The Mediating Role of Psychological Resilience in the Relationship Between Spiritual Well-Being and Supportive Care Needs in Women With Breast Cancer

The influence of spirituality on psychological resilience in cancer patients undergoing oncological treatment: a cross-sectional study

INTRODUCTION

Spirituality and resilience have been studied as possible factors influencing psychological adjustment in cancer patients. However, the evidence on their relationship remains inconsistent, and their impact in this context is not fully established.

OBJECTIVE

This study assessed the influence of spirituality on psychological resilience in cancer patients undergoing chemotherapy and/or radiotherapy.

METHODS

This cross-sectional observational study included 170 oncology outpatients who were receiving chemotherapy and/or radiotherapy at a specialized oncology center in Peru. Spirituality was measured with the Spiritual Perspective Scale (SPS) and resilience with the Wagnild and Young Resilience Scale. Spearman correlation coefficient (rs) analyses and multiple linear regression models adjusted for age, gender, educational level, socioeconomic status, clinical stage, and comorbidities were applied.

RESULTS

A significant positive correlation was found between spirituality and resilience (rs=0.53, p < 0.001). The spiritual beliefs dimension exhibited a stronger association with resilience (rs=0.56, p < 0.001) compared to spiritual practices (rs=0.28, p < 0.001). In the multivariate analysis, spiritual beliefs (β = 2.38; 95%CI: 1.92-2.83) and a higher educational level (β = 12.61; 95%CI: 6.27-18.95) were significant predictors of higher resilience.

CONCLUSIONS

Spirituality, particularly spiritual beliefs, had a positive influence on resilience in cancer patients, regardless of educational level. These findings enhance the need to integrate the spiritual approach in psycho-oncological care to contribute to patients' emotional well-being. However, further studies are required to deepen this relationship and explore its impact in different clinical contexts.

IMPLICATIONS FOR PRACTICE

Including spiritual assessments, especially spiritual beliefs, in clinical practice may enhance personalized approaches to optimize psycho-oncological care.

Family Resilience in Adult Oncology: A Systematic Review and Meta-Analysis

PROBLEM IDENTIFICATION

This systematic review and meta-analysis assessed the state of the science to determine relationships among adult patient- and family member-perceived family resilience, individual resilience and perceived family resilience, and perceived family resilience and psychosocial outcomes.

LITERATURE SEARCH

PubMed®, CINAHL®, PsycINFO®, Sociological Abstracts, and Cochrane Library databases were searched. Random effects models were performed to calculate pooled effect sizes, and meta-analyses were conducted.

DATA EVALUATION

Two authors assessed risk of bias using the Appraisal tool for Cross-Sectional Studies and the Mixed Methods Appraisal Tool. Study heterogeneity was assessed using Cochran's Q test and the I2 statistic. Publication bias was evaluated.

SYNTHESIS

Patient-perceived family resilience and family member-perceived family resilience were positively correlated. Family resilience was positively related to patient and family member individual resilience. Higher family resilience was associated with patients' reduced symptom burden and perceived stress and improved affect and quality of life, and family members' reduced caregiver burden and stress and higher social support and quality of life.

IMPLICATIONS FOR NURSING

Investigations employing a longitudinal design are needed to understand any causal relationships between family resilience and psychosocial outcomes for the dyad.

Spiritual needs of women with breast cancer: A structural equation model

PURPOSE

The purpose of this study was to develop a structural equation model (SEM) to explore the factors influencing the spiritual needs of breast cancer patients.

METHODS

A cross-sectional study was conducted in the breast surgery department of a tertiary hospital in China from September 2020 to December 2020; convenience sampling and questionnaires were used to facilitate sampling and data collection. A total of 220 female breast cancer patients were included in the study. The data were analysed using multiple linear regression and structural equation modelling.

RESULTS

Compared with patients with other diseases, patients with breast cancer have greater spiritual needs (76.16 ± 13.19). Multivariate analysis revealed that religious beliefs, education level, social support, and resilience are important factors affecting the mental health of women with cancer (p < 0.05). The structural equation model fit well (RMSEA = 0.056, χ2p = 0.002). Social support directly affected spiritual needs (β = 0.607, p < 0.001) and indirectly affected spiritual needs through resilience (β = 0.353, p < 0.001). Resilience directly affected spiritual needs (β = 0.386, p < 0.05). Education level indirectly affected spiritual needs through social support (β = 0.307, p < 0.001).

CONCLUSION

This study provides a theoretical basis for intervention measures to improve the spiritual needs of female breast cancer patients. Paying more attention to social support and resilience may help solve the problem of meeting the high spiritual needs of breast cancer patients. Further research is needed to develop interventions.

Spiritual care needs and their attributes among Chinese inpatients with advanced breast cancer based on the Kano model: a descriptive cross-sectional study

BACKGROUND

Numerous previous research have established the need for spiritual care among patients with cancer globally. Nevertheless, there was limited research, primarily qualitative, on the spiritual care needs of Chinese inpatients with advanced breast cancer. Furthermore, the need for spiritual care was rarely explored using the Kano model. To better understand the spiritual care needs and attributes characteristics of inpatients with advanced breast cancer, this study examined the Kano model.

METHODS

A descriptive cross-sectional design study was conducted in the oncology departments of three tertiary grade-A hospitals in China from October 2022 to May 2023. To guarantee high-quality reporting of the study, the Strengthening the Reporting of Observational Studies in Epidemiology Checklist was used. Data on the demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale (NSTS), and the Kano model-based Nurse Spiritual Therapeutics Attributes Scale (K-NSTAs) were collected through convenience sampling. The Kano model, descriptive statistics, two independent samples t-tests, and one-way analysis of variance were used to analyze the data.

RESULTS

The overall score for spiritual care needs was 31.16 ± 7.85. The two dimensions with the highest average scores, "create a good atmosphere" (3.16 ± 0.95), and the lowest average scores, "help religious practice" (1.72 ± 0.73). The 12 items were distributed as follows: three attractive attributes were located in Reserving Area IV; five one-dimensional attributes were distributed as follows: three one-dimensional attributes were located in Predominance Area I, and two were found in Improving Area II; two must-be attributes were located in Improving Area II; and two indifference attributes were located in Secondary Improving Area III.

CONCLUSION

The Chinese inpatients with advanced breast cancer had a middle level of spiritual care needs, which need to be further improved. Spiritual care needs attributes were defined, sorted, categorized, and optimized accurately and perfectly by the Kano model. And "create a good atmosphere" and "share self-perception" were primarily one-dimensional and must-be attributes. In contrast, the items in the dimensions of "share self-perception" and "help thinking" were principally attractive attributes. Nursing administrators are advised to optimize attractive attributes and transform indifference attributes by consolidating must-be and one-dimensional attributes, which will enable them to take targeted spiritual care measures based on each patient's characteristics and unique personality traits.