Abstract
This study examined whether spiritual beliefs are associated with greater decision-making satisfaction, lower decisional conflict and decision-making difficulty with the decision-making process in newly diagnosed men with prostate cancer. Participants were 1114 men diagnosed with localized prostate cancer who had recently made their treatment decision, but had not yet been treated. We used multivariable linear regression to analyze relationships between spirituality and decision-making satisfaction, decisional conflict, and decision-making difficulty, controlling for optimism and resilience, and clinical and sociodemographic factors. Results indicated that greater spirituality was associated with greater decision-making satisfaction (B = 0.02; p < 0.001), less decisional conflict (B = −0.42; p < 0.001), and less decision-making difficulty (B = −0.08; p < 0.001). These results confirm that spiritual beliefs may be a coping resource during the treatment decision-making process. Providing opportunities for patients to integrate their spiritual beliefs and their perceptions of their cancer diagnosis and trajectory could help reduce patient uncertainty and stress during this important phase of cancer care continuum.
Similar content being viewed by others
Notes
As the FACIT-Sp subscales assess quite distinct constructs, it is possible that one or the other was largely responsible for the reported associations with the decision-making outcomes. We wanted to verify that both subscales were associated with the decision-making scales. They were; scores on the meaning/peace subscale were significantly associated with greater decision-making satisfaction (B = 0.03; 95 % CI 0.03, 0.04; p < .001), lower decisional conflict (B = −0.77; 95 % CI −0.92, −0.62; p < .001), and lower decision-making difficulty (B = −0.15; 95 % CI −0.19, −0.11; p < .001). Scores on the faith in illness subscale were also associated with greater decision-making satisfaction (B = 0.02; 95 % CI 0.01, 0.02; p < .001), less decisional conflict (B = −0.39; 95 % CI −0.53, −0.24; p < .001), and less decision-making difficulty (B = −0.06; 95 % CI −0.10, −0.02; p = 0.003).
References
Adler, N. E., Epel, E. S., Castellazzo, G., & Ickovics, J. R. (2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, White women. Health Psychology, 19, 586–592. doi:10.1037/0278-6133.19.6.586
American Urological Association Education and Research. (2007). Prostate cancer: Guideline for the management of clinical localized prostate cancer: 2007 update. Rockville: National Guideline Clearinghouse.
Balboni, T., Vanderweker, L., Block, S. D., Paulk, M., Lathan, C., Peteet, J., & Prigerson, H. G. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25(5), 555–560.
Bill-Axelson, A., Holmberg, L., & Ruutu, M. (2011). Radical prostatectomy versus watchful waiting in early prostate cancer. New England Journal of Medicine, 364(18), 1708–1717.
Cervone, D. (2004). The architecture of personality. Psychological Review, 111, 183–204.
Cooperberg, M., Broering, J., & Carroll, P. (2010). Time trends and local variation in primary treatment of localized prostate cancer. Journal of Clinical Oncology, 28(7), 1117–1123.
Cotton, S., Levine, E., Fitzpatrick, C., Dold, K., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429–438.
Dale, W., Bilir, P., Han, M., & Meltzer, D. (2005). The role of anxiety in prostate carcinoma: A structured review of the literature. Cancer, 104, 467–468. doi:10.1002/cncr.21198
Gall, T. (2004). The role of religious coping in adjustment to prostate cancer. Cancer Nursing, 27(6), 454–461.
Gall, T., Charbonneau, C., Clarke, N., & Grant, K. (2005). Understanding the nature and role of spirituality in relation to coping and health: A conceptual framework. Canadian Psychology, 46(2), 88–104.
Gwede, C. K., Pow-Sang, J., Seigne, J., Heysek, R., Helal, M., Shade, K., & Jacobsen, P. (2005). Treatment decision-making strategies and influences in patients with localized prostate carcinoma. Cancer, 104(7), 1381–1390.
Hill, P. C., & Pargament, K. I. (2003). Advances in the conceptualization and measurement of religion and spirituality. American Psychologist, 58(1), 64–74.
Holmes-Rovner, M., Kroll, J., Schmitt, N., Rovner, D., Breer, M., Rothert, M., & Talarczyk, G. (1996). Patient satisfaction with health care decisions: The satisfaction with decision scale. Medical Decision Making, 16(1), 56–64.
Hu, J., Kwan, L., Krupski, T., Anger, J., Maliski, S., Connor, S., & Litwin, M. (2008). Determinants of treatment regret in low-income, uninsured men with prostate cancer. Oncology Nursing Forum, 72(6), 1274–1279. doi:10.1016/j.urology.2007.11.066
Jenkins, R., & Pargament, K. I. (1995). Religion and spirituality as resources for coping with cancer. Journal of Psychosocial Oncology, 13, 51–74.
Kaplan, A., Crespi, C., Saucedo, J., Connor, S., Litwin, M., & Saigal, C. (2014). Decisional conflict in economically disadvantaged men with newly diagnosed prostate cancer. Cancer, 120, 2721–2727. doi:10.1002/cncr.28755
Krupski, T., Kwan, L., Fink, A., Sonn, G., Maliski, S., & Litwin, M. (2006). Spirituality influences health related quality of life in men with prostate cancer. Psycho-Oncology, 15, 121–131.
Lazarus, R. S. (1991). Emotion and adaptation. New York: Oxford University Press.
Maton, K. (1989). The stress-buffering role of spiritual support: Cross-sectional and prospective investigations. Journal for the Scientific Study of Religion, 28(3), 310–323.
Mattis, J. S. (2000). African American women’s definitions of spirituality and religiosity. Journal of Black Psychology, 26(1), 101–122.
O’Connor, A. (1995). Validation of a decisional conflict scale. Medical Decision Making, 15, 25–30.
Oh, P., & Kim, Y. (2012). Meta-analysis of spiritual intervention studies on biological, psychological, and spiritual outcomes. Journal of the Korean Academy of Nursing, 42(6), 833–842.
Orom, H., Penner, L., West, B., Downs, T., Rayford, W., & Underwood, W. I. (2009). Personality predicts prostate cancer treatment decision-making difficulty and satisfaction. Psycho-Oncology, 18, 290–299. doi:10.1002/pon.1385
Pargament, K., Smith, B., Koenig, H., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 27(4), 710–724.
Park, C. (2007). Religiousness/spirituality and health: A meaning systems perspective. Journal of Behavioral Medicine, 30, 319–328. doi:10.1007/s10865-007-9111-x
Pearce, M., Coan, A., Herndon, J., Koenig, H., & Abernethy, A. P. (2012). Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Supportive Care in Cancer, 20, 2269–2276.
Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). Annals of Behavioral Medicine, 24(1), 49–58.
Richardson, P. (2012). Assessment and implementation of spirituality and religiosity in cancer care: Effects on patient outcomes. Clinical Journal of Oncology Nursing, 16(4), E150–E155. doi:10.1188/12.CJON.E150-E155
Roesch, S., Adams, L., Hines, A., Palmores, A., Vyas, P., Tran, C., & Vaughn, A. (2005). Coping with prostate cancer: A meta-analytic review. Journal of Behavioral Medicine, 28(3), 281–293. doi:10.1007/s10865-005-4664-z
Salsman, J., Brown, T., Brechting, E., & Carlson, C. (2005). The link between religion and spirituality and psychological adjustment: The mediating role of optimism and social support. Personality and Social Psychology Bulletin, 31, 522–535. doi:10.1177/0146167204271563
Salsman, J., Yost, K., West, D., & Cella, D. (2010). Spiritual well-being and health related quality of life in colorectal cancer: A multi-site examination of the role of personal meaning. Supportive Care in Cancer,. doi:10.1007/s00520-010-0871-4
Scheier, M., Carver, C., & Bridges, M. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A re-evaluation of the life orientation test. Journal of Personal Social Psychology, 67, 1063–1078.
Silvestri, G., Knittig, S., Zoller, J., & Nietert, P. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology, 21(7), 1379–1382.
Smith, B., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15, 194–200.
Stewart, D., & Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics, 52(3), 199–208.
Swainston, K., Campbell, C., van Wersch, A., & Durning, P. (2011). Treatment decison making in breast cancer: A longitudinal exploration of women’s experiences. British Journal of Health Psychology, 17(1), 155–170. doi:10.1111/j.2044-8287.2011.02028.x
Sweeny, K., Melnyk, D., Miller, W., & Shepperd, J. (2010). Information avoidance: Who, what, when, and why. Review of General Psychology, 14(4), 340–353. doi:10.1037/a0021288
Tate, D., & Forcheimer, M. (2002). Quality of life, life satisfaction, and spirituality: Comparing outcomes between rehabilitation and cancer patients. American Journal of Physical Medicine and Rehabilitation, 81, 400–410.
Thune-Boyle, I., Stygall, J., Keshtgar, M., & Newman, S. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social Science and Medicine, 63, 151–164.
Visser, A., Garssen, B., & Vingerhoets, A. (2010). Spirituality and well-being in cancer patient: A review. Psycho-Oncology, 19, 565–572.
Wilt, T., Brawer, M., Barry, M., et al. (2009). The prostate cancer intervention versus observation trial: VA/NCI/AHRQ cooperative studies program #407 (PIVOT): Design and baseline results of a randomized controlled trial comparing radical prostatectomy to watchful waiting for men with clinically localized prostate cancer. Contemporary Clinical Trials, 30(1), 81–87.
Wilt, T., Brawer, M., & Jones, K. (2012). Radical prostatectomy versus observation for localized prostate cancer. New England Journal of Medicine, 367(3), 203–213.
Xu, J., Dailey, R., Eggly, S., Neale, A., & Schwartz, K. (2011). Men’s perspectives on selecting their prostate cancer treatment. Journal of the National Medical Association, 103, 468–478.
Zeliadt, S., Ramsey, S., Penson, D., Hall, I., Ekqueme, D., Stroud, L., & Lee, J. (2006). Why do men choose one treatment over another? A review of patient decision making for localized prostate cancer. Cancer, 106(9), 1865–1974. doi:10.1002/cncr.21822
Funding
NCI R01 CA152425.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Michelle A. Mollica, Willie Underwood III, Gregory G. Homish, D. Lynn Homish, Heather Orom declare that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
Rights and permissions
About this article
Cite this article
Mollica, M.A., Underwood, W., Homish, G.G. et al. Spirituality is associated with better prostate cancer treatment decision making experiences. J Behav Med 39, 161–169 (2016). https://doi.org/10.1007/s10865-015-9662-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-015-9662-1