Reliance on God's help, depression and fatigue in female cancer patients

Influence of spirituality and religiosity on perceived social stigma among Iranian caregivers of children with autism spectrum disorder

BACKGROUND

The perceived social stigma of caregivers of children with autism spectrum disorder (ASD) may negatively affect caregivers' mental health and, consequently, the quality of care for these children. Religious and spiritual well-being may serve as protective factors against such stigma. This study aimed to examine the relationship between spirituality, religiosity, and perceived social stigma among caregivers of children with ASD.

METHOD

This cross-sectional study was conducted from September 2022 to June 2023 in Qom, Iran. A total of 102 caregivers were recruited from specialized rehabilitation centers through convenience sampling. Participants completed the Multidimensional Inventory for Religious-Spiritual Well-being (MI-RSB 48) and the Stigma Scale for Chronic Illnesses (SSCI-8), along with a demographic questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS

The mean perceived social stigma score was 16.85 ± 6.76, with 45.5% of participants reporting higher-than-average social stigma. All dimensions of spiritual-religious well-being, except belief in the afterlife and the experience of meaning, showed a significant negative correlation with perceived social stigma (P < 0.05). Multiple regression analysis revealed that the child's age (β = 0.401, P = 0.018) and hope transcendent (β = 0.418, P = 0.012) were significant negative predictors of perceived stigma, explaining 59% of the variance.

CONCLUSION

The findings suggest that fostering transcendent hope and spiritual connectedness may mitigate the perceived stigma among caregivers of children with ASD, highlighting the potential of spirituality-based interventions in rehabilitation programs.

Spiritual coping strategies: Relationship with physical, anxiety, and depression symptoms of patients with cancer

Introduction

Spirituality is considered an important source against chronic diseases and can promote self-esteem, mental comfort, and hope in patients. Concerning its importance, the present study aims to investigate spiritual coping strategies and its relationship with physical, anxiety, and depression symptoms of patients with cancer who are referred to the oncologic ward.

Method

This was a descriptive-correlative study that 159 patients with cancer participated in the study. Information was collected using a four-part questionnaire including sociodemographic characteristics, Spiritual Coping Strategies Scale, physical symptoms as well as anxiety and depression symptoms. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis, and Spearman correlation coefficient.

Results

Results of the study showed that the mean (±SD) of the application of methods of spiritual coping strategies was 35.69 ± 10.92 and for its subscales the mean (±SD) of the application of religious coping and nonreligious coping strategies were 16.92 ± 5.6 and 18.77 ± 6.24, respectively. Furthermore, physical symptoms perceived by patients were tiredness, drowsiness, and lack of appetite. There was no significant correlation between physical, anxiety, and depression symptoms and spiritual coping strategies (r = -0.12, P = 0.12; r = 0.07, P = 0.41; and r = -0.05, P = 0.5 respectively).

Discussion

Regarding no significant relationship between physical, anxiety and depression symptoms and spiritual (religious and nonreligious) coping strategies in this study, belief towards cancer and cultural aspects of patients may be more essential to their sense of wellness and help them to cope with negative aspects of illness or treatment. Therefore, more study needs to be done in this area.

Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis

CONTEXT

Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer.

OBJECTIVES

The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer.

METHODS

The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics.

RESULTS

A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ2 = 0.0000; I2 = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue.

CONCLUSION

This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.

Belief in God's Help During Hepatitis C: A Qualitative Study on Muslim Patients in Pakistan

Religious/spiritual beliefs play an important role in nursing of patients during chronic condition. Religion comprises an institutionalized set of transcendent ideas, while spirituality is personal and subjective dimension of religious experience in search of sacred (Hill and Pargament in Psychol Relig Spiritual S(1):3-17, 2008). The prevailing literature describes the influential impact of religiosity/spirituality on coping with chronic disease, but specifically patients with chronic liver disease (CLD) have not been studied in Pakistani context. This study examined the patients' belief in religious/spiritual coping, role of religious/spiritual beliefs and prayer as coping strategy. Furthermore, it explored the importance of religious/spiritual beliefs in diverting attention from pain and other needs of CLD patient. A total of 20 patients with chronic liver disease were selected through an appropriate screening process. Subsequently, in-depth detailed interviews were conducted to gather experiences of the hepatitis patients. Religious/spiritual beliefs put forth multiple positive effects that help in coping with chronic hepatitis C. It has been found that patients of hepatitis C use prayer as a coping strategy. Religious/spiritual beliefs have been found as source of diverting attention from pain for the patients suffering from chronic hepatitis C.

The relation between mindfulness and the fatigue of women with breast cancer: path analysis

Background

Although fatigue is a common and distressing symptom in cancer survivors, the mechanism of fatigue is not fully understood. Therefore, this study aims to investigate the relation between the fatigue and mindfulness of breast cancer survivors using anxiety, depression, pain, loneliness, and sleep disturbance as mediators.

Methods

Path analysis was performed to examine direct and indirect associations between mindfulness and fatigue. Participants were breast cancer survivors who visited a breast surgery department at a university hospital in Japan for hormonal therapy or regular check-ups after treatment. The questionnaire measured cancer-related-fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance. Demographic and clinical characteristics were collected from medical records.

Results

Two-hundred and seventy-nine breast cancer survivors were registered, of which 259 answered the questionnaire. Ten respondents with incomplete questionnaire data were excluded, resulting in 249 participants for the analyses. Our final model fit the data well (goodness of fit index = .993; adjusted goodness of fit index = .966; comparative fit index = .999; root mean square error of approximation = .016). Mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance were related to fatigue, and mindfulness had the most influence on fatigue (β = − .52). Mindfulness affected fatigue not only directly but also indirectly through anxiety, depression, pain, loneliness, and sleep disturbance.

Conclusions

The study model helps to explain the process by which mindfulness affects fatigue. Our results suggest that mindfulness has both direct and indirect effects on the fatigue of breast cancer survivors and that mindfulness can be used to more effectively reduce their fatigue. It also suggests that health care professionals should be aware of factors such as anxiety, depression, pain, loneliness, and sleep disturbance in their care for fatigue of breast cancer survivors.

Trial registration

This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN number. 000027720) on June 12, 2017.

Religiosity/Spirituality and Mental Health: A Meta-analysis of Studies from the German-Speaking Area

The meta-analysis presented here investigates the relationship between religiosity/spirituality (R/S) and mental health based on 67 studies from the German-speaking area (Germany, Austria, Switzerland). The weighted average correlation is .03 (95% CI [.01, .05]), indicating that a greater R/S is minimally but significantly associated with better mental health. The results are moderated by the type of R/S measure: negative R/S types correlate - .20 with mental health, whereas other R/S measures exhibit small positive associations. In comparison with US-American meta-analyses, the average effect size is lower, and the associations between negative R/S types and lower mental health are particularly strong.

Self-Care in Iranian Cancer Patients: The Role of Religious Coping

Religious and spiritual practices are related to physical and mental health. Social support is an important source to aid coping, but this is not without its difficulties. This study was conducted to investigate the relationship between religious coping and self-care in a sample of Iranian cancer patients. In this cross-sectional study (October-December, 2015), 380 cancer patients were entered into the study using non random sampling (accessible sampling). Data were collected using socio-demographic, religious coping (R-COPE), and self-care questionnaires. Male patients (48.39 ± 13.39; 95% CI 46.41-50.38) were older than the females patients (45.33 ± 18.44; 95% CI 42.79-47.87). The findings indicated that there was a significant correlation between self-care and positive religious coping (r = .188, p = .009). Also there was a significant relationship between self-care and a history of smoking (p < .05). It seems that improving the level of positive religious affiliation can have beneficial effect on the self-care of cancer patients. Therefore, it is necessary to conduct these studies with greater scale and more different societies to achieve more reliable results about the effects of religious coping on self-care behaviors in cancer patients.

On the periphery of HIV and AIDS: Reflections on stress as experienced by caregivers in a child residential care facility in South Africa

Few researchers have investigated how female caregivers of institutionalised children, especially those affected by HIV and AIDS, experience stress. The role played by caregivers cannot be overemphasised; yet caregivers who work in institutions caring for orphaned and/or abandoned children affected by HIV and AIDS, are often marginalised and on the periphery of the HIV and AIDS pandemic. The implication is that insufficient attention or consideration is given to the importance of the role they play in these children's lives. The objective of the study was to explore how female caregivers of institutionalised children affected by HIV and AIDS experience stress. A qualitative research project with a case study design was conducted. The purposively selected participants from a previously identified care facility were seven females in the age ranges of 35-59. Data was gathered during individual interviews and focus group discussions. Thematic content analysis of the data yielded the following themes: (1) contextualising caregiving as 'work'; (2) stresses linked to caregiving; and (3) coping with stress. Findings from this study indicated that participants experienced caregiving in an institution as stressful, demotivating, and emotionally burdensome. Moreover, caregivers working in an environment of HIV and AIDS experienced additional stress related to organisational and management impediments, lack of emotional and practical support, inadequate training, discipline difficulties, and lack of respect and appreciation from the children in their care. It is recommended that training and management support as well as personal support and counselling for caregivers in the institutional context could help them to cope better, feel empowered and to potentially elevate their status as valued members of society.

Styles of coping with stress of cancer in patients treated with radiotherapy and expectations towards medical staff - Practical implications

BACKGROUND

It is essential to adjust oncological treatment to medical procedures but also to the expectations of patients themselves. Expectations of patients may depend on the way of coping with the stress of cancer. Many researchers have dealt with this issue. However, it is difficult to find studies concerning relations between the styles of coping and expectations of patients towards medical staff.

AIM

To demonstrate the relationship between the style of coping with stress of cancer shown by patients undergoing radiotherapy at the Greater Poland Cancer Centre and the nature of their expectations towards the medical staff, and to present work of the Clinical Psychology Unit in response to the expectations of patients.

MATERIALS AND METHODS

Questionnaire survey. The respondents filled in a questionnaire consisting of a patient request form (PRF), the mini-mental adjustment to cancer scale (Mini-MAC), and personal data. Obtained results were subjected to statistical analysis.

RESULTS

SIGNIFICANT ASSOCIATIONS: the expectation to have the disease explained is associated with anxious preoccupation, fighting spirit, helplessness-hopelessness; the expectation of emotional support is associated with anxious preoccupation and helplessness-hopelessness; and the expectation of information on examinations and treatment is associated with anxious preoccupation and helplessness-hopelessness.

CONCLUSIONS

Expectations of patients undergoing radiotherapy in the Greater Poland Cancer Centre towards the medical staff depend on their styles of coping with the stress of cancer.

Spiritual needs of patients with chronic pain diseases and cancer - validation of the spiritual needs questionnaire

Purpose

For many patients confronted with chronic diseases, spirituality/religiosity is a relevant resource to cope. While most studies on patients' spiritual needs refer to the care of patients at the end of life, our intention was to develop an instrument to measure spiritual, existential and psychosocial need of patients with chronic diseases.

Methods

In an anonymous cross-sectional survey, we applied the Spiritual Needs Questionnaire (SpNQ version 1.2.) to 210 patients (75% women, mean age 54 ± 12 years) with chronic pain conditions (67%), cancer (28%), other chronic conditions (5%). Patients were recruited at the Community Hospital Herdecke, the Institute for Complementary Medicine (University of Bern), and at a conference of a cancer support group in Herten.

Results

Factor analysis of the 19-item instrument (Cronbach's alpha = .93) pointed to 4 factors which explain 67% of variance: Religious Needs, Need for Inner Peace, Existentialistic Needs (Reflection/Meaning), and Actively Giving. Within the main sample of patients with chronic pain and cancer, Needs for Inner Peace had the highest scores, followed by Self competent Attention; Existentialistic Needs had low scores, while the Religious Needs scores indicate no interest. Patients with cancer had significantly higher SpNQ scores than patients with chronic pain conditions. There were just some weak associations between Actively Giving and life satisfaction (r = .17; p = .012), and negatively with the symptom score (r = -.29; p < .0001); Need for Inner Peace was weakly associated with satisfaction with treatment efficacy (r = .24; p < .0001). Regression analyses reveal that the underlying disease (i.e., cancer) was of outstanding relevance for the patients' spiritual needs.

Conclusion

The preliminary results indicate that spiritual needs are conceptually different from life satisfaction, and can be interpreted as the patients' longing for spiritual well-being. Methods how health care professionals may meet their patients' spiritual needs remain to be explored.

Predictors of depression among older African American cancer patients

BACKGROUND

Depression is becoming an increasing concern in cancer patients because of its impact on quality of life. Although risk factors of having depression have been examined in the literature, there has been no research examining these factors in older African American cancer patients.

OBJECTIVE

This study explores the demographic and illness-related risk factors in older African American cancer patients.

METHODS

Two hundred eighty-three patients were recruited from outpatient oncology clinics. These older African American patients completed a questionnaire that included the Geriatric Depression Scale as well as sociodemographic characteristics and medical information. chi2 Tests, trend tests, and logistic regression were used to identify the demographic and illness-related factors that predict depression in the sample.

RESULTS

The overall prevalence of depression in the sample was 27.2%. Younger age (<65 years), employment status, proximity to family, and multiple symptoms due to cancer or treatment were independent predictors of depression.

CONCLUSION

This study represents the first attempt to describe the risk factors of depression within older African American cancer patients. Findings indicate a high prevalence of depression in African American cancer patients which can be attributed to identifiable risk factors.

IMPLICATIONS FOR PRACTICE

An understanding of the risk factors associated with depression can be used to identify those cancer patients at risk for depression and initiate early interventions to improve psychological outcomes and lessen the potential burden of cancer on these patients.

Validation of the brief multidimensional life satisfaction scale in patients with chronic diseases

Objective

We intended to determine the reliability of a brief life satisfaction scale in a sample of patients with chronic diseases, and to analyze its external validity.

Methods

Reliability and factor analysis of the 8-item 'Brief Multidimensional Life Satisfaction Scale' (BMLSS) were performed according to standard procedures. The test sample contained 979 individuals (mean age 54 ± 11 years). Forty-two percent had cancer, 22% chronic pain conditions, 10% depressive disorders, 6% other chronic diseases, and 20% were healthy.

Results

Reliability analysis of the 8-item pool revealed a good internal consistency coefficient (Cronbach's alpha = .869), and a single-factor structure which explains 53% of variance. The BMLSS sum scores significantly differed with respect to the underlying disease, family status, duration of disease, and age. The highest scores were found in healthy individuals, and the lowest in patients with chronic pain conditions and depressive disorders. In cancer patients, the BMLSS correlated negatively with Depression/Anxiety (HADS), Fatigue (CFS-D), and positively with SF-12's mental health and to a weaker content also with physical health. Stepwise regression analyses revealed that life satisfaction can be predicted best by (the absence of) depression, but also by Conscious Living (AKU), which is an active cognitive-behavioral style in terms of adaptive coping.

Conclusions

The evaluation of the BMLSS revealed that the instrument has good psychometric properties and can be regarded as a brief, reliable and valid measure of LS in patients with chronic diseases. The instrument can be an important additive to existing health-related quality of life questionnaires, since it captures dimensions that contribute to quality of life but are not health related.