Effects of Spirituality in Breast Cancer Survivors

Martha Meraviglia

ONF 2006, 33(1), E1-E7. DOI: 10.1188/06.ONF.E1-E7

Purpose/Objectives: To examine the effects of spirituality (meaning in life and prayer) on a sense of well-being among women who have had breast cancer.

Design: Descriptive, correlational, cross-sectional.

Setting: Rural and urban communities in central Texas.

Sample: Convenience sample of 84 women, 34-80 years of age diagnosed less than one year previously (36%), within the previous one to five years (38%), and more than five years previously (26%).

Methods: The study approach consisted of completing a questionnaire assessing personal and cancer characteristics, aspects of spirituality (meaning in life and prayer), and physical and psychological responses to breast cancer.

Main Research Variables: Meaning in life, prayer, and physical and psychological responses to breast cancer.

Findings: Meaning in life was positively related to psychological responses and negatively related to physical responses. Prayer was positively related to psychological well-being. Women with higher prayer scale scores reported lower education levels, less income to meet their needs, and closer relationships with God. Meaning in life mediated the impact of breast cancer on physical and psychological well-being.

Conclusions: Strong relationships exist among spirituality and personal and cancer characteristics. Meaning in life mediated the effects of breast cancer on well-being in breast cancer survivors.

Implications for Nursing: The findings support healthcare providers encouraging women diagnosed with breast cancer to explore their spirituality as an effective resource for dealing with the physical and psychological responses to cancer.

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    Ai, A.L., Peterson, C., & Bolling, S.F. (1997). Psychological recovery from coronary artery bypass graft surgery: The use of complementary therapies. Journal of Alternative and Complementary Medicine, 3, 343-353.

    American Cancer Society. (2005). Cancer facts and figures 2005. Atlanta, GA: Author.

    Baron, R.M., & Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.

    Bearon, L.B., & Koenig, H.G. (1990). Religious cognitions and use of prayer in health and illness. Gerontologist, 30, 249-253.

    Bobko, P., & Rieck, A. (1980). Large sample estimators for standard errors of functions of correlation coefficients. Applied Psychological Measurement, 4, 385-398.

    Byrd, R.C. (1988). Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Medical Journal, 81, 826-829.

    Campbell, A., Converse, P.E., & Rodgers, W.L. (1976). The quality of American life: Perceptions, evaluations, and satisfactions. New York: Russell Sage Foundation.

    Carson, V.B. (1993). Prayer, meditation, exercise, and special diets: Behaviors of the hardy person with HIV/AIDS. Journal of the Association of Nurses in AIDS Care, 4, 18-28.

    Flaskerud, J.H., & Rush, C.E. (1989). AIDS and traditional health beliefs and practices of black women. Nursing Research, 38, 210-215.

    Frankl, V.E. (1986). The doctor and the soul: From psychotherapy to logotherapy (R. Winston & C. Winston, Trans.). New York: Vintage Books. (Original work published 1946)

    Frankl, V.E. (1988). The will to meaning: Foundations and applications of logotherapy. New York: Meridian Books.

    Fuller, S., Clements, R., & Swenson, C.H. (1993). Stages of religious faith and reactions to terminal cancer. Journal of Psychology and Theology, 21, 238-245.

    Gall, T.L., & Cornblat, M.W. (2002). Breast cancer survivors give voice: A qualitative analysis of spiritual factors in long-term adjustment. Psycho-Oncology, 11, 524-535.

    Gartner, J., Allen, G.D., & Larson, D.B. (1991). Religious commitment and mental health: A review of the empirical literature. Journal of Psychology and Theology, 19, 6-25.

    Geary, P.A., Formella, L.A., & Tringali, R. (1994). Significance of the insignificant. Critical Care Nursing Quarterly, 17(3), 51-59.

    Germino, B.B., Fife, B.L., & Funk, S.G. (1995). Cancer and the partner relationship: What is its meaning? Seminars in Oncology Nursing, 11, 43-50.

    Halstead, M.T., & Fernsler, J.L. (1994). Coping strategies of long-term cancer survivors. Cancer Nursing, 17 94-100.

    King, D.G. (1990). Religion and health relationships: A review. Journal of Religion and Health, 29, 101-112.

    MacKinnon, D.P., Lockwood, C.M., Hoffman, J.M., West, S.G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83-104.

    McCorkle, R. (1987). The measurement of symptom distress. Seminars in Oncology Nursing, 3, 248-256.

    McCray, N.D. (1993). Psychosocial issues. In S.E. Otto (Ed.), Oncology nursing (2nd ed., pp. 720-736). St. Louis, MO: Mosby.

    Meraviglia, M.G. (1999). Critical analysis of spirituality and its empirical indicators: Prayer and meaning in life. Journal of Holistic Nursing, 17, 18-33.

    Meraviglia, M.G. (2002). Prayer in people with cancer. Cancer Nursing, 25, 326-331.

    Meraviglia, M.G. (2004). The effects of spirituality on well-being of people with lung cancer. Oncology Nursing Forum, 31, 89-94.

    Nicholson, T., Higgins, W., Turner, P., James, S., Stickle, F., & Pruitt, T. (1994). The relation between meaning in life and the occurrence of drug abuse: A retrospective study. Psychology of Addictive Behaviors, 8, 24-28.

    O'Connor, A.P., Wicker, C.A., & Germino, B.B. (1990). Understanding the cancer patient's search for meaning. Cancer Nursing, 13, 167-175.

    Olkin, I., & Finn, J.D. (1995). Correlations redux. Psychological Bulletin, 118, 155-164.

    Poloma, M.M., & Pendleton, B.F. (1991). The effects of prayer and prayer experiences on measures of general well-being. Journal of Psychology and Theology, 19, 71-83.

    Reker, G.T. (1992). Manual of the Life Attitude Profile-Revised (LAP-R). Peterborough, Canada: Student Psychologists Press.

    Reker, G.T. (1997). Personal meaning, optimism, and choice: Existential predictors of depression in community and institutional elderly. Gerontologist, 37, 709-716.

    Reker, G.T., & Butler, B. (1990, October). Personal meaning, stress and health in older adults. Paper presented at the meeting of the Canadian Association on Gerontology, Victoria, Canada.

    Reker, G.T., & Peacock, E.J. (1981). The Life Attitude Profile (LAP): A multidimensional instrument for assessing attitudes toward life. Canadian Journal of Behavioural Science, 13, 264-273.

    Reker, G.T., Peacock, E.J., & Wong, P.T. (1987). Meaning and purpose in life and well-being: A life-span perspective. Journal of Gerontology, 42, 44-49.

    Saudia, T.L., Kinney, M.R., Brown, K.C., & Young-Ward, L. (1991). Health locus of control and helpfulness of prayer. Heart and Lung, 20, 60-65.

    Shrout, P.E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422-445.

    Skinn, B. (1994). The relationship of belief in control and purpose in life to adult lung cancer patients' information to use unproven cancer therapies. Canadian Oncology Nursing Journal, 4, 66-71.

    Smith, E.D., Stefanek, M.E., Joseph, M.V., Verdieck, M.J., Zabora, J.R., & Fetting, J.H. (1993). Spiritual awareness, personal perspective on death, and psychosocial distress among cancer patients: An initial investigation. Journal of Psychosocial Oncology, 11(3), 89-103.

    Sleeves, R.H. (1992). Patients who have undergone bone marrow transplantation: Their quest for meaning. Oncology Nursing Forum, 19, 899-905.

    Taylor, E.J. (1993). Factors associated with meaning in life among women with recurrent cancer. Oncology Nursing Forum, 9, 1399-1405.

    Thompson, S.C., & Pitts, J. (1993). Factors relating to a person's ability to find meaning after a diagnosis of cancer. Journal of Psychosocial Oncology, 11, 1-21.

    Turner, J.A., & Clancy, S. (1986). Strategies for coping with chronic low back pain: Relationship to pain and disability. Pain, 24, 355-364.