Document Type : Original Article
Authors
- . Amir Musarezaie
- . Homayoon Naji-Esfahani
- . Tahere Momeni-Ghale ghasemi
- . Jahangir Karimian 1
- . Amroallah Ebrahimi 2
1 Faculty of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
2 Center for psychosomatic research, school of medicine Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract
Background: Spiritual well‑being is well‑recognized as a factor that affects cancer patients’
quality of life, quality of care, and satisfaction. There is evidence that supports the fact that
patients’ spiritual needs are associated with better quality of care, higher hospice utilization,
and less aggressive care at the end of life. However, few studies have examined the Spiritual
well‑being (SWB) in cancer patients. Less is known about spirituality; furthermore, no published
research about SWB and its relationship with demographic parameters in breast cancer
patients exists; this made us carry out this project. Materials and Methods: This cross‑sectional
study was a descriptive – analytical one, conducted on 297 breast cancer patients, with
a simple sampling methodology. The data collection instrument included a questionnaire
containing two parts (demographic information and standard SWB Scale questionnaire). The
data were analyzed with 95% confidence by SPSS18, using descriptive and analytic statistics.
Results: According to the results of the present study, SWB of most of the study subjects (52.52%)
was at a moderate level. Results showed that the average score for religious aspect of spiritual
well‑being (RWB) was 51.38 ± 8.17 for 60, average score for the existential aspect of spiritual
well‑being (EWB) was 42.47 ± 10.21 for 60, and the total score of SWB was 93.69 ± 10.04 for 120.
Based on the study findings, there was a statistically significant correlation between the SWB and
age (P = 0.03, r = 0.59), educational level (P = 0.04, r = −0.58), and marital status (P = 0.001), of
breast cancer patients. Conclusion: According to the results of the present study, the SWB of
most study subjects was at a moderate level. Furthermore, according to the results there was a
correlation between some important demographic parameters in women with breast cancer and
SWB. Hence, it is necessary for the treatment team to assess and improve the SWB of patients;
meanwhile the role of nurses is highlighted. In fact, the nurse is the first person who can recognize
the spiritual needs of a patient and even his/her family, and can be effective in meeting the spiritual
needs and improving their SWB. Therefore, it is strongly recommended that in patients with cancer,
a holistic care plan, based on spiritual care, development, and education of patients be applied, as
it is considered to improve their SWB.
Keywords
and self‑esteem in women with breast cancer after surgery.
Procedia‑Social and Behavioral Sciences 2012;33:124‑7.
2. Pollan M, Gustavsson P. High‑risk occupations for breast cancer
in the Swedish female working population. Am J Public Health
1999;89:875‑81.
3. Van Esch L, Roukema JA, Ernst MF, Nieuwenhuijzen GA, De Vries J.
Combined anxiety and depressive symptoms before diagnosis of
breast cancer. J Affect Disord 2012;136:895‑901.
4. Poorkiani M, Hazrati M, Abbaszadeh A, Jafari P, Sadeghi M,
Dejbakhsh T, et al. Does a rehabilitation program improve quality
of life in breast cancer patients? Payesh 2010;9:61‑8.
5. Guarneri V, Conte PF. The curability of breast cancer and the
treatment of advanced disease. Eur J Nucl Med Mol Imaging
2004;31:S149‑61.
6. Taleghani F, Yekta ZP, Nasrabadi AN. Coping with breast cancer in
newly diagnosed Iranian women. J Adv Nurs 2006;54:265‑72.
7. Seedhom AE, Kamal NN. Factors affecting survival of women
diagnosed with breast cancer in El‑Minia governorate, Egypt. Int J
Prev Med 2011;2:131‑8.
8. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer
in Iran: Results of a multi‑center study. Asian Pac J Cancer Prev
2004;5:24‑7.
9. Sirous M, Ebrahimi A. The epidemiology of breast masses among
women in Esfahan. Journal of Surgery 2008;16:51‑6.
10. Pedram M, Mohammadi M, Naziri GH, Aeinparast N. Effectiveness
of cognitive‑behavioral group therapy on the treatment of anxiety
and depression disorders and on raising hope in women with breast
cancer. Journal of Woman and Society 2011;1:61‑75.
11. Hall A, A’Hern R, Fallowfield L. Are we using appropriate self report
questionnaires for detecting anxiety and depression in women with
early breast cancer? Eur J Cancer 1999;35:79‑85.
12. Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A.
Depression and anxiety in women with early breast cancer: Five
year observational cohort study. BMJ 2005;330:702. [published
4 February 2005].
13. Rezaei M, Seyedfatemi N, Hosseini F. Spiritual well‑being in cancer
patients who undergo chemotherapy. The Journal of Faculty of
Nursing and Midwifery (Hayat) 2009;14:33‑9. [Persian].
14. Surbone A, Baider L, The spiritual dimension of cancer care. Crit
Rev Oncol Hematol 2010;73:228‑35.
15. Sulmasy DP. Is medicine a spiritual practice? Acad Med
1999;74:1002‑5.
16. Puchalski C, Ferrell B, Virani R, Otis‑Green S, Baird P, Bull J, et al.
Improving the quality of spiritual care as a dimension of palliative
care: The report of the consensus conference. J Palliat Med
2009;12:885‑904.
17. Milstein JM. Introducing spirituality in medical care: Transition from
hopelessness to wholeness. JAMA 2008;299:2440‑1.
18. Sulmasy DP. Spiritual issues in the care of dying patients“. It’s okay
between me and God”. JAMA 2006;296:1385‑92.
19. Hill PC, Pargament KI. Advances in the conceptualization and
measurement of religion and spirituality. Implications for physical
and mental health research. Am Psychol 2003;58:64‑74.
20. Puchalski C, Romer AL. Taking a spiritual history allows clinicians
to understand patients more fully. J Palliat Med 2000;3:129‑37.
21. Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS,
Peteet JR, et al. Religiousness and spiritual support among
advanced cancer patients and associations with end‑of‑life treatment
preferences and quality of life. J Clin Oncol 2007;25:555‑60.
22. WHOQOL SRPB Group. A cross‑cultural study of spirituality, religion,
and personal beliefs as components of quality of life. Soc Sci Med
2006;62:1486‑97.
23. Astrow AB, Wexler A, Texeira K, He MK, Sulmasy DP. Is failure to
meet spiritual needs associated with cancer patients’ perceptions
of quality of care and their satisfaction with care? J Clin Oncol
2007;25:5753‑7.
24. Phelps AC, Maciejewski PK, Nilsson M, Balboni TA, Wright AA,
Paulk ME, et al. Religious coping and use of intensive lifeprolonging
care near death in patients with advanced cancer. JAMA
2009;301:1140‑7.
25. Karekla M, Constantinou M. Religious coping and cancer: Proposing
an acceptance and commitment therapy approach. Cogn Behav
Pract 2010;17:371‑81.
26. Thune’‑Boylea IC, Stygalla JA, Keshtgarc MR, Newman SP. Do
religious/spiritual coping strategies affect illness adjustment in
patients with cancer? A systematic review of the literature. Soc Sci
Med 2006;63:151‑64.
27. Imam SS, Nurullah AS, Makol‑Abdul Pute R, Rahman Saodah A,
Noon Hazizan M. Spiritual and psychological health of Malaysian
youths, research in the social scientific study of religion. Volume
20. Leiden: Koninklijke Brill NV; 2009.
28. Ellison CG, Levin JS. The religion‑health connection: Evidence,
theory, and future directions. Health Educ Behav 1998;25:700‑20.
29. Gall TL, Grant K. Spiritual disposition and understanding illness.
Pastoral Psychol 2005;53:515‑33.
30. Lugo L, Stencel S, Green J, Smith G, Cox D, Pond A, et al. U.S. religious
landscape survey: Religious affiliation — diverse and dynamic. The
Pew Forum on Religion and Public Life. Available from: http://
religions.pewforum.org/pdf/report‑religious‑landscape‑study‑full.
pdf. [Last cited in 2008].
31. Hsiao AF, Wong MD, Miller MF, Ambs AH, Goldstein MS, Smith A,
et al. Role of religiosity and spirituality in complementary and
alternative medicine use among cancer survivors in California.
Integr Cancer Ther 2008;7:139‑46.
32. Ross LE, Hall IJ, Fairley TL, Taylor YJ, Howard DL. Prayer and
self‑reported health among cancer survivors in the United States,
National Health Interview Survey, 2002. J Altern Complement Med
2008;14:931‑8.
33. Holland JC, Passik S, Kash KM, Russak SM, Gronert MK, Sison A,
et al. The role of religious and spiritual beliefs in coping with
malignant melanoma. Psychooncology 1999;8:14‑26.
34. Gall TL, Kristjansson E, Charbonneau C, Florack P. A longitudinal
study on the role of spirituality in response to the diagnosis and
treatment of breast cancer. J Behav Med 2009;32:174‑86.
35. Monroe MH, Bynum D, Susi B, Phifer N, Schultz L, Franco M, et al.
Primary care physician preferences regarding spiritual behavior in
medical practice. Arch Intern Med 2003;163:2751‑6.
36. Chibnall JT, Brooks CA. Religion in the clinic: The role of physician
beliefs. South Med J 2001;94:374‑9.
37. King DE, Wells BJ. End‑of‑life issues and spiritual histories. South
Med J 2003;96:391‑3.38. Imam SS, Karim NH, Jusoh NR, Mamad NE. Malay version of
spiritual well‑being scale. Is Malay spiritual well‑being scale a
psychometrically sound instrument. The Journal of Behavioral
Science 2009;4:71‑83.
39. Seyedfatemi N, Rezaie M, Givari A, Hosseini F. Prayer and spiritual
well‑being in cancer patients. Payesh, Journal of The Iranian Institute
For Health Sciences Research 2006;5:295‑303. [Persian].
40. Mauk K, Scnemidt N. Spirituality in nursing, In: Mauk K, Scnemidt N,
editors. Spirituality care in nursingpractice, 2th ed. Philadelphia:
Lippincott company; 2004.
41. Romero C, Friedman LC, Kalidas M, Elledge R, Chang J, Liscum KR.
Self‑forgiveness, spirituality, and psychological adjustment in
women with breast cancer. J Behav Med 2006;29:29‑36.
42. McCoubrie RC, Davies AN. Is there a correlation between spirituality
and anxiety and depression in patients with advanced cancer?
Support Care Cancer 2006;14:379‑85.
43. Nelson CJ, Rosenfeld B, Breitbart W, Galietta M. Spirituality, religion,
and depression in the terminally ill. Psychosomatics 2002;43:213‑20.
44. Leung KK, Chiu TY, Chen CY. The influence of awareness of terminal
condition on spiritual well‑being in terminal cancer patients. J Pain
Symptom Manage 2006;31:449‑56.
45. Rowe MM, Allen RG. Spirituality as a means of coping with chronic
illness. Am J Health Stud 2004;19:62‑7.
46. Fernsler JI, Klemm P, Miller MA. Spiritual well‑being and
demands of illness in people with colorectal cancer. Cancer Nurs
1999;22:134‑40.
47. Riley BB, Perna R, Tate DG, Forchheimer M, Anderson C, Luera G.
Types of spiritual well‑being among persons with chronic illness:
Their relation to various forms of quality of life. Arch Phys Med
Rehabil 1998;79:258‑64.
48. Highfield MF. Spiritual health of oncology patients. Nurse and patient
perspectives. Cancer Nurs 1992;15:1‑8.
49. Asvadi kermani E, Aghhoseini SS, Rahmani A, Abdolahzadeh F.
Spiritual health in cancer patients and its related factors.Qom
University of Medical Sciences Journal 2011;5:7‑12.
50. Livneh H, Lott SH, Antonak R. Patterns of psychosocial adaptation
to chronic illness and disability: A cluster analytic approach.
Psycho‑Health and Med 2004;9:411‑30.
51. Feher S, Maly RC. Coping with breast cancer in later life: The role
of religious faith. Psychooncology 1999;8:408‑16.
52. Moschella VD, Pressman KR, Pressman P, Weissman D. Religious
response to cancer and the problem of theodicy. J Relig Health
1997;36:17‑20.
53. Watson T, Mock V. Exercise as an intervention for cancer‑related
fatigue. Phys Ther 2004;84:736‑43