Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

Abstract

BackgroundSpiritual well-being plays an important role in helping patients cope with disease. Previous studies have investigated the association between social support and spiritual well-being, whereas few studies have explored the relationship in patients with esophageal cancer (EC), and the mechanisms behind this pathway have not been thoroughly examined.ObjectiveThis study aimed to explore the relationship between social support and spiritual well-being of Chinese patients with EC aged over 50 years and to analyze whether the relationship was mediated by rumination.MethodsA cross-sectional survey was conducted with 197 EC patients. Participants completed the general information questionnaire, the Functional Assessment of Chronic Illness Therapy–Spiritual Scale, the Chinese Event Related Rumination Inventory, and the Perceived Social Support Scale (PSSS).ResultsResults demonstrated that social support of patients with EC aged over 50 years was positively correlated with spiritual well-being and deliberate rumination and negatively correlated with intrusive rumination; spiritual well-being was positively associated with deliberate rumination and negatively correlated with intrusive rumination. The effect of social support on spiritual well-being was partially mediated by deliberate rumination and intrusive rumination.ConclusionsThe findings suggest that interventions directed toward enhancing social support and deliberate rumination and reducing the level of intrusive rumination may help patients with EC aged over 50 years improve spiritual well-being.

The concept of spirituality in the context of Chinese patients with cancer: A scoping review

“…Twenty‐six studies were quantitative designs and were conducted in mainland China ( n = 18), Taiwan ( n = 6), and the USA ( n = 2). Among them, five studies explored spiritual needs (Cheng et al, 2018; Deng et al, 2015; Du et al, 2022), spiritual state (Cheng et al, 2019), and spiritual nursing needs (Li et al, 2017); 11 studies examined the correlation between spiritual aspects and other variables (Chang et al, 2022; Cho & Lu, 2017; Feng et al, 2021; Guo et al, 2022; Kao et al, 2013; Li et al, 2012, 2022; Tao et al, 2022; Wang & Lin, 2016; Yang et al, 2021; Yeung et al, 2014); seven studies were conducted to translate spirituality‐related instruments originally developed in Western countries into Chinese for use with Chinese people with cancer (Astrow et al, 2012; Lin et al, 2015; Liu et al, 2016; Lo et al, 2016; Tang & Kao, 2017; Xie et al, 2019; Zhao et al, 2019); and three studies aimed to examine the effects of interventions on the spirituality of Chinese people with cancer (Chen et al, 2021; Sun et al, 2021; Xiao et al, 2022). One study with a mixed methods design was conducted in mainland China to explore the quality of life (including a spiritual dimension) of breast cancer survivors (Cheng et al, 2016).…”

“…spiritual transcendence such as selfless social responsibility in Confucianism) was added (Lo et al, 2016), specific examples such as ‘Chinese god’, ‘Buddha’, ‘bodhisattva’ and ‘ancestor’ were added (Cheng et al, 2018; Du et al, 2022; Zhao et al, 2019), and the term was paraphrased as ‘heaven or deities’ (Tao et al, 2022). For religious activities, some religious terms were replaced with culturally appropriate concepts such as from ‘scripture reading’ to ‘positive reading’ (Cheng et al, 2018; Du et al, 2022; Guo et al, 2022; Li et al, 2017; Xie et al, 2019), ‘prayer’ was supplemented with terms ‘chanting’, ‘worshipping deities’, ‘burning incense’ and ‘offering tribute’ (Tao et al, 2022), specific examples such as ‘chanting scriptures’, ‘praying’, ‘morning ceremony’ were added (Guo et al, 2022; Li et al, 2022; Xie et al, 2019), and ‘sacrament’, ‘mass’, and other rituals not commonly performed by Chinese people were removed (Cheng et al, 2018; Du et al, 2022). As for the term ‘spirituality’, which is unfamiliar to many Chinese, the phrase ‘writing about my spirituality’ was modified to ‘writing down the spiritual world in my brain’, and specific examples of spiritual resources such as ‘temple’, ‘church’ or ‘other religious sites’ were added (Guo et al, 2022; Li et al, 2017; Xie et al, 2019).…”

“…For religious activities, some religious terms were replaced with culturally appropriate concepts such as from 'scripture reading' to 'positive reading' (Cheng et al, 2018;Du et al, 2022;Guo et al, 2022;Li et al, 2017;Xie et al, 2019), 'prayer' was supplemented with terms 'chanting', 'worshipping deities', 'burning incense' and 'offering tribute' (Tao et al, 2022), specific examples such as 'chanting scriptures', 'praying', 'morning ceremony' were added (Guo et al, 2022;Li et al, 2022;Xie et al, 2019), and 'sacrament', 'mass', and other rituals not commonly performed by Chinese people were removed (Cheng et al, 2018;Du et al, 2022). As for the term 'spirituality', which is unfamiliar to many Chinese, the phrase 'writing about my spirituality' was modified to 'writing down the spiritual world in my brain',…”

The influence of deliberate rumination on the post-traumatic growth of college students during the COVID-19 pandemic and the moderating role of self-efficacy

“…Moreover, other studies have shown that depression is negatively correlated with deliberate rumination ( 18 ). A study of Chinese patients over 50 years old with esophageal cancer explored the relationship between social support and mental wellbeing, finding that they were negatively correlated with intrusive rumination and positively correlated with deliberate rumination ( 19 ). In addition, a study suggests that continuous deliberate rumination is a protective factor against post-traumatic stress disorder and a predictor of post-traumatic growth ( 20 ).…”

Trajectories of intrusive and deliberate rumination in young and middle‐aged stroke survivors: A growth mixture modeling approach

“…In addition, rumination was found to be linked to social support and the severity of traumatic situations (Stockton et al, 2011;Tedeschi & Calhoun, 2004). Coping strategies such as positive coping and emotional expression can influence rumination (Pan et al, 2022;Wang et al, 2023). Therefore, it is necessary to identify predictors of rumination trajectory classes in young and middle-aged stroke survivors.…”