Religious Practice and Spirituality in the Psychological Adjustment of Survivors of Breast Cancer

Religion and spirituality are resources regularly used by patients with cancer coping with diagnosis and treatment, yet there is little research that examines these factors separately. This study investigated the relationships between religious practice and spirituality and quality of life (QoL) and stress in survivors of breast cancer. The sample included 130 women assessed 2 years following diagnosis. Using hierarchical multiple regression analysis, the authors found that spiritual well‐being was significantly associated with QoL and traumatic stress, whereas religious practice was not significantly associated with these variables. The results suggest that it may be helpful for clinicians to address spirituality, in particular with survivors of breast cancer.     

The stage-specific role of spirituality among African American Christian women throughout the breast cancer experience

This study presents the results of semistructured interviews conducted with 18 African American Christian women regarding the role of spirituality throughout their breast cancer experiences. The spiritual themes relevant for phases of the breast cancer experience are identified. Analysis resulted in the identification of 11 codes and 5 subcodes that corresponded to the diagnosis, treatment, and posttreatment phases of the breast cancer experience. Most of the survivors indicated that their spirituality and faith assisted them throughout the breast cancer experience. Discussion focuses on the spiritual resources used by the participants at the different stages in the breast cancer experience. Attention is given to implications for how professionals can use these resources to assist African American women coping with breast cancer.     

Integrating Religious Resources Within a General Model of Stress and Coping: Long-Term Adjustment to Breast Cancer

The purpose of the present cross-sectional study was to explore the role of religious resources in long-term adjustment to breast cancer. A sample of fifty-two survivors was assessed on indices of religious resources (e.g., image of God), nonreligious resources (e.g., cognitive appraisal) and emotional and spiritual well-being. Results indicated that both relationship with God/God image and religious coping behaviour were related to the nonreligious mediator variables of cognitive appraisal and coping in response to the current cancer situation. Various experiences of relationship with God (e.g., Presence) were related to more positive appraisals of the current cancer situation as well as to the greater use of the nonreligious coping behaviour of focusing on the positive. In contrast, religious coping behaviours demonstrated more complex associations with cognitive appraisal and nonreligious coping factors. The same coping behaviour, for example religious avoidance, could be related to both positive and negative appraisals of the cancer situation. Finally, religious resources, but not nonreligious resources predicted emotional and spiritual well-being for these long-term breast cancer survivors.     

Posttraumatic spiritual growth: a phenomenological study of cancer survivors

A small but growing body of research has sought to investigate the specific role of religion and spirituality in posttraumatic growth. Recently, investigations have reported identifying spiritual growth following trauma, specifically that of cancer patients and survivors. The purpose of this qualitative study was to investigate how having cancer affects the spiritual growth of cancer survivors across a multidimensional conceptualisation of spirituality. The researchers investigated posttraumatic spiritual growth by studying the lived experience of 13 cancer survivors using phenomenological data analysis. Participants reported experiencing spiritual growth across the following domains of spirituality: (a) general spirituality, (b) spiritual development, (c) spiritual social participation, (d) spiritual private practices, (e) spiritual support, (f) spiritual coping, (g) spirituality as motivating forces, (h) spiritual experiences, and (i) spiritual commitment. Growth was not endorsed by participants in the following three domains of spirituality outlined in the model: (a) spiritual history, (b) spiritual beliefs and values, and (c) spiritual techniques for regulating and reconciling relationships. Two additional domains of growth emerged beyond the theoretical model that was used to guide this study from participants’ narratives, including evangelism and enhanced spirituality of family/friends.     

Posttraumatic growth following breast cancer: a controlled comparison study.

Cancer may be viewed as a psychosocial transition with the potential for positive and negative outcomes. This cross-sectional study (a) compared breast cancer (BC) survivors' (n = 70) self-reports of depression, well-being, and posttraumatic growth with those of age- and education-matched healthy comparison women (n = 70) and (b) identified correlates of posttraumatic growth among BC survivors. Groups did not differ in depression or well-being, but the BC group showed a pattern of greater posttraumatic growth, particularly in relating to others, appreciation of life, and spiritual change. BC participants' posttraumatic growth was unrelated to distress or well-being but was positively associated with perceived life-threat, prior talking about breast cancer, income, and time since diagnosis. Research that has focused solely on detection of distress and its correlates may paint an incomplete and potentially misleading picture of adjustment to cancer.     

Spiritual coaching in cancer patients: treating the spirit as well as the disease

Interest in the exploration of spirituality in medical practice has been growing recently due to some studies suggesting its role in the improvement of patient well-being and quality of life. This project examined the feasibility of providing spiritual coaching with patients in an outpatient Radiation Oncology clinic setting. The purpose of spiritual coaching was to provide patients with opportunities to explore their current spiritual lives, increase their involvement in spiritually enhancing activities, and expand their spiritual opportunities. Quality-of-life measurements focused on feelings of hopefulness and distress were used in patients undergoing radiation treatment for cancer. This study suggests that there is a potential benefit for spiritual coaching in the care of cancer patients, and future studies will be done to further el ucidate the ationship of spirituality and quality of life in this population.     

“Leaving it to God” Religion and Spirituality among Filipina Immigrant Breast Cancer Survivors

Many Filipinos have a powerful adherence to Catholicism. However, little is known about spirituality and religious involvement of Filipina Americans who have been diagnosed with breast cancer. Ten (n = 10) in-depth qualitative interviews with Filipina immigrant breast cancer survivors identified prayer to be the most common religious practice, followed by prayers by others and spiritual support from the Catholic Church. These findings can help clinicians and researchers understand the role of spirituality and religion in providing comfort and support for Filipina immigrant breast cancer patient as they face the stress of diagnosis and treatment.     

Rural breast cancer patients,coping and depressive symptoms: A prospective comparison study

Many studies have revealed that individual differences in coping responses to the diagnosis and treatment of breast cancer are associated with psychological adjustment. The vast majority of these studies, however, focus exclusively on urban breast cancer survivors despite that rural breast cancer survivors are likely to have distinct experiences both in general and in relation to breast cancer. The current study quantitatively examined the coping strategies employed by both rural and urban breast cancer patients while they were undergoing radiation therapy. Further, the influence of these coping behaviours on concurrent as well as subsequent depressive symptoms (3 and 6 months later) was examined. The results revealed that the rurality of breast cancer patients was unrelated to the ways in which they coped, but did influence the relationships between some coping responses and depressive symptoms. Specifically, active coping and positive reinterpretation were negatively related to depressive symptoms for more rural breast cancer patients, but not their relatively urban counterparts. Similarly, behavioural disengagement was more strongly related to depressive symptoms for more rural patients. Possible reasons for this pattern of results and implications are discussed.     

Predictors of physical activity among rural and small town breast cancer survivors: An application of the theory of planned behaviour

The primary objective of this study was to investigate the utility of the two-component theory of planned behaviour (TPB) in understanding physical activity intentions and behaviour in rural and small town breast cancer survivors. The secondary objective was to elicit the most common behavioural, normative and control beliefs of rural and small town survivors regarding physical activity. Using a cross-sectional survey design, 524 rural and small town breast cancer survivors completed a mailed survey that assessed physical activity and TPB variables. Physical activity intention explained 12% of the variance in physical activity behaviour (p?相似文献   

Spiritual Coping, Family History, and Perceived Risk for Breast Cancer—Can We Make Sense of it?

Differences in spiritual beliefs and practices could influence perceptions of the role of genetic risk factors on personal cancer risk. We explored spiritual coping and breast cancer risk perceptions among women with and without a reported family history of breast cancer. Analyses were conducted on data from 899 women in primary care clinics who did not have breast cancer. Structural equation modeling (SEM), linear, and logistic modeling tested an interaction of family history of breast cancer on the relationship between spiritual coping and risk perceptions. Overall analyses demonstrated an inverse relationship between spiritual coping and breast cancer risk perceptions and a modifying effect of family history. More frequent spiritual coping was associated with lower risk perceptions for women with positive family histories, but not for those with negative family histories. Results support further research in this area that could influence communication of risk information to cancer genetic counseling patients.     

The Impact of a Breast Cancer Diagnosis on Religious/Spiritual Beliefs and Practices in the UK

The use of religious/spiritual resources may increase when dealing with the stress of a cancer diagnosis. However, there has been very little research conducted into changes in religious/spiritual beliefs and practices as a result of a cancer diagnosis outside the USA. The aim of this study was to examine the impact of a breast cancer diagnosis on patients’ religious/spiritual beliefs and practices in the UK where religious practice is different. The study used two methods. One compared the religious/spiritual beliefs and practices of 202 patients newly diagnosed with breast cancer with those of a control group of healthy women (n = 110). The other examined patients’ perceived change in religious/spiritual beliefs and practices at the time of surgery with those in the year prior to surgery. The aspects of religiousness/spirituality assessed were: levels of religiosity/spirituality, strength of faith, belief in God as well as private and public practices. Patient’s perceived their belief in God, strength of faith and private religious/spiritual practices to have significantly increased shortly after surgery compared with the year prior to surgery. However, there were no significant differences in religious/spiritual beliefs and practices between patients and healthy participants. Change scores demonstrated both a reduction and an increase in religious/spiritual beliefs and practices. Although belief in God, strength of faith and private religious/spiritual practices were perceived by patients to be significantly higher after their cancer diagnosis, no significant differences in religious/spiritual beliefs and practices were found between the cancer group at the time of surgery and the control group. Different methodologies appear to produce different results and may explain contradictions in past US studies. Limitations of this study are discussed and suggestions for future research are made.     

Health-Related Quality of Life in Iranian Breast Cancer Survivors: A Qualitative Study

Women play the most important role in Iranian families. Therefore, it is necessary to pay attention to efforts to maintain and promote their health. The diagnosis and treatment of breast cancer have significant physical and psycho-social impacts on patients, families and friends. This qualitative study was designed to analyze the role of several social and cultural factors and their relationship to health-related quality of life among Iranian breast cancer survivors. In-depth semi-structured and unstructured face-to-face interviews were conducted with 39 breast cancer survivors. The results of the present study revealed that most prevalent physical problems that were reported by Iranian breast cancer survivors were fatigue, pain and lymphedema related to the adverse effects of mastectomy. We found that most participants have a strong sense of spirituality and used this as a source of psychological support to help them accept their disease. Spirituality has been found to be a strong source of psychological support among Iranian breast cancer survivors. Religious faith has provided this community the strength and motivation to seek medical treatment and to be patient and relax. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.     

Mapping the apetitive and aversive systems with emotional pictures using a block-design fMRI procedure

Negative emotional pictures from the International Affective Pictures System (IAPS) have been successful in mapping brain areas related to the aversive system. However, the capacity of positive emotional pictures to study the brain areas related to the appetitive system (i.e., nucleus accumbens, prefrontal cortex) is less established. In this study, we used a block fMRI design to investigate this issue, including emotional pictures as background while participants performed a vowel-consonant discrimination task. Importantly, participants were heterosexual males and all positive pictures were related to erotic couples, opposite-sex erotica, or romantic scenes. Negative pictures were similar to those used in previous studies. Results were consistent with previous studies using event-related designs, showing activation of amygdala, lateral prefrontal cortex, and occipito-temporal areas, but positive pictures showed a significant activation in the left nucleus accumbens. These findings provide evidence of the utility of block designs in emotional research (positive emotional pictures).     

Eliciting mixed feelings with the paired-picture paradigm: A tribute to Kellogg (1915)

Can people experience mixed feelings; that is, concurrent experiences of pleasure and displeasure? Kellogg (1915) examined this question with alternating presentations of pleasant and unpleasant pictures. Although some participants reported mixed feelings, Kellogg's data were inconclusive. The present study used the paired-picture paradigm to examine this question more systematically. In addition, the nature of the positive and negative pictures was manipulated. Results show that positive pictures inhibit displeasure and negative pictures inhibit pleasure. Nevertheless, conflicting pairs elicit mixed feelings at low to moderate intensities. Furthermore, the strength of the inhibition effect and the intensity of mixed feelings varied with the nature of the positive and negative pictures. The results show that the paired-picture paradigm is a useful paradigm to study the relation between pleasure and displeasure experimentally.     

Feelings of vulnerability in response to threatening messages: Effects of self-affirmation

We examined effects of self-affirmation on feelings of vulnerability and behavioral intentions following exposure to personally threatening messages varying in message strength. In Experiment 1, female alcohol consumers read a strong message linking alcohol to breast cancer risk. Self-affirmed participants exhibited higher feelings of vulnerability concerning consumption levels and personal risk. In Experiment 2, female caffeine consumers read a weak or strong message linking caffeine to breast disease. Self-affirmed participants reported greater feelings of vulnerability to breast disease and greater intentions to reduce caffeine consumption (relative to control participants) only when reading the strong message. Effects on intentions were mediated by effects on feelings of vulnerability. These studies show that feelings of vulnerability can mediate effects of self-affirmation on intentions to change behavior under threat, although only in the presence of strong messages.     

Healing Faith: A Qualitative Exploration of Latina Breast Cancer Survivors

Latina cancer survivors report higher levels of distress and depression and lower levels of social quality of life and overall health‐related quality of life when compared with all other cancer survivors. Cultural values influence cancer survivorship; however, little research to date has examined how aspects of the Latina culture may be healing during the cancer journey. Therefore, the purpose of this article is to present findings from a qualitative study exploring the influence of culture on quality of life for Latina breast cancer survivors. The authors use consensual qualitative research to understand the lived experiences of Latina breast cancer survivors.     

Latina breast cancer survivors' lived experiences: diagnosis, treatment, and beyond

Latina breast cancer survivors are not benefiting from advances in psychosocial interventions. Despite their greater breast cancer burden, there is a dearth of information about this population. This qualitative study examined the experiences of 18 immigrant Latina breast cancer survivors along the survivorship continuum, from diagnosis to long-term survivorship. The authors conducted separate focus groups with women in the acute, reentry, and long-term survivorship stages. Through grounded theory analysis, the authors uncovered 5 themes of experience: perceptions of psychological well-being, impact of diagnosis, impact of treatment, need for social support, and development of new attitudes. Some themes were applicable across all survivorship stages, whereas others were more salient at a particular stage. Within themes, the authors identified experiences reported in the general literature (i.e., the debilitating effect of chemotherapy) and distinct cultural experiences (i.e., fear that a cancer diagnosis leads to certain death). Results suggest that treatments tailored for each survivorship stage are more likely to be effective than generic interventions. These findings have the potential to lessen health disparities in utilization of psychosocial treatments by Latina breast cancer survivors.     

The influence of breast cancer survivors' Perceived partner social support and need satisfaction on depressive symptoms: A longitudinal analysis

The present study examines the ways in which breast cancer survivors’ perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.     

The Role of Optimism,Social Constraints,Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.