Religious Coping in Cancer: A Quantitative Analysis of Expressive Writing Samples From Patients With Renal Cell Carcinoma

Abstract

Context.-Past religiosity/spirituality (R/S) research has mainly relied on self-report instruments which may result in self-presentation and defensive biases.Objectives.-To address these limitations, we reviewed the writing samples that were generated as part of an expressive writing trial, coded the samples for R/S content, and examined crosssectional and prospective associations between R/S content and symptom and psychosocial outcomes.Methods.-Participants diagnosed with renal cell carcinoma who were randomized to the expressive writing arm completed a standard writing protocol. Prior to randomization, they completed validated measures of R/S, depressive symptoms, social support, fatigue, and sleep disturbances and 1, 4 and 10 months after completing the intervention. Writing samples were coded for positive and negative religious coping (RC), and personal (e.g., private prayer) and collective (e.g., church attendance) religious engagement (RE).Results.-Of the 138 patients, 117 provided at least one writing sample, and 89% of participants made at least one R/S reference with 70% including at least one positive RC statement and 45.3% revealed personal and 42.3% collective religious engagement. Negative RC was rare (8%). Although positive RC and RE were significantly associated with the R/S Index (P<.01), negative RC was not. In prospective analyses, RE was associated with reduced cancer-related symptoms over time (P=.04) and negative RC was associated with increased psychological distress over time (P=.004).

What Aspects of Religion and Spirituality Affect the Physical Health of Cancer Patients? A Systematic Review

“…However, in other cases, R/S is assessed through variables such as spiritual experiences, religious beliefs and practices, congregational support, or religious coping [ 66 , 67 , 68 , 69 ]. The latter represents an R/S variable present in the previous three articles mentioned.…”

“…Regarding the physical health variables assessed in the research, we found that the variables that appeared most frequently pertain to physical symptoms, such as pain or fatigue, in a total of 16 articles [ 46 , 49 , 50 , 52 , 55 , 56 , 60 , 62 , 63 , 64 , 65 , 67 , 68 , 69 , 70 ]. Symptoms are followed by physical and functional well-being, which appeared as a health variable in a total of ten articles [ 47 , 48 , 50 , 51 , 53 , 55 , 56 , 57 , 58 , 59 ]).…”

“…On the other hand, other behavioral aspects such as positive spiritual experiences and private religious practice were associated with better physical functioning and lower pain and, in addition, the former were also associated with lower cortisol levels [ 67 ]. In addition, a longitudinal study found that negative coping led to more sleep problems, as well as finding that private religious engagement was associated with more cancer-related symptoms [ 69 ].…”

“…Finally, several studies focus on a more behavioral dimension of R/S and its relationship with cancer, as Jim et al [ 39 ] would term it, which likewise present heterogeneous results. Among these aspects we can highlight R/S coping, religious engagement, spiritual experiences, or religious practices [ 67 , 68 , 69 ]. In any case, these behavioral aspects of R/S are to a certain extent contradictory to the synthesis by Jim et al [ 39 ], who did not observe an overall significant relationship between aspects such as coping or religious practice and physical health.…”

“…In any case, these behavioral aspects of R/S are to a certain extent contradictory to the synthesis by Jim et al [ 39 ], who did not observe an overall significant relationship between aspects such as coping or religious practice and physical health. However, for example, one of the longitudinal studies [ 69 ] has shown that certain behavioral aspects (such as negative coping or private religious engagement) have a negative impact on the physical health of oncology patients.…”