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Is there a correlation between spirituality and anxiety and depression in patients with advanced cancer?

Supportive Care in Cancer volume 14, pages 379–385 (2006)Cite this article

Abstract

Aims and objectives

To establish whether there is a correlation between spirituality and anxiety and depression in patients with advanced cancer.

Patients and methods

Patients with a diagnosis of cancer at St. Peter’s day hospice in Bristol were asked to complete three questionnaires to assess anxiety, depression and spirituality. Informed consent was obtained. Anxiety and depression are indicated by the Hospital Anxiety and Depression Scale score, and spirituality is indicated by scores on the Spiritual Well-Being Scale (SWBS) and the Royal Free Interview for Spiritual and Religious Beliefs. As will be explained, religion and spirituality are generally recognised as having different meanings—religion entailing a relationship with a higher being, while spirituality can be thought of in terms of meaning and purpose in life.

Results

Eighty-five complete data sets were obtained. A significant negative correlation was found between both anxiety and depression scores and overall spiritual well-being scores (p<0.0001). When the SWBS subscale scores were analysed individually, a significant negative correlation was found between the existential well-being scores and the anxiety and depression scores (p<0.001). However, no correlation was found between the religious well-being scores and anxiety or depression.

Conclusions

This study found a significant negative correlation between spirituality (in particular, the existential aspect) and anxiety and depression in patients with advanced cancer. Religious well-being and strength of belief had no impact on psychological well-being in this study.

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References

  1. Anandarajah G, Hight E (2001) Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician 63(1):81–88

    PubMed  CAS  Google Scholar 

  2. Boivin MJ, Kirby AL, Underwood LK, Silva H (1999) Spiritual well-being scale. In: Hill PC, Hood RW (eds) Measures of religiosity. Religious Education Press, Birmingham, AL, pp 382–385. ISBN 089135106X

    Google Scholar 

  3. Breitbart W, Rosenfeld B, Pessin H, Kaim M, Funesti-Esch J, Galietta M, Nelson CJ, Brescia R (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284(22):2907–2911

    PubMed  Article  CAS  Google Scholar 

  4. Burton LA (1998) The spiritual dimension of palliative care. Semin Oncol Nurs 14(2):121–128

    PubMed  Article  CAS  Google Scholar 

  5. Cassileth BR, Lusk EJ, Hutter R, Strouse TB, Brown LI (1984) Concordance of depression and anxiety in patients with cancer. Psychol Rep 54:588–590

    PubMed  CAS  Google Scholar 

  6. Chibnall JT, Videen SD, Duckro PN, Miller DK (2002) Psychosocial–spiritual correlates of death distress in patients with life-threatening medical conditions. Palliat Med 16:331–338

    PubMed  Article  Google Scholar 

  7. Cotton SP, Levine EG, Fitzpatrick CM, Dold KH, Targ E (1999) Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psychooncology 8:429–438

    PubMed  Article  CAS  Google Scholar 

  8. Daaleman TP, VandeCreek L (2000) Placing religion and spirituality in end-of-life care. JAMA 284(19):2514–2517

    PubMed  Article  CAS  Google Scholar 

  9. Dom H (1999) Spiritual care, need and pain—recognition and response. Eur J Palliat Care 6(3):87–90

    Google Scholar 

  10. Dyson J, Cobb M, Forman D (1997) The meaning of spirituality: a literature review. J Adv Nurs 26:1183–1188

    PubMed  Article  CAS  Google Scholar 

  11. Encarta (1999) World English dictionary, Microsoft Corporation

  12. Fehring RJ, Miller JF, Shaw C (1997) Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncol Nurs Forum 24(4):663–671

    PubMed  CAS  Google Scholar 

  13. Fryback PB, Reinert BR (1999) Spirituality and people with potentially fatal diagnoses. Nurs Forum 34(1):13–22

    PubMed  Article  CAS  Google Scholar 

  14. Gartner J, Larson DB, Allen GD (1994) Religious commitment and mental health: a review of the empirical literature. J Psychol Theol 19(1):6–25

    Google Scholar 

  15. Gioiella ME, Berkman B, Robinson M (1998) Spirituality and quality of life in gynaecologic oncology patients. Cancer Pract 6(6):333–338

    PubMed  Article  CAS  Google Scholar 

  16. Grey A (1994) The spiritual component of palliative care. Palliat Med 8:215–221

    PubMed  Article  CAS  Google Scholar 

  17. Hassad CS (2000) Depression: dispirited or spiritually deprived? Med J Aust 173:545–547

    Google Scholar 

  18. Hermann CP (2001) Spiritual needs of dying patients: a qualitative study. Oncol Nurs Forum 28(1):67–72

    PubMed  CAS  Google Scholar 

  19. Herrmann C (1997) International experiences with the hospital anxiety and depression scale—a review of validation data and clinical results. J Psychosom Res 42(1):17–41

    PubMed  Article  CAS  Google Scholar 

  20. Holtom N, Barraclough J (2000) Is the hospital anxiety and depression scale (HADS) useful in assessing depression in palliative care? Palliat Med 14:219–220

    PubMed  Article  CAS  Google Scholar 

  21. Hotopf M, Chidgey J, Addington-Hall J, Lan Ly K (2002) Depression in advanced disease: a systematic review. Part 1. Prevalence and case finding. Palliat Med 16:81–97

    PubMed  Article  CAS  Google Scholar 

  22. House A, Stark D (2002) ABC of psychological medicine: anxiety in medical patients. BMJ 325:207–209

    PubMed  Article  Google Scholar 

  23. Johnston M, Pollard B, Hennessey P (2000) Construct validation of the hospital anxiety and depression scale with clinical populations. J Psychosom Res 48:579–584

    PubMed  Article  CAS  Google Scholar 

  24. Kaczorowski J (1989) Spiritual well-being and anxiety in adults diagnosed with cancer. Hosp J 5:105–116

    PubMed  Article  CAS  Google Scholar 

  25. Kellehear A (2000) Spirituality and palliative care: a model of needs. Palliat Med 14:149–155

    PubMed  Article  CAS  Google Scholar 

  26. King M, Speck P, Thomas A (1995) The royal free interview for religious and spiritual beliefs: development and standardization. Psychol Med 25:1125–1134

    PubMed  CAS  Google Scholar 

  27. King M, Speck P, Thomas A (2001) The royal free interview for spiritual and religious beliefs: development and validation of a self-report version. Psychol Med 31:1015–1023

    PubMed  Article  CAS  Google Scholar 

  28. Koenig HG, Larson DB, Weaver AJ (1998) Research on religion and serious mental illness. New Dir Ment Health Serv 80:81–95

    PubMed  Article  Google Scholar 

  29. Lloyd-Williams M, Spiller J, Ward J (2003) Which depression screening tool should be used in palliative care? Palliat Med 17:40–43

    PubMed  Article  Google Scholar 

  30. McClain CS, Rosenfeld B, Breitbart W (2003) Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet 361:1603–1607

    PubMed  Article  Google Scholar 

  31. Mickley JR, Soeken K, Belcher A (1992) Spiritual well-being, religiousness and hope among women with breast cancer. Image J Nurs Scholarsh 24(4):267–272

    Article  CAS  Google Scholar 

  32. Moberg DO, Brusek PM (1978) Spiritual well-being: a neglected subject in quality of life research. Soc Indic Res 5:303–323

    Article  Google Scholar 

  33. Moorey S, Greer S, Watson M, Gorman C, Rowden L, Tunmore R, Robertson B, Bliss J (1991) The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer. Br J Psychiatry 158:255–259

    PubMed  CAS  Article  Google Scholar 

  34. Mytko JJ, Knight SJ (1999) Body, mind and spirit: towards the integration of religiosity and spirituality in cancer quality of life research. Psychooncology 8:439–450

    PubMed  Article  CAS  Google Scholar 

  35. Paloutzian RF, Ellison CW (1982) Loneliness, spiritual well-being and the quality of life. In: Peplau LA, Perlman D (eds) Loneliness: a source book of current theory, research and therapy. Wiley, New York, pp 224–237

    Google Scholar 

  36. Razavi D, Delvaux N, Farvacques C, Robaye E (1990) Screening for adjustment disorders and major depressive disorders in cancer inpatients. Br J Psychiatry 156:79–83

    PubMed  CAS  Google Scholar 

  37. Reed PG (1987) Spirituality and well-being in terminally ill hospitalised adults. Res Nurs Health 10:335–344

    PubMed  Article  CAS  Google Scholar 

  38. Rousseau P (2000) Spirituality and the dying patient. J Clin Oncol 18(9):2000–2002

    PubMed  CAS  Google Scholar 

  39. Sloan RP, Bagiella E, Powell T (1999) Religion, spirituality and medicine. Lancet 353:664–667

    PubMed  Article  CAS  Google Scholar 

  40. Speck P (1998) Spiritual issues in palliative care. In: Doyle D, Hanks GW, MacDonald N (eds) Oxford textbook of palliative medicine, 2nd edn. Oxford University Press, Oxford, pp 805–814

    Google Scholar 

  41. Thomson J (2000) The place of spiritual well-being in hospice patients’ overall quality of life. Hosp J 15(2):13–27

    PubMed  Article  CAS  Google Scholar 

  42. Walter T (2002) Spirituality in palliative care: opportunity or burden? Palliat Med 16:133–139

    PubMed  Article  CAS  Google Scholar 

  43. Wright MC (2001) Spirituality: a developing concept within palliative care? Prog Palliat Care 9(4):143–147

    Google Scholar 

  44. Yates JW, Chalmer BJ, St James P, Follansbee M, McKegney FP (1981) Religion in patients with advanced cancer. Med Pediatr Oncol 9(2):121–128

    PubMed  Article  CAS  Google Scholar 

  45. Zigmund A, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  Google Scholar 

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Acknowledgements

We would like to thank Christopher Foy and Rosemary Greenwood for statistical assistance and Prof. Michael King, Rev. Peter Speck, Rev. Mark Cobb, Prof. Mari Lloyd-Williams and Dr. Bill Noble for other additional assistance.

Author information

Authors and Affiliations

  1. Department of Palliative Medicine, Elgar House, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK

    Rachel C. McCoubrie

  2. Department of Palliative Medicine, Royal Marsden Hospital, Sutton, Surrey, SM2 5PT, UK

    Andrew N. Davies

Authors
  1. Rachel C. McCoubrie
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  2. Andrew N. Davies
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Corresponding author

Correspondence to Rachel C. McCoubrie.

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McCoubrie, R.C., Davies, A.N. Is there a correlation between spirituality and anxiety and depression in patients with advanced cancer?. Support Care Cancer 14, 379–385 (2006). https://doi.org/10.1007/s00520-005-0892-6

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  • DOI: https://doi.org/10.1007/s00520-005-0892-6

Keywords

  • Spirituality
  • Religion
  • Anxiety
  • Depression
  • Cancer