Assessment of the relation between religiosity, mental health, and psychological resilience in breast cancer patients

Research progress on the psychological burden and intervention measures in cancer patients

In the past 40 years, the gradually increasing incidence and mortality rates of malignant tumors have severely impacted the quality of life of patients, bringing significant physical and psychological burdens and becoming an increasingly serious social issue. With the development of medical standards, new methods for cancer detection and treatment have been continuously proposed. Although it has been proven that cancer is related to increased psychological burden and suicidal behaviors in patients, current research on the psychological burden caused by cancer is insufficient. Clinicians often overlook the psychological health issues of patients while treating their physical diseases. Considering the high incidence of cancer, this review will outline the psychological burdens of cancer patients worldwide in recent years and its high-risk factors. Moreover, this review will summarize the common methods for evaluating psychological burdens, present current predictive models and treatment methods for the psychological burden of cancer patients, aiming to provide a research basis and future direction for the timely and accurate assessment of the psychological burden in cancer patients.

The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke

PURPOSE

To explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation.

METHODS

A cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analyzed using structural equation modeling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist.

RESULTS

A positive relationship was found between social support and psychological resilience (β1 = 0.548), which was mediated by hope (β2 = 0.114), and social support had significant direct effect on resilience (β3 = 0.434). A positive relationship was also found between self-esteem and psychological resilience (β4 = 0.380), which was mediated by hope (β5 = 0.200), and self-esteem had significant direct effect on resilience (β6 = 0.179).

CONCLUSION

According to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients' social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.

Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan

BACKGROUND

Patients with advanced breast cancer require consistent help and support from family caregivers. These caregivers often endure financial burdens and psychological stress, with their experiences significantly influenced by sociocultural factors. This study aims to explore the experiences of family caregivers of advanced breast cancer patients in Punjab province, Pakistan.

METHODS

Data was collected through in-depth interviews with fifteen family caregivers of advanced breast cancer patients in three major cities of Punjab, Pakistan. Caregivers, who had been in close contact with the patient for the last two years, were purposively sampled from five major hospitals. The data was analyzed using thematic analysis.

RESULTS

The study revealed that the experiences of family caregivers are deeply rooted in the sociocultural context. Key themes identified include social responsibility and cultural reciprocity norms; limited awareness and mobility options for caregivers; financial responsibility and strain; impacts of beauty myths and shyness on caregiving attitudes and decisions; the stressful and emotional nature of caregiving; treatment perspectives influenced by social groups; challenges in consulting male physicians and associated stigma; the role of religious beliefs in caregiving; and stress management, with religion often being a coping mechanism. These factors can contribute to delayed treatment decisions for patients.

CONCLUSIONS

Family caregivers are crucial in facilitating timely treatment decisions for advanced breast cancer patients in the Pakistani context. To minimize treatment delays and alleviate caregiver stress, addressing sociocultural barriers in care-seeking is essential. A tailored approach, considering sociocultural and religious factors, is imperative for the management and early diagnosis of breast cancer, necessitating appropriate policymaking and implementation.

The Role of Spirituality in Anxiety and Psychological Resilience of Hemodialysis Patients in Turkey

Chronic kidney disease (CKD) is a significant health problem that affects millions of people worldwide and its end-stage manifestation requires hemodialysis treatment, which can have a considerable impact on patients' mental health and quality of life. This study aims to examine the relationship between spirituality and anxiety, as well as spirituality and psychological resilience among hemodialysis patients using the iterative weighted least squares method. Participants included 91 hemodialysis patients, consisting of 49 females and 42 males, whose ages ranged from 20 to 82 years, with a mean age of 48 (SD = 14). The data were collected using the Beck Anxiety Inventory, Spirituality Scale, and Brief Psychological Resilience Scale. Results indicated a weak positive relationship between spirituality and psychological resilience (t = 1.35, P = .183) and a moderate negative relationship between spirituality and anxiety (t = -2.84, P = .006). Furthermore, spirituality accounted for a 1% variance in psychological resilience and a 5% of the variance in anxiety. Additionally, patients' education level, gender, and whom they live with were relatively stronger correlates of psychological resilience, while the patient's education level, gender, marital status, whom they live with, presence of another patient at home receiving hemodialysis treatment were strong correlates of anxiety. This study emphasizes the need for comprehensive care that addresses both physical and psychological aspects of CKD management to improve patient outcomes and quality of life.

The Mediating Role of Psychological Resilience in the Relationship Between Spiritual Well-Being and Supportive Care Needs in Women With Breast Cancer

Objective

The aim of this study was to examine the mediating role of psychological resilience as part of the effect of spiritual well-being in the supportive care needs of women with breast cancer.

Materials and Methods

Cross-sectional design. The Connor-Davidson Resilience Scale Short Form, the Spiritual Well-Being Scale, and the Supportive Care Needs Survey Short Form were completed women with breast cancer treated at the oncology clinic of a university hospital. For the mediation model, Bootstrap methods with PROCESS Macro were used.

Results

The study was conducted with 126 breast cancer patients. A significant negative, moderate relationship was found between supportive care needs and psychological resilience (r = -0.560). There was a significant negative, but weak relationship between supportive care needs and spiritual well-being (r = -0.385). The indirect effect of spiritual well-being on supportive care needs was significant, thus, psychological resilience was shown to have a mediating effect on the relationship between spiritual well-being and supportive care needs [b = -0.370, 95% confidence interval (- 0.5568, -0.1911)].

Conclusion

Psychological resilience appears to contribute to a reduction in supportive care needs of breast cancer patients by affecting spiritual well-being.

Factors influencing resilience in patients with advanced cancer: A cross-sectional study

Background

Advanced cancer and its treatments lead to various detrimental impacts on patients. Resilience is an important ability to adapt to such adversity, but there is limited information about its influencing factors, specifically in patients with advanced cancer.

Objective

This study aimed to examine the influence of social support, depression, anxiety, hope, optimism, spiritual well-being, religious belief, and hardiness on resilience among adults with advanced cancer.

Methods

This cross-sectional research used multi-stage sampling to select 288 participants from a university hospital and three tertiary hospitals in northern Thailand. Data were collected using a demographic data collection form, the Hospital Anxiety and Depression Scale (HADS), the Thai version of the Social Support Questionnaire (SSQ), the Herth Hope Index (HHI), Life Orientation Test-Revised (LOT-R), Buddhist Belief Questionnaire, Health-Related Hardiness Scale (HRHS), and Connor-Davidson Resilience Scale (CD-RISC), from February 2021 to February 2022. Data were analyzed using descriptive statistics, Pearson correlation, and regression analysis.

Results

Depression (r = -0.47, p <0.01) and anxiety (r = -0.39, p <0.01) had a significant negative relationship with resilience. Spiritual well-being (r = 0.74, p <0.01), hope (r = 0.67, p <0.01), religious belief (r = 0.53, p <0.01), optimism (r = 0.40, p <0.01), social support (r = 0.33, p <0.01), and hardiness (r = 0.21, p <0.01) had significant positive relationships with resilience. Only hope (β = 0.29, p <0.01) and spiritual well-being (β = 0.59, p <0.01) together influenced resilience by 64.70%.

Conclusion

Spiritual well-being and hope are crucial to resilience in patients with advanced cancer. Nurses should provide spiritual support to strengthen patients' ability to adapt successfully to life with advanced cancer.

The Effect of Spirituality on Psychological Resilience in Women with Breast Cancer Who Have Received Chemotherapy: A Cross-sectional Study from Turkey

Spirituality involves all of the internal resources of the individual, including religion, the desire to live, and a commitment to life. This study was conducted to determine the effect of spirituality on psychological resilience in women with breast cancer who have received chemotherapy. The study was conducted in a chemotherapy unit between April and June 2022. The sample size of the current cross-sectional study consisted of 85 women who have received chemotherapy. For the measuring of spirituality and psychological resilience, the Spirituality Scale (SS) and the Brief Resilience Scale (BRS), respectively, were completed. In the current study, it was determined that there was a positive weak correlation between the mean SS total score and the mean BRS total score (r = 0.471, p < 0.05). In addition, among women with breast cancer who have received chemotherapy, spirituality accounted for 22% of the variance in psychological resilience (R² = 0.22, p < 0.05). It can also be said that the level of spirituality of women may positively affect their psychological resilience.

Religiosity, Theism, Perceived Social Support, Resilience, and Well-Being of University Undergraduate Students in Singapore during the COVID-19 Pandemic

The COVID-19 pandemic infection control measures severely impacted mental well-being, allowing insight into possible protective parameters. With religion playing a role during challenging times, this study investigated theism and religiosity on the mental well-being of university students during the COVID19 pandemic and how social support and resilience can mediate this effect. One hundred eighty-five university students between 17 and 42 years old responded to online surveys on their theism, religious affiliations, religiosity, well-being, perceived support, and resilience. Pearson's correlations and single and sequential mediation analyses showed that theism did not significantly predict well-being (r = 0.049), but religiosity mediated the relationship (r = 0.432, effect size = 0.187). Sequential mediation analysis showed that resilience did not mediate the relationship between religiosity and well-being, but perceived social support significantly positively mediated religiosity and well-being with an effect size of 0.079. The findings reveal that factors, such as religiosity and social support could thus aid in the mental well-being of future challenging times such as the pandemic.

"Faith Is Not Enough?" Ego-Resiliency and Religiosity as Coping Resources with Pandemic Stress-Mediation Study

Based on the concepts of Pargament's adaptational functions of religiosity, Huber's centrality of religiosity, and Block's conceptualisation of ego-resiliency as psychosocial resources, a nonexperimental, moderated mediation project was designed for a group of 175 women and 57 men who voluntarily participated in an online study to determine whether and to what extent religiosity mediated or moderated the relationship between ego-resiliency and the severity of PTSD and depression during the COVID-19 epidemic. The analyses carried out showed that the studied variables, ego-resiliency and centrality of religiosity, were predictors of the intensity of some psychopathological reactions caused by the COVID-19 pandemic but were not connected via a mediation relationship. Therefore, one question remains open: what is the role of ego-resiliency and the nature of the stated immunogenic effect of the centrality of religiosity in dealing with the critical threat to mental health that is the COVID-19 pandemic?

Spiritual Needs of Lung Cancer Patients and Their Relation to Psychological Distress and Quality of Life

Background

This study aimed to investigate the spiritual needs of patients suffering from lung cancer in relation to their mental health and quality of life.

Methodology

A cross-sectional quantitative study design was employed to investigate 110 lung cancer patients receiving chemotherapy. A four-part self-assessment instrument was used to gather the data comprising a sheet containing demographic and clinical information, Spiritual Needs Questionnaire, The Depression, Anxiety, and Stress Scale-21 Items, and the 12-item Health Survey. Descriptive inferential statistics were applied.

Results

Of the 110 patients, 71.8% were men, the mean age was 64.25 (±9.3) years, and 71.8% were married. In total, 40.9% of the patients were retired, and 92.7% had a public insurance company. Regarding education, 30% were primary school graduates and 31.8% were high school graduates. Regarding the clinical features of the sample, 23.6% of the patients had small-cell carcinoma, 71.9% had non-small-cell carcinoma, and 4.5% had large-cell carcinoma. Spiritual needs have a negative effect on the mental health component of quality of life (p < 0.001) and can increase psychological distress in lung cancer patients.

Conclusions

In contrast to the findings of other international studies, spiritual needs appeared to be lower; however, similar to other studies, spiritual needs increased in those suffering from depression and anxiety. Moreover, the subtype of lung cancer also appeared to play a role.

Religiosity and Contentment among Teachers in the Philippines during COVID-19 Pandemic: Mediating Effects of Resilience, Optimism, and Well-Being

The COVID-19 pandemic has had an unprecedented effect on many areas of people’s lives all over the world, including in the area of education. Many educational institutions must un-preparedly transition from physical classes to distance learning modalities, affecting both the students and teachers. Given that the teachers are confronted with so many challenges, leading to their increased stress and mental health issues, this research project investigated the role of religiosity in the contentment of a sample of 296 teachers in the Philippines, mediated by the effects of resilience, optimism, and well-being. Bivariate correlation analysis showed that religiosity, resilience, optimism, and well-being were positively and significantly correlated with each other, while contentment was positively and significantly correlated with optimism and well-being. Regression analysis indicated no direct significant association between religiosity and contentment. Mediation analyses suggested that optimism partially mediated the impact of religiosity on well-being, whereas well-being fully mediated the impact of religiosity on contentment and the impact of optimism on contentment. Lastly, the measurement model indicated a significant path from religiosity to contentment through optimism and well-being. These significant results suggest that, while facing adversities in life, the teachers in the Philippines might use religiosity and its relevant dimensions as positive coping mechanisms to face the academic challenges triggered by the COVID-19 pandemic, and thus derive contentment that is mediated by the positive effects of optimism and well-being.

Relationship Dynamics among Couples Dealing with Breast Cancer: A Systematic Review

Most studies have been concerned with the experiences and needs of women with breast cancer and spouses/partners separately. In this review, the relationship dynamics that characterize the couple’s experience of breast cancer treatment were investigated. Findings will inform both researchers and professionals in the area of oncology. A systematic literature search was performed in CINAHL, PsychINFO, MEDLINE, Scopus and Web of Science. A checklist for qualitative and observational studies was used to evaluate the methodological quality of the studies. Seventeen studies were included, and the synthesis of the literature revealed five domains that characterized the dyadic process: dyadic coping strategies, psychosocial support, communication, the couple’s sexual life and spirituality. The included studies provide the basis for knowledge and awareness about the experience of couples with cancer, the specific dimensions enacted during the breast cancer treatment path and the type of responses that are associated with a positive couple’s adjustment to the disease.

Both "Vitamin L for Life" and "One Milligram of Satan": A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer

Adjuvant endocrine therapy (AET) is recommended after hormone receptor-positive breast cancer to reduce risk of recurrence, but adherence is sub-optimal in many women. Behavioral interventions have been ineffective in improving adherence rates to AET. This qualitative descriptive study investigates factors that support women in AET use and suggestions for interventions to improve AET use and management. Interviews with women who persisted with AET (n = 23), women who discontinued AET (n = 15), and healthcare providers (HCPs; oncologists, oncology residents, and pharmacists; n = 9) were conducted, transcribed, and described using thematic analysis. Data collection stopped once saturation occurred (i.e., no new codes or themes emerged during interviews). Two researchers created codes and developed themes in an iterative process; a third researcher verified the representativeness of final themes. This study was approved by the Health Research Ethics Board of Alberta (ID: HREBA.CC-17-0513). Women who persisted described being prepared for side effects and having self-management strategies, strong rationale for AET use, supportive HCPs, and available resources as relevant factors. Women who discontinued described feeling overwhelmed by side effects, information needs, drawbacks of AET, helpful/unhelpful experiences with HCPs, and contextual factors as relevant to their discontinuation. HCPs described health system-related and patient-related barriers, side effect management, and patient-provider interactions as relevant to supporting AET use. The considerable overlap in themes among the three groups suggests broad recognition of salient factors relevant to AET use and that associated strategies to improve use may be acceptable to patients and providers alike. Factors supporting AET use could include the following: education (which may be necessary but insufficient), developing a strong personal rationale for use, being prepared for side effects, having side effect management strategies, reciprocal communication between patients and HCPs, and accessible resources.

Factors related to changes in resilience and distress in women with endometrial cancer

The purpose of the study is to explore changes in resilience and physical and psychological distress and their related factors over time in women with endometrial cancer. This study adopted a repeated measures design using purposive sampling and was conducted in a hospital in Taiwan. Data were collected before surgery, 2 weeks after surgery, and 3 months after surgery. The measured variables consisted of demographic and disease characteristics, social support, resilience, and physical and psychological distress. A total of 48 women participated in the study, of whom 42 (mean age = 54.2 years old) completed all of the questionnaires. The results showed that resilience and physical distress in women with endometrial cancer was not statistically significantly changed over time. Rather, their psychological distress was significantly alleviated 2 weeks and 3 months after surgery as compared to before surgery. Women with less social support showed a lower level of resilience. In addition, those with a lower level of resilience experienced greater psychological distress. Compared with those who received only surgical treatment, women who had undergone surgery combined with chemotherapy and radiotherapy had more physical distress. Clinical medical staff should conduct continuing assessments of the resilience, physical distress, and psychological distress of women with endometrial cancer. Interventions related to resilience-enhancing and self-care should be implemented to avoid worsening or to improve women's resilience and distress.

Psychological Resilience and Health-Related Quality of Life in 418 Swedish Women with Primary Breast Cancer: Results from a Prospective Longitudinal Study

Simple Summary

Psychological resilience is an important psychological mechanism that enables a person to successfully handle significant adversities, e.g., a cancer diagnosis. Despite improved prognosis, breast cancer is associated with emotional distress across the trajectory of the disease. This study aimed to investigate psychological resilience and health-related quality of life in Swedish women with breast cancer at diagnosis and one year later. The resilience score declined in the cohort and was associated with health-related quality of life at both time points. Assessment of psychological resilience in breast cancer care might enable the identification of patients in need of intensified rehabilitation to improve their health-related quality of life.

Abstract

Psychological resilience is considered a major protective psychological mechanism that enables a person to successfully handle significant adversities, e.g., a cancer diagnosis. Higher levels of resilience have been associated with higher levels of health-related quality of life (HRQoL) in breast cancer (BC) patients, but research examining the longitudinal process of resilience is limited. The aim of this population-based longitudinal study was to investigate resilience and HRQoL from diagnosis to one year later in 418 Swedish women with primary BC. Resilience was measured with the Connor–Davidson Resilience Scale 25, and HRQoL was measured with the Short Form Health Survey. The participants responded to questions regarding demographic and study-specific variables. Clinicopathological variables were collected from the Swedish National Quality Register for Breast Cancer. The mean score for resilience was 70.6 (standard deviation, SD = 13.0) at diagnosis and 68.9 (SD = 14.0) one year later, p < 0.001. The level of trust in the treatment and financial situation demonstrated the greatest association with the change in resilience levels. No oncological treatment modality was associated with a change in resilience levels. HRQoL decreased over time in the cohort. Resilience was positively associated with HRQoL at one year post diagnosis, which demonstrates that resilience is an important factor in maintaining HRQoL.

“Dies Irae?” The Role of Religiosity in Dealing with Psychological Problems Caused by The COVID-19 Pandemic—Studies on a Polish Sample

Based on Huber’s centrality of religiosity concept, a non-experimental research project was designed in a group of 178 women and 72 men, voluntary participants in online studies, quarantined at home during the first weeks (the first wave) of the pandemic, to determine whether and to what extent religiosity, understood as a multidimensional construct, was a predictor of the worsening of PTSD and depression symptoms in the conditions of the COVID-19 pandemic. The study made use of CRS Huber’s scale to study the centrality of religiosity, Spitzer’s PHQ-9 to determine the severity of depression, and Weiss and Marmar’s IES-R to measure the symptoms of PTSD. Our study, which provided interesting and non-obvious insights into the relationship between the studied variables, did not fully explain the protective nature of religiosity in dealing with pandemic stress. Out of five components of religiosity understood in accordance with Huber’s concept (interest in religious issues, religious beliefs, prayer, religious experience, and cult), two turned out to contribute to modifications in the severity of psychopathological reactions of the respondents to stress caused by the pandemic during its first wave. A protective role was played by prayer, which inhibited the worsening of PTSD symptoms, whereas religious experience aggravated them. This means that in order to interpret the effect of religiosity on the mental functioning of the respondents in a time of crisis (the COVID-19 pandemic), we should not try to explain this effect in a simple and linear way, because religious life may not only bring security and solace, but also be a source of stress and an inner struggle.

Is there a relationship between spirituality/religiosity and resilience? A systematic review and meta-analysis of observational studies

Resilience is the ability to recover or cope with adverse situations. Spiritual and religious beliefs may be associated with important "resilience resources." To investigate whether there is a relationship between spirituality/religiosity (S/R) and resilience. This is a systematic review (observational studies) with meta-analysis following the PRISMA guidelines. From a total of 2468 articles, 34 observational studies were included. We identified a moderate positive correlation between S/R and resilience (r = 0.40 (95% CI, 0.32-0.48], p < 0.01). When only high-quality articles were included, the results were maintained. Conclusion: A moderate positive correlation was found between S/R and resilience.

The Use of Religion in the Management of Depression in Sickle Cell Disease: A Systematic Review

The incidence of depression in individuals with sickle cell disease (SCD) is significantly higher compared to the general population. This systematic literature review was conducted to: (1) describe depressive symptoms in SCD individuals and (2) explore religiosity as a coping mechanism for alleviating depressive symptoms. Emerging themes were physical depressive symptoms and psychosocial depressive implications. Despite uptake of religion and religiosity as a coping strategy in other chronic illnesses, no studies were found that used religiosity to cope with depressive symptoms in SCD. Future research should explore the use of religiosity as an alternative therapy to cope with depression symptoms.

Translation and Validation of the Spiritual Care Intervention-Provision Scale in the Greek Language

INTRODUCTION

Spiritual care is defined as activities and interventions that promote spiritual health and the spiritual dimension of quality of life. Empirical data indicate the importance that spiritual care provision has on nursing practice. The spiritual care intervention-provision (SCIP) scale was developed to assess the frequency of spiritual care intervention implemented by nurses. Currently, there are no validated scales for assessing spiritual care in the Greek language.

OBJECTIVE

To adapt and validate the spiritual care intervention-provision scale in the Greek language.

METHODS

A descriptive cross-sectional study was employed, in which 275 nurses working in two public hospitals participated. The SCIP scale underwent the process of cross-cultural adaptation and was evaluated by assessing its reliability and validity.

RESULTS

The process resulted in a valid Greek version of the SCIPS, the internal consistency (Cronbach's α 0.887), reliability testing-retesting (r = 0.997, p < 0.001, and t = 0.387, p > 0.05), construct, and convergent validities were evaluated.

CONCLUSION

The Greek version of the spiritual care intervention-provision scale is a validated scale that can be used to examine spiritual care provision in Greek health services.