Skip to main content

Religious coping and death depression in Iranian patients with cancer: relationships to disease stage

Supportive Care in Cancer volume 26, pages 2571–2579 (2018)Cite this article

Abstract

Purpose

The study investigated relationships among the extent of disease, religious coping, and death depression in Iranian patients with cancer.

Method

A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious coping surveys.

Results

After controlling for demographic and health characteristics, positive and negative religious coping behaviors were significantly related to the experience of death depression. There was an interaction effect between negative religious coping and extent of disease with significant positive relationships to the experience of death depression.

Conclusions

Negative religious coping was found to be more closely associated with death depression in patients with earlier stage disease than those with advanced stages of cancer in this sample of patients with cancer from Iran. Findings support assessing patients for use of religious coping strategies. Muslim patients who are religiously alienated and have existential anguish may be vulnerable and need heightened support following diagnosis and during treatment of early stage cancer.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Gonen G, Kaymak SU, Cankurtaran ES, Karslioglu EH, Ozalp E, Soygur H (2012) The factors contributing to death anxiety in cancer patients. J Psychosoc Oncol 30(3):347–358. https://doi.org/10.1080/07347332.2012.664260

    Article  PubMed  Google Scholar 

  2. Sharif Nia H, Pahlevan Sharif S, Esmaeili R, Goudarzian AH, Tahmasbi B, Yaghoobzadeh A, Kaveh O (2017) Factors influencing the level of death depression in patients with cancer: a path analysis. J Mazandaran Univ Med Sci 26(145):318–331

    Google Scholar 

  3. Mashhadi MA, Shakiba M, Zakeri Z (2013) Evaluation of depression in patients with cancer in South of Iran (Zahedan). Iran J Cancer Prev 6(1):12–16

    PubMed  PubMed Central  Google Scholar 

  4. Pasquini M, Biondi M (2007) Depression in cancer patients: a critical review. Clin Pract Epidemiol Ment Health 3(1):2–2. https://doi.org/10.1186/1745-0179-3-2

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ng GC, Mohamed S, Sulaiman AH, Zainal NZ (2017) Anxiety and depression in cancer patients: the association with religiosity and religious coping. J Relig Health 56(2):575–590. https://doi.org/10.1007/s10943-016-0267-y

    Article  PubMed  Google Scholar 

  6. Lavery ME, O’Hea EL (2010) Religious/spiritual coping and adjustment in individuals with cancer: unanswered questions, important trends, and future directions. Ment Health Relig Cult 13(1):55–65. https://doi.org/10.1080/13674670903131850

    Article  Google Scholar 

  7. Braam AW, Schrier AC, Tuinebreijer WC, Beekman AT, Dekker JJ, de Wit MA (2010) Religious coping and depression in multicultural Amsterdam: a comparison between native Dutch citizens and Turkish, Moroccan and Surinamese/Antillean migrants. J Affect Disord 125(1–3):269–278. https://doi.org/10.1016/j.jad.2010.02.116

    Article  PubMed  Google Scholar 

  8. Rand KL, Cripe LD, Monahan PO, Tong Y, Schmidt K, Rawl SM (2012) Illness appraisal, religious coping, and psychological responses in men with advanced cancer. Support Care Cancer 20(8):1719–1728. https://doi.org/10.1007/s00520-011-1265-y

    Article  PubMed  Google Scholar 

  9. Zamanian H, Eftekhar-Ardebili H, Eftekhar-Ardebili M, Shojaeizadeh D, Nedjat S, Taheri-Kharameh Z, Daryaafzoon M (2015) Religious coping and quality of life in women with breast cancer. Asian Pac J Cancer Prev: APJCP 16(17):7721–7725. https://doi.org/10.7314/APJCP.2015.16.17.7721

    Article  PubMed  Google Scholar 

  10. Trevino KM, Balboni M, Zollfrank A, Balboni T, Prigerson HG (2014) Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer. Psycho-Oncology 23(8):936–945. https://doi.org/10.1002/pon.3505

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Templer DI, Lavoie M, Chalgujian H, Thomas-Dobson S (1990) The measurement of death depression. J Clin Psychol 46(6):834–839. https://doi.org/10.1002/1097-4679(199011)46:6<834::AID-JCLP2270460623>3.0.CO;2-0

    Article  PubMed  CAS  Google Scholar 

  12. Baetz M, Toews J (2009) Clinical implications of research on religion, spirituality, and mental health. Can J Psychiatr 54(5):292–301. https://doi.org/10.1177/070674370905400503

    Article  Google Scholar 

  13. Peteet JR, Balboni MJ (2013) Spirituality and religion in oncology. CA Cancer J Clin 63(4):280–289. https://doi.org/10.3322/caac.21187

    Article  PubMed  Google Scholar 

  14. Crane JN (2009) Religion and cancer: examining the possible connections. J Psychosoc Oncol 27(4):469–486. https://doi.org/10.1080/07347330903182010

    Article  PubMed  Google Scholar 

  15. Thune-Boyle IC, Stygall J, Keshtgar MR, Davidson TI, Newman SP (2013) Religious/spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psycho-Oncology 22(3):646–658. https://doi.org/10.1002/pon.3048

    Article  PubMed  Google Scholar 

  16. Saarelainen S-M (2017) Emerging Finnish adults coping with cancer: religious, spiritual, and secular meanings of the experience. Pastoral Psychol 66(2):251–268. https://doi.org/10.1007/s11089-016-0735-z

    Article  Google Scholar 

  17. Hill PC, Pargament KI (2003) Advances in the conceptualization and measurement of religion and spirituality: implications for physical and mental health research. Am Psychol 58(1):64–74. https://doi.org/10.1037/0003-066X.58.1.64

    Article  PubMed  Google Scholar 

  18. Lee M, Nezu AM, Nezu CM (2014) Positive and negative religious coping, depressive symptoms, and quality of life in people with HIV. J Behav Med 37(5):921–930. https://doi.org/10.1007/s10865-014-9552-y

    Article  PubMed  Google Scholar 

  19. Vallurupalli MM, Lauderdale MK, Balboni MJ, Phelps AC, Block SD, Ng AK, Kachnic LA, VanderWeele TJ, Balboni TA (2012) The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. J Support Oncol 10(2):81–87. https://doi.org/10.1016/j.suponc.2011.09.003

    Article  PubMed  Google Scholar 

  20. Perez JE, Rex Smith A (2015) Intrinsic religiousness and well-being among cancer patients: the mediating role of control-related religious coping and self-efficacy for coping with cancer. J Behav Med 38(2):183–193. https://doi.org/10.1007/s10865-014-9593-2

    Article  PubMed  Google Scholar 

  21. Hebert R, Zdaniuk B, Schulz R, Scheier M (2009) Positive and negative religious coping and well-being in women with breast cancer. J Palliat Med 12(6):537–545. https://doi.org/10.1089/jpm.2008.0250

    Article  PubMed  PubMed Central  Google Scholar 

  22. Pargament KI, Koenig HG, Perez LM (2000) The many methods of religious coping: development and initial validation of the RCOPE. J Clin Psychol 56(4):519–543. https://doi.org/10.1002/(SICI)1097-4679(200004)56:4<519::AID-JCLP6>3.0.CO;2-1

    Article  PubMed  CAS  Google Scholar 

  23. Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA (2013) The relationships among coping strategies, religious coping, and spirituality in African American women with breast cancer receiving chemotherapy. Oncol Nurs Forum 40(2):120–131. https://doi.org/10.1188/13.onf.120-131

    Article  PubMed  Google Scholar 

  24. Pargament KI, Tarakeshwar N, Ellison CG, Wulff KM (2001) Religious coping among the religious: the relationships between religious coping and well-being in a National Sample of Presbyterian Clergy, Elders, and Members. J Sci Study Relig 40(3):497–513. https://doi.org/10.1111/0021-8294.00073

    Article  Google Scholar 

  25. Neimeyer RA, Currier JM, Coleman R, Tomer A, Samuel E (2011) Confronting suffering and death at the end of life: the impact of religiosity, psychosocial factors, and life regret among hospice patients. Death studies 35(9):777–800. https://doi.org/10.1080/07481187.2011.583200

    Article  PubMed  Google Scholar 

  26. Biegler K, Cohen L, Scott S, Hitzhusen K, Parker P, Gilts CD, Canada A, Pisters L (2012) The role of religion and spirituality in psychological distress prior to surgery for urologic cancer. Integr Cancer Ther 11(3):212–220. https://doi.org/10.1177/1534735411416456

    Article  PubMed  Google Scholar 

  27. Paiva CE, Paiva BS, de Castro RA, Souza Cde P, de Paiva Maia YC, Ayres JA, Michelin OC (2013) A pilot study addressing the impact of religious practice on quality of life of breast cancer patients during chemotherapy. J Relig Health 52(1):184–193. https://doi.org/10.1007/s10943-011-9468-6

    Article  PubMed  Google Scholar 

  28. Pahlevan Sharif S, Khanekharab J (2017) External locus of control and quality of life among Malaysian breast cancer patients: the mediating role of coping strategies. J Psychosoc Oncol 35(6):1–20. https://doi.org/10.1080/07347332.2017.1308984

    Article  Google Scholar 

  29. Barber N (2011) A cross-national test of the uncertainty hypothesis of religious belief. Cross Cult Res 45(3):318–333. https://doi.org/10.1177/1069397111402465

    Article  Google Scholar 

  30. Abernethy AD, Chang HT, Seidlitz L, Evinger JS, Duberstein PR (2002) Religious coping and depression among spouses of people with lung cancer. Psychosomatics 43(6):456–463. https://doi.org/10.1176/appi.psy.43.6.456

    Article  PubMed  Google Scholar 

  31. Sharif Nia H, Pahlevan Sharif S, Lehto RH, Boyle C, Yaghoobzadeh A, Kaveh O, Goudarzian AH (2017) Development and psychometric evaluation of a Persian version of the death depression scale-revised: a cross-cultural adaptation for patients with advanced cancer. Jpn J Clin Oncol 47(8):1–7. https://doi.org/10.1093/jjco/hyx065

    Article  Google Scholar 

  32. Templer DI, Harville M, Hutton S, Underwood R, Tomeo M, Russell M, Mitroff D, Arikawa H (2002) Death depression scale-revised. Omega 44(2):105–112. https://doi.org/10.2190/32L3-DPDA-M4U3-7L81

    Article  Google Scholar 

  33. Sharif Nia H, Pahlevan Sharif S, Goudarzian AH, Allen KA, Jamali S, Heydari Gorji MA (2017) The relationship between religious coping and self-care behaviors in Iranian medical students. J Relig Health 56(6):2109–2117. https://doi.org/10.1007/s10943-017-0376-2

    Article  PubMed  Google Scholar 

  34. Nesami MB, Goudarzian AH, Zarei H, Esameili P, Pour MD, Mirani H (2015) The relationship between emotional intelligence with religious coping and general health of students. Mater Sociomed 27(6):412–416. https://doi.org/10.5455/msm.2015.27.412-416

    Article  PubMed  PubMed Central  Google Scholar 

  35. Sherman AC, Plante TG, Simonton S, Latif U, Anaissie EJ (2009) Prospective study of religious coping among patients undergoing autologous stem cell transplantation. J Behav Med 32(1):118–128. https://doi.org/10.1007/s10865-008-9179-y

    Article  PubMed  Google Scholar 

  36. Pahlevan Sharif S, Mahdavian V (2015) Structural equation modeling by the use of AMOS. Fazel, Tehran

    Google Scholar 

  37. Fornell C, Larcker DF (1981) Evaluating structural equation models with unobservable variables and measurement error. J Mark Res 18(1):39–50. https://doi.org/10.2307/3151312

    Article  Google Scholar 

  38. Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach, 1st edn. Guilford Press, New York

    Google Scholar 

  39. Malhotra NK, Dash S (2011) Marketing research an applied orientation (paperback). Pearson Publishing, London

    Google Scholar 

  40. Babapour J, Sh Z, Zarezade F, Nejati B (2016) The structural association of religious attitude and soping style with quality of life and fatigue in cancer patients. J Health Care 18(1):45–54

    Google Scholar 

  41. D’Souza CA, Antony S, Thomas B, Murthy SG (2016) Coping strategies used by cancer patients to deal with physical and psychological problems of chemotherapy. Int J Innov Res Dev 5(3):36–41

    Google Scholar 

  42. Bloomer MJ, Al-Mutair A (2013) Ensuring cultural sensitivity for Muslim patients in the Australian ICU: considerations for care. Aust Crit Care 26(4):193–196. https://doi.org/10.1016/j.aucc.2013.04.003

    Article  PubMed  Google Scholar 

  43. Kaliampos A, Roussi P (2015) Religious beliefs, coping, and psychological well-being among Greek cancer patients. J Health Psychol 22(6):754–764. https://doi.org/10.1177/1359105315614995

    Article  PubMed  Google Scholar 

  44. Murata H (2003) Spiritual pain and its care in patients with terminal cancer: construction of a conceptual framework by philosophical approach. Palliat Support Care 1(1):15–21. https://doi.org/10.1017/S1478951503030086

    Article  PubMed  Google Scholar 

  45. Balboni TA, Paulk ME, Balboni MJ, Phelps AC, Loggers ET, Wright AA, Block SD, Lewis EF, Peteet JR, Prigerson HG (2009) Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 28(3):445–452. https://doi.org/10.1200/JCO.2009.24.8005

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would also like to thank patients and officials of selected hospitals for their participation in this study.

Funding

The research committee of Mazandaran University of medical sciences (Sari, Iran) financially supported this study.

Author information

Affiliations

  1. Taylor’s Business School, Taylor’s University Malaysia, Subang Jaya, Malaysia

    Saeed Pahlevan Sharif

  2. College of Nursing, Michigan State University, East Lansing, MI, USA

    Rebecca H. Lehto

  3. School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran

    Hamid Sharif Nia, Bahram Tahmasbi & Roghieh Nazari

  4. Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

    Amir Hossein Goudarzian

  5. Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Ali Akbar Haghdoost

  6. School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

    Ameneh Yaghoobzadeh

Authors
  1. Saeed Pahlevan Sharif
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rebecca H. Lehto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hamid Sharif Nia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amir Hossein Goudarzian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ali Akbar Haghdoost
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ameneh Yaghoobzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bahram Tahmasbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Roghieh Nazari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hamid Sharif Nia.

Ethics declarations

All study procedures were approved by the Ethics Committee (Ethical Code: IR.MAZUMS.REC.1396.10189) of Mazandaran University of Medical Sciences, Sari, Iran. Prior to obtaining written informed consent, patients were apprised relative to the study purpose, what the investigation entailed, and voluntary nature. The confidentiality of patients’ information was ensured with no identifiers used in any surveys and all data were collected in private locations.

Conflict of interest

The authors declare that they have no competing interests.

Additional information

What’s new?

Research on the association between religious coping and death depression is abundant in the literature. However, studies investigating the mechanism behind this relationship are scarce. The results indicated that cancer stage moderates the relationship between religious coping and death depression so that for patients with more advanced cancer, negative religious coping is less associated with death depression.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sharif, S.P., Lehto, R.H., Nia, H.S. et al. Religious coping and death depression in Iranian patients with cancer: relationships to disease stage. Support Care Cancer 26, 2571–2579 (2018). https://doi.org/10.1007/s00520-018-4088-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4088-2

Keywords

  • Cancer
  • Culture
  • Death depression
  • Religious coping
  • Muslim