Levine, Targ Spiritual Correlates of Functional Well-Being Spiritual Correlates of Functional Well-Being in Women With Breast Cancer (original) (raw)
Abstract
Breast cancer is the most common cancer in women in the United States and constitutes a major source of medical and psychological morbidity. The psychosocial sequelae, while not always severe, can last up to a year after diagnosis. This may be a time when spiritual and social resources become important. It is known that practical and emotional support during treatment for breast cancer benefits the patient's mood and quality of life, but it is unclear as to how spirituality and spiritual well-being may benefit the patient. This study examined this question by exploring the relationships between spirituality, spiritual well-being, physical well-being, functional well-being, mood, and adjustment style in a sample of 191 women recently diagnosed with breast cancer or who had metastatic cancer. The women were asked to complete questionnaires pertaining to the above topics at enrollment to a group intervention study. Measures of spirituality, spiritual well-being, physical well-being, functional wellbeing, mood, and adjustment style taken at the same point in time were then correlated with each other. There were more significant correlations of spirituality and spiritual wellbeing with functional well-being than physical well-being, but items pertaining to meaning and peace tended to correlate significantly with physical well-being. Spirituality also correlated significantly with several coping styles, but not avoidance as has been previously suggested. Regression analyses were also performed to find the best combination of variables to predict physical and functional well-being. A combination of social well-being and several questions pertaining to peacefulness accounted for 18% of the variance in physical well-being. However, a combination of social wellbeing and the spiritual scales accounted for 46% of the variance in functional well-being. When the spiritual scales were examined alone, they accounted for 40% of the variance in functional well-being. The results of this study confirm the importance of spirituality and spiritual well-being in both physical and functional well-being. Asking patients about the role of spirituality in their lives may be a useful marker to predict patient's ability to cope with stress in their lives and of their quality of life. 17 Levine, Targ 166 INTEGRATIVE CANCER THERAPIES 1(2); 2002 pp. 166-174 EGL and ET are at the
Figures (5)
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.
References (46)
- American Cancer Society, California Division. Cancer Facts and Figures. Oakland, Calif: American Cancer Society, 2000.
- Greer S, Morris P, Pettingale KW. Psychological response to breast cancer: effect on outcome. Lancet.1979;I:785.
- Levine EG, Raczynski JM, Carpenter JT. Psychological factors, weight gain and recurrence of breast cancer: two and five year follow-up. Presented at the Second International Congress of Behavioral Medicine, July 1992; Hamburg, Germany.
- Levy SM. Behavior and Cancer. San Francisco: Jossey-Bass; 1992.
- Levy SM, Lee J, Bagby C, Lippman M. Survival hazards analysis and first recurrent breast cancer patients: seven year follow-up. Psychosomatic Medicine. 1998;50:520-528.
- Pettingale KW. Coping and cancer prognosis. J Psychosom Res. 1984;28:363-364.
- Pettingale KW, Morris T, Greer S, Haybittle JL. Mental attitudes to cancer: an additional prognostic factor. Lancet. 1985;I:750.
- Morris T, Pettingale K, Haybittle J. Psychological response to cancer diagnosis disease outcome in patients with breast cancer and lymphoma. Psycho-Oncol. 1992;1:105-114.
- Glanz K, Lerman C. Psychosocial impact of breast cancer: a crit- ical review. Ann Behav Med. 1992;14:204-212.
- Irvine D, Brown B, Crooks D, Roberts J, Browne G. Psychosocial adjustment in women with breast cancer. Cancer. 1991;67:1097- 1117.
- APA. Diagnostic and Statistical Manual of Mental Disorders: 4th ed. Washington DC: American Psychiatric Association; 1980.
- Derogatis LR, Morrow GR, Fetting J. The prevalence of psychi- atric disorders among cancer patients. JAMA. 1983;249:751- 757.
- Montbriand M. Freedom of choice: an issue concerning alter- native therapies chosen by patients with cancer. Oncol Nurs For. 1993;20:1195-1201.
- VandeCreek L, Rogers E, Lester J. Use of alternative therapies among breast cancer outpatients compared with the general population. Altern Ther. 1999;5:71-76.
- Sloan RI. Religion, Spirituality and Medicine. The 22nd Annual Convention of the Freedom From Religion Foundation, November 6, 1999; San Antonio, Tex.
- Hiatt JF. Spirituality, medicine and healing. South Med J. 1986;79:736-743.
- Targ EF, Levine EG. A mind-body-spirit model for cancer sup- port groups. In: Tripathy D, Tagliaferri M, eds. Breast Cancer: Beyond Convention, The World's Foremost Authorities on Alternative and Complementary Medicine. New York: Pocket Books; 2001.
- Mueller PM, Plevak DJ, Rummans TA. Religious involvement, spirituality and medicine: implications for spiritual practice. Mayo Clinic Protocol. 2001;76:1225-1235.
- Musick MA, Keonig HG, Larson DB, Matthews D. Religion and spiritual beliefs. In: Holland JC, ed. Psycho-Oncology. New York: Oxford University Press; 1998:780-789.
- Phillips RL, Garfinkel L, Kuzma JW, Beeson WL, Lotz T, Brin B. Mortality among California Seventh-Day Adventists for selected cancer sites. J Natl Cancer Inst. 1980;65:1097-1107.
- Enstrom JE. Cancer and total mortality among active Mor- mons. Cancer. 1978;42:1943-1951.
- Levin J. God, Faith and Health. New York: John Wiley and Sons; 2001.
- Levin SS, Vanderpool HY. Is religion therapeutically significant for hypertension? Soc Sci Med. 1989:29:69-78.
- Ellison CW. Spiritual well being; conceptualization and mea- surement. J Psychol Theol. 1983;11(4):330-340.
- Cella DF. Manual: Functional Assessment of Chronic Illness Therapy (FACIT) Scales, Chicago: Center on Outcomes, Research, and Education, Evanston Northwestern Healthcare and North- western University; 1997.
- Fitchett G, Peterman A, Cella D. Spiritual beliefs and quality of life in cancer patients and HIV patients. Paper presented at: Third World Congress of Psycho-Oncology; October, 1996; New York.
- Kaczorowski JM. Spiritual well-being and anxiety in adults diag- nosed with cancer. Hosp J. 1989;5:105-116.
- Cotton SP, Levine EG, Fitzpatrick CM, Dold KH, Targ EF. Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast can- cer. Psycho-Oncol. 1999;8(6):429-438.
- Ellison CG, Gay DA, Glass TA. Does religious commitment con- tribute to individual life satisfaction? Soc Forces. 1989;68:100- 123.
- Larson DB, Koenig HG, Kaplan BH, et al. The impact of reli- gion on men's blood pressure. J Religion and Health. 1989;8:265- 278.
- Benson H. Timeless Healing: The Power of Biology and Belief. New York: Scribner; 1996.
- Jenkins, RA, Pargament, KI. Religion and spirituality as resources for coping with cancer. J Psychosoc Oncol. 1995;13:51- 74.
- Sicher F, Targ EF, Moore D, Smith H. A randomized double- blind study of distant healing in a population with advanced AIDS. West J Med. 1998;169(6):356-363.
- Astin JA, Harkness E, Ernst E. The efficacy of distant healing: a systematic review of randomized trials. Ann Intern Med. 2000; 132:903-910.
- Harris WS, Gowda M, Kolb JW, et al. A randomized controlled trial of the effects of remote, intercessory prayer on outcomes of patients admitted to the coronary care unit. Arch Intern Med. 1999;159:2273-2278.
- Benor DJ. Healing Research. Vol 1. Deddington, UK: Helix Edi- tions Ltd; 1992:chap 1-2.
- Johnson SC, Spilka B. Coping with breast cancer: the roles of clergy and faith. J Religion Health. 1991;30:21-33.
- McNair DM, Lorr M, Droppelman LF. Profile of Mood States. 2nd ed. San Diego, Calif: Educational and Industrial Testing Ser- vice; 1981.
- Andrykowski MA, Brady MJ, Hunt JW. Positive psychosocial treatment in potential bone marrow transplant recipients: can- cer as a psychosocial intervention. Psycho-Oncol. 1993;2:261- 276.
- Levine EG, Targ EF. A comparison of complementary and tradi- tional psychosocial treatment for breast cancer [abstract]. Psy- cho-Oncol. 1999;8(6):14
- Levine EG, Targ EF, Stone BM, Kronenwetter C. A comparison of complementary and traditional psychosocial treatment for breast cancer. Ann Behav Med. 1999; 21(Suppl):156.
- Thoresen C, Bowman E, Koopman C, Yang P, Spiegel D. Factors related to the use of three strategies for experience of life meaning among HIV+ adults. 1997. Unpublished paper.
- Brady M, Peterman AH, Mo M, Cella D. A case for including spirituality in quality of life measurement in oncology. Psycho- Oncol. 1999;8(5):417-428.
- Watson M, Greer S, Young J, Inayat Q, Burgess C, Robertson B. Development of a questionnaire measure of adjustment to can- cer: the MAC scale. Psychol Med.,1998;18:203-209.
- Watson M, La M, dos Santo M, Greer S, Baruch J, Bliss JM. The Mini-Mac: further development of the mental adjustment to cancer scale [abstract]. Psycho-Oncol. 1994;3:153.
- Levine EG, Fitzpatrick CM, Eckhardt J, Cotton S, Targ EF. Fac- tor analysis of the Mini-Mental Adjustment to Cancer Scale in women with breast cancer. Ann Behav Med. 1999;21(suppl): 156.