Illness severity, religiosity, and spirituality in advanced cancer
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Background: Religion and spirituality (R/S) can be important resources for those struggling to cope with advanced cancer and have been linked with various measures of psychological and emotional wellbeing. Available research suggests that R/S may also be connected with higher levels of physical functioning, and that physical suffering may negatively impact R/S. The overall goal of this study was to examine the impact of physical wellbeing on R/S in advanced cancer patients. Methods: This is a secondary analysis of a dataset using cross-sectional baseline data from a study of Meaning-Centered Group Psychotherapy, a novel psychotherapy for individuals with advanced cancer. Eligible patients were diagnosed with stage III or IV solid tumor cancers or non-Hodgkin's lymphoma, were ambulatory, over 18 years old, English speaking, and had no significant cognitive impairments or psychosis. Data included sociodemographics, disease and treatment related factors, indicators of disease status (functional status, symptom distress, and days until death), spirituality, and religion. Univariate and multivariate analyses were conducted to test the relationship between disease status, religion, and spirituality. Results: Of the 168 patients, average age was 58.4(SD=11.3, range:27-91); the population was 75% female and 78.6% white. With regard to R/S, 67.8% considered themselves somewhat or very religious and 91.1% reported being somewhat or very spiritual. In univariate analysis, a significant relationship emerged between symptom distress and the meaning/peace subscale of spirituality (r=-0.21, p=0.008). No further significant univariate or multivariate relationships emerged between R/S and measures of physical functioning. Conclusions: Results of this study did not support our hypotheses that physical functioning would predict R/S among advanced cancer patients. Additional research is needed to clarify the relationship between these constructs.