Abstract
Considerable attention has focused on relationships between religious or spiritual coping and health outcomes among cancer patients. However, few studies have differentiated among discrete dimensions of religious coping, and there have been surprisingly few prospective investigations. Negative or conflicted aspects of religious coping, in particular, represent a compelling area for investigation. This prospective study examined negative religious coping, positive religious coping, and general religious orientation among 94 myeloma patients undergoing autologous stem cell transplantation. Participants were assessed during stem cell collection, and again in the immediate aftermath of transplantation, when risks for morbidity are most elevated. Outcomes included Brief Symptom Inventory anxiety and depression and Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMI) scales. Negative religious coping at baseline predicted worse post-transplant anxiety, depression, emotional well-being, and transplant-related concerns, after controlling for outcome scores at baseline and other significant covariates. Post-transplant physical well-being was predicted by an interaction between baseline positive and negative religious coping. Results suggest that religious struggle may contribute to adverse changes in health outcomes for transplant patients, and highlight the importance of negative or strained religious responses to illness.
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Notes
Forty-five percent of patients demonstrated an increase in positive religious coping over time (mean change = 4.9), while 45.7% showed a decline (mean change = 4.9). Increases in negative religious coping over time were evident for 21.3% of patients (mean change in raw score = 3.3), while declines were seen in 23.4% (mean change in raw score = 2.0).
In contrast to these particular religious domains, results regarding spiritual well-being have been more uniformly favorable. However, measures of spiritual well-being generally include items that overlap with adjustment or mood, and thus are confounded with psychosocial outcomes. In the aggregate, these studies perhaps may contribute to an impression that links between religious resources and favorable outcomes among cancer patients are more firmly established than they really are (Sherman and Simonton 2001, 2007).
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Supported by a grant from the Ignatian Center for Jesuit Education, Santa Clara University. Based in part on data presented at the annual meeting of the Society of Behavioral Medicine, March 26–29, 2008, San Diego, CA.
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Sherman, A.C., Plante, T.G., Simonton, S. et al. Prospective study of religious coping among patients undergoing autologous stem cell transplantation. J Behav Med 32, 118–128 (2009). https://doi.org/10.1007/s10865-008-9179-y
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DOI: https://doi.org/10.1007/s10865-008-9179-y