Journal of Religion and Health

, Volume 54, Issue 2, pp 612–622 | Cite as

Image of God, Religion, Spirituality, and Life Changes in Breast Cancer Survivors: A Qualitative Approach

Original Paper


Religion and spirituality are much studied coping mechanisms; however, their relationship to changes in behaviors, relationships, and goals is unclear. This study explored the impact of a breast cancer diagnosis on religion/faith and changes in behaviors, relationship, or goals. In this qualitative study, women, who participated in a larger, quantitative study, completed written responses to questions regarding the role of religion/faith in their lives, the impact of their diagnosis on their image of God and on faith/religious beliefs, and any changes in behaviors, relationships, or life goals were examined. Based on previous findings noting differences in psychological outcomes based on a higher (HE) or lesser (LE) engaged view of God, 28 (14 HE; 14 LE) women were included in the analysis. Awareness of life and its fleeting nature was common to all. Ensuing behaviors varied from a need to focus on self-improvement—egocentrism (LE)—to a need to focus on using their experiences to help others—altruism (HE). Study results suggest that seemingly small, but highly meaningful, differences based on one’s worldview result in considerably different attitudinal and behavioral outcomes.


Religion/spirituality Worldview Psychological well-being Altruism Egocentrism 


  1. Ai, A. L., Peterson, C., Bolling, S. F., & Koenig, H. (2002). Private prayer and optimism in middle-aged and older patients awaiting cardiac surgery. Gerontologist, 42(1), 70–81.PubMedCrossRefGoogle Scholar
  2. Archer, M. S., Collier, A., & Porpora, D. V. (2004). Transcendence: Critical realism and God. London: Routledge.Google Scholar
  3. Bader, C., & Froese, P. (2005). Images of God: The effect of personal theologies on moral attitudes, political affiliations, and religious behavior. Interdisciplinary Journal of Research on Religion, 1(11), 1–24.
  4. Bader, C. D., Mencken, F. C., & Froese, P. (2007). American piety 2005: Content and methods of the Baylor Religion Survey. Journal for the Scientific Study of Religion, 46(4), 447–463. doi:10.1111/j.1468-5906.2007.00371.x CrossRefGoogle Scholar
  5. Baldacchino, D., & Draper, P. (2001). Spiritual coping strategies: A review of the nursing research literature. Journal of Advanced Nursing, 34(6), 833–841.PubMedCrossRefGoogle Scholar
  6. Berry, D. M., Bass, C. P., Forawi, W., Neuman, M., & Abdallah, N. (2011). Measuring religiosity/spirituality in diverse religious groups: A consideration of methods. Journal of Religion and Health, 50(4), 841–851. doi:10.1007/s10943-011-9457-9.PubMedCrossRefGoogle Scholar
  7. Boscaglia, N., Clarke, D. M., Jobling, T. W., & Quinn, M. A. (2005). The contribution of spirituality and spiritual coping to anxiety and depression in women with a recent diagnosis of gynecological cancer. International Journal of Gynecologic Cancer, 15(5), 755–761. doi:10.1111/j.1525-1438.2005.00248.x.CrossRefGoogle Scholar
  8. Bosworth, H. B., Park, K. S., McQuoid, D. R., Hays, J. C., & Steffens, D. C. (2003). The impact of religious practice and religious coping on geriatric depression. International Journal of Geriatric Psychiatry, 18(10), 905–914. doi:10.1002/gps.945.PubMedCrossRefGoogle Scholar
  9. Bussing, A., Balzat, H. J., & Heusser, P. (2010). Spiritual needs of patients with chronic pain diseases and cancer—Validation of the spiritual needs questionnaire. European Journal of Medical Research, 15(6), 266–273.PubMedCentralPubMedCrossRefGoogle Scholar
  10. Chan, C. L., Ng, S. M., Ho, R. T., & Chow, A. Y. (2006). East meets west: Applying Eastern spirituality in clinical practice. Journal of Clinical Nursing, 15(7), 822–832. doi:10.1111/j.1365-2702.2006.01649.x.PubMedCrossRefGoogle Scholar
  11. Chibnall, J. T., Videen, S. D., Duckro, P. N., & Miller, D. K. (2002). Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16(4), 331–338.PubMedCrossRefGoogle Scholar
  12. Cole, B. S., Hopkins, C. M., Tisak, J., Steel, J. L., & Carr, B. I. (2008). Assessing spiritual growth and spiritual decline following a diagnosis of cancer: Reliability and validity of the Spiritual Transformation Scale. Psycho-oncology, 17(2), 112–121. doi:10.1002/pon.1207.PubMedCrossRefGoogle Scholar
  13. Cordova, M. J., Cunningham, L. L., Carlson, C. R., & Andrykowski, M. A. (2001). Posttraumatic growth following breast cancer: A controlled comparison study. Health Psychology, 20(3), 176–185. doi:10.1037//0278-6133.20.3.176.PubMedCrossRefGoogle Scholar
  14. Cotton, S. P., Levine, E. G., Fitzpatrick, C. M., Dold, K. H., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-oncology, 8(5), 429–438.PubMedCrossRefGoogle Scholar
  15. de Jager Meezenbroek, E., Garssen, B., van den Berg, M., van Dierendonck, D., Visser, A., & Schaufeli, W. B. (2012). Measuring spirituality as a universal human experience: A review of spirituality questionnaires. Journal of Religion and Health, 51(2), 336–354. doi:10.1007/s10943-010-9376-1.PubMedCentralPubMedCrossRefGoogle Scholar
  16. Dhar, N., Chaturvedi, S., & Nandan, D. (2011). Spiritual health scale 2011: Defining and measuring 4 dimension of health. Indian Journal of Community Medicine, 36(4), 275–282. doi:10.4103/0970-0218.91329.PubMedCentralPubMedCrossRefGoogle Scholar
  17. Duriez, B. (2004). Are religious people nicer people? Taking a closer look at the religion-empathy relationship. Mental Health, Religion & Culture, 7, 249–254. doi:10.1080/13674670310001606450.CrossRefGoogle Scholar
  18. Emmons, R. A. (2000). Is spirituality an intelligence? Motivation, cognition, and the psychology of ultimate concern. International Journal for the Psychology of Religion, 10(1), 3.CrossRefGoogle Scholar
  19. Frankl, V. E. (1978). The unheard cry for meaning: Psychotherapy and humanism. New York: Simon & Schuster.Google Scholar
  20. Gall, T. L., Kristjansson, E., Charbonneau, C., & Florack, P. (2009). A longitudinal study on the role of spirituality in response to the diagnosis and treatment of breast cancer. Journal of Behavioral Medicine, 32(2), 174–186. doi:10.1007/s10865-008-9182-3.PubMedCrossRefGoogle Scholar
  21. Hall, T. W., & Edwards, K. J. (2002). The spiritual assessment inventory: A theistic model and measure for assessing spiritual development. Journal for the Scientific Study of Religion, 41(2), 341–357.CrossRefGoogle Scholar
  22. Hamilton, J. B., Crandell, J. L., Carter, J. K., & Lynn, M. R. (2010). Reliability and validity of the perspectives of support from God scale. Nursing Research, 59(2), 102–109. doi:10.1097/NNR.0b013e3181d1b265.PubMedCentralPubMedCrossRefGoogle Scholar
  23. Harris, S. K., Sherritt, L. R., Holder, D. W., Kulig, J., Shrier, L. A., & Knight, J. R. (2007). Reliability and validity of the brief multidimensional measure of religiousness/spirituality among adolescents. Journal of Religion and Health, 47(4), 438–457. doi:10.1007/s10943-007-9154-x.CrossRefGoogle Scholar
  24. Hesse, H. Retrieved October 11, 2011.
  25. Hill, P. C., & Hood, R. W. (1999). Measures of religiosity. Birmingham, AL: Religious Education Press.Google Scholar
  26. Huber, J. T., & MacDonald, D. A. (2012). An investigation of the relations between altruism, empathy, and spirituality. Journal of Humanistic Psychology, 52, 206–221. doi:10.1177/0022167811399442.CrossRefGoogle Scholar
  27. Idler, E. L., Musick, M. A., Ellison, C. G., George, L. K., Krause, N., Ory, M. G., et al. (2003). Measuring multiple dimensions of religion and spirituality for health research: Conceptual background and findings from the 1998 General Social Survey. Research on Aging, 25(4), 327–365. doi:10.1177/0164027503025004001.CrossRefGoogle Scholar
  28. Kangas, M., Henry, J. L., & Bryant, R. A. (2005). Predictors of posttraumatic stress disorder following cancer. Health Psychology, 24(6), 579–585. doi:10.1037/0278-6133.24.6.579.PubMedCrossRefGoogle Scholar
  29. Kapuscinski, A. N., & Masters, K. S. (2010). The current status of measures of spirituality: A critical review of scale development. Psychology of Religion and Spirituality, 2(4), 191–205. doi:10.1037/a0020498.CrossRefGoogle Scholar
  30. Kassab, V. A., & MacDonald, D. A. (2011). Examination of the psychometric properties of the spiritual fitness assessment. Journal of Religion and Health, 50(4), 975–985. doi:10.1007/s10943-010-9325-z.PubMedCrossRefGoogle Scholar
  31. Koltko-Rivera, M. E. (2004). The psychology of worldviews. Review of General Psychology, 8(1), 3–58. doi:10.1037/1089-2680.8.1.3.CrossRefGoogle Scholar
  32. MacDonald, D. A., & Friedman, H. L. (2002). Assessment of humanistic, transpersonal, and spiritual constructs: State of the science. Journal of Humanistic Psychology, 42, 102–125.CrossRefGoogle Scholar
  33. Maiello, C. (2005). Degrees of belief in God: A measure of belief for use in cross culture. Mental Health, Religion & Culture, 8(2), 87–95. doi:10.1080/13674670410001702371.CrossRefGoogle Scholar
  34. Merriam-Webster. (2014). Merriam-Webster online dictionary. Retrieved April 10, 2014.
  35. Monod, S., Brennan, M., Rochat, E., Martin, E., Rochat, S., & Bula, C. J. (2011). Instruments measuring spirituality in clinical research: A systematic review. Journal of General Internal Medicine, 26(11), 1345–1357. doi:10.1007/s11606-011-1769-7.PubMedCentralPubMedCrossRefGoogle Scholar
  36. Neergaard, M. A., Olesen, F., Andersen, R. S., & Sondergaard, J. (2009). Qualitative description—The poor cousin of health research? BMC Medical Research Methodology, 9, 52. doi:10.1186/1471-2288-9-52.PubMedCentralPubMedCrossRefGoogle Scholar
  37. Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2004). Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study. Journal of Health Psychology, 9(6), 713–730. doi:10.1177/1359105304045366.PubMedCrossRefGoogle Scholar
  38. Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., et al. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12(10), 885–904. doi:10.1089/jpm.2009.0142.PubMedCrossRefGoogle Scholar
  39. QSR International Pty Ltd. (2010). NVivo 9 qualitatitve data analysis software, version 9. Retrieved April 10, 2014.
  40. Rosmarin, D. H., Pirutinsky, S., & Pargament, K. I. (2011). A brief measure of core religious beliefs for use in psychiatric settings. International Journal of Psychiatry in Medicine, 41(3), 253–261.PubMedCrossRefGoogle Scholar
  41. Schreiber, J. A. (2011). Image of God: Effect on coping and psychospiritual outcomes in early breast cancer survivors. Oncology Nursing Forum, 38(3), 293–301. doi:10.1188/11.ONF.293-301.PubMedCrossRefGoogle Scholar
  42. Schreiber, J. A., & Brockopp, D. Y. (2012). Twenty-five years later—What do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. Journal of Cancer Survivorship, 6(1), 82–94. doi:10.1007/s11764-011-0193-7.PubMedCrossRefGoogle Scholar
  43. Selman, L., Harding, R., Gysels, M., Speck, P., & Higginson, I. J. (2011). The measurement of spirituality in palliative care and the content of tools validated cross-culturally: A systematic review. Journal of Pain and Symptom Management, 41(4), 728–753. doi:10.1016/j.jpainsymman.2010.06.023.PubMedCrossRefGoogle Scholar
  44. Taunay, T. C., Cristino, E. D., Machado, M. O., Rola, F. H., Lima, J. W., Macedo, D. S., et al. (2012). Development and validation of the intrinsic religiousness inventory (IRI). Revista Brasileira de Psiquiatria, 34(1), 76–81.PubMedCrossRefGoogle Scholar
  45. Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Trauma and Stress, 9(3), 455–471.CrossRefGoogle Scholar
  46. Vidal, C. (2008). Wat is een wereldbeeld? (What is a worldview?). In H. Van Belle & J. Van der Veken (Eds.), Nieuwheid denken. De wetenschappen en het creatieve aspect van de werkelijkheid. Leuven: Acco.Google Scholar
  47. Zinnbauer, B. J., Pargament, K. I., Cole, B., Rye, M. S., Butter, E. M., Belavich, T. G., et al. (1997). Religion and spirituality: Unfuzzying the fuzzy. Journal for the Scientific Study of Religion, 36(4), 549–564.CrossRefGoogle Scholar
  48. Zinnbauer, B. J., Pargament, K. I., & Scott, A. B. (1999). The emerging meaning of religiousness and spirituality: Problems and prospects. Journal of Personality, 67(6), 889–919.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.School of NursingUniversity of LouisvilleLouisvilleUSA
  2. 2.College of NursingUniversity of Massachusetts BostonBostonUSA

Personalised recommendations