Religion, Culture and Meaning-Making Coping: A Study Among Cancer Patients in Malaysia

A Qualitative Study on Psychosocial Challenges of Patients With Cancer in Ethiopia Using the Social-Ecological Model

Cancer diagnosis and treatment can be physically arduous, disrupting patients' social and work lives. Understanding the extent of these problems is key to addressing patients' needs, but specific psychosocial challenges have not yet been well studied in resource-limited settings. A qualitative study was conducted in the capital and two regions of Ethiopia with the aim of exploring psychosocial challenges among cancer patients. A total of 14 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were done with cancer patients, health professionals, community representatives, and religious leaders. Four separate interview guides were used to facilitate the interviews and discussions. All transcribed documents, field notes, and reflexive memos were entered into NVivo 12 software, and deductive thematic analysis using the social-ecological model was applied to summarize the main findings. At an individual level, emotional distress, suicidal risk, denial, and refusal of treatment were identified immediately after diagnosis while hopelessness, feeling depressed, and fear of death were commonly reported psychosocial challenges during the course of treatment. Involvement of family members in major treatment decisions was recognized at an interpersonal level. Our result also revealed that cancer patients had strong social support from family members and close friends. In the community, traditional medicine and religious rituals were considered an alternative treatment for cancer. The findings indicate that counselling and psychoeducation are crucial for cancer patients, family members, and close friends. Awareness creation programmes should be delivered through collaboration with religious leaders and traditional healers.

Association Between Religiosity and Spirituality and Cocaine Use: A Systematic Review

Previous literature has evidenced a possible impact on health, mental health, and health-related faith behaviors due to the effects of an individual's spiritual dimension. The aim of this study is to collect and summarize all current data from observational studies regarding the association between religiosity or spirituality (R/S) and cocaine use (CU). A systematic literature search of analytical observational studies on the association between religiosity or spirituality and the use of cocaine was performed in PubMed and Scopus databases. Twenty observational studies were included in this review. Fifteen of the twenty observational studies found that a higher level of religiosity was associated with lower lifetime and actual cocaine use, both in adults and adolescents. However, one study conducted in a sexual minorities sample found that higher religiosity-measured as frequency of private religious activities such as prayer-was associated with a higher probability of cocaine use. Two studies found no evidence of any association between religiosity and cocaine use, and two found mixed results. This review found a possible protective role of religiosity on cocaine use, even if the cross-sectional nature of the greater part of the studies prevented drawing any casual relation. Future studies with a longitudinal approach are required. However, the support of activities aimed at broadening a religious attitude and beliefs could result in creating an environment protective for young people against cocaine use.

Effect of Spirituality on Psychological Resilience and Hope in Patient-Family Caregiver Dyads Experiencing Gynecological Cancer: An Actor-Partner Interdependence Analysis

BACKGROUND

Women experiencing gynecological cancer (GCPs) and family caregivers (FCGs) use spirituality to cope with cancer. However, the dual relationship between the impact of spirituality on psychological resilience and hope among both GCPs and FCGs has not yet been explored.

OBJECTIVE

To examine the interdependent relationship between spirituality, psychological resilience, and hope of women with gynecological cancer and their FCGs at the dyadic level.

METHODS

In this cross-sectional study, 107 dyads were recruited from the gynecological oncology departments of 2 university hospitals in Ankara, Turkey. The GCPs and FCGs completed a Patient/Family Caregiver Information Form, Spiritual Well-being Scale, Connor-Davidson Resilience Scale, and Dispositional Hope Scale. Data were analyzed using descriptive statistics and Pearson's correlations. This study used the Actor-Partner Interdependence Model.

RESULTS

Spirituality of both GCPs and FCGs had a significant positive effect on their psychological resilience ( B = 0.918, P < .001; B = 0.435, P < .001, respectively) and hope ( B = 0.350, P < .001; B = 0.246, P < .001, respectively). However, the spirituality of GCPs and FCGs did not have a partner effect on psychological resilience ( B = -0.150, P < .052; B = -0.150, P = .052, respectively) and hope ( B = -0.012, P = .810; B = 0.073, P = .157, respectively).

CONCLUSIONS

Spirituality of GCPs and their FCGs positively affected their psychological resilience and hope, but the effect on each other was limited.

IMPLICATIONS FOR PRACTICE

Health professionals, especially nurses, should focus on tailoring spiritual care interventions to the unique needs of each individual within the GCP and FCG dyads. Personalized approaches that recognize and address the specific spiritual concerns of patients and caregivers may be more effective in promoting psychological resilience and hope.

Exploring coping strategies among caregivers of children who have survived paediatric cancer in Jordan

OBJECTIVE

To explore the coping strategies of caregivers of children who have survived paediatric cancer in Jordan.

MATERIALS AND METHODS

This study used a cross-sectional survey design and convenient sampling. The sample included 102 caregivers of children who have survived cancer, and outcome measures included the Arabic-translated Brief COPE, and caregiver and child demographic and condition questionnaire. Data analyses included descriptive statistics, analysis of frequencies, Spearman-rank order correlations and linear regression.

RESULTS

Caregivers most frequently used religion coping (mean=6.42, SD=1.85), followed by acceptance (mean=5.95, SD=1.96) and planning (mean=5.05, SD=1.94). The least used coping strategies were humour (mean=2.98, SD=1.24) and behavioural disengagement as coping strategies (mean=3.01, SD=1.42). Having a female child predicted more self-distraction utilisation (β=0.265, p=0.007).

CONCLUSION

Caregivers of children who have survived cancer in Jordan frequently use passive coping strategies like religion and acceptance coping to overcome daily life stressors. Caregivers might benefit from psychosocial occupational therapy interventions to support their engagement in more active or problem-focused coping strategies.

Prospective cohort study of unmet supportive care needs, post-traumatic growth, coping strategy and social supports among patients with breast cancer: The PenBCNeeds study

PURPOSE

While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis.

METHODS

A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34).

RESULTS

The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score.

CONCLUSIONS

Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.

Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer

PURPOSE

The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers.

METHODS

A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression.

RESULTS

Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B =  - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B =  - 0.099, p = 0.054) and patients (B =  - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001).

CONCLUSION

Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.

Decision-making process for breast-conserving therapy from the perspective of women with breast cancer: A grounded theory study

PURPOSE

To explore the decision-making and coping processes of women with newly diagnosed breast cancer receiving breast-conserving therapy.

METHODS

The grounded theory methodology approach was employed in this study. Purposive and theoretical sampling methods were used to enroll 27 women with stage I-III breast cancer. Individual interviews were conducted using a semi-structured interview guide, and data were analyzed using open, axial, and selective coding.

RESULTS

The core category is "limitations of boundaries," which includes three categories: feminine body boundary, emotional boundary, and knowledge boundary. Clusters, conflicts, and changeability were among the unique contextual conditions. The decision-making process became more challenging because of the differences between the levels of knowledge of physicians and patients receiving treatment information. Women's actions and interactions included information seeking, controlling, negotiating, and accepting nondecision-making support. The consequences of decisions included redecision and reoperation, and most women did not regret receiving breast-conserving therapy.

CONCLUSION

Even after choosing breast-conserving therapy, some women may experience changes in treatment procedures. Medical professionals should identify women's challenges and limitations during their decision-making process, explain the benefits and drawbacks of different surgical modalities, address concerns about the outcome of breast-conserving surgery, and provide intellectual and emotional support for decision-making.

"I Am Grateful for Every Day I Live": A Qualitative Study on the Spiritual Experiences of Women With Gynecological Cancer

BACKGROUND

Considering the life-threatening nature of gynecological cancers, spirituality and religious beliefs may play a key role in the experiences of the patients during the disease process and their coping.

OBJECTIVE

The aim of this study was to understand the spiritual experiences of Muslim women with gynecological cancer during the disease process.

METHODS

A qualitative, phenomenological, and hermeneutic approach was followed in the research. Fourteen women with gynecological cancer in Turkey were interviewed individually. The thematic analysis approach of Braun and Clarke was used to evaluate the data.

RESULTS

The results of the data analysis revealed 3 themes (consisting of 9 subthemes): (1) reaction to cancer: spiritual distress (fear of death, perception of punishment, fear of obscurity and uncertainty, and being a cause of spiritual distress in the family); (2) reaction to cancer: spiritual well-being (accepting whatever may come from Allah, strengthening the faith in Allah); and (3) spiritual resources for coping with cancer (religious practices, hobbies and complementary practices, and family support).

CONCLUSIONS

The results of the study shed light on the cases that may cause spiritual distress and improve the spiritual well-being that is experienced by Muslim women with gynecological cancer during the disease process; they also reveal that religion has an effect on the experiences during the cancer process and the coping methods.

IMPLICATIONS FOR PRACTICE

Healthcare professionals who care for Muslim women with gynecological cancer should plan spiritual care by being aware of the cultural characteristics and religious beliefs of these women and their families.

Religious meaning-making among Muslim parents bereaved by homicide: Struggling to accept 'God's will' and yearning for 'Qayama' day

Objective

Parental bereavement by homicide is considered an extremely difficult grief experience; hence it may significantly undermine one's meaning structures. Although bereaved parents' meaning-making process has been extensively researched, less is known about meaning reconstruction among Muslim parents bereaved by homicide - an understudied population. The study's goal was to gain an in-depth understanding of bereaved Muslim parents' meaning-making process in light of their religious background using Park's religious meaning-making model.

Methods

Employing a qualitative approach, in-depth interviews were held with 12 Muslim parents bereaved by homicide. The data were analyzed using both categorical-content and categorical-form analyses.

Results

The findings indicated that Muslim parents' meaning-making process involves silencing, which is grounded in their religious background. This process is characterized by a difficulty to accept this loss as God's will, as expected from them by religion, given that it was caused by an intentional act of human violence. Consequently, their global belief meanings are undermined. They, then, yearn for "Qayama" day-the day of judgment.

Conclusions

The findings are discussed in light of Park's religious meaning-making model, highlighting that bereaved Muslim parents' coping process includes an additional challenge related to their religious background. This underscores the need for culturally-sensitive inquiry and spiritually-informed therapy.

The Role of Islamic Beliefs in Facilitating Acceptance of Cancer Diagnosis

Although survival rates for patients with cancer have increased, this disease continues to affect couples significantly. Religion and culture seem to be part of the therapeutic process for people with cancer. Despite the abundance of the Arab Muslim community in Western countries, there is a lack of documented data on Arab Muslim couples experiencing cancer. A simple exploratory qualitative study was conducted through semi-structured interviews on six married couples (n = 12) identifying with the Arab Muslim culture and being affected by cancer. An iterative data analysis was performed. Results were reported under the following themes: accepting illness through coping strategies provided by Muslim religious beliefs and practices, experiencing problems with the expression of needs and feelings within the couple, experiencing closeness within the family, and experiencing illness in the hospital setting as Muslims. Our results show that Islamic beliefs can facilitate acceptance of a cancer diagnosis. It is also noted that religion seems to unite spouses in supporting each other and maintaining hope in a difficult context. Communication issues may persist between a couple due to stressors related to cancer. The results of this study could raise awareness about the importance of exploring religious and spiritual beliefs when supporting couples affected by cancer.

Exploring Meaning of Life in Women With Breast Cancer in Taiwan: A Phenomenological Study

BACKGROUND

Globally, breast cancer is the most common cancer type in terms of incidence for women. Women with breast cancer endure higher levels of psychological distress than other types of cancer because many lose their identity as a woman, which is an additional characteristic of their psychological distress. Research using phenomenology to explore "the meaning of life" is rare among women with breast cancer.

PURPOSE

The purpose of this study was to explore the perspectives of women with breast cancer on "the meaning of life."

METHODS

A phenomenological approach was used. Twenty-six women living with breast cancer drawn from a cancer treatment hospital in Taiwan participated in this study. A semistructured interview was utilized to collect the data, and Colaizzi's seven steps were used to analyze the data.

RESULTS

Four themes emerged: (a) value of overcoming suffering, (b) value of reciprocal love, (c) value of self-transcendence, and (d) value of spiritual comfort. This means that the participants defined "the meaning of life" through the lens of suffering from cancer, reciprocal love from their families and friends, uncovering and discovering creative pathways that transformed their pain while searching for the value of their existence, and seeking spiritual guidance from religion.

CONCLUSIONS

The participants identified the most pivotal aspect of healing as transforming their pain and accepting value for their suffering. They acknowledged they could not change the fact that they had cancer, but they could learn to accept it as part of their lived experience. Healthcare professionals may use these four themes at a clinically appropriate time on women's journeys toward healing to inspire women with breast cancer to process their own unique "meaning of life."

Elder abuse and hospitalization in rural Malaysia

Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9–9.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.

Spiritual Care Needs of Patients in Oncology Units and Nursing Practices in Turkey: A Qualitative Study

This descriptive qualitative study was planned to determine the spiritual care needs of patients hospitalized in the oncology department and nursing care practices. Twenty-five patients and 15 nurses were interviewed. Concerning the spiritual care practices expected from nurses, the following themes were determined: Interest-Compassion, Smiling Face, Confidence, Being Informative, Morale, and Understanding. The themes for spiritual nursing practices were Chatting-Suggesting, Smiling Face, Giving Opportunities for Religious Practice, Love and Belonging, Giving Hope-Precedent Examples, and Giving Information. Patients expected nurses to ask about their spiritual needs. However, nurses did not ask about spiritual issues because they were afraid of affecting patients adversely.

Volunteering Experience among Older Adults with End-stage Renal Disease (ESRD)

Living with End-stage Renal Disease (ESRD) can be stressful and associated with long-term psychological effects on older adults, especially when they have to undergo a lifetime treatment. Previous studies have documented numerous positive effects of volunteering as a potential intervention on health and well-being among older adults. However, there is limited understanding of the experience of older adults in volunteering while having ESRD. This study aimed to explore the experience often older adults with ESRD volunteering while battling with their illness. Several themes emerged from the data analysis regarding the experience of volunteerism among the older adult ESRD patients. The themes are pre-volunteerism experience, enriching and inspiring experience, volunteering experience as sources of support system, improvement of health and wellbeing experience, experience in discovering meaning in life, experience in repaying the good deed, and challenges in volunteerism participation. This study contributes to the literature and practices through the illumination of innovative intervention through volunteering for older adults with ESRD.

Existential Meaning-Making Coping in Iran: A Qualitative Study among Patients with Cancer

This article is written on the basis of a study on meaning-making coping in Iran. The study is a part of an international project in 10 countries with different religious and cultural backgrounds. This article aims to discuss the secular existential meaning-making coping methods employed by Iranian cancer patients. Interviews were conducted with 27 participants with various kinds of cancer. Nine secular existential meaning-making coping strategies emerged from the analyses of the qualitative interviews. These coping methods are as follows: Ignoring the illness, Distraction, Altruism, Encounter with others, Nature, Discourse of the self, Visualization, Positive solitude, and Positive thinking and transformational orientation. It seems that, using these strategies, our sample of Iranian cancer patients/survivors have been denying/ignoring their illness, and/or empowering themselves. We discuss the results, considering the potential influence of cultural elements, including Iranian Islam, Persian mysticism, and Persian literature, on the selection of the coping strategies. The study contributes to our understanding of coping via elucidating how seriously ill individuals in Iran try to manage the challenges caused by a health crisis.

Connectedness, Self-Esteem, and Prosocial Behaviors Protect Adolescent Mental Health Following Social Isolation: A Systematic Review

Societal trends and COVID-19 quarantines have increased the number of adolescents experiencing social isolation, placing them at heightened risk for mental health issues. The aim of this review is to explore protective factors that might mitigate psychological harm in the presence of social isolation. A systematic literature review was conducted using Fink's step-by-step process. Four library databases were searched, and results were reported using PRISMA. Of the 246 studies reviewed, 12 studies were retained following the quality assessment. The sample includes 14,064 participants from USA, Australia, and Europe, ranging from 10-19 years old. Social connectedness (ie., family connectedness, school connectedness, social support), self-esteem, and prosocial behaviors were the most common protective factors to social isolation. Additional factors such as self-efficacy, optimism, and ethnic identity are discussed. Implications for future research are recommended, including the need to explore spiritual, biological, and sociocultural factors influencing social connectedness and mental health in adolescents.

Different Relations of Religion and Mental Health

Abstract. Background: Religiosity can foster mental health after traumatic experiences. Yet, religiosity among Muslim immigrants has also been linked to separation-oriented acculturation, which is linked to reduced mental health. Therefore, the function of religiosity for resilience in Middle Eastern refugee and immigrant adolescents might differ as their migration contexts differ in terms of traumatic experiences and the nature of cultural interactions . Aims: This study examined whether religiosity is associated with better mental health after traumatic experiences, particularly among young refugees. In addition, it was explored whether religiosity is associated with better mental health among refugees through less marginalization and whether religious immigrant peers show worse mental health through stronger separation. Method: 135 adolescents ( MAge = 18.25 years, SD = 1.73; nrefugees = 75, nimmigrants = 60) completed self-reports on religiosity, mental health, trauma, and acculturation orientations. Regression analyses were calculated examining group-specific differences in potential moderating effects of religiosity on the relationship between trauma exposures and internalizing symptoms. Furthermore, potential indirect effects of religiosity on internalizing symptoms via acculturation orientations were investigated. Results: Stronger religiosity was associated with better mental health following trauma exposure. No group-specific differences were observed. While religious refugee adolescents reported less marginalization associated with fewer internalizing symptoms, religious immigrant peers reported more separation and internalizing symptoms. Limitations: Results are limited to male Muslim adolescents in Germany. The cross-sectional nature prohibits any implications for causal dynamics in the associations. Conclusion: Religiosity is generally protective against post-traumatic consequences, but associations with acculturation differ across migration contexts.

Meaning-Making Coping Methods among Bereaved Parents: A Pilot Survey Study in Sweden

The death of a child may result in traumatizing forms of grief, and meaning-making coping with loss seems to be important in prevention of intense psychosocial problems among bereaved parents. The aim of this quantitative pilot study was to discover the divergent meaning-making coping methods used by bereaved parents in Sweden. In doing so, 162 respondents were selected using a convenience sampling method, and they responded to the modified version of RCOPE. The study revealed that the strategies talking to others about their feelings, pondering the meaning of life alone, and being in nature for greater emotional affiliation, i.e., what we call secular existential coping methods, have been the most used meaning-making coping methods among Swedish mourning parents. While explaining the results, we considered the respondents' cultural background and speculated about the potential influence of cultural teachings and elements in the selection of ways of coping with bereavement. Further, we compared the results obtained with those of the two other Swedish studies conducted among people coping with cancer and COVID-19 to further discuss the impact of culture on coping with illness, loss, grief, and crisis. The study supports the idea that culture plays an essential role in the choice of coping methods.

Experiences of Muslim Cancer Survivors Living in the United States

PURPOSE

To gain an understanding of the cancer diagnosis, treatment, and survivorship experiences of adult Muslim cancer survivors residing in the United States.

PARTICIPANTS & SETTING

A purposive sample of 17 male and 15 female Muslim cancer survivors was recruited from across the United States. Data on Muslim cancer survivors' experience were collected through individual, in-depth, semistructured interviews.

METHODOLOGIC APPROACH

An interpretive, descriptive, qualitative approach was used to gain an understanding of the experience of Muslim cancer survivors.

FINDINGS

Six broad themes were identified to gain an understanding of the cancer experiences of adult Muslim cancer survivors residing in the United States.

IMPLICATIONS FOR NURSING

This study provided key information concerning the unique experience of Muslim cancer survivors residing in the United States. Identifying, understanding, and meeting survivors' religious needs, as well as understanding their cancer experience, may reduce cancer health disparities and enhance health outcomes.

Cultural Responses to Covid-19 Pandemic: Religions, Illness Perception, and Perceived Stress

Many psychological researchers have proven the deteriorating effects of the coronavirus disease 2019 (Covid-19) pandemic on public mental health. In Malaysia, various Covid-19 clusters were associated with religious gatherings. From a cultural psychology perspective, how ethno-religious groups respond to this crisis originating from their unique rationality and ecological systems. Therefore, this study aimed to explore the illness perceptions of major religious groups (Christian, Muslim, and Buddhist) in Malaysia toward the Covid-19 pandemic, their stress levels, and the relationship between illness perception, stress, and forms of religious expression during the lockdown period. Through an online survey method, 608 Malaysian religious believers were included in this mixed-method empirical study, which adapted standardized instruments [Duke University Religion Index (DUREL), Brief Illness Perception Questionnaire (BIPQ), and Perceived Stress Scale (PSS)]. Statistical analysis showed that all three groups reported moderate levels of stress in average without any significant difference after controlling for age. Both internal and external forms of religious expression had a significant negative relationship with stress levels. Personal control, comprehension, and emotions domains of illness perception accounted for a significant variance in the stress level. Furthermore, religious expression significantly moderated the relationship between some illness perception domains and stress. Qualitative coding revealed that most participants perceived human behavior and attitudes, sociopolitical, and sociological factors as causal factors to the current pandemic. These findings confirmed the relationship between religious expression, illness belief, and stress regulation during the pandemic lockdown. Incidental findings of age as a potential protective factor for Malaysian believers warrants further study. In the conclusion, implications for public health policymakers and religious communities on pandemic prevention and well-being promotion were discussed.

Spiritual Beliefs of Jordanian Adult Patients Receiving Palliative Care

This study aimed to explore spiritual beliefs held by Jordanian patients receiving palliative care. In order to accomplish this aim, three objectives were specified: 1) identify the spiritual beliefs of adult patients receiving palliative care, 2) to develop an Arabic version of the beliefs and values scale, and 3) to identify the perception of spirituality of adult patients receiving palliative care. Cross-sectional descriptive research design was used to describe the spiritual beliefs. The response rate was 70%; non-probability convenience sampling method was used for (N = 119) adult palliative patients who are receiving care at specialized oncology Center in Jordan. The findings revealed that the spirituality religious beliefs aspect total mean score (3.38 ± .33) was higher than the spirituality non-religious beliefs aspect total mean score (2.49 ± .50). There was a significant impact on enhancing spirituality score with patient who had attended a course about spirituality (p = .007) or had been visited by religious adviser (p = .022). Statistically significant differences were found between the religious beliefs score and age (p = .014), educational level (p = .015), and the patient who had attended a course about spirituality (p = .27). The conceptualizations of spirituality highly cultural are marked, and it differs from populations to others; it appears that spirituality among Middle East population is different than Western populations.

Depression and anxiety among patients with psoriasis: A correlation with quality of life and associated factors

OBJECTIVES

Psoriasis is a chronic, immune-mediated illness that primarily affects the skin, nails and joints. This illness may predispose people to mental disorders such as depression and anxiety. This study aims to determine the prevalence of depression and anxiety in patients with psoriasis and their correlation with quality of life and associated factors.

METHODS

This cross-sectional study involved 174 patients with psoriasis at the dermatology clinic of Hospital Sultanah Bahiyah, Alor Setar. All patients were instructed to complete four sets of questionnaires relating to: sociodemographic profile, clinical characteristics of illness, the validated Malay version of Hospital Anxiety and Depression Scale (HADS) and the Malay validated version of Dermatology Life Quality Index (DLQI). Data were analysed using a descriptive analysis and correlational and multiple logistic regression analyses.

RESULTS

We have found that 8.5% patients had depressive and 16.9% had anxiety symptoms. Multiple logistic regression analysis showed that higher DLQI scores, presence of lower limbs' lesions and dyslipidaemia were associated with depression in the sampled population.

CONCLUSION

This study has shown that the cohort with psoriasis exhibited notable symptoms of depression and anxiety. This emphasises the need for the assessment of anxiety and depression among patients with psoriasis as these symptoms predict poor quality of life. Such correlation of psoriasis with anxiety and depression essentially leads to psychological sequelae. Affected psoriasis patients need appropriate intervention. Our study paves the way for further research by involving other underlying constructs such as perceived body image and stigma.

Essential Package of Palliative Care for Women With Cervical Cancer: Responding to the Suffering of a Highly Vulnerable Population

Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of interventions, medicines, simple equipment, social supports, and human resources, and is designed to be safe and effective for preventing and relieving all types of suffering associated with cervical cancer. It includes only inexpensive and readily available medicines and equipment, and its use requires only basic training. Thus, the EPPCCC can and should be made accessible everywhere, including for the rural poor. We provide guidance for integrating the EPPCCC into gynecologic and oncologic care at all levels of health care systems, and into primary care, in countries of all income levels.

Testing of a Dual Process Model to Resolve the Socioeconomic Health Disparities: A Tale of Two Asian Countries

A wealth of past studies documented that individuals of lower socioeconomic status (SES) are more susceptible to both acute and chronic life stress than those of higher SES, but some recent evidence documents that not all individuals from the lower SES group experience immense stress. The present study was grounded in theories of coping and psychological adjustment, and a dual process model was formulated to address some resolved issues regarding socioeconomic disparities in health. For a robust test of the proposed dual process model, data were collected from two Asian countries—Hong Kong and Indonesia—with different socioeconomic heritage and conditions. Consistent with the predictions of our model, the present findings revealed that coping flexibility was a psychological mechanism underlying the positive association between social capital and health for the lower SES group, whereas active coping was a psychological mechanism underlying this positive association for the higher SES group. These patterns of results were largely replicable in both Asian samples, providing robust empirical support for the proposed dual process model.

“We are all under the same roof”: Coping and meaning-making among older Bhutanese with a refugee life experience

Objective:

Refugees have elevated risk of psychological distress and mental health disorders compared to the general population. The majority of research has been conducted with youth and younger adults, and little is known about the mental health of older refugees. We apply the theoretical framework of meaning making to understand how older Bhutanese with a refugee life experience cope with migratory traumas and grief.

Method:

We conduct semi-structured individual interviews with 41 ethnic-Nepali Bhutanese aged 50 and over with a refugee life experience resettled in the United States and analyze data using thematic content analysis.

Results:

Forced expulsion from Bhutan was viewed as a violation of core ethnic-Nepali beliefs and sense of purpose related to collective identity. Throughout their 30-year refugee life trajectory, participants utilized coping strategies, including interpersonal support, reappraisal of experiences of trauma and loss, and helping oneself by helping others, that were informed by, and strengthened, this collective identity. These strategies served to both reaffirm worldviews and make new, positive meaning out of a refugee life experience. Individuals who were unable to leverage these strategies struggled to find meaning.

Conclusions:

We discuss study implications for psychosocial services for older refugees and contribution to theory on meaning making among diverse, vulnerable populations who experience multiple traumas and loss.

Coping Strategies among Malaysian Women with Recurrent Ovarian Cancer: A Qualitative Study

Objective:

Ovarian cancer is one of the most common cancers among Malaysian women with high recurrence. Patients with recurrence are prone to emotional distress and are forced to cope with poor prognosis. This study aimed to explore the coping strategies employed by women with recurrent ovarian cancer in Malaysia, a developing multicultural country in Asia.

Methods:

This was a qualitative study with patients diagnosed with recurrent ovarian cancer and receiving chemotherapy at a hospital gynecologic day-care unit. In-depth individual interviews were conducted with patients to explore how they coped with recurrence of ovarian cancer. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically.

Results:

The participants' (n = 10) age range was 52–84 years, the three most common ethnic backgrounds were represented (Malay, Chinese, and Indian), and most of the patients were well educated. All patients were on chemotherapy. Six coping strategies were identified: (1) maintaining a mindset of hopefulness, (2) avoidance of information, (3) accepting their condition, (4) seeking spiritual help, (5) relying on family for support, and (6) coping with financial costs.

Conclusions:

Coping strategies employed during ovarian cancer recurrence in this setting were rarely based on the accurate information appraisal, but rather on the individual emotion and personal beliefs.

A Comparative Survey Study on Meaning-Making Coping among Cancer Patients in Turkey

(1) Background: The role of culture in secular, spiritual, and religious coping methods is important, but needs more attention in research. The aim has been to (1) investigate the meaning-making coping methods among cancer patients in Turkey and (2) whether there were differences in two separate samples (compared to Study 2, Study 1 had a younger age group, was more educated, and grew up in a big city), (3) paying specific attention to gender, age, education, and area of residence. (2) Methods: Quantitative study using a convenience sampling in two time periods, Study 1 (n = 94) and Study 2 (n = 57). (3) Results: In Study 2, there is a significant increase in several religious and spiritual coping strategies. Additionally, there is a positive correlation between being a woman and using more religious or spiritual coping strategies. Secular meaning-making coping strategies also increase significantly in Study 2. The results confirmed the hypotheses for gender, educational, and age differences in seeking support from religious leaders. The results also confirmed the hypotheses for gender and educational level in a punishing God reappraisal and demonic reappraisal. (4) Conclusions: As Turkey is a country at the junction of strong religiosity and deep-rooted secularism, dividing up the meaning-making coping methods into the religious and spiritual, on one hand, and the secular, on the other, reveals interesting results.