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Spirituality in the context of life-threatening illness and life-transforming change

Published online by Cambridge University Press:  28 April 2014

William C. Young
Affiliation:
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
Sheeba R. Nadarajah
Affiliation:
Department of Nursing, Bowie State University, Bowie, Maryland
Perry R. Skeath
Affiliation:
Arizona Center for Integrative Medicine, University of Arizona, Tucson, Arizona
Ann M. Berger*
Affiliation:
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
*
Address correspondence and reprint requests to: Ann M. Berger, Pain and Palliative Care Service, National Institutes of Health Clinical Center, 10 Center Drive, Building 10, Room 2-1733, Bethesda, Maryland 20892. E-mail: aberger@cc.nih.gov

Abstract

Objective:

Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care.

Method:

A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality.

Results:

Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses.

Significance of results:

Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Albaugh, J.A. (2003). Spirituality and life-threatening illness: A phenomenological study. Oncology Nursing Forum, 30, 593598.Google Scholar
Baldacchino, D.R., Borg, J., Muscat, C., et al. (2012). Psychology and theology meet: Illness appraisal and spiritual coping. Western Journal of Nursing Research, 34, 818847.Google Scholar
Berge, J.M. & Holm, K.E. (2007). Boundary ambiguity in parents with chronically ill children: Integrating theory and research. Family Relations, 56, 123134.Google Scholar
Brady, M.J., Peterman, A.H., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psycho-Oncology, 8, 417428.Google Scholar
Brennan, J. (2001). Adjustment to cancer: Coping or personal transition. Psycho-Oncology, 10, 118.Google Scholar
Brewer, E.D.C. (1979). Life stages and spiritual wellbeing. In Spiritual well-being, sociological perspectives. Moberg, D.O. (ed.), pp. 99111. Washington, DC: Rowman & Littlefield.Google Scholar
Coughlin, S.S. (2008). Surviving cancer or other serious illness: A review of individual and community resources. A Cancer Journal for Clinicians, 58, 6064.Google Scholar
Czyzewski, D.I., Mariotto, M.J., Bartholomew, L.K., et al. (1994). Measurement of quality of well being in a child and adolescent cystic fibrosis population. Medical Care, 32, 965972.Google Scholar
Elkins, D.N., Hedstrom, L.J., Hughes, L.L., et al. (1988). Toward a humanistic phenomenological spirituality. Journal of Humanistic Psychology, 28, 518.Google Scholar
Ginzberg, K., Solomon, Z. & Bleich, A. (2002). Repressive coping style, acute stress disorder and posttraumatic stress disorder after myocardial infarction. Psychosomatic Medicine, 64, 748757.Google Scholar
Greisinger, A.J., Lorimor, R.J., Aday, L.A., et al. (1997). Terminally ill cancer clients: Their most important concerns. Cancer Practice, 5, 147154.Google Scholar
Hampton, D.M., Hollis, D.E., Lloyd, D.A., et al. (2007). Spiritual needs of persons with advanced cancer. American Journal of Hospice & Palliative Care, 24, 4248.Google Scholar
Hermann, C.P. (2001). Spiritual needs of dying clients: A qualitative study. Oncology Nursing Forum, 28, 6772.Google Scholar
Hiatt, J.F. (1986). Spirituality, medicine, and healing. Southern Medical Journal, 79, 736743.Google Scholar
Highfield, M.F. & Cason, C. (1983). Spiritual needs of patients: Are they recognized? Cancer Nursing, 6, 187192.Google Scholar
Hill, P.C., Pargament, K.I., Hood, R.W., et al. (2000). Conceptualizing religion and spirituality: Points of commonality, points of departure. Journal for the Theory of Social Behaviour, 30, 5177.Google Scholar
Holland, J.C. & Bultz, B.D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 37.Google Scholar
Holland, J.C., Andersen, B., Breitbart, W.S., et al. (2007). Distress management: Clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 5, 6698.Google Scholar
Hungelmann, J., Kenkel-Rossi, E., Klassen, L., et al. (1985). Spiritual well-being in older adults: Harmonious interconnectedness. Journal of Religion and Health, 24, 147153.Google Scholar
Hutton, J.M. & Perkins, S.J. (2008). A qualitative study of men's experience of myocardial infarction. Psychology, Health & Medicine, 13, 8797.Google Scholar
Jackson, J.M., Rolnick, S.J., Coughlin, S.S., et al. (2007). Social support among women who died of ovarian cancer. Supportive Care in Cancer, 15, 547556.Google Scholar
Jacobsen, P.B., Donovan, K.A., Trask, P.C., et al. (2005). Screening for psychological distress in ambulatory cancer patients: A multicenter evaluation of the distress thermometer. Cancer, 103, 14941502.Google Scholar
Katz, S. (2002). When the child's illness is life threatening: Impact on the parents. Continuing Education Series, 28, 453463.Google Scholar
Ley, D.C.H. & Corless, I.B. (1988). Spirituality and hospice care. Death Studies, 12, 101110.Google Scholar
MacAskill, S. & Petch, A. (1999). Palliative cancer care: Support in the community following diagnosis and treatment. London: Macmillan Cancer Relief.Google Scholar
Michael, Y.L., Berkman, L.F., Colditz, G.A., et al. (2002). Social networks and health-related quality of life in breast cancer survivors: A prospective study. Journal of Psychosomatic Research, 52, 285293.Google Scholar
Moberg, D.O. (1979). Development of social indicators of spiritual well-being for quality of life research. In Spiritual well-being: sociological perspectives. Moberg, D.O. (ed.), pp. 113. Washington, DC: University Press of America.Google Scholar
Muldoon, M. & King, N. (1995). Spirituality, health care, and bioethics. Journal of Religion and Health, 34, 329349.Google Scholar
Murray, S.A., Kendall, M., Boyd, K., et al. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their careers. Palliative Medicine, 18, 3945.Google Scholar
Nadarajah, S., Berger, A.M. & Thomas, S.A. (2013). Current status of spirituality in cardiac rehabilitation programs: A review of the literature. Journal of Cardiopulmonary Rehabilitation and Prevention, 33, 135143.Google Scholar
Prince-Paul, M. (2008). Relationships among communicative acts, social well-being and spiritual well-being on the quality of life at the end of life in clients with cancer enrolled in hospice. Journal of Palliative Medicine, 11, 2025.Google Scholar
Puchalski, C., Ferrell, B., Virani, R., 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, 885904.Google Scholar
Reed, P.G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing & Health, 10, 335344.Google Scholar
Skeath, P., Norris, S., Katheria, V., et al. (2013). The nature of life-transforming changes among cancer survivors. Qualitative Health Research, 23, 11551167.Google Scholar
Vaughan, F., Wittine, B. & Walsh, R. (1998). Transpersonal psychology and the religious person. In Religion and the clinical practice of psychology. Shafranske, E.P. (ed.), pp. 483509. Washington, DC: American Psychological Association.Google Scholar
Wachholtz, A.B. & Pearce, M.J. (2007). Exploring the relationship between spirituality, coping and pain. Journal of Behavioural Medicine, 30, 311318.Google Scholar
Walton, J. & Sullivan, N. (2004). Men of prayer: Spirituality of men with prostate cancer. Journal of Holistic Nursing, 22, 133151.Google Scholar
Wertz, F.J. (2005). Phenomenological research methods for counseling psychology. Journal of Counseling Psychology, 52, 167177.Google Scholar
Woll, M.L., Hinshaw, D.B. & Pawlik, T.M. (2008). Spirituality and religion in the care of surgical oncology: Patients with life-threatening or advanced illnesses. Annals of Surgical Oncology, 15, 30483057.Google Scholar