Religiosity, spirituality, and quality of life in cancer patients: a literature review

Abstract

This study intends to investigate how cancer affects one’s quality of life in the context of religion and spirituality using bibliometric analysis. Keyword-specific publishing trends are analyzed based on a search on the Scopus database. In total, 406 documents were considered in the final analysis. The review of the available literature focused on six primary themes: religion, spirituality, coping, depression, quality of life, optimism. Following that, a thorough examination of these cancer-related topics was conducted. As a result, spirituality, religion, and optimism paved the way for cancer therapy.

Keywords
Quality of life; Happiness; Health

Resumen

Este estudio tiene como objetivo identificar cómo el cáncer afecta la calidad de vida de una persona en el contexto de la religión y la espiritualidad a partir de un análisis bibliométrico. Las tendencias de publicación específicas desde las palabras clave se analizan en función de una búsqueda en la base de datos Scopus. Para el análisis final se consideraron 406 documentos. La revisión de la literatura disponible se centró en seis temas principales: religión, espiritualidad, afrontamiento, depresión, calidad de vida y optimismo. Después, se realizó un análisis en profundidad de estos temas relacionados con el cáncer. Los resultados demuestran que la espiritualidad, la religión y el optimismo allanaron el camino para el tratamiento del cáncer.

Palabras clave
Calidad de vida; Felicidad; Salud

Resumo

Este estudo objetiva investigar como o câncer afecta a qualidade de vida de uma pessoa no contexto da religião e da espiritualidade, utilizando uma análise bibliométrica. As tendências de publicação específicas por palavra-chave são analisadas com base numa pesquisa na base de dados Scopus. No total, 406 documentos foram considerados na análise final. A revisão da literatura disponível centrou-se em seis temas principais: religião, espiritualidade, enfrentamento, depressão, qualidade de vida e otimismo. Em seguida, procedeu-se a uma análise aprofundada destes temas relacionados com o cancro. Como resultado, a espiritualidade, a religião e o otimismo abriram o caminho para a terapia do cancro.

Palavras-chave
Qualidade de vida; Felicidade; Saúde

Patients with cancer often experience discomfort, especially in more severe stages of the disease. Pain is frequently so intense that it interferes with a patient’s functional abilities ¹,². Coping resources for patients with cancer have been studied, emphasizing individualized methods, including positivity, combating negative attitudes, or personality attributes such as consistency and attachment feelings ³-⁵. In numerous cultural contexts, religion has been investigated as a possible adaptive resource for cancer patients and survivors ⁶-⁸.

The prevalence of cancer and death rate is quickly increasing as a result of causes including aging populations and global population expansion. With around 18 million new cases each year worldwide, cancer is one of the most common diseases ⁹. Receiving a cancer diagnosis can cause a lot of pain and suffering, in addition to the disease development and the dying phase ¹⁰. By 2030, the number of cancer-related deaths is expected to reach 13 million per year ¹¹. Such people may suffer distress in all aspects, including psychological or mental (depression or anxiety), physical (pain), social (loneliness or sense of isolation), and spiritual (purpose, meaning, and connections) ¹²,¹³.

While religion is founded on a common set of rituals and beliefs inside a social organization or institution ¹⁴, spirituality is more personalized and connected with transcendence and in the connection with a higher being, and connections that bring meaning and purpose ¹⁵. Patients with cancer should receive the treatment depending on the biopsychosocial spiritual paradigm ¹⁶. According to research, people living with a life-threatening disease who embrace a spiritual perspective find purpose, strength, and comfort ¹⁷.

Cancer diagnoses are terrifying for both patients and their families, who frequently provide care for them. People in some cultures and ethnic groups might not fully comprehend the origins or progression of cancer, making them uncertain as to whether the disease or treatment poses a risk to others as well, especially those close to them. Although patients receive comprehensive information on their malignancies nowadays, this may not always happen ¹⁸.

The role of religion in connection to one’s health, illness, and medical practice is gaining more attention. Cancer frequently causes the faith of patients who are already devout believers to grow even stronger, while also causing patients who are not as devout to occasionally seek out spirituality and build a bond and connection to higher powers. By examining the role of religion, researchers demonstrated that spiritual options can be beneficial in coping with the illness in the first year after a breast cancer diagnosis and can also regulate anxiety and sadness ¹⁹.

Given this context, this systematic review used bibliometric analysis to evaluate and identify the impact of religiosity and spirituality on the quality of life among patients with cancer.

Method

This systematic review followed the standard Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), namely: 1) identification; 2) screening; 3) eligibility using the inclusion criteria; and 4) assessment of the quality of the studies and detection of any possible bias.

The Scopus database was used for the search of articles published between 1996 and January 2023. The inclusion criteria included articles in English language only, articles that included patients with cancer in the general population, and that considered the role of spirituality or religiosity in the quality of life of the study population.

The search resulted in 486 documents, of which 80 were excluded due to not meeting the criteria, for 406 documents (358 articles; 40 reviews; four book chapters; and three conference papers) being included in the final study. Figure 1 provides the flowchart for the selection of studies.

Figure 1
Flowchart describing the systematic review (adapted from the PRISMA statement)

Bias that may have occurred in the study since it might include the non-reporting of the studies that may not depict the positive pathway of spirituality in reducing the negative symptoms that may be caused by cancer (selective non-reporting bias).

Bibliometric analysis was used to evaluate the connections and effects of publications within the particular topic chosen using mathematical and statistical techniques.

The findings led to a detailed analysis of the search outcomes, in which a maximum number of article papers was found, followed by review papers and other different types of documents such as editorials, conference papers, short surveys, notes, etc.

Figure 2 shows the clusters and association of co-occurrence between keywords identified in the search. The visual representation shows 6 clusters corresponding to 6 contrasting colors, with important keywords being “religion,” “spirituality,” and “quality of life,” together with a link of curved lines that reveals an enumerator’s interest in the indicated themes regarding the already stated keywords. The author keywords tally is represented by the size of the node.

Figure 2
Co-occurrence of keywords

Discussion

Spirituality and religiosity are highly studied in relation to cancer, as many patients find a path to meaning and purpose in their lives with the help of such aspects. This bibliometric analysis may help researchers to understand the various other variables studied in relation to cancer, keeping in mind the major impact of religion and spirituality. The articles and reviews were thoroughly read, resulting in the six themes discussed below.

Theme 1: religiosity

Religion is a structured system of values, rituals, practices, and symbols intended to promote a feeling of closeness to something holy or transcendent, such as God, a higher power, or the truest reality/truth ²⁰. Like religion, religiosity may be viewed as a relationship with the entire community, as well as a person’s solitary conduct. Fundamentally, the choice will be based on a person’s spiritual requirements, including the desire to belong to a group, the desire to advance society, and the need for social and emotional support ²¹. Religiosity can be a supplemental technique used by those who feel unwell and experience severe suffering and pain ²², assisting individuals and families when dealing with serious or protracted diseases ²³.

Given that cancer frequently raises feelings connected to pain, terminality, and especially since we have little control or no control over such conditions ²⁴, even people who do not have or reject religious and spiritual views or principles desire to talk about this dimension during their treatment. By offering emotional support, optimism, and a sense of meaning and purpose, positive religious coping, by far the most prevalent construct ²⁵, may affect one’s long-term adaptation to sickness ²⁶.

Theme 2: spirituality

Spirituality is the search for one’s unique knowledge of the answers to basic issues about life, including its purpose and connection to the holy or transcendental ²⁰. Studies ²⁷-²⁹ demonstrate the usage of spiritual practices to grow, feel comfort, and get nearer to God in difficult times, which helps to promote a sense of calmness and tranquility when one experiences pain ³⁰,³¹, a way to ask God for help to have strength and comfort in the situations that are being experienced ³²; religiosity is a technique that enhances one’s psychological well-being ²⁷, and that is used to try to deal with the grief that manifests during illness ³³.

Hill and Pargament ³⁴ argue that spirituality is the individualized and sentimental component of religion, which might include “an inner strength or an inside characteristic of a person,” which is also used to deal with significant stressors like breast cancer ³⁵,³⁶. Spirituality aids patients in adopting an optimistic outlook while dealing with a diagnosis ³⁷. Incorporating spiritual care into clinical practice may have positive emotional effects on patients, as well as positive interpersonal effects on patient satisfaction and the patient-health provider relationship ³⁸,³⁹.

Enhancing coping, adjusting psychosocially to a cancer diagnosis, and positively changing behavior following a cancer diagnosis are some examples of positive psychosocial benefits and consequences of spirituality ³⁷,⁴⁰.

Theme 3: coping

Coping is another crucial element for the quality of life of people facing cancer. It is understood as the attitudes, beliefs, and actions that patients employ to deal with the demanding situations, conflicts, and issues encountered throughout cancer treatment progression. Coping techniques can be categorized into many categories such as problem-focused coping (which deals with problem-solving techniques, including planning, active coping, looking for supportive assistance, or suppressing emotions), and emotion-focused coping (which deals with adjustments in one’s emotional responses to circumstances and a variety of avoidant and defensive tactics, including turning to social or emotional support, religious guidance, or denial) ⁴¹.

Coping techniques play a key role in deciding how adaptive mechanisms are put into action after receiving a cancer diagnosis ⁴². Active coping is evident in non-cancer patients ⁴³, and problem-focused coping mechanisms are more commonly seen in cancer patients ⁴⁴.

According to research on specific coping techniques used by patients with cancer and their relationship to mental health outcomes, more active coping techniques (such as active problem-focused coping, positive reframing, and seeking support) are more beneficial to outcomes than the more passive techniques (such as denial and avoidance) ⁴⁵,⁴⁶.

Theme 4: quality of life

Quality of life is multifaceted and includes aspects of social, physical, and psychological function, as well as areas of health and well-being that contribute to a fulfilling and worthwhile life ⁴⁷,⁴⁸. Negative affect, positive affect, and life satisfaction are the three distinct elements of an individual’s subjective well-being ⁴⁹. Life satisfaction relates to the cognitive-judgmental parts of quality of life, whereas positive and negative affect refer to its emotional aspects. Throughout their cancer journey, many women deal with some degree of psychosocial anguish, which may have a long-lasting effects on their ability to make wise treatment decisions and adhere to it, as well as on their psychosocial adjustment to cancer and their quality of life ³⁵.

The presence of sorrow, despair, and anxiety is a significant risk factor for poor overall and domain-specific quality of life among patients with breast cancer ⁵⁰-⁵². Patients who depend on God but are always involved in active coping cite improved health outcomes as a benefit more often, including quality of life ⁵³,⁵⁴. Lower quality of life levels haven been related to decreased levels of spiritual well-being ⁵⁵.

Theme 5: depression

The cancer continuum is a time of potentially upsetting occurrences, where patients experience difficulties with adjusting to new lives during treatment ⁵⁶. An especially disproportionate burden of spiritual obligations affect patients with cancer due to constant worry, despair, dread, and uncertainty feelings ⁵⁷. Between 20% and 30% of cancer patients may, at any given moment, suffer clinically severe depression symptoms ⁵⁸.

Worse clinical outcomes, such as greater depression rates, worse quality of life, and a heightened risk of mortality, have been linked to negative religious coping (e.g., battling with disbelief in spiritual/religious principles) ⁵⁹. Female breast cancer patients have a significant prevalence of mental health issues, with anxiety and depression prevalence rates reaching 40% ⁶⁰,⁶¹. A patient’s quality of life, perception of pain, adherence to therapy, self-care ability, duration of hospital stay, and even the course of the illness itself, are all negatively impacted by depression ⁶².

Theme 6: optimism

Along with spirituality, other advantageous traits that have been linked to improved health outcomes in recent years include optimism and social support ⁶³. As a personal resource, optimism helps individuals stay upbeat and see the good in difficult situations. It also provides a more adaptable coping mechanism for situations in which it is impossible to manage unpleasant stimuli and shields people from the potential side effects of cancer therapy ⁶⁴. More spiritually advanced patients with cancer are likely to seem more optimistic ¹⁹,⁶⁵.

Study limitations

The literature search was constrained to a single database, namely Scopus. Alternative databases such as WOS and PubMed were not considered for the extraction of data.

Final considerations

This research aims to explore the impact of cancer on an individual’s quality of life within the realms of religion and spirituality, employing bibliometric analysis. The examination of existing literature delved into six key themes: religion, spirituality, coping, depression, quality of life, and optimism. The findings of this investigation revealed that individuals facing cancer encounter diverse mental health challenges, including anxiety and depression, coupled with certain physiological issues. Notably, spirituality, religiosity, and optimism emerged as crucial factors in addressing these challenges, contributing to treatment effectiveness and enhancing overall quality of life for cancer patients.

References

• ¹
  Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA et al. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med [Internet]. 1994 [acesso 13 out 2023];330(9):592-6. DOI: 10.1056/nejm199403033300902
  » https://doi.org/10.1056/nejm199403033300902
• ²
  Von Roenn JH, Cleeland CS, Gonin R, Hatfield AK, Pandya KJ. Physician attitudes and practice in cancer pain management: a survey from the Eastern Cooperative Oncology Group. Ann Intern Med [Internet]. 1993 [acesso 13 out 2023];119(2):121-6. DOI: 10.7326/0003-4819-119-2-199307150-00005
  » https://doi.org/10.7326/0003-4819-119-2-199307150-00005
• ³
  Antonovsky A. Health, stress and coping: new perspectives on mental and physical well-being. San Francisco: Jossey-Bass; 1979.
• ⁴
  Sarenmalm EK, Browall M, Persson LO, Fall-Dickson J, Gaston-Johansson F. Relationship of sense of coherence to stressful events, coping strategies, health status, and quality of life in women with breast cancer. Psychooncology [Internet]. 2013 [acesso 13 out 2023];22(1):20-7. DOI: 10.1002/pon.2053
  » https://doi.org/10.1002/pon.2053
• ⁵
  Silva SM, Crespo C, Canavarro MC. Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth. Psychol Health [Internet]. 2012 [acesso 13 out 2023];27(11):1323-41. DOI: 10.1080/08870446.2012.676644
  » https://doi.org/10.1080/08870446.2012.676644
• ⁶
  Gesselman AN, Bigatti SM, Garcia JR, Coe K, Cella D, Champion VL. Spirituality, emotional distress, and post-traumatic growth in breast cancer survivors and their partners: an actor-partner interdependence modeling approach. Psychooncology [Internet]. 2017 [acesso 13 out 2023];26(10):1691-9. DOI: 10.1002/pon.4192
  » https://doi.org/10.1002/pon.4192
• ⁷
  Thuné-Boyle IC, Stygall JA, Keshtgar MR, Newman SP. Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Soc Sci Med [Internet]. 2006 [acesso 13 out 2023];63(1):151-64. DOI: 10.1016/j.socscimed.2005.11.055
  » https://doi.org/10.1016/j.socscimed.2005.11.055
• ⁸
  Thuné-Boyle ICV, Stygall J, Keshtgar MRS, Davidson TI, Newman SP. Religious coping strategies in patients diagnosed with breast cancer in the UK. Psychooncology [Internet]. 2011 [acesso 13 out 2023];20(7):771-82. DOI: 10.1002/pon.1784
  » https://doi.org/10.1002/pon.1784
• ⁹
  Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Câncer J Clin [Internet]. 2018 [acesso 13 out 2023];68(6):394-424. DOI: 10.3322/caac.21492
  » https://doi.org/10.3322/caac.21492
• ¹⁰
  Martins H, Caldeira S. Spiritual distress in cancer patients: a synthesis of qualitative studies. Religions [Internet]. 2018 [acesso 13 out 2023];9(10):285. DOI: 10.3390/rel9100285
  » https://doi.org/10.3390/rel9100285
• ¹¹
  Fidler MM, Bray F, Soerjomataram I. The global cancer burden and human development: a review. Scand J Public Health [Internet]. 2018 [acesso 13 out 2023];46(1):27-36. DOI: 10.1177/1403494817715400
  » https://doi.org/10.1177/1403494817715400
• ¹²
  Puchalski CM. Spirituality and end-of-life care: a time for listening and caring. J Palliat Med [Internet]. 2002 [acesso 13 out 2023];5(2):289-94. DOI: 10.1089/109662102753641287
  » https://doi.org/10.1089/109662102753641287
• ¹³
  Organization, W. H. (2021). Cancer: https://www.who.int/news-room/fact-sheets/detail/cancer Son Erisim Tarihi, 24.
  » https://www.who.int/news-room/fact-sheets/detail/cancer
• ¹⁴
  Dyson J, Cobb M, Forman D. The meaning of spirituality: a literature review. J Adv Nurs [Internet]. 1997 [acesso 13 out 2023];26(6):1183-8. DOI: 10.1046/j.1365-2648.1997.00446.x
  » https://doi.org/10.1046/j.1365-2648.1997.00446.x
• ¹⁵
  Siddall PJ, Lovell M, MacLeod R. Spirituality: what is its role in pain medicine? Pain Med [Internet]. 2015 [acesso 13 out 2023];16(1):51-60. DOI: 10.1111/pme.12511
  » https://doi.org/10.1111/pme.12511
• ¹⁶
  Puchalski CM. Spirituality in the cancer trajectory. Ann Oncol [Internet]. 2012 [acesso 13 out 2023];23(supl 3):49-55. DOI: 10.1093/annonc/mds088
  » https://doi.org/10.1093/annonc/mds088
• ¹⁷
  Albaugh JA. Spirituality and life-threatening illness: a phenomenologic study. Oncol Nurs Forum [Internet]. 2003 [acesso 13 out 2023];30(4):593-8. DOI: 10.1188/03.onf.593-598
  » https://doi.org/10.1188/03.onf.593-598
• ¹⁸
  Krouwel EM, Nicolai MPJ, van Steijn-van Tol AQMJ, Putter H, Osanto S, Pelger RCM et al. Addressing changed sexual functioning in cancer patients: a cross-sectional survey among dutch oncology nurses. Eur J Oncol Nurs [Internet]. 2015 [acesso 13 out 2023];19(6):707-15. DOI: 10.1016/j.ejon.2015.05.005
  » https://doi.org/10.1016/j.ejon.2015.05.005
• ¹⁹
  Thuné-Boyle ICV. Religiousness and spirituality in coping with cancer. In: Carr BI, Steel J, editores. Psychological aspects of cancer [Internet]. Boston: Springer US; 2013 [acesso 13 out 2023]. p. 129-55. DOI: 10.1007/978-1-4614-4866-2_9
  » https://doi.org/10.1007/978-1-4614-4866-2_9
• ²⁰
  Koenig HG, King DE, Carson VB. Coping with stress. Handbook of religion and health. 2ª ed. New York: Oxford University Press; 2012. p. 74-93.
• ²¹
  Shatenstein B, Ghadirian P. Influences on diet, health behaviours and their outcome in select ethnocultural and religious groups. Nutrition [Internet]. 1998 [acesso 13 out 2023];14(2):223-30. DOI: 10.1016/s0899-9007(97)00425-5
  » https://doi.org/10.1016/s0899-9007(97)00425-5
• ²²
  Mustafa G, Bashir N, Aslam M. Parental beliefs and practice of spiritual methods for their sick children at a tertiary care hospital of Pakistan- a cross sectional questionnaire study. BMC Complement Altern Med [Internet]. 2016 [acesso 13 out 2023];16(1):14. DOI: 10.1186/s12906-016-0986-3
  » https://doi.org/10.1186/s12906-016-0986-3
• ²³
  Karekla M, Constantinou M. Religious coping and cancer: proposing an acceptance and commitment therapy approach. Cogn Behav Pract [Internet]. 2010 [acesso 13 out 2023];17(4):371-81. DOI: 10.1016/j.cbpra.2009.08.003
  » https://doi.org/10.1016/j.cbpra.2009.08.003
• ²⁴
  Pearce MJ, Coan AD, Herndon JE 2nd, Koenig HG, Abernethy AP. Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer [Internet]. 2012 [acesso 13 out 2023];20(10):2269-76. DOI: 10.1007/s00520-011-1335-1
  » https://doi.org/10.1007/s00520-011-1335-1
• ²⁵
  Tix AP, Frazier PA. The use of religious coping during stressful life events: main effects, moderation, and mediation. J0 Consult Clin Psychol [Internet]. 1998 [acesso 13 out 2023];66(2):411-22. DOI: 10.1037//0022-006x.66.2.411
  » https://doi.org/10.1037//0022-006x.66.2.411
• ²⁶
  Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA. The relationships among coping strategies, religious coping, and spirituality in african-american women with breast cancer receiving chemotherapy. Oncol Nurs Forum [Internet]. 2013 [acesso 13 out 2023];40(2):120-31. DOI: 10.1188/13.onf.120-131
  » https://doi.org/10.1188/13.onf.120-131
• ²⁷
  Kamper R, Van Cleve L, Savedra M. Children with advanced cancer: responses to a spiritual quality of life interview. J Spec Pediatr Nurs [Internet]. 2010 [acesso 13 out 2023];15(4):301-6. DOI: 10.1111/j.1744-6155.2010.00253.x
  » https://doi.org/10.1111/j.1744-6155.2010.00253.x
• ²⁸
  Souza V de M, Frizzo HCF, Paiva MHP de, Bousso RS, Santos Á da S. Spirituality, religion and personal beliefs of adolescents with cancer. Rev Bras Enferm [Internet] 2015 [acesso 13 out 2023];68(5):791-6. DOI: 10.1590/0034-7167.2015680504i
  » https://doi.org/10.1590/0034-7167.2015680504i
• ²⁹
  Wilson K, Mazhar W, Rojas-Cooley T, De Rosa V, Van Cleve L. A glimpse into the lives of 3 children: their cancer journey. J Pediatr Oncol Nurs [Internet] 2011 [acesso 13 out 2023];28(2):100-6. DOI: 10.1177/1043454210377899
  » https://doi.org/10.1177/1043454210377899
• ³⁰
  Siqueira HBOM, Santos MA, Gomez RRF, Saltareli S, Sousa FAEF. Expressão da dor na criança com câncer: uma compreensão fenomenológica. Estud Psicol (Campinas) [Internet]. 2015 [acesso 13 out 2023];32(4):663-74. DOI: 10.1590/0103-166X2015000400009
  » https://doi.org/10.1590/0103-166X2015000400009
• ³¹
  Sposito AMP, Silva-Rodrigues FM, Sparapani VC, Pfeifer LI, Lima RAG, Nascimento LC. Coping strategies used by hospitalized children with cancer undergoing chemotherapy. J Nurs Scholarsh [Internet]. 2015 [acesso 13 out 2023];47(2):143-51. DOI: 10.1111/jnu.12126
  » https://doi.org/10.1111/jnu.12126
• ³²
  Moore K, Talwar V, Gomez-Garibello C, Bosacki S, Moxley-Haegert L. Children's spirituality: exploring spirituality in the lives of cancer survivors and a healthy comparison group. J Health Psychol [Internet] 2020 [acesso 13 out 2023];25(7):888-99. DOI: 10.1177/1359105317737605
  » https://doi.org/10.1177/1359105317737605
• ³³
  Ahmadi F, Khodayarifard M, Zandi S, Khorrami-Markani A, Ghobari-Bonab B, Sabzevari M et al. Religion, culture and illness: a sociological study on religious coping in Iran. Ment Health Relig Cult [Internet]. 2018 [acesso 13 out 2023];21(7):721-36. DOI: 10.1080/13674676.2018.1555699
  » https://doi.org/10.1080/13674676.2018.1555699
• ³⁴
  Hill PC, Pargament KI. Advances in the conceptualization and measurement of religion and spirituality: implications for physical and mental health research. Am Psychol [Internet]. 2003 [acesso 13 out 2023];58(1):64-74. DOI: 10.1037/0003-066x.58.1.64
  » https://doi.org/10.1037/0003-066x.58.1.64
• ³⁵
  Hewitt M, Herdman R, Holland J, editores. Meeting psychosocial needs of women with breast cancer [Internet]. Washington: National Academies Press; 2004 [acesso 8 dez 2023]. 3, Psychosocial needs of women with breast cancer. DOI: 10.17226/10909
• ³⁶
  Koenig H, McCullough ME, Larson DB. Handbook of religion and health [Internet]. Oxford: Oxford University Press; 2001 [acesso 8 dez 2023]. DOI: 10.1093/acprof:oso/9780195118667.001.0001
  » https://doi.org/10.1093/acprof:oso/9780195118667.001.0001
• ³⁷
  Cotton SP, Levine EG, Fitzpatrick CM, Dold KH, Targ E. Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psychooncology [Internet]. 1999 [acesso 13 out 2023];8(5):429-38. Disponível: https://bit.ly/47K892r
  » https://bit.ly/47K892r
• ³⁸
  Astrow AB, Puchalski CM, Sulmasy DP. Religion, spirituality, and health care: Social, ethical, and practical considerations. Am J Med [Internet]. 2001 [acesso 13 out 2023];110(4):283-7. DOI: 10.1016/s0002-9343(00)00708-7
  » https://doi.org/10.1016/s0002-9343(00)00708-7
• ³⁹
  Phelps AC, Lauderdale KE, Alcorn S, Dillinger J, Balboni MT, Van Wert M et al. Addressing spirituality within the care of patients at the end of life: perspectives of patients with advanced cancer, oncologists, and oncology nurses. J Clin Oncol [Internet] 2012 [acesso 13 out 2023];30(20):2538-44. DOI: 10.1200/jco.2011.40.3766
  » https://doi.org/10.1200/jco.2011.40.3766
• ⁴⁰
  Hawkins NA, Smith T, Zhao L, Rodriguez J, Berkowitz Z, Stein KD. Health-related behavior change after cancer: results of the American Cancer Society's studies of cancer survivors (SCS). J Cancer Surviv [Internet]. 2010 [acesso 13 out 2023];4(1):20-32. DOI: 10.1007/s11764-009-0104-3
  » https://doi.org/10.1007/s11764-009-0104-3
• ⁴¹
  Mehrabi E, Hajian S, Simbar M, Hoshyari M, Zayeri F. Coping response following a diagnosis of breast cancer: a systematic review. Electron Physician [Internet]. 2015 [acesso 13 out 2023];7(8):1575-83 DOI: 10.19082/1575
  » https://doi.org/10.19082/1575
• ⁴²
  Hopman P, Rijken M. Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psychooncology [Internet]. 2015 [acesso 13 out 2023];24(1):11-8. DOI: 10.1002/pon.3591
  » https://doi.org/10.1002/pon.3591
• ⁴³
  Joaquín-Mingorance M, Arbinaga F, Carmona-Márquez J, Bayo-Calero J. Coping strategies and self-esteem in women with breast cancer. Anal Psicol [Internet]. 2019 [acesso 13 out 2023];35(2):188-94. DOI: 10.6018/analesps.35.2.336941
  » https://doi.org/10.6018/analesps.35.2.336941
• ⁴⁴
  Cao W, Qi X, Cai DA, Han X. Modeling posttraumatic growth among cancer patients: the roles of social support, appraisals, and adaptive coping. Psychooncology [Internet]. 2018 [acesso 13 out 2023];27(1):208-15. DOI: 10.1002/pon.4395
  » https://doi.org/10.1002/pon.4395
• ⁴⁵
  Aarts JWF, Deckx L, van Abbema DL, Tjan-Heijnen VCG, van den Akker M, Buntinx F. The relation between depression, coping and health locus of control: differences between older and younger patients, with and without cancer. Psychooncology [Internet]. 2015 [acesso 13 out 2023];24(8):950-7. DOI: 10.1002/pon.3748
  » https://doi.org/10.1002/pon.3748
• ⁴⁶
  Spiegel D. Mind matters: coping and cancer progression. J Psychosom Res [Internet]. 2001 [acesso 13 out 2023];50(5):287-90. DOI: 10.1016/S0022-3999(00)00200-2
  » https://doi.org/10.1016/S0022-3999(00)00200-2
• ⁴⁷
  Noll HH, Michalos AC. International Sociological Association Working Group/Research Committee on Social Indicators. In: Michalos AC. Encyclopedia of quality of life and well-being research [Internet]. Dordrecht: Springer; 2014. p. 3331-6. DOI: 10.1007/978-94-007-0753-5_1509
  » https://doi.org/10.1007/978-94-007-0753-5_1509
• ⁴⁸
  Panzini RG, Mosqueiro BP, Zimpel RR, Bandeira DR, Rocha NS, Fleck MP. Quality-of-life and spirituality. Int Rev Psychiatry [Internet]. 2017 [acesso 13 out 2023];29(3):263-82. DOI: 10.1080/09540261.2017.1285553
  » https://doi.org/10.1080/09540261.2017.1285553
• ⁴⁹
  Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Personal Assess [Internet]. 1985 [acesso 13 out 2023];49(1):71-5. DOI: 10.1207/s15327752jpa4901_13
  » https://doi.org/10.1207/s15327752jpa4901_13
• ⁵⁰
  Gold M, Dunn LB, Phoenix B, Paul SM, Hamolsky D, Levine JD et al. Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life. Eur J Oncol Nurs [Internet]. 2016 [acesso 13 out 2023];20: 97-105. DOI: 10.1016/j.ejon.2015.06.003
  » https://doi.org/10.1016/j.ejon.2015.06.003
• ⁵¹
  Reyes-Gibby CC, Anderson KO, Morrow PK, Shete S, Hassan S. Depressive symptoms and health-related quality of life in breast cancer survivors. J Women's Health [Internet]. 2012 [acesso 13 out 2023];21(3):311-8. DOI: 10.1089/jwh.2011.2852
  » https://doi.org/10.1089/jwh.2011.2852
• ⁵²
  So WKW, Marsh G, Ling WM, Leung FY, Lo JCK, Yeung M et al. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs [Internet]. 2010 [acesso 13 out 2023];14(1):17-22. DOI: 10.1016/j.ejon.2009.07.005
  » https://doi.org/10.1016/j.ejon.2009.07.005
• ⁵³
  McLaughlin B, Yoo W, D'Angelo J, Tsang S, Shaw B, Shah D et al. It is out of my hands: how deferring control to God can decrease quality of life for breast cancer patients. Psychooncology [Internet]. 2013 [acesso 13 out 2023];22(12):2747-54. DOI: 10.1002/pon.3356
  » https://doi.org/10.1002/pon.3356
• ⁵⁴
  Zamanian H, Eftekhar-Ardebili H, Eftekhar-Ardebili M, Shojaeizadeh D, Nedjat S, Taheri-Kharameh Z, Daryaafzoon M. Religious coping and quality of life in women with breast cancer. Asian Pac J Cancer Prev [Internet]. 2015 [acesso 13 out 2023];16(17):7721-5. DOI: 10.7314/apjcp.2015.16.17.7721
  » https://doi.org/10.7314/apjcp.2015.16.17.7721
• ⁵⁵
  Canada AL, Murphy PE, Fitchett G, Stein K. Re-examining the contributions of faith, meaning, and peace to quality of life: a Report from the American Cancer Society's Studies of Cancer Survivors-II (SCS-II). Ann Behav Med [Internet]. 2016 [acesso 13 out 2023];50(1):79-86. DOI: 10.1007/s12160-015-9735-y
  » https://doi.org/10.1007/s12160-015-9735-y
• ⁵⁶
  Molina Y, Yi JC, Martinez-Gutierrez J, Reding KW, Yi-Frazier JP, Rosenberg AR. Resilience among patients across the cancer continuum: diverse perspectives. Clin J Oncol Nurs [Internet]. 2014 [acesso 13 out 2023];18(1):93-101. DOI: 10.1188/14.cjon.93-101
  » https://doi.org/10.1188/14.cjon.93-101
• ⁵⁷
  Robb C, Haley WE, Balducci L, Extermann M, Perkins EA, Small BJ, Mortimer Jl. Impact of breast cancer survivorship on quality of life in older women. Crit Rev Oncol Hematol [Internet]. 2007 [acesso 13 out 2023];62(1):84-91. DOI: 10.1016/j.critrevonc.2006.11.003
  » https://doi.org/10.1016/j.critrevonc.2006.11.003
• ⁵⁸
  Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology [Internet]. 2001 [acesso 13 out 2023];10(1):19-28. Disponível: https://bit.ly/3Tgpvzd
  » https://bit.ly/3Tgpvzd
• ⁵⁹
  Pargament KI, Koenig HG, Tarakeshwar N, Hahn J. Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study. J Health Psychol [Internet] 2004 [acesso 13 out 2023];9(6):713-30. DOI: 10.1177/1359105304045366
  » https://doi.org/10.1177/1359105304045366
• ⁶⁰
  Fatiregun OA, Olagunju AT, Erinfolami AR, Fatiregun OA, Arogunmati OA, Adeyemi JD. Anxiety disorders in breast cancer: Prevalence, types, and determinants. J Psychosoc Oncol [Internet]. 2016 [acesso 13 out 2023];34(5):432-47. DOI: 10.1080/07347332.2016.1196805
  » https://doi.org/10.1080/07347332.2016.1196805
• ⁶¹
  Reece JC, Chan YF, Herbert J, Gralow J, Fann JR. Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer. Gen Hosp Psychiatry [Internet]. 2013 [acesso 13 out 2023];35(4):376-81. DOI: 10.1016/j.genhosppsych.2013.03.017
  » https://doi.org/10.1016/j.genhosppsych.2013.03.017
• ⁶²
  McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemeroff CB. Depression in patients with cancer: diagnosis, biology, and treatment. Arch Gen Psychiatry [Internet]. 1995 [acesso 13 out 2023];52(2):89-99. DOI: 10.1001/archpsyc.1995.03950140007002
  » https://doi.org/10.1001/archpsyc.1995.03950140007002
• ⁶³
  Salsman JM, Brown TL, Brechting EH, Carlson CR. The link between religion and spirituality and psychological adjustment: the mediating role of optimism and social support. Pers Soc Psychol Bull [Internet]. 2005 [acesso 13 out 2023];31(4):522-35. DOI: 10.1177/0146167204271563
  » https://doi.org/10.1177/0146167204271563
• ⁶⁴
  Matthews EE, Cook PF. Relationships among optimism, well-being, self-transcendence, coping, and social support in women during treatment for breast cancer. Psychooncology [Internet]. 2009 [acesso 13 out 2023];18(7):716-26. DOI: 10.1002/pon.1461
  » https://doi.org/10.1002/pon.1461
• ⁶⁵
  Nam I, Yoon H, Kim Y, Lim YO, Lee H, Choi K. The mediating role of optimism and pessimism on the relationship between spirituality and depression among elderly cancer patients. Korean J Health Promot [Internet]. 2016 [acesso 13 out 2023];16(2):127-33. DOI: 10.15384/kjhp.2016.16.2.127
  » https://doi.org/10.15384/kjhp.2016.16.2.127

Publication Dates

• Publication in this collection
  23 Sept 2024
• Date of issue
  2024

History

• Received
  17 Mar 2023
• Reviewed
  13 Oct 2023
• Accepted
  17 Oct 2023