Role of spirituality in cancer coping among African Americans: a qualitative examination

Introduction  This study used qualitative methods to examine whether, and if so how, African American cancer survivors use spirituality in coping with the disease. Spirituality was defined using a model involving connectedness to self, others, a higher power, and the world. Methods  Twenty-three African American patients with various forms of cancer were recruited from physician offices and completed 1–1.5 h interviews. Data were coded by multiple coders using an inductive process and open-coding. Results  Themes that emerged included, but were not limited to the aforementioned types of connectedness, one theme being connections to God. Given the important role of social support in the cancer experience, participants also emphasized their connectedness to others, which is in support of the spirituality model. Participants also articulated the notion that connections with others were not always positive, indicating that some perceived certain connections as having a detrimental impact on their well-being. Participants also expressed the desire to share their cancer story with others, often gained a new perspective on life, and obtained new self-understanding as a result of their illness experience. Discussion/conclusions  Findings indicate that African Americans perceive that spirituality plays a strong role in their cancer coping and survivorship. Spirituality may address a human need for certitude in crisis. Further research is warranted for model testing, and to examine the role of spirituality in cancer coping among those of different backgrounds and cancer types/stages. Implications for cancer survivors  These themes may have utility for the development of support interventions for cancer survivors.     

Religion as an Alleviating Factor in Iranian Cancer Patients: a Qualitative Study

After diagnosis of cancer, many patients show more inclination towards religion and religious activities. This qualitative study using semi-structured interviews explored the perspectives and experiences of 17 Iranian cancer patients and their families regarding the role of religion in their adaptation to cancer in one of the hospitals in Tehran and a charity institute. The content analysis identified two themes: “religious beliefs “(illness as God’s will, being cured by God’s will, belief in God’s supportiveness, having faith in God as a relieving factor, and hope in divine healing) and “relationship with God during the illness.” In general, relationship with God and religious beliefs had a positive effect on the patients adapting to their condition, without negative consequences such as stopping their treatment process and just waiting to be cured by God. Thus a strengthening of such beliefs, as a coping factor, could be recommended through religious counseling.     

Coping with the onset of cancer: coping strategies and resources of young people with cancer

A chronic illness, such as cancer, causes permanent changes in a person's way of life and their way of adapting to changes. The purpose of this study was to describe the coping strategies and resources of adolescents and young adults with cancer. The data were collected by interviewing adolescents and young adults aged 16–22 ( n  = 14) who had had cancer for more than 2 months and who came to a university hospital for treatment or control check ups. The interview material was analysed by content analysis. Emotion-focused, appraisal-focused and problem-focused coping strategies were used. The major coping strategies were social support, belief in recovery and getting back to normal life as soon as possible. The subjects discussed with health care providers their disease, its treatment and how they could cope with everyday life as well as their energy and will-power to cope. The family was the most important source of emotional support. Also, gaining knowledge about cancer and its treatment was a good coping strategy. Moreover, a positive life attitude, belief in one's own resources, belief in God, earlier life experiences and willingness to fight against the disease were resources for coping with cancer.     

The relation of spouse illness representations to patient representations and coping behavior: A study in couples dealing with a newly diagnosed cancer

Abstract

The central role of spouses/partners in patients’ adaptation to cancer is well-established, but few studies have examined how partners facilitate adaptation. The Common Sense Model posits that a representation of illness as more controllable and less threatening promotes adaptive coping, but this has not been examined in a dyadic context. This cross-sectional study examined the relations of spouse illness representations of personal and treatment control, and emotional representations to recently diagnosed cancer patients’ coping behaviors, through patient illness representations. One hundred forty-nine heterosexual couples (39.60% female patients; 77.18% dealing with early stage cancer) participated in the study. Structural Equation Modeling showed that spouse illness representations were related to patient coping directly and indirectly through patient illness representations. Both partners’ representations of control were related to greater patient adaptive coping, and both partners’ emotional representations were related to greater dysfunctional coping. These findings highlight the importance of partner illness representations in patients’ adaptation to cancer. They also suggest that early intervention programs that address both partners’ illness representations may enhance patients’ adaptation to cancer.     

The combined contribution of social support and coping strategies in predicting post-traumatic growth: a longitudinal study on cancer patients

Objectives: The aim of this study is to investigate the role of social support and coping strategies in enhancing post‐traumatic growth (PTG) in cancer patients. The study focused on both avoidance and approaching coping and on four distinct types of social support: (a) perceived availability, (b) actual received, (c) satisfaction with received support, and (d) the competence of caregiver to satisfy the patient's basic psychological needs of autonomy, competence, and relatedness. Methods: A longitudinal study was conducted with a group of 41 cancer patients currently in the treatment and management phase of their illness. Data were collected by means of a written questionnaire, at two time points (T1 and T2) that were 6 months apart. Social support was assessed using the Interpersonal Support Evaluation List and the Need Satisfaction in Relationship Scale. Coping strategies were assessed using the Brief COPE questionnaire. Social support and coping strategies were assessed only at T1. PTG was assessed using the Post‐Traumatic Growth Inventory at T1 and T2. Correlation and regression analyses were used to examine the association between social support and coping strategies with short‐term reports of post‐traumatic growth. Results: Regression analyses showed that autonomy‐supportive caregivers and a problem‐focused strategy of coping significantly predicted greater PTG at T2. Conclusions: This study contributes to a deeper understanding of the type of social support that may specifically aid cancer patients in experiencing PTG. Furthermore, findings confirm the important role of problem‐focused coping strategies in growing psychologically. Copyright © 2010 John Wiley & Sons, Ltd.     

Spirituality and Coping Among Survivors of Prostate Cancer

Abstract

This pilot study explored the influence of religion and spirituality on coping among survivors of prostate cancer. Thirty-eight men (14 African Americans and 24 Caucasians) completed a self-administered survey; 29 of the men participated in five focus group sessions. Four major themes emerged from these sessions: (1) the beneficial effect of faith or religious belief on coping with the disease, (2) the multiple functions of church social and spiritual support and educational forum, (3) the durability of faith in God, and (4) the distinction between religion and spirituality (institutional versus personal). Consistent with the group sessions, the survey data indicated that a majority of participants reported a high degree of religiosity, measured by denominational affiliation and attendance at places of worship. The data also showed that having prostate cancer influenced greater religious attendance, with the change attributed to a desire to gain spiritual support. Racial comparisons showed that the African American men had higher levels of religiosity than the Caucasian men did, as measured by church attendance, quality of spiritual life, and importance of God in the recovery process.     

The Role of Social Support in Families Coping with Childhood Brain Tumor

Previous studies suggest that support from social networks is a protective factor buffering the negative effects of stressful events, such as having a child with a chronic illness. The literature highlights the need for more systematic examination of parents’ social support networks across the disease trajectory, to obtain a more complete understanding of how a family's support system affects adjustment over time. This was attempted in this study of 88 parents of children with brain tumors, recruited from hospitals in Australia, Singapore, and New Zealand. It employed a longitudinal design, tracking families for 2 years postdiagnosis to examine the relationship between social support and coping. As in previous research this study showed that different types of support are needed at different stages in the illness trajectory. The study also identified the use of various coping strategies by families, directed at the maintenance and enhancement of existing supports and the securing of new supports. The study failed to establish a statistically significant relationship between level of coping and social support, however, suggesting that parents were using primarily “internal” familial modes of coping, including preexisting patterns of coping, with external social support being an adjunct to their coping rather than being a major contributor.     

The Influence of Relational Factors on Men's Adjustment to Their Partners' Newly-Diagnosed Breast Cancer

Abstract

Steadily rising breast cancer rates in America's women are forcing more men to confront challenges of living with a partner afflicted with this disease. This study assesses teh impact of mutual emotional support as perceived by male partners on their adjustment to the diagnosis and the illness and on interactions between their perceied emotional support nd their coping methods. Seventy-one male partners of newly-diagnosed breast cancer patients completed standardized instruments that measured emotional wellbeing, illness intrusiveness, emotional support, dyadic coping styles and demographic factors. Regression analysis revealed significant associations between perceived emotional support and men's coping strategies, and between coping styles and illness intrusiveness. Also, a history of depression predisposes men to poorer adjustment and affects their coping patterns. Findings suggest that as the health care system continues to relocate burden of care to partners and families, social workers must increase their understanding of how to effectively assist patients' partners. This study emphasizes the need to work with patients and partners to develop positive coping strategies as a couple.     

Sources of hope in chronic illness.

Patients with many types of diagnosis find that hope is an important strategy in coping with their illness. One purpose of this study was to identify and explore the sources that patients with chronic illnesses report as being supportive of their hope. Another purpose was to determine if the sources differ between patients with cancer and patients with other chronic illnesses. A combination of Stotland's work on hope and Lazarus and Folkman's work on coping formed the conceptual framework for this study. Ninety patients, 45 with cancer and 45 with other chronic illnesses, were interviewed using an investigator-developed interview guide. Using chi-square and t-test analyses, no statistically significant differences were found between patients with cancer and patients with other chronic illnesses in any responses to the interview questions. The most commonly reported sources for supporting hopefulness were family, friends, and religious beliefs. Patients were able to identify specific ways in which these sources helped to support their hope. The majority of patients reported positive attitudes about their illnesses, with transient periods of lowered hope related to illness. They also described specific cognitive or behavioral strategies used for maintaining hope. The results of this study provide additional insight into the coping strategies of adults with a chronic illness.     

Coping Strategies of African American Head and Neck Cancer Survivors

A cross-sectional study was conducted with 50 African American head and neck cancer survivors. Common coping strategies were identified and examined in relation with quality of life and relationship well-being. Coping through support from God, seeking emotional support from family and friends, and helping others were the most commonly used strategies. Having emotional support, being strong and self-reliant, and engaging in distracting activities with family and friends had strongest associations with quality of life. Coping through emotional support, help from God, assistance from one's church family to maintain religious practices, helping others, and engaging in distracting activities with others was more strongly associated with relationship well-being. Future intervention studies should consider these strategies and their possible impact on the physical, psychological, and relationship well-being of this population.     

An exploration of the lived experiences of individuals with relapsed multiple myeloma

The experience of living with relapsed Multiple Myeloma (myeloma) for eight patients accessing treatment within a haematology unit in a large London hospital is explored in this study. Myeloma is recognised as incurable and is sometimes described as an 'incurable chronic disease' with a main treatment option of chemotherapy. Hermeneutic phenomenology was the methodology used in conducting the study and data were collected through open-ended, unstructured interviews. Findings suggest that living with relapsed myeloma in the context of a chronic illness causes an ever-shifting perspective between illness and wellness consequently maintaining a state of uncertainty. The patients in this study placed importance on the emotional aspect of their experience. Hope, intuitive knowing and a fighting spirit were expressed as required positive elements that enabled living with relapsed myeloma. These assisted in maintaining normality, coping with bad news and adjusting to the illness. Pervading through the themes was the need to control uncertainty. Having strong support from significant others provided something to live for and the necessary social support required to promote a new orientation to life.     

The Influence of relational factors on men's adjustment to their partners' newly-diagnosed breast cancer

Steadily rising breast cancer rates in America's women are forcing more men to confront challenges of living with a partner afflicted with this disease. This study assesses teh impact of mutual emotional support as perceived by male partners on their adjustment to the diagnosis and the illness and on interactions between their perceived emotional support nd their coping methods. Seventy-one male partners of newly-diagnosed breast cancer patients completed standardized instruments that measured emotional wellbeing, illness intrusiveness, emotional support, dyadic coping styles and demographic factors. Regression analysis revealed significant associations between perceived emotional support and men's coping strategies, and between coping styles and illness intrusiveness. Also, a history of depression predisposes men to poorer adjustment and affects their coping patterns. Findings suggest that as the health care system continues to relocate burden of care to partners and families, social workers must increase their understanding of how to effectively assist patients' partners. This study emphasizes the need to work with patients and partners to develop positive coping strategies as a couple.     

The role of illness representations in coping and health of patients treated for breast cancer

Objective: The present study examined the relation of cognitive and emotional representations of illness specified by the Common Sense Model of Illness Cognition (Handbook of Psychology and Health: Social Psychological Aspects of Health. Earlbaum, Hillsdale: New York, 1984; 219–252) with the coping strategies and perceived health of patients who were treated for breast cancer. Methods: Participants were 119 women within 2 years after their diagnosis of breast cancer, who completed a questionnaire containing measures of illness representations, coping strategies and perceived physical and mental health. Results: Breast cancer patients differ in the subjective perception of their disease. Patients who view their illness as a condition with serious symptoms and consequences, patients who believe their illness is chronic and patients who consider their illness uncontrollable were found to report worse physical and mental health than those who believed the opposite. Regression analysis showed that, after controlling for external variables, the cognitive illness representations identity and consequences explained 57% of variance in physical health, whereas emotional illness representation and treatment control explained 47% of variance in mental health. Conclusion: Results provide some support for the hypotheses of the Common Sense Model of Illness Cognition. Illness representations seem to play an important role in perceived health in breast cancer. The implications of these findings for the design of health‐care‐related interventions for breast cancer patients are discussed. Copyright © 2008 John Wiley & Sons, Ltd.     

To tell or not to tell: patterns of disclosure among men with prostate cancer

This paper draws on the results of a longitudinal, qualitative study of men with prostate cancer (treated with prostatectomy) and their spouses. Interviews were conducted separately and simultaneously with men and their spouses, at three points in time (pre-surgery, 8-10 weeks post-surgery and 11-13 months post-surgery). The primary focus in the paper is on men's responses to questions about their decisions to share information (or not) with others about their diagnosis and ongoing medical situation. Most men with prostate cancer avoided disclosure about their illness where possible, and placed great importance on sustaining a normal life. Factors related to limiting disclosure included men's low perceived need for support, fear of stigmatization, the need to minimize the threat of illness to aid coping, practical necessities in the workplace, and the desire to avoid burdening others. This study contributes to an understanding of disclosure issues related to prostate cancer, and raises issues about how best to be helpful to men, given their tendency to minimize the impact of illness, and the need for support.     

Prognostic factors for hereditary cancer distress six months after BRCA1/2 or HNPCC genetic susceptibility testing

This study explored predictors for hereditary cancer distress six months after genetic susceptibility testing for a known familial BRCA1/2 or HNPCC related mutation, in order to gain insight into aspects relevant for the identification of individuals needing additional psychosocial support. Coping, illness representations, experiences with cancer in relatives and family system characteristics were assessed in 271 applicants for genetic testing before result disclosure. Hereditary cancer distress was assessed prospectively up to six months after disclosure. Regression analysis revealed that the pretest level of distress, complicated grief, the number of affected first-degree relatives and strong emotional illness representations were factors that best explained hereditary cancer distress. Other significant predictors were illness coherence, passive coping, distraction seeking, being aged <13 years when a parent was affected by cancer and family communication. Individuals who may benefit from additional support may be identified before result disclosure using a short instrument assessing the relevant aspects.     

Religious Coping and Posttraumatic Growth Among Family Caregivers of Cancer Patients in India

Growing attention has focused on relationships between religious coping and health outcomes among cancer patients. However, surprisingly little is known about religious coping among family caregivers. Moreover, few studies have been conducted outside of Western developed nations. This investigation evaluated family caregivers in Pune, India. The authors examined discrete dimensions of cancer-specific religious coping, and their associations with posttraumatic growth, among families at a similar phase of treatment. As hypothesized, posttraumatic growth was associated with increased use of positive religious coping strategies and diminished use of negative coping strategies. In multivariate analyses, the strongest predictors were benevolent religious reappraisals and punishing God reappraisals. Findings underscore the importance of meaning-focused religious coping.     

Informal caregiving to older cancer patients: preliminary research outcomes and implications

BackgroundThe population of the Western world is aging while cancer survival rates are rising. Older patients with cancer will increasingly be taken care of by informal family caregivers. The current study describes levels of psychological distress, social support and coping abilities reported by partners who are caregivers to older patients with cancer (60+ years), comparing them to a control group of spouses of similarly aged people not suffering from life-threatening illness.Patients and MethodsTwo hundred sixteen partners who are primary caregivers of cancer patients aged 60+ were compared with 76 partners of healthy people aged 60+ and never diagnosed with any terminal illness. Participants completed self-reporting measures on psychological distress, coping ability and social support.ResultsCaregivers to cancer patients reported high levels of distress, low levels of social support and low levels of coping abilities which are negatively correlated to distress. Increased patient age was found to accentuate these processes.ConclusionAge and the progression of cancer as a chronic illness present the physician with the reality that focus of care should be on the dyad (patient and caregiver), with high priority given to partners who are informal caregivers.     

Psychosocial characteristics associated with breast cancer survivors' intimate partners' needs for information and support after primary breast cancer treatment

This study examines which psychosocial characteristics are associated with breast cancer survivors' partners' posttreatment needs for information and support. Eighty-four partners completed measures of coping, social support, illness representations, perceived stress, self-efficacy, anxiety, depression, and marital malfunctioning. Partners in need reported higher anxiety and depression, emotional illness representations, and emotion-oriented coping than partners without needs. Moreover, partners needing information and support took a more negative view on the timeline and consequences of their spouse's posttreatment condition. Interventions aimed at enhancing partners' posttreatment adjustment should focus on partners responding emotionally as well as perceiving their spouse's condition as a chronic condition.