Abstract
This study explores the relationship between spiritual well-being (SWB) (meaning/peace & faith), depression, and quality of life (QOL). Cancer survivors often use their spirituality as a way of coping. Among a sample of 97 Latina breast cancer survivors (LBCS), SWB was assessed with the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being Scale, QOL was measured using the Functional Assessment of Cancer Therapy—General (FACT-G), and depression was measured with the Patient Health Questionnaire. Study findings revealed that SWB, specifically the meaning/peace factor, is the main predictor of an increase in QOL and a reduction in depression among LBCS.
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Aguado Loi, C. X., Baldwin, J. A., McDermott, R. J., McMillan, S., Martinez Tyson, D., Yampolskaya, S., & Vandeweerd, C. (2013). Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship. Psycho-Oncology, 22(12), 2779–2788. https://doi.org/10.1002/pon.3357.
Alegría, M., Canino, G., Ríos, R., Vera, M., Calderón, J., Rusch, D., & Ortega, A. N. (2002). Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Psychiatric Services, 53(12), 1547–1555. https://doi.org/10.1176/appi.ps.53.12.1547.
Ashing-Giwa, K., Tejero, J., Kim, J., Padilla, G., & Hellemann, G. (2007). Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma. Quality of Life Research, 16(3), 413–428.
Ashing-Giwa, K. T., & Lim, J.-W. (2010). Predicting physical quality of life among a multiethnic sample of breast cancer survivors. Quality of Life Research, 19(6), 789–802.
Ashing-Giwa, K. T., Padilla, G. V., Bohorquez, D. E., Tejero, J. S., & Garcia, M. (2006). Understanding the breast cancer experience of Latina women. Journal of Psychosocial Oncology, 24(3), 19–52.
Barden, S. M., Gutierrez, D., Gonzalez, J., & Ali, S. (2016). Healing Faith: A qualitative exploration of Latina breast cancer survivors. Counseling and Values, 61(2), 142–158. https://doi.org/10.1002/cvj.12034.
Brady, M. J., Peterman, A. H., Fitchett, G., Mo, M., & Cella, D. (1999). A case for including spirituality in quality of life measurement in oncology. Psychooncology, 8(5), 417–428.
Bredle, J., Salsman, J., Debb, S., Arnold, B., & Cella, D. (2011). Spiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy—spiritual well-being scale (fACIT-Sp). Religions. https://doi.org/10.3390/rel2010077.
Breitbart, W., Pessin, H., Rosenfeld, B., Applebaum, A. J., Lichtenthal, W. G., Li, Y., & Fenn, N. (2018). Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer, 124(15), 3231–3239. https://doi.org/10.1002/cncr.31539.
Breitbart, W., Poppito, S., Rosenfeld, B., Vickers, A. J., Li, Y., Abbey, J., & Cassileth, B. R. (2012). Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology, 30(12), 1304–1309.
Breitbart, W., Rosenfeld, B., Gibson, C., Pessin, H., Poppito, S., Nelson, C., & Olden, M. (2010a). Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Pscyho-Oncology, 19(1), 21–28.
Breitbart, W., Rosenfeld, B., Gibson, C., Pessin, H., Poppito, S., Nelson, C., & Olden, M. (2010b). Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psychooncology, 19(1), 21–28. https://doi.org/10.1002/pon.1556.
Bureau, U. C. (2019). U.S. Census Bureau QuickFacts: United States.
Campesino, M., & Schwartz, G. E. (2006). Spirituality among Latinas/os: implications of culture in conceptualization and measurement. ANS Adv Nurs Sci, 29(1), 69–81.
Canada, A. L., Fitchett, G., Murphy, P. E., Stein, K., Portier, K., Crammer, C., & Peterman, A. H. (2012). Racial/ethnic differences in spiritual well-being among cancer survivors. Journal of Behavioral Medicine. https://doi.org/10.1007/s10865-012-9439-8.
Cella, D. F., Tulsky, D. S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., et al. (1993). The functional assessment of cancer therapy scale: development and validation of the general measure. Journal of Clinical Oncology, 11(3), 570–579.
Chochinov, H. M., Hack, T., Hassard, T., Kristjanson, L. J., McClement, S., & Harlos, M. (2005). Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. Journal of Clinical Oncology, 23(24), 5520–5525. https://doi.org/10.1200/jco.2005.08.391.
Coreil, J., Corvin, J. A., Nupp, R., Dyer, K., & Noble, C. (2012). Ethnicity and cultural models of recovery from breast cancer. Ethn Health, 17(3), 291–307. https://doi.org/10.1080/13557858.2011.616188.
Costas-Muñiz, R., Garduño-Ortega, O., González, C. J., Rocha-Cadman, X., Breitbart, W., & Gany, F. (2017a). Meaning-Centered Psychotherapy in the Cancer Setting Finding Meaning and Hope in the Face of Suffering. In Cultural and Linguistic Adaptation of Meaning-Centered Psychotherapy for Spanish-Speaking Latino Cancer Patients: Oxford University Press.
Costas-Muñiz, R., Garduño-Ortega, O., Hunter-Hernández, M., Morales, J., Castro-Figueroa, E. M., Gany, F., (2020a). Barriers of psychosocial services use of white versus Latina breast cancer survivors. Journal of Behavioural Health Services and Research. https://doi.org/10.1176/appi.psychotherapy.20190036.
Costas-Muñiz, R., Hunter-Hernández, M., Garduño-Ortega, O., Morales-Cruz, J., & Gany, F. (2017b). Ethnic differences in psychosocial service use among non-Latina white and Latina breast cancer survivors. Journal of Psychosocial Oncology, 35(4), 424–437. https://doi.org/10.1080/07347332.2017.1310167.
Costas-Muniz, R., Sen, R., Leng, J., Aragones, A., Ramirez, J., & Gany, F. (2013). Cancer stage knowledge and desire for information: mismatch in Latino cancer patients? Journal of Cancer Education, 28(3), 458–465. https://doi.org/10.1007/s13187-013-0487-8.
Costas-Muñiz, R., Torres-Blasco, N., Castro-Figueroa, E. M., González, C. J., Breitbart, W., & Gany, F. (2020b). Meaning-centered psychotherapy for Latino patients with advanced cancer: Cultural adaptation process. Journal of Palliative Medicine, 23(4), 489–497.
Crane, T. E., Badger, T. A., Sikorskii, A., Segrin, C., Hsu, C. H., & Rosenfeld, A. G. (2019). Trajectories of depression and anxiety in Latina breast cancer survivors. Oncology Nursing Forum, 46(2), 217–227. https://doi.org/10.1188/19.Onf.217-227.
DeSantis, C., Siegel, R., Bandi, P., & Jemal, A. (2011). Breast Cancer Statistics. CA: A Cancer Journal for Clinicians, 61(6), 409–418. doi:doi:https://doi.org/10.3322/caac.20134.
Dwight-Johnson, M., Ell, K., & Lee, P. J. (2005). Can collaborative care address the needs of low-income Latinas with comorbid depression and cancer? Results from a randomized pilot study. Psychosomatics, 46(3), 224–232. https://doi.org/10.1176/appi.psy.46.3.224.
Fitchett, G., Peterman, A. H., & Cella, D. F. (1996). Spiritual beliefs and quality of life in cancer and HIV patients. TN: Presented in The Society for Scientific Study of Religion Nashville.
Graves, K. D., Jensen, R. E., Canar, J., Perret-Gentil, M., Leventhal, K. G., Gonzalez, F., & Mandelblatt, J. (2012). Through the lens of culture: quality of life among Latina breast cancer survivors. Breast Cancer Research and Treatment, 136(2), 603–613. https://doi.org/10.1007/s10549-012-2291-2.
Harris, B. A., Berger, A. M., Mitchell, S. A., Steinberg, S. M., Baker, K. L., Handel, D. L., & Pavletic, S. Z. (2010). Spiritual well-being in long-term survivors with chronic graft-versus-host disease after hematopoietic stem cell transplantation. Journal of Supportive Oncology, 8(3), 119–125.
Hunter-Hernández, M., Costas-Muñiz, R., & Gany, F. (2015). Missed Opportunity: Spirituality as a Bridge to Resilience in Latinos with Cancer. Journal of Religion and Health. https://doi.org/10.1007/s10943-015-0020-y.
Janz, N. K., Mujahid, M. S., Hawley, S. T., Griggs, J. J., Alderman, A., Hamilton, A. S., & Katz, S. J. (2009). Racial/ethnic differences in quality of life after diagnosis of breast cancer. Journal of Cancer Survivorship, 3(4), 212–222. https://doi.org/10.1007/s11764-009-0097-y.
Jurkowski, J. M., Kurlanska, C., & Ramos, B. M. (2010). Latino women’s spiritual beliefs related to health. Am J Health Promot, 25(1), 19–25. https://doi.org/10.4278/ajhp.080923-QUAL-211.
Kissane, D., & Li, Y. (2008). Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer, 112(2), 443–444. https://doi.org/10.1002/cncr.23179.
Kissane, D. W., McKenzie, M., Bloch, S., Moskowitz, C., McKenzie, D. P., & O’Neill, I. (2006). Family focused grief therapy: a randomized, controlled trial in palliative care and bereavement. American Journal of Psychiatry, 163(7), 1208–1218. https://doi.org/10.1176/appi.ajp.163.7.1208.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a Brief Depression Severity measure. Journal of General Internal Medicine, 16, 606–613.
Krupski, T. L., Kwan, L., Fink, A., Sonn, G. A., Maliski, S., & Litwin, M. S. (2006). Spirituality influences health related quality of life in men with prostate cancer. Psychooncology, 15(2), 121–131. https://doi.org/10.1002/pon.929.
Lin, H. R., & Bauer-Wu, S. M. (2003). Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. Journal of Advanced Nursing, 44(1), 69–80.
Lowe, B., Kroenke, K., Herzoga, W., & Grafe, K. (2004). Measuring Depression Outcome with a Brief Self-report Instrument: Sensitivity to Change of the Patient Health Questionnaire (PHQ-9). Journal of Affective Disorders, 81, 61–66. https://doi.org/10.1016/S0165-0327(03)00198-8.
Lyons, M. A., Jacobson, S. S., & Prescott, B. (2002). Women’s Experiences During the First Year Following Diagnosis of Breast Cancer. Oncology Nursing Forum, 3(1), 1–26.
Martínez, M., Arantzamendi, M., Belar, A., Carrasco, J. M., Carvajal, A., Rullán, M., & Centeno, C. (2017). “Dignity therapy”, a promising intervention in palliative care: A comprehensive systematic literature review. Palliative medicine, 31(6), 492–509. https://doi.org/10.1177/0269216316665562.
Masterson, M. P., Schuler, T. A., & Kissane, D. W. (2013). Family focused grief therapy: a versatile intervention in palliative care and bereavement. Bereavement care : for all those who help the bereaved, 32(3), 117–123. https://doi.org/10.1080/02682621.2013.854544.
Mickley, J., & Soeken, K. (1993). Religiousness and hope in Hispanic- and Anglo-American women with breast cancer. Oncology Nursing Forum, 20(8), 1171–1177.
Miller, A. M., Ashing, K. T., Modeste, N. N., Herring, R. P., & Sealy, D.-A.T. (2015). Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors. Journal of Cancer Survivorship, 9(3), 441–449. https://doi.org/10.1007/s11764-014-0420-0.
Murphy, P. E., Canada, A. L., Fitchett, G., Stein, K., Portier, K., Crammer, C., & Peterman, A. H. (2010). An examination of the 3-factor model and structural invariance across racial/ethnic groups for the FACIT-Sp: a report from the American Cancer Society’s Study of Cancer Survivors-II (SCS-II). Psychooncology, 19, 264–272.
Nelson, C. J., Rosenfeld, B., Breitbart, W., & Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43(3), 213–220. https://doi.org/10.1176/appi.psy.43.3.213.
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.
Polacek, L. C., Reisch, S., Saracino, R. M., Pessin, H., & Breitbart, W. (2019). Implementation of a meaning-centered psychotherapy training (MCPT) program for oncology clinicians: a qualitative analysis of facilitators and barriers. Translational Behavioral Medicine. https://doi.org/10.1093/tbm/ibz138.
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. J Cancer Surviv, 6(1), 82–94. https://doi.org/10.1007/s11764-011-0193-7.
Simonelli, L. E., Fowler, J., Maxwell, G. L., & Andersen, B. L. (2008). Physical sequelae and depressive symptoms in gynecologic cancer survivors: meaning in life as a mediator. Annal of Behavioral Medicine, 35, 275–284. https://doi.org/10.1007/s12160-008-9029-8.
Society, A. C 2018 Cancer Facts & Figures for Hispanics/Latinos 2018–2020 American Cancer Society Atlanta
Visser, A., Garssen, B., & Vingerhoets, A. (2010). Spirituality and well-being in cancer patients: A review. Psycho-Oncology, 19(6), 565–572. https://doi.org/10.1002/pon.1626.
Webster, K., Cella, D., & Yost, K. (2003). The functional assessment of chronic illness therapy (facit) measurement system: properties, applications, and interpretation. Health and Quality of Life Outcomes, 1, 1–7.
Wulsin, L., Somoza, E., & Heck, J. (2002). The feasibility of using the Spanish PHQ-9 to screen for depression in primary care in honduras. Journal of Clinical Psychiatry, 4(5), 191–195.
Wyatt, G., & Friedman, L. L. (1996). Long-term female cancer survivors: quality of life issues and clinical implications. Cancer Nursing, 19(1), 1–7.
Yanez, B., Edmondson, D., Stanton, A. L., Park, C. L., Kwan, L., Ganz, P. A., & Blank, T. O. (2009). Facets of spirituality as predictors of adjustment to cancer: relative contributions of having faith and finding meaning. Journal of consulting and clinical psychology, 77(4), 730–741. https://doi.org/10.1037/a0015820.
Yanez, B., McGinty, H. L., Buitrago, D., Ramirez, A. G., & Penedo, F. J. (2016). Cancer outcomes in Hispanics/Latinos in the United States: An integrative review and conceptual model of determinants of health. Journal of Latina/o psychology, 4(2), 114–129. https://doi.org/10.1037/lat0000055.
Yanez, B., Thompson, E. H., & Stanton, A. L. (2011). Quality of life among Latina breast cancer patients: a systematic review of the literature. Journal of Cancer Survivorship, 5(2), 191–207. https://doi.org/10.1007/s11764-011-0171-0.
Acknowledgements
We would like to express our sincere appreciation to the Latina Breast Cancer Survivor community who dedicated their time and effort to participate in this research initiative. We would like to thank the National Cancer Institute # U54-13778804 CCNY/MSKCC Partnership, training Grant: T32CA009461, R21 CA180831-02 Grant (Cultural Adaptation of Meaning-Centered Psychotherapy for Latinos), and the Memorial Sloan Kettering Cancer Center Grant (P30 CA008748) for their financial support. The contents of this article are solely the responsibility of the authors and do not necessarily represent the views of the awarding agencies.
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The National Cancer Institute U54-13778804 CCNY/MSKCC Partnership training Grant T32CA009461, R21 CA180831-02 (Cultural Adaptation of Meaning-Centered Psychotherapy for Latinos) Grant, and the Memorial Sloan Kettering Cancer Center Grant (P30 CA008748) funded this research. The contents of this article are solely the author’s responsibility and are not representative of the views of the awarding agencies.
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Garduño-Ortega, O., Morales-Cruz, J., Hunter-Hernández, M. et al. Spiritual Well-Being, Depression, and Quality of Life Among Latina Breast Cancer Survivors. J Relig Health 60, 1895–1907 (2021). https://doi.org/10.1007/s10943-020-01147-9
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DOI: https://doi.org/10.1007/s10943-020-01147-9