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Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group

Published online by Cambridge University Press:  28 September 2010

Luzia Travado ,
Luigi Grassi ,
Francisco Gil ,
Cristina Martins ,
Cidália Ventura  and
Joana Bairradas
Luzia Travado*
Affiliation:
Clinical Psychology Unit, Central Lisbon Hospital Center - Hospital S. José, Lisbon, Portugal
Luigi Grassi
Affiliation:
Department of Behavior and Communication, Section of Psychiatry, University of Ferrara and Department of Mental Health and General University S. Anna Hospital, Ferrara, Italy
Francisco Gil
Affiliation:
Psycho-Oncology Unit, Hospital Duran i Reynals, Catalan Institute of Oncology, L′Hospitalet, Barcelona, Spain
Cristina Martins
Affiliation:
Clinical Psychology Unit, Central Lisbon Hospital Center - Hospital S. José, Lisbon, Portugal
Cidália Ventura
Affiliation:
Clinical Psychology Unit, Central Lisbon Hospital Center - Hospital S. José, Lisbon, Portugal
Joana Bairradas
Affiliation:
PsiSaude, Center for Research in Health and Human Development, Lisbon, Portugal
*
Address correspondence and reprint requests to: Luzia Travado, Unidade de Psicologia Clínica, CHLC - Hospital de S. José, Rua José António Serrano,1150-199 Lisboa, Portugal. E-mail: luzia.travado@chlc.min-saude.pt
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Abstract

Objective:

In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study – SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients.

Method:

A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale— HADS), coping strategies (Mini-Mental Adjustment to Cancer — Mini-MAC) and concerns about illness (Cancer Worries Inventory — CWI).

Results. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = −0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = −0.25), depression (r = −0.22) and HAD total (r = −0.17).

Significance of results:

Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.

Keywords

SpiritualityCancer copingSouthern Europe Psycho-oncology
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 4 , December 2010 , pp. 405 - 413
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

Aukst-Margetić, B., Jakovljević, M., Margetic, B., et al. (2005). Religiosity, depression and pain in patients with breast cancer. General Hospital Psychiatry, 27, 250–255.CrossRefGoogle ScholarPubMed
Brady, M.J., Peterman, A.H., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psycho-oncology, 8, 417–428.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Breitbart, W. (2002). Spirituality and meaning in supportive care: Spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Supportive Care in Cancer, 10, 272–280.CrossRefGoogle ScholarPubMed
Broyles, P.A. & Drenovsky, C.K. (1992). Religious attendance and the subjective health in the elderly. Review of Religious Research, 34, 152–160.CrossRefGoogle Scholar
Bussing, A., Ostermann, T. & Matthiessen, P.F. (2005). Search for meaningful support and the meaning of illness in German cancer patients. Anticancer Research, 25, 1449–1455.Google ScholarPubMed
Bussing, A. & Koenig, H.G. (2008). The benefit through spirituality/religiosity scale – a 6-item Measure for use in health outcome studies. International Journal of Psychiatry and Medicine, 38, 493–506.CrossRefGoogle Scholar
Canada, A.L., Parker, P.A., de Moor, J.S., et al. (2006). Active coping mediates the association between religion/spirituality and quality of life in ovarian cancer. Gynecologic Oncology, 101, 102–107.CrossRefGoogle ScholarPubMed
Carroll, B.T., Kathol, R.G., Noyes, R., et al. (1993). Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale. General Hospital Psychiatry, 15, 69–74.CrossRefGoogle ScholarPubMed
Cole, B.S., Hopkins, C.M., Tisak, J., et al. (2008). Assessing spiritual growth and spiritual decline following a diagnosis of cancer: Reliability and validity of the spiritual transformation scale. Psycho-Oncology, 17, 112–121.CrossRefGoogle ScholarPubMed
Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., et al. (1999). Exploring the relationships among spiritual well-being, quality of life and psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429–438.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
D'Errico, G.M., Galassi, J.P., Schanberg, R., et al. (1999). Development and validation of the Cancer Worries Inventory: A measure of illness-related cognitions. Journal of Psychosocial Oncology, 17, 119–137.CrossRefGoogle Scholar
Dolbeault, S., Bredart, A., Mignot, V., et al. (2008). Screening for psychological distress in two French cancer centers: Feasibility and performance of the adapted distress thermometer. Palliative Supportive Care, 6, 107–117.CrossRefGoogle ScholarPubMed
Elkins, D.N., Hedstrom, L.J., Hughes, L.L., et al. (1988). Toward a humanistic phenomenological spirituality. Journal of Humanist Psychology, 28, 5–18.CrossRefGoogle Scholar
Ellison, C.G. (1991). Religious involvement and subjective well-being. Journal of Health and Social Behavior, 32, 80–99.CrossRefGoogle ScholarPubMed
Feher, S. & Maly, R.C. (1999). Coping with breast cancer in later life: The role of religious faith. Psycho-Oncology, 8, 408–416.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Fitchett, G., Peterman, A.H. & Cella, D. (1996). Spiritual beliefs and quality of life in cancer and HIV patients. Psycho-Oncology, 5, Supplement 3.Google Scholar
Fitchett, G. & Handzo, G. (1998). Spiritual assessment, screening and intervention. In Psycho-Oncology, Holland, J.C. (ed.), pp. 790–808. New York: Oxford University Press.Google Scholar
Gil, F., Grassi, L., Travado, L., et al. (2005) Use of A Visual Analogue Scale to measure psychosocial concomitants of cancer in Southern European countries. Supportive Care in Cancer, 13, 600–606.Google Scholar
Gioiella, M.E., Berkman, B. & Robinson, M. (1998). Spirituality and quality of life in gynecologic oncology patients. Cancer Practice, 6, 333–338.CrossRefGoogle ScholarPubMed
Grassi, L., Travado, L., Gil, F., et al. (2004). Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: Findings from the Southern European Psycho-Oncology Study (SEPOS). Journal of Affective Disorders, 83, 243–248.CrossRefGoogle Scholar
Grassi, L., Travado, L., Gil, F., et al. (2005). A communication intervention for training Southern European oncologists to recognize psychosocial morbidity in cancer patients. I - Development of the model and preliminary results on physicians' satisfaction. Journal of Cancer Education, 20, 79–84.CrossRefGoogle ScholarPubMed
Grassi, L., Sabato, S., Rossi, E., et al. (2009). Affective syndromes and their screening in cancer patients with early and stable disease: Italian ICD-10 data and performance of the Distress Thermometer from the Southern European Psycho-Oncology Study (SEPOS). Journal of Affective Disorders, 114, 193–199.CrossRefGoogle ScholarPubMed
Grassi, L., Travado, L., Gil, F., et al. (2010). Hopelessness and related variables among cancer patients in the Southern European Psycho-Oncology Study (SEPOS). Psychosomatics, 51, 201–207.CrossRefGoogle ScholarPubMed
Hiatt, J.F. (1986). Spirituality, medicine and healing. Southern Medical Journal, 79, 736–743.CrossRefGoogle ScholarPubMed
Holland, J.C., Passik, S., Kash, K.M., et al. (1999). The role of religious and spiritual beliefs in coping with melanoma. Psycho-Oncology, 8, 14–26.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Ibbotson, T., Maguire, P., Selby, P., et al. (1994). Screening for anxiety and depression in cancer patients: The effects of disease and treatment. European Journal of Cancer, 30, 37–40.CrossRefGoogle Scholar
Idler, E.L. (1987). Religious involvement and the health of the elderly: Some hypotheses and an initial test. Social Forces, 66, 226–238.CrossRefGoogle Scholar
Jacobsen, P.B., Donovan, K.A., Trask, P.C., et al. (2005). Screening for psychologic distress in ambulatory cancer patients. Cancer, 103, 1494–1502.CrossRefGoogle ScholarPubMed
Jenkins, R.A. & Pargament, K.I. (1995). Religion and spirituality as resources for coping with cancer. Journal of Psychosocial Oncology, 13, 51–74.CrossRefGoogle Scholar
Larson, D.B. & Greenwold-Milano, M.A. (1995). Are religion and spirituality clinically relevant in health care? Mind-Body Medicine, 1, 147–157.Google Scholar
Ley, D.C.H. & Corless, I.B. (1988). Spirituality and hospice care. Death Studies, 12, 101–110.CrossRefGoogle ScholarPubMed
Matthews, D.A., Larson, D.B. & Barry, C.P. (1993). The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects, Vol.1. Rockville: National Institute for Healthcare Research.Google Scholar
Matthews, D.A. & Larson, D.B. (1995). The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects, Vol. 3. Rockville: National Institute for Healthcare Research.Google Scholar
Matthews, D.A. (1997). Religion and spirituality in primary care. Mind-Body Medicine, 2, 9–19.Google Scholar
McCoubrie, R.C. & Davies, A.N. (2006). Is there a correlation between spirituality and anxiety and depression in patients with advanced cancer? Supportive Care in Cancer, 4, 379–385.CrossRefGoogle Scholar
McCullough, M.E., Hoyt, W.T., Larson, D.B., et al. (2000). Religious involvement and mortality: A meta-analytic review. Health Psychology, 19, 211–222.CrossRefGoogle ScholarPubMed
Meraviglia, M. (2006). Effects of spirituality in breast cancer survivors. Oncology Nursing Forum, 33, E1–7. http://ons.metapress.com/content/CrossRefGoogle ScholarPubMed
Moberg, D.O. (1979). Development of social indicators of spiritual well-being for quality of life research. In Spiritual Well-Being: Sociological Perspectives, Moberg, D.O. (ed.), pp. 1–13. Washington, DC: University Press of America.Google Scholar
Musick, M.A., Koenig, H.G., Larson, D.B., et al. (1998). Religion and Spiritual Beliefs. In Psycho-Oncology, Holland, JC (ed.), pp. 780–789. New York: Oxford University Press.Google Scholar
Mytko, J.J. & Knight, S.J. (1999). Body, mind and spirit: Towards the integration of religiosity and spirituality in cancer quality of life research. Psycho-Oncology, 8, 439–450.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network. (2007). Clinical practice guidelines in oncology (NCCN Guidelines™ ). Distress management V.I. 2007/2008. http://www.nccn.org.Google Scholar
Nelson, C.J., Rosenfeld, J.B., Breitbart, W., et al. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–220.CrossRefGoogle ScholarPubMed
Peterman, A.H., Fitchett, G., Brady, M.J., et al. (2002). Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58.CrossRefGoogle ScholarPubMed
Pettet, J.R. (1985). Religious issues presented by cancer patients seen in psychiatric consultation. Journal of Psychosocial Oncology, 3, 53–66.CrossRefGoogle Scholar
Razavi, D., Delvaux, N., Farvacques, C., et al. (1990). Screening for adjustment disorders and major depressive disorders in cancer in-patients. British Journal of Psychiatry, 156, 79–83.CrossRefGoogle ScholarPubMed
Reed, P.G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing and Health, 10, 335–344.CrossRefGoogle ScholarPubMed
Ritkin, A., Daddi, S., Karagji, B., et al. (1999). Religious and other predictors of psychosocial adjustment in cancer patients. Psychosomatics, 40, 251–256.Google Scholar
Shim, E.J., Shin, Y.W., Jeon, H.J., et al. (2008). Distress and its correlates in Korean cancer patients: Pilot use of the distress thermometer and the problem list. Psycho-Oncology, 17, 548–555.CrossRefGoogle ScholarPubMed
Smith, T.B., McCullough, M.E. & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin, 129, 614–636.CrossRefGoogle ScholarPubMed
St. George, A. & McNamara, P.H. (1984). Religion, race and psychological well-being. Journal for the Scientific Study of Religion, 23, 351–363.CrossRefGoogle Scholar
Thompson, G.N. & Chochinov, H.M. (2008). Dignity-based approaches in the care of terminally ill patients. Current Opinion in Supportive and Palliative Care, 2, 49–53.CrossRefGoogle ScholarPubMed
Thune-Boyle, I.C., Stygall, J.A., Keshtgar, M.R., et al. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social Science and Medicine, 63, 151–164.CrossRefGoogle Scholar
Torosian, M.H. & Biddle, V.R. (2005). Spirituality and healing. Seminars in Oncology, 32, 232–236.CrossRefGoogle ScholarPubMed
Travado, L. & Matos, J.N. (2001). Who lives longer and better? A study with treated breast cancer women. Liberdade, Anais Científicos da Universidade Independente, 2, 145–153.Google Scholar
Travado, L., Grassi, L., Gil, F., et al. (2005). Physician-patient communication among Southern European cancer physicians: The influence of psychosocial orientation, and burnout. Psycho-Oncology, 14, 661–670.CrossRefGoogle ScholarPubMed
Watson, M., Greer, S., Young, J., et al. (1988). Development of a questionnaire measure of adjustment to cancer: The MAC scale. Psychological Medicine, 18, 203–209.CrossRefGoogle ScholarPubMed
Watson, M., Greer, S., & Bliss, J.M. (1989). Mental Adjustment to Cancer (MAC) Scale Users' Manual. Sutton, Surrey: Cancer Research Campaign Medical Research Group, Royal Marsden Hospital.Google Scholar
Weaver, A.J. & Flannelly, K.J. (2004). The role of religion/spirituality for cancer patients and their caregivers. Southern Medical Journal, 97, 1210–1214.CrossRefGoogle ScholarPubMed
Williams, D.R., Larson, D.B., Buckler, R.E., et al. (1991). Religion and psychological distress in a community sample. Social Science in Medicine, 32, 1257–1262.CrossRefGoogle Scholar
Zigmond, S.A. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed