spirituality in clinical settings as well as the development of holistic approaches, which may have a positive impact on the quality of life and well-being of cancer patients.
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Castro LS, Balboni TA, Lobo TC, Moreira RSL, Koenig HG, Peteet JR, Cintra F. Assessing Religious Commitment in a Multicultural Inpatient Setting: A Psychometric Evaluation of the 10-item Belief into Action Scale. JOURNAL OF RELIGION AND HEALTH 2021; 60:3576-3590. [PMID: 33710465 DOI: 10.1007/s10943-021-01223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Abstract
Religious and spiritual (R/S) issues impact medical decision-making, particularly among highly R/S populations, for whom existing measures have limitations in identifying levels of R/S commitment. The Belief into Action (BIAc) scale was designed for this purpose and was never tested among hospitalized patients. We interviewed 152 patients (51% men) with a mean age of 48.9 years (SD = 15.2), having either cancer (27%), cardiovascular (26%), rheumatic (21%), or other diseases (26%). Cronbach alpha was .82 and a 3-factor structure (subjective, social, and private religious commitment) was the most robust. Results suggest the BIAc has adequate convergent, divergent, and incremental validity compared to other well-established questionnaires and is appropriate for the inpatient setting.
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Affiliation(s)
- Laura S Castro
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 715, Térreo, Vl. Clementino, São Paulo, 04024-002, Brazil.
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA.
| | - Tracy A Balboni
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA
| | - Talita C Lobo
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 715, Térreo, Vl. Clementino, São Paulo, 04024-002, Brazil
| | - Rita Simone L Moreira
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 715, Térreo, Vl. Clementino, São Paulo, 04024-002, Brazil
| | - Harold G Koenig
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - John R Peteet
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA
| | - Fatima Cintra
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 715, Térreo, Vl. Clementino, São Paulo, 04024-002, Brazil
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Palmer Kelly E, Hyer M, Tsilimigras D, Pawlik TM. Healthcare provider self-reported observations and behaviors regarding their role in the spiritual care of cancer patients. Support Care Cancer 2021; 29:4405-4412. [PMID: 33439350 DOI: 10.1007/s00520-020-05957-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The provision of spiritual care by an interprofessional healthcare team is an important, yet frequently neglected, component of patient-centered cancer care. The current study aimed to assess the relationship between individual and occupational factors of healthcare providers and their self-reported observations and behaviors regarding spiritual care in the oncologic encounter. METHODS A cross-sectional survey was administered to healthcare providers employed at a large Comprehensive Cancer Center. Pearson's chi-square test and logistic regression were used to determine potential associations between provider factors and their observations and behaviors regarding spiritual care. RESULTS Among the participants emailed, 420 followed the survey link, with 340 (80.8%) participants completing the survey. Most participants were female (82.1%) and Caucasian (82.6%) with a median age was 35 years (IQR: 31-48). Providers included nurses (64.7%), physicians (17.9%), and "other" providers (17.4%). There was a difference in provider observations about discussing patient issues around religion and spirituality (R&S). Specifically, nurses more frequently inquired about R&S (60.3%), while physicians were less likely (41.4%) (p = 0.028). Also, nurses more frequently referred to chaplaincy/clergy (71.8%), while physicians and other providers more often consulted psychology/psychiatry (62.7%, p < 0.001). Perceived barriers to not discussing R&S topics included potentially offending patients (56.5%) and time limitations (47.7%). CONCLUSION Removing extrinsic barriers and understanding intrinsic influences can improve the provision of spiritual care by healthcare providers.
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Affiliation(s)
- Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Diamantis Tsilimigras
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Narayanan S, Milbury K, Wagner R, Cohen L. Religious Coping in Cancer: A Quantitative Analysis of Expressive Writing Samples From Patients With Renal Cell Carcinoma. J Pain Symptom Manage 2020; 60:737-745.e3. [PMID: 32387140 PMCID: PMC7508963 DOI: 10.1016/j.jpainsymman.2020.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/12/2022]
Abstract
CONTEXT Past religiosity/spirituality (R/S) research has mainly relied on self-report instruments, which may result in self-presentation and defensive biases. OBJECTIVES To address these limitations, we reviewed the writing samples that were generated as part of an expressive writing (EW) trial, coded the samples for R/S content, and examined cross-sectional and prospective associations between R/S content and symptom and psychosocial outcomes. METHODS Participants diagnosed with renal cell carcinoma who were randomized to the EW arm completed a standard writing protocol. Before randomization, they completed validated measures of R/S, depressive symptoms, social support, fatigue, and sleep disturbances and one, four, and 10 months after completing the intervention. Writing samples were coded for positive and negative religious coping (RC), and personal (e.g., private prayer) and collective (e.g., church attendance) religious engagement (RE). RESULTS Of the 138 patients, 117 provided at least one writing sample, and 89% of participants made at least one R/S reference with 70% including at least one positive RC statement, and 45.3% revealed personal and 42.3% collective RE. Negative RC was rare (8%). Although positive RC and RE were significantly associated with the R/S Index (P < 0.01), negative RC was not. In prospective analyses, RE was associated with reduced cancer-related symptoms over time (P = 0.04), and negative RC was associated with increased psychological distress over time (P = 0.004). CONCLUSION Behavioral coding of EW samples supported the literature suggesting that positive RC is common among patients with cancer. Although negative RC may be relatively rare, it may be associated with psychological distress.
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Affiliation(s)
- Santhosshi Narayanan
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Kathrin Milbury
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard Wagner
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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14
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O'Callaghan CC, Georgousopoulou E, Seah D, Clayton JM, Kissane D, Michael N. Spirituality and religiosity in a palliative medicine population: mixed-methods study. BMJ Support Palliat Care 2020; 12:316-323. [PMID: 32499406 DOI: 10.1136/bmjspcare-2020-002261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/09/2020] [Accepted: 05/02/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Spiritual care allows palliative care patients to gain a sense of purpose, meaning and connectedness to the sacred or important while experiencing a serious illness. This study examined how Australian patients conceptualise their spirituality/religiosity, the associations between diagnosis and spiritual/religious activities, and views on the amount of spiritual support received. METHODS This mixed-methods study used anonymous semistructured questionnaires, which included the Functional Assessment of Chronic Illness Therapy-Spiritual Scale-12 (FACIT-SP-12) and adapted and developed questions examining religion/spirituality's role and support. RESULTS Participants numbered 261, with a 50.9% response rate. Sixty-two per cent were affiliated with Christianity and 24.2% with no religion. The mean total FACIT-SP-12 score was 31.9 (SD 8.6). Patients with Christian affiliation reported a higher total FACIT-SP-12 score compared with no religious affiliation (p=0.003). Those with Christian and Buddhist affiliations had higher faith subscale scores compared with those with no religious affiliation (p<0.001). Spirituality was very important to 39.9% and religiosity to 31.7% of patients, and unimportant to 30.6% and 39.5%, respectively. Following diagnosis, patients prayed (p<0.001) and meditated (p<0.001) more, seeking more time, strength and acceptance. Attendance at religious services decreased with frailty (p<0.001), while engagement in other religious activities increased (p=0.017). Patients who received some level of spiritual/religious support from external religious/faith communities and moderate to complete spiritual/religious needs met by the hospitals reported greater total FACIT-SP-12 spirituality scores (p<0.001). CONCLUSION Respectful inquiry into patients spiritual/religious needs in hospitals allows for an attuned approach to addressing such care needs while considerately accommodating those disinterested in such support.
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Affiliation(s)
- Clare C O'Callaghan
- Palliative and Supportive Care Research Department, Cabrini Health, Melbourne, Victoria, Australia.,Institute of Ethics and Society, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Ekavi Georgousopoulou
- School of Medicine Sydney Campus, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
| | - Davinia Seah
- School of Medicine Sydney Campus, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.,Sacred Heart Health Service, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Josephine M Clayton
- Hammond Care, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - David Kissane
- School of Medicine Sydney Campus, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.,Sacred Heart Health Service, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Natasha Michael
- Palliative and Supportive Care Research Department, Cabrini Health, Melbourne, Victoria, Australia .,School of Medicine Sydney Campus, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
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15
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Palmer Kelly E, Paredes AZ, DiFilippo S, Hyer M, Myers B, McGee J, Rice D, Bae J, Tsilimigras DI, Pawlik TM. Do Religious/Spiritual Preferences and Needs of Cancer Patients Vary Based on Clinical- and Treatment-Level Factors? Ann Surg Oncol 2020; 28:59-66. [PMID: 32424588 DOI: 10.1245/s10434-020-08607-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The objective of this study is to characterize the religion and spiritual (R&S) needs of patients who undergo cancer-directed surgery. In addition, we seek to examine how R&S needs vary based on R&S identity and clinical and surgical treatment characteristics. PATIENTS AND METHODS A cross-sectional survey was administered to potential participants who were recruited through outpatient clinics and online. Respondent desires for R&S resources and engagement with the healthcare team around R&S topics were assessed. RESULTS Among 383 potential participants who were identified, 236 respondents were included in the analytic cohort. Mean age was 58.8 (SD 12.10) years, and most participants were female (75.8%) and White/Caucasian (94.1%). The majority (78.4%) identified as currently cancer free. Commonly treated malignancies included breast (43.2%), male reproductive (8.9%), skin (8.5%), and gastrointestinal (GI) (7.2%). Two-thirds of the respondents indicated a desire to have R&S incorporated into their cancer treatment (63.3%). Patients who identified as highly/moderately religious reported wanting R&S more often (highly religious: 95.2% versus moderately religious: 71.4% vs. nonreligious but spiritual: 4.5%). On multivariable analysis, patients who believed their health would improve in the future were more likely to report wanting R&S service (OR 2.2, 95% CI 1.0-4.7) as well as wanting to engage their healthcare providers on R&S topics (OR 2.4, 95% CI 1.2-4.7). In contrast, perception of current or future health status was not associated with patient desire for the actual surgeon/doctor him/herself to be involved in R&S activities (OR 1.83, 95% CI 0.97-3.45). CONCLUSIONS Two-thirds of patients undergoing cancer-directed surgery expressed a desire to have R&S incorporated into their cancer treatment. Incorporating R&S into cancer treatment can help a subset of patients throughout their cancer experience.
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Affiliation(s)
| | - Anghela Z Paredes
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brian Myers
- The Ohio State University, Columbus, OH, USA
| | - Julia McGee
- The Ohio State University, Columbus, OH, USA
| | - Daniel Rice
- Lake Erie College of Osteopathic Medicine, Greensburg, PA, USA
| | - Junu Bae
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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16
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de Diego Cordero R, Lucchetti G, Fernández-Vazquez A, Badanta-Romero B. Opinions, Knowledge and Attitudes Concerning "Spirituality, Religiosity and Health" Among Health Graduates in a Spanish University. JOURNAL OF RELIGION AND HEALTH 2019; 58:1592-1604. [PMID: 30771142 DOI: 10.1007/s10943-019-00780-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study aims to investigate the opinions, knowledge and attitudes concerning spirituality, religiosity and health among 75 health MSc graduates from a Spanish university. The questionnaire "Religion and Spirituality in Medicine, Perspectives of Physicians" was used. Most students had low levels of religious activities, agreeing that S/R could have a high influence on the health professional-patient relationship (62.6%). Nevertheless, they felt little prepared to address these issues (90.6%) and believed that universities were not providing enough information on this topic (91.9%). The most common barriers for addressing R/S were insufficient time (34.7%) and fear of offending the patients (31.9%). Nurse students tended to believe more on the influence of R/S on patients' health and on the appropriateness of addressing R/S issues. However, religious beliefs were not associated with students' R/S opinions. The incorporation of such topic could potentially promote the spiritual sensitivity of health professionals, improving the holistic care.
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17
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Peterman AH. Religious beliefs influencing aggressive end‐of‐life care preferences: A measurement advance and continued challenges. Cancer 2019; 125:1414-1416. [DOI: 10.1002/cncr.31945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/27/2018] [Accepted: 11/27/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Amy H. Peterman
- Health Psychology PhD Program University of North Carolina–Charlotte Charlotte North Carolina
- Department of Psychological Science University of North Carolina–Charlotte Charlotte North Carolina
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18
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Canada AL, Murphy PE, Stein KD, Alcaraz KI, Fitchett G. Trajectories of spiritual well-being in long-term survivors of cancer: A report from the American Cancer Society's Studies of Cancer Survivors-I. Cancer 2019; 125:1726-1736. [PMID: 30633818 DOI: 10.1002/cncr.31967] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/08/2018] [Accepted: 12/11/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Existing research indicates that religion, spirituality, or both are important to the quality of life of patients with cancer. The current study is the first to characterize trajectories of spiritual well-being (SWB) over time and to identify their predictors in a large, diverse sample of long-term cancer survivors. METHODS The participants were 2365 cancer survivors representing 10 cancer diagnoses from the American Cancer Society's Studies of Cancer Survivors-I, and they were assessed at 3 time points: 1, 2, and 9 years after their diagnosis. SWB was assessed with the 3 subscales of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp; ie, Meaning, Peace, and Faith). Predictors included demographic, medical, and psychosocial variables. Latent growth mixture modeling was used to identify trajectories and test their predictors. RESULTS Four distinct trajectories of SWB were identified for each of the FACIT-Sp subscales: stable-high (45%-61% of the sample, depending on the subscale), stable-moderate (23%-33%), stable-low (7%-16%), and declining (6%-10%). Significant predictors of these trajectories included age, sex, race, education, comorbidities, symptom burden, social support, and optimism, but not always in the hypothesized direction. For some of the subscale trajectories, a recurrence of cancer, multiple cancers, or metastatic cancer was associated with lower SWB. CONCLUSIONS This is the first study to establish the existence and predictors of heterogeneous trajectories of SWB in long-term survivors of cancer. Because SWB is an important component of quality of life, the current results indicate characteristics of persons who could be at greater risk for a decline or consistently low scores in SWB and may warrant clinical attention.
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Affiliation(s)
- Andrea L Canada
- Rosemead School of Psychology, Biola University, La Mirada, California
| | - Patricia E Murphy
- Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
| | - Kevin D Stein
- Rollins School of Public Health, Emory University, Atlanta, Georgia.,Research and Training Institute, Cancer Support Community, Washington, DC
| | | | - George Fitchett
- Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
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19
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Lee SA, Choi EJ, Ryu HU. Negative, but not positive, religious coping strategies are associated with psychological distress, independent of religiosity, in Korean adults with epilepsy. Epilepsy Behav 2019; 90:57-60. [PMID: 30513435 DOI: 10.1016/j.yebeh.2018.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/01/2018] [Accepted: 11/17/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE Religion can be important in the everyday lives of persons with epilepsy (PWE). However, there is little research on religion, as it relates to individuals with epilepsy. We determined a relationship between religious coping strategies and psychological distress in Korean adults with epilepsy who had a religious affiliation. METHODS This cross-sectional study was conducted in outpatient clinics. Religiosity and religious coping strategies were assessed using the Duke University Religion Index (DUREL) and the Brief Religious Coping Scale (B-RCOPE). Psychological distress was measured using the Hospital Anxiety Depression Scale (HADS). Univariate and multivariate linear regression analyses were performed. RESULTS A total of 88 participants were included. Positive religious coping strategies were more likely utilized than negative religious coping (p < 001). Religiosity was positively correlated with positive coping (r = 0.439, p < 0.001) but was not correlated with negative coping. Negative coping was significantly related to higher levels of anxiety (β = 0.237, standard error (SE) = 0.107, p < 0.05) and depressive symptoms (β = 0.260, SE = 0.095, p < 0.01), after controlling for religiosity and other confounding factors. However, positive coping was not related to anxiety and depressive symptoms. The two types of coping strategies were positively related to each other (r = 0.304, p < 0.01). CONCLUSIONS We found significant positive associations between negative religious coping and anxiety and depressive symptoms in PWE. Positive religious coping was not related to anxiety and depressive symptoms.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Eun-Ju Choi
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Uk Ryu
- Department of Neurology, Chonbuk National University Medical School, Jeonju, Republic of Korea
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20
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Cal A, Kabatas Yildiz M, Aydin Avci I. Examination of Knowledge and Fear Levels of Breast Cancer With the Spiritual Characteristics of Nurses. Front Public Health 2018; 6:331. [PMID: 30515372 PMCID: PMC6256066 DOI: 10.3389/fpubh.2018.00331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/29/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: Breast cancer is a common problem and it is important to understand the beliefs that increase awareness of breast cancer and guide early diagnosis behaviors. This research is planned to examine the knowledge and fear levels of breast cancer along with the spiritual characteristics of nurses. Methods: This is a descriptive type research. The domain of the research consists of women nurses working in Health Sciences University Samsun Education and Research Hospital. Sampling was not undertaken, rather 327 nurses who were on duty between January and May of 2016 and were willing to cooperate were incorporated into the study. Data was collected by use of the survey forms, "Breast Cancer Fear Scale" and "Comprehensive Breast Cancer Knowledge Test (GKMBT)." Data were analyzed with SPSS 21 Software. Results: Nurses who participated in the research had an average of age of 32.27 ± 1.04 years, 60.6% of whom were married, and had an average duration of nursing practice of 12.49 ± 9.92. The nurses' breast cancer fear level point average was 26.11 ± 6.58, the GMKBT scale general information sub-dimension point average was 7.20 ± 2.81, the treatability sub-dimension point average was 5.80 ± 1.68, and the total point average was found out to be 12.87 ± 2.81. It was determined that nurses' knowledge levels of breast cancer were not related to fear levels. Conclusion: It was concluded that the nurses' breast cancer fear level was high and their knowledge level was moderate. In line with the results obtained, it might be recommended that studies should be made to increase the nurses' knowledge and awareness on breast cancer.
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Affiliation(s)
| | | | - Ilknur Aydin Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
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21
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Lu J, Woo H, Huffman K. Spiritual Competency Scale: A Confirmatory Factor Analysis. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1080/07481756.2018.1435191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Junfei Lu
- The University of Alabama, Tuscaloosa, AL, USA
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22
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Boucher NA, Steinhauser KE, Johnson KS. Older, Seriously Ill Veterans’ Views on the Role of Religion and Spirituality in Health-Care Delivery. Am J Hosp Palliat Care 2018; 35:921-928. [DOI: 10.1177/1049909118767113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: To describe older Veteran’s perspectives on the current delivery of religious or spiritual (R/S) care. Methods: Semi-structured interviews with older veterans with advanced stage cancer, heart failure, or pulmonary disease to elicit views on when, how, and by whom religious and spiritual care is preferred. Results: The sample (n = 17) was largely male (94%), non-Hispanic white (52.9%), Christian (82.3%), and most had at least some college education (64.7%). Participants shared diagnoses of cancer (47%), heart failure (35.2%), or chronic obstructive pulmonary disease (17.6%). As a group, participants had moderate religiosity. Themes relevant to the study goal of improving VA care delivery are as follows: (1) process of R/S engagement, (2) timing of R/S engagement, and (3) awareness of services. Veterans discussed the need for VA providers to accommodate diverse spiritual beliefs, importance of screening for spiritual needs, inclusion of family spiritual support, need for higher visibility of services, use of nonchaplains for R/S support, and times when R/S is important. Discussion: Veterans recognize the diversity of their fellow veterans and note the opportunities and challenges in providing R/S support in the VA care setting. The findings have implications for quality improvement in VA care including efforts focused on enhanced outreach to veterans, bolstered education for staff, and more nuanced approaches to R/S support.
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Affiliation(s)
| | | | - Kimberly S. Johnson
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
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23
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Park CL, Masters KS, Salsman JM, Wachholtz A, Clements AD, Salmoirago-Blotcher E, Trevino K, Wischenka DM. Advancing our understanding of religion and spirituality in the context of behavioral medicine. J Behav Med 2017; 40:39-51. [PMID: 27342616 PMCID: PMC5183527 DOI: 10.1007/s10865-016-9755-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
Abstract
Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Kevin S Masters
- Department of Psychology, University of Colorado Denver, Denver, CO, 80217, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine & the Comprehensive Cancer Center of Wake, Forest University, Winston-Salem, NC, 27157, USA
| | - Amy Wachholtz
- Department of Psychology, University of Colorado Denver, Denver, CO, 80217, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Andrea D Clements
- Department of Psychology, East Tennessee State University, Johnson City, TN, 37614, USA
| | - Elena Salmoirago-Blotcher
- Department of Medicine and Epidemiology, Brown University School of Medicine and School of Public Health, Providence, RI, USA
| | - Kelly Trevino
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Danielle M Wischenka
- Ferkauf Graduate School of Psychology, Yeshivah University, Bronx, NY, 10461, USA
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24
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Wilson JZ, Marin D, Maxwell K, Cumming J, Berger R, Saini S, Ferguson W, Chibnall JT. Association of Posttraumatic Growth and Illness-Related Burden With Psychosocial Factors of Patient, Family, and Provider in Pediatric Cancer Survivors. J Trauma Stress 2016; 29:448-456. [PMID: 27580167 DOI: 10.1002/jts.22123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/04/2016] [Accepted: 06/19/2016] [Indexed: 11/12/2022]
Abstract
Research has indicated that childhood cancer may lead to posttraumatic growth (PTG), given cancer's association with posttraumatic stress. PTG may be associated with family/home and health care dynamics, as well as parental resilience, distress, and coping. This cross-sectional study investigated the associations of psychosocial factors of the patient, family, and health care team with PTG and illness-related burden (IRB) in childhood cancer survivors. The sample comprised 61 children and adolescents (7-18 years of age), their parents, and their nurses. Respondents completed their assessment an average of 1.73 years after the end of treatment for the child's disease, which was either leukemia, a solid tumor, or lymphoma. Regression analyses showed that PTG was positively associated with the patients' posttraumatic stress symptoms. It was also positively associated with the parents' religious coping, and with measures of stronger family and oncologist relationships (R2 = .32). IRB was positively associated with patient-reported posttraumatic stress symptoms, negatively associated with the nurse's trust in the family, and positively associated with parent-reported mental distress, lower family socioeconomic status, and female gender (R2 = .53). There was no significant association with parenting style or parent-reported posttraumatic stress symptoms in the child. The findings suggested that the young cancer patient's psychosocial and resource milieu (e.g., financial) may be instrumental in PTG and IRB. Psychosocial interventions with high-risk families and their health care teams could increase growth and reduce burden.
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Affiliation(s)
- J Zachary Wilson
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Donna Marin
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Katherine Maxwell
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Joseph Cumming
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Ryan Berger
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Shermini Saini
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - William Ferguson
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - John T Chibnall
- Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
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25
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Salsman JM, Pustejovsky JE, Park CL, Sherman AC, Merluzzi TV, Danhauer SC, Jim HSL, Fitchett G. Reply to the association between religion/spirituality and mental health in cancer. Cancer 2016; 122:2441-2. [PMID: 27197776 DOI: 10.1002/cncr.30019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 11/10/2022]
Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina, Comprehensive Cancer Center of Wake Forest University, Winston Salem, North Carolina
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas
| | - Crystal L Park
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Allen C Sherman
- Behavioral Medicine, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina, Comprehensive Cancer Center of Wake Forest University, Winston Salem, North Carolina
| | - Heather S L Jim
- Health Outcomes and Behavior Department, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Illinois
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26
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Park CL, Cho D. Spiritual well-being and spiritual distress predict adjustment in adolescent and young adult cancer survivors. Psychooncology 2016; 26:1293-1300. [PMID: 27196993 DOI: 10.1002/pon.4145] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/16/2016] [Accepted: 03/30/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Spirituality is related to many aspects of cancer survivors' physical and psychological adjustment. Given their unique developmental issues, spiritual issues may be especially important to adolescent and young adult (AYA) survivors, yet little research has been conducted on spirituality with AYA survivors. The present study examines how two aspects of spirituality, spiritual well-being (comprising faith and meaning/peace), and spiritual struggle relate to later post-cancer adjustment. METHODS At Time 1 (T1), 120 AYA survivors completed questionnaires on spirituality and adjustment (fear of recurrence, post-traumatic stress symptoms, perceived post-traumatic growth, psychological distress, and health-related quality of life). Eighty-three of these participants also completed these questionnaires at Time 2 (T2), one year later. RESULTS Our sample reported fairly low spiritual well-being (meaning/peace, faith) and spiritual struggle. As expected, T1 spiritual well-being was positively correlated with some aspects of psychological adjustment at T2, whereas T1 spiritual struggle was inversely correlated with T2 psychological adjustment. Both dimensions of T1 spiritual well-being, but not struggle, were positively associated with perceived T2 posttraumatic growth. In general, T1 spiritual well-being and struggle correlated with T2 psychological adjustment even when demographics and cancer-related variables were controlled. CONCLUSIONS These results suggest that while spirituality is not important to all AYA survivors, both spiritual well-being and struggle have important associations with adjustment and may warrant clinical attention. Future research is needed to more fully understand the role of spirituality in AYA survivors' adjustment in more depth. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Crystal L Park
- University of Connecticut, Department of Psychological Sciences, Storrs, CT, United States
| | - Dalnim Cho
- University of Connecticut, Department of Psychological Sciences, Storrs, CT, United States
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27
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Peters JA, Kenen R, Bremer R, Givens S, Savage SA, Mai PL. Easing the Burden: Describing the Role of Social, Emotional and Spiritual Support in Research Families with Li-Fraumeni Syndrome. J Genet Couns 2015; 25:529-42. [PMID: 26621765 DOI: 10.1007/s10897-015-9905-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/19/2015] [Indexed: 01/10/2023]
Abstract
This study presents findings of a mixed-method descriptive exploration of the role of friends and spirituality/religiosity in easing the burden of families with the rare inherited disorder, Li-Fraumeni Syndrome (LFS). LFS is caused by germline mutations in the TP53 gene and is associated with very high lifetime risk of developing one or more malignancies. During the first clinical visit we assessed several types of social support among a subset of study participants (N = 66) using an established interactive research tool called the Colored Eco-Genetic Relationship Map (CEGRM). We performed both quantitative and qualitative analyses of social relationships with LFS family members and close non-kin. Distress scores (N = 59) were mostly low normal, with some outliers. We found that reported friendships varied widely, that the friendships were often deep and enduring, and were important sources of informational, tangible, emotional and spiritual support. Confidantes tended to be best friends and/or spouses. Organized religion was important in selected families, typically from mainstream traditions. However, a number of people identified themselves as "spiritual" and reported spiritual and humanist explorations. Our results shed preliminary light on how some people in families with LFS cope in the face of tremendous medical, social and emotional challenges.
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Affiliation(s)
- June A Peters
- Clinical Genetics Branch (CGB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA.
| | - Regina Kenen
- Department of Sociology and Anthropology, The College of New Jersey, Ewing, NJ, USA
| | - Renee Bremer
- Clinical Genetics Branch (CGB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA
| | - Shannon Givens
- Clinical Genetics Branch (CGB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA
| | - Sharon A Savage
- Clinical Genetics Branch (CGB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA
| | - Phuong L Mai
- Clinical Genetics Branch (CGB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA
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28
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Sherman AC, Merluzzi TV, Pustejovsky JE, Park CL, George L, Fitchett G, Jim HSL, Munoz AR, Danhauer SC, Snyder MA, Salsman JM. A meta-analytic review of religious or spiritual involvement and social health among cancer patients. Cancer 2015; 121:3779-88. [PMID: 26258730 DOI: 10.1002/cncr.29352] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/29/2014] [Accepted: 11/10/2014] [Indexed: 12/25/2022]
Abstract
Religion and spirituality (R/S) play an important role in the daily lives of many cancer patients. There has been great interest in determining whether R/S factors are related to clinically relevant health outcomes. In this meta-analytic review, the authors examined associations between dimensions of R/S and social health (eg, social roles and relationships). A systematic search of the PubMed, PsycINFO, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases was conducted, and data were extracted by 4 pairs of investigators. Bivariate associations between specific R/S dimensions and social health outcomes were examined in a meta-analysis using a generalized estimating equation approach. In total, 78 independent samples encompassing 14,277 patients were included in the meta-analysis. Social health was significantly associated with overall R/S (Fisher z effect size = .20; P < .001) and with each of the R/S dimensions (affective R/S effect size = 0.31 [P < .001]; cognitive R/S effect size = .10 [P < .01]; behavioral R/S effect size = .08 [P < .05]; and 'other' R/S effect size = .13 [P < .001]). Within these dimensions, specific variables tied to social health included spiritual well being, spiritual struggle, images of God, R/S beliefs, and composite R/S measures (all P values < .05). None of the demographic or clinical moderating variables examined were significant. Results suggest that several R/S dimensions are modestly associated with patients' capacity to maintain satisfying social roles and relationships in the context of cancer. Further research is needed to examine the temporal nature of these associations and the mechanisms that underlie them.
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Affiliation(s)
- Allen C Sherman
- Behavioral Medicine, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas
| | - Crystal L Park
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Login George
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - George Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
| | - Heather S L Jim
- Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, Florida
| | - Alexis R Munoz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina.,Comprehensive Cancer Center of Wake Forest University, Winston-Salem, North Carolina
| | - Mallory A Snyder
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - John M Salsman
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
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