Religiosity and spirituality in

women with breast cancer:

integrative review of the

literature.

Religiosidad y espiritualidad en mujeres con

cáncer de mama: revisión integrativa de la

literatura

Aleixandre Brian Duche Pérez1

Fanny Miyahira Paredes Quispe2

Olger Albino Gutiérrez Aguilar3

Katherine Liudva Roldán Vargas4

Abstract

Breast cancer represents 16% of all

female cancers worldwide. The

religious and spiritual values of patients

can have different meanings and even

cause spiritual suffering. The present

literature review explores the place of

spirituality and religiosity in the way in

which a group of women with breast

cancer assume, signify and face their

disease. For this, the documentary

analysis was carried out in different

specialized databases. It was observed

that spirituality and religious sense

significantly affect decision making in

advanced stages of the disease and

influence the quality of life, socio-family

relationships and the treatment of

patients. Spirituality and religiosity are

perceived as an emotional and

psychological support to face the

disease. Therefore, it is important to

strengthen the spiritual dimension of the

patient so that they face the disease,

that of the family so that they face the

suffering caused by the patient's

disease, that of the health professionals

Centro Sur.

Social Science Journal

April - June Vol 5 No 2

http://centrosureditorial.com/in

dex.php/revista

eISSN: 2600-5743

revistacentrosur@gmail.com

Receipt: June 24, 2020

Approval 01 November 2020

22- 37

1 Dr. Universidad Católica de Santa María, Arequipa, Perú,

aduche@ucsm.edu.pe, https://orcid.org/0000-0001-9905-

1489

2 Dra. Universidad Católica de Santa María, Arequipa,

Perú, fparedesq@ucsm.edu.pe, https://orcid.org/0000-

0003-2336-8716

3 Dr. Universidad Católica de Santa María, Arequipa, Perú,

ogutierrez@ucsm.edu.pe, https://orcid.org/0000-0002-

6657-7529

4 Dra. Universidad Católica de Santa María, Arequipa,

Perú, kroldan@ucsm.edu.pe, https://orcid.org/ 0000-0002-

0272-0330

https://orcid.org/0000-0002-5135-252X

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

so that they carry out an ethical,

humanized and excellent in terms of

biopsychosocial approach.

Keywords: Religiosity; Spirituality,

Breast Cancer, Women, Diagnosed

patients, Surviving patients.

Resumen

El cáncer de mama representa el 16%

de todos los cánceres femeninos a nivel

mundial. Los valores religiosos y

espirituales de los pacientes pueden

tener distintos significados e inclusive

causar sufrimiento espiritual. La

presente revisión de la literatura

explora el lugar que ocupa la

espiritualidad y religiosidad en la

manera en la que un grupo de mujeres

con cáncer de mama asumen,

significan y enfrentan su enfermedad.

Para ello se efectuó el análisis

documental en distintas bases de datos

especializadas. Se observó que la

espiritualidad y el sentido religioso

afectan de manera importante la toma

de decisiones en etapas avanzadas de

la enfermedad e influyen en la calidad

de vida, las relaciones socio-familiares

y el tratamiento de las pacientes. La

espiritualidad y religiosidad son

percibidas como un soporte emocional

y psicológico para afrontar la

enfermedad. Por ello, es importante

fortalecer la dimensión espiritual del

paciente para que afronte la

enfermedad, la de la familia para que

afronte el sufrimiento que le produce la

enfermedad del paciente, la de los

profesionales de la salud para que

realicen una práctica ética, humanizada

y excelente en cuanto al enfoque

biopsicosocial.

Palabras clave: Religiosidad;

Espiritualidad, Cáncer de Mama,

Mujeres, Pacientes diagnósticadas,

Pacientes sobrevivientes.

Introduction

Breast cancer is the most common cancer among women worldwide. It accounts for

16% of all female cancers. According to WHO, there are 1.38 million new cases and

458,000 deaths from breast cancer each year. The National Cancer Institute warns

that religious and spiritual values are important in patients facing cancer, as they can

have different meanings and even cause spiritual suffering. Based on these data, the

question arises as to the place of spirituality and religiosity in the way women with

breast cancer assume, understand and face their disease, considering that they have

an important impact on decision making in advanced stages of the disease and

influence the quality of life, socio-family relationships and treatment of patients.

Spirituality and religiosity are perceived as an emotional and psychological support for

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

coping with the disease. Therefore, it is important to explore the spiritual dimension of

the patient in coping with the disease, the support of the family in coping with the

suffering that the disease produces in the patient, and that of the health professionals

in carrying out an ethical and humanized practice.

Studies on the relationship between religiosity and spirituality in women with breast

cancer have shown three main lines of study. The first one locates coping strategies

in the face of the disease. Feher & Maly (1999), Gall, Charbonneau & Florack (2011),

Gamboa Romero, M. A., Barros Morales, R. L., & Barros Bastidas, C. (2016). Thuné-

Boyle et al. (2013), Veit & Kern de Castro (2013) and Khodaveirdyzad et al. (2016)

have inquired that the main strategies employed by women to cope, internalize and

accept the diagnosis of cancer and minimize the emotional impact on patients'

behavior. At par, Morgan, Gaston-Johansson & Moc (2006) and Gaston-Johansson et

al. (2013) prioritized their look at the relationship with spiritual well-being during the

treatment process identifying that patients' quality of life correlates directly with coping

strategies. Other authors such as Mesquita et al. (2013) and Manning & Radina (2014)

particularly inquired about coping during chemotherapy and the post illness period,

respectively. A second block of studies has been driven by the inquiry between

religiosity, spirituality, well-being and mental health. Mickley, Soeken & Belcher (1992)

used the concept of spiritual well-being in order to explore the notion of spiritual health,

a concept developed to make explicit individual and socio-religious notions related to

the body, health and illness. Meanwhile, Cotton, Levine, Fitzpatric, Dolda & Targ

(1999) observed the efficacy of psychosocial support on the well-being and quality of

life of diagnosed women identifying that social networks play a fundamental role in the

social construction of illness and well-being. And, Khoramirad, Mousavi,

Dadkhahtehrani & Pourmarzi (2014) showed for their part the existing relationship with

sleep quality. And, the third line of research addresses the quality of life from the

religious and spiritual dimensions of women with breast cancer. Purnell & Andersen

(2009), Jung-Won & Jaehee (2009) and Wildes. Miller, San Miguel de Majors &

Ramirez (2009) looked at the relationship between social support and quality of life by

identifying factors of success and failure in the coping strategies employed by breast

cancer survivors.

From this theoretical-empirical look at the relationship between religiosity, spirituality

and breast cancer in women, a question arises about how studies on this field have

been developed in the last thirty years and to understand the theoretical and

methodological advances that have occurred in this period of time in order to generate,

from a review of the literature, possible theoretical and methodological trajectories for

future research.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Materials and methods

This paper is an integrative literature review conducted during December 2018 to

February 2019. The central question that guided the study was: what is the existing

evidence in the literature on the relationship between spirituality and religiosity in

women with breast cancer, for which the following databases were used: APA

PsycNET® (APAPN), EBSCO, JSTOR, ProQuest (PQ), Wiley, Web of Sciences

(WOS) and Scopus (SP). The descriptors were Religiosity

(Religion/Religious/Religiosity), Spirituality (Spiritual/Spirituality), Breast Cancer

(Breast Cancer/Breast Cancer), with the Boolean operator "AND" between terms.

The following inclusion criteria were used to identify a document as valid: scientific

articles in indexed journals and conference papers and proceedings in English,

Spanish or Portuguese reviewed under the double-blind peer-review system,

published between 1992 and 2018, which are available for full-text review. Three

reviewers, at different times, performed the document search in the identified

databases using the proposed descriptors in order to triangulate, verify and validate

the results obtained.

Meta-analyses, review studies, books, book chapters, dissertations, theses, reports,

journal articles and non-scientific texts were not considered, nor were any other

document where the three inclusion descriptors were not found within the keywords,

objectives, results and conclusions.

Once the search procedure and verification of the results obtained in accordance with

the established methodology had been carried out, a sample of 29 documents was

obtained.

The final sample of identified documents was categorized according to the following

criteria: author, main objective and study population or sample.

Table 1.

Synthesis of articles published in databases from 1992 to 2018.

Author(s)

Central Objective

Population/

Sample

Mickley, Soeken

& Belcher (1992)

To shed light on spiritual health by examining the

role of spiritual well-being (SWB), religiosity and

hope in spiritual health.

175 women

diagnosed

with breast

cancer.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Feher & Maly

(1999)

To identify and examine coping strategies among

women with a past and recent diagnosis of breast

cancer.

33 women

diagnosed

with breast

cancer.

Cotton, Levine,

Fitzpatric, Dolda

& Targ (1999)

To examine the relationship between spiritual

well-being, quality of life, and psychological

adjustment to compare the effectiveness of two

psychosocial support programs.

142 women

diagnosed

with breast

cancer.

Choumanova,

Wanat, Barret &

Koopman (2006)

Examine how patients changed the roles of

religion and spirituality in coping with the disease.

03 female

breast

cancer

survivors.

Morgan, Gaston-

Johansson &

Mock (2006)

To examine the spiritual well-being, spiritual

coping strategies, and quality of life of African

American women during breast cancer treatment.

11 women

diagnosed

with breast

cancer.

Purnell &

Andersen (2009)

To investigate the relationship between religious

practices, spirituality, quality of life, and stress in

breast cancer survivors.

130 women

diagnosed

with breast

cancer.

Jung-Won &

Jaehee (2009)

To examine the differences between religiosity,

spirituality, and quality of life among Korean

American and Korean breast and gynecologic

cancer survivors, as well as to investigate the

effects of religiosity, spirituality, and social

support on quality of life.

169 women

diagnosed

with breast

cancer

Wildes. Miller,

San Miguel de

Majors & Ramirez

(2009).

To evaluate the association between

religiosity/spirituality and health as a quality of life

in Latina breast cancer survivors in order to

determine the positive correlation between R/E

and Health as a quality of life and whether it

influences quality of life.

117 female

breast

cancer

survivors.

Gullate, Brawley,

Kinney, Powe &

Moone (2010)

To examine the influence of religiosity,

spirituality, and cancer fatalism on delayed

diagnosis of breast cancer in women with self-

detected symptoms.

129 women

diagnosed

with breast

cancer.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Barboza & Forero

(2011)

To analyze and compare spiritual and religious

beliefs, as well as anxiety and depression levels

between healthy women and women diagnosed

with breast cancer.

61 female

breast

cancer

survivors.

Muhammad &

Abdullah (2011)

To reveal the meaning of experience through the

stories of women breast cancer survivors, to

better understand the deep meanings that inform

their experiences with spirituality and religiosity

as they cope with those of breast cancer.

03 female

breast

cancer

survivors.

Thune-Boyle,

Stygall, Keshtgar,

Davidson &

Newman (2011).

To examine the impact of breast cancer

diagnosis on the spiritual and religious practices

and beliefs of UK patients.

202 women

diagnosed

with breast

cancer.

Gall,

Charbonneau &

Florack (2011).

To investigate the salient role of religion, god

image and religious coping strategies in relation

to the perception of the development of breast

cancer diagnosis.

87 women

diagnosed

with breast

cancer.

Lagman, Yoo,

Levine, Donnell &

Lim (2012).

Examining the spiritual and religious adherence

of Filipino women diagnosed with breast cancer.

10 women

diagnosed

with breast

cancer.

Veit & Kern de

Castro (2013)

To examine the relationship between religious

coping, clinical variables, and subjective

perception of who god is in women diagnosed

with breast cancer.

83 women

diagnosed

with breast

cancer.

Veit & Kern de

Castro (2013)

To understand, in women with breast cancer with

high levels of positive religious/spiritual coping,

the place that religiosity/spirituality has in their

lives, the forms of coping used during diagnosis

and treatment, and the possible changes that

occurred during the disease.

07 women

diagnosed

with breast

cancer.

Mesquita, Lopes,

Valcanti,

Denismar, Alves,

Gerhke &

Campos de

Carvalho (2013)

To investigate the use of religious/spiritual coping

by people with cancer in chemotherapy.

101 women

diagnosed

with breast

cancer.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Hurtado & Finck

(2013)

To establish whether the Post-Critical Beliefs

Scale (PCBS), developed by Hutsebaut et al

(1996,1997), is a valid instrument in the study of

the religiosity and spirituality of breast cancer

patients in Colombia.

84 women

diagnosed

with breast

cancer.

Thuné-Boyle,

Stygall, Keshtgar,

Davidson &

Newman (2013).

To examine the benefits and container effects of

religious/spirituality coping strategies in the

adjustment process of the first year of diagnosis.

155 women

diagnosed

with breast

cancer.

Gaston-

Johansson,

Haisfield-Wolfe,

Reddick,

Goldstein &

Lawal (2013).

To examine coping capacity, psychological

distress, spiritual well-being, positive and

negative spiritual coping, and coping strategies in

African American women diagnosed with breast

cancer.

17 women

diagnosed

with breast

cancer.

Lynn, Yoo &

Levine (2013).

Examining the role of spirituality and religiosity in

African American women with breast cancer.

47 female

breast

cancer

survivors.

Schreiber (2014)

To examine the impact of breast cancer

diagnosis on religion/faith and behavioral

changes as well as the relationships or

achievements between these.

28 women

diagnosed

with breast

cancer.

Sanchez, Sierra

& Zarate (2014).

Establishing whether spirituality and religiosity

are independent dimensions

251 women

diagnosed

with breast

cancer.

Puentes, Urrego

& Sánchez

(2014).

To explore the place of spirituality and religiosity

in the way a group of women with breast cancer

assume, signify and face their illness.

04 women

diagnosed

with breast

cancer.

Khoramirad,

Mousavi,

Dadkhahtehrani

& Pourmarzi

(2014).

To determine the relationship between sleep

quality and spiritual well-being and religious

practices in Muslim women diagnosed with

breast cancer.

80 women

breast

cancer

survivors.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Manning &

Radina (2014)

To examine how mothers of breast cancer

survivors managed the adversities associated

with the disease.

30 women

diagnosed

with breast

cancer.

Khodaveirdyzad,

Rahimi, Rahmani,

Ghahramanian,

Kodayari & Eivazi

(2016).

To examine the relationship between spiritual

coping, adjustment to breast cancer diagnosis in

Iranian women.

266 women

diagnosed

with breast

cancer.

Borges, Caldeira

Loyola-Caetano,

de Magalhaes,

Areco &

Panobianco

(2017).

To examine the level of spiritual/religious coping

in women with breast cancer.

94 women

diagnosed

with breast

cancer.

Park, Waddington

& Abraham

(2018).

To examine the relationship between

religiosity/spirituality in breast cancer survivors

and their healthy behavior.

172 female

breast

cancer

survivors.

Results

Twenty-nine articles met the inclusion criteria established according to the proposed

methodology. A greater number of publications were identified in the databases Wiley

(32), Web of Science (25), ProQuest (19), APA PsycNET® (19), Scopus (18), followed

by Springer (12), EBSCO (11) and JSTOR (07), to a lesser extent.

Regarding the methodological approach, 20 quantitative and 09 qualitative articles

were identified. The quantitative articles were developed under a descriptive-

correlational-retrospective (12), descriptive-transversal (07) and comparative-

retrospective (01) methodological design. In the case of qualitative designs,

descriptive-cross-sectional (06), comparative-cross-sectional (02) and exploratory-

cross-sectional (01) were identified. The main publication language of the articles was

English (22), Spanish (05) and Portuguese (02).

Research was conducted in the United States (15), Colombia (05), Brazil (04), Iran

(02), followed by Chile, Malaysia and the United Kingdom, with one study each.

Most studies were conducted in the years 2013 (07), 2014 (05), 2011 (04), 2009 (03),

1999 (02), 2006 (02), and the rest in 1992, 2010, 2012, 2016, 2017, and 2018, each

with one publication.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

It was identified that all qualitative studies (09) worked with samples of ≤50 cases: x≤10

(05 cases), 11≥x≤20 (01 case), 21≥x≤30 (02 cases), 41≥x≤50 (01 case). While those

of quantitative character, 02 did so with samples ≤50 cases (17 and 33 cases,

respectively) and, the remaining ranged from 51≥x≤266: 51≥x≤100 (06 cases),

101≥x≤150 (05 cases), 151≥x≤200 (04 cases) and 201≥x≤266 (03 cases). Along the

same lines, overall, 06 studies focused on female breast cancer survivors and 23

studies on diagnosed women. However, the quantitative studies had a particularity: 19

studies focused on diagnosed women and 01 on survivors. Meanwhile, in those with a

qualitative approach, a certain similarity was observed: survivors (04) and diagnosed

(05).

With respect to the use of research techniques and instruments, it was identified that

all the qualitative studies used the in-depth interview technique and 01 study in

particular also used focus groups. On the other hand, in the case of the quantitative

studies, to measure religious coping and spirituality they mainly used three evaluation

instruments: Religious Coping Scale (RCOPE) by Pargament (1997), Multidimensional

Measurement of Religiousness/Spirituality (MMRS) by the Fetzer Institute (1997) and

Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-

Sp) by Peterman et al. (2002). The same instruments were repeated in several studies.

The relationship between the variables religiosity and spirituality as central elements

for coping with the disease in female patients with breast cancer has been a general

criterion in all the articles identified that have been part of this integrative review. It was

observed that the topic addressed has been of interest to professionals in the social

and health sciences, especially during the last decade, due to the increase of patients

diagnosed with this type of cancer worldwide and the search for new ways of coping,

understanding and resilience in the face of the impact of diagnosis, treatment, therapy

(including chemotherapy), body mutilation (removal of the breast) and the proximity to

death.

In the last decade, increased attention has been given to the study of

spirituality/religiosity as a coping strategy used by people with cancer, given its

protective role against psychological morbidity. Each individual relates spirituality to

the hope of surviving cancer. However, the review of the literature specifies a

conceptual ordering/differentiation between religiosity and spirituality as independent

theoretical concepts (Sanchez, Sierra, & Zarate, 2014), the same that is situated from

the approach to the modes of agency and interpretation of the events of the disease,

which, in turn, are crossed by conceptions and practices related to "the spiritual" and

"the religious" (Puentes, Urrego, Sanchez, 2015). Then, religiosity is understood as a

social dimension that includes theological beliefs, practices, commitments and

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

congregational activities as an institutional organization (Plant & Sherman, 2001). On

the other hand, religiosity is also defined as the personal meaning that individuals

attribute to a particular system of beliefs, values, rules of conduct and rituals (Mickey,

Soeken & Belcher, 1992). Meanwhile, spirituality relates more to an individual and

private experience with "the sacred" that suggests a sense of transcendence and may

or may not be embedded within a particular religious tradition (Breitbart, 2005).

Additionally, spirituality is shown to be a felt connection to a non-mental, non-

emotional, and non-physical aspect of the self (Hiatt, 1986), which includes elements

of meaning, purpose, and connection to a Higher Power or something greater than the

self (Targ & Levine 2002). Some authors have divided spirituality into two factors:

intrinsic and extrinsic, with the intrinsic factor originating from within the person, while

extrinsic factors are seen outside the person (Donahue, 1985) and (Allport, 1967).

After reading the articles, extracting and analyzing the relevant information to answer

the guiding question, the data were organized into two categories: positive or negative

CRS use in diagnosed patients and by survivors.

R.1. Use of positive CRS in diagnosed patients.

Religiosity in women diagnosed with breast cancer is expressed in most cases as a

coping resource towards the disease (religious coping). That is, in a more functional

sense in terms of subjective well-being, but not as the underlying structure that governs

their daily actions based on religious norms and values (Mickley, Soeken & Belcher

(1992). Thus, faith and religiosity are coping tools in women with breast cancer (Feher,

& Maly, 1999). This coincides with the findings reported by Cotton, Levine, Fitzpatric,

Dolda, & Targ (1999) where it was evidenced that spiritual well-being and quality of life

have a positive correlation and that it is related to five psychological adjustment styles

(fighting spirit, helplessness/hopelessness, fatalism, anxious preoccupation and

cognitive avoidance), clarifying the intimate relationship between psychological

adjustment and spirituality. In addition, a strong relationship between spiritual well-

being and quality of life was evidenced, resulting in an associated increase in physical,

emotional and functional well-being (Morgan, Gaston-Johansson & Mock, (2006).

Likewise, Barboza, & Forero-Forero (2011) observed a tendency, in women with breast

cancer, to be more spiritual/religious than those without breast cancer. They reported

a greater commitment to belief in god and a sense of responsibility to try to alleviate

suffering in the world. Thus, Gall, Charbonneau, & Florack (2011) have concluded that

various aspects of religiosity/spirituality have different positive implications for the

experience of breast cancer perception, growth, and clinical follow-up.

For example, some women use spirituality/religiosity as a coping resource (Lagman,

Yoo, Levine, Donnell, & Lim, 2012), with prayer being the most commonly used

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

practice of religiosity and spirituality, as it was reported to help them cope positively

with their daily lives. In other cases, it was reported that some women expressed a firm

belief that the prayers they prayed contributed to their healing process (Lagman, Yoo,

Levine, Donnell, & Lim, 2012).

Additionally, Thuné-Boyle, Stygall, Keshtgar, Davidson & Newman (2013) found that

the time at which the illness is detected and how RS coping resources are effected at

the onset of the patient's illness and how the illness is perceived is also important.

The literature review in this particular leads to the notion of religious coping. Mesquita,

Lopes, Valcanti, Denismar, Alves, Gerhke, & Campos de Carvalho (2013) reported

that breast cancer patients, with a greater religious sense, consider spirituality and

religiosity as a very important factor for coping with the disease so they use more

positive coping strategies, different from patients who did not consider themselves

religious, as the latter tend to use negative spiritual/religious coping.

It has also been identified that, in other cases, diagnosed women use more positive

religious/spiritual coping strategies than negative CRE. Positive (CRE) (perceiving god

as a presence or condition of existence/survival) helps patients cope with the stress of

the disease, and may serve as a potential resource during treatment (Veit, & Kern de

Castro, 2013). In addition, a strong relationship was found between diagnosed women

and a higher power (God): the practice of faith helped in the elaboration of a meaning

of the disease, which favored a greater control of their condition and the mobilization

of a sense of hope towards healing. The social support of the religious community also

appears as a positive coping tool, as all participants established good relationships

with those who helped them, they felt more valued and loved through these friendships

(Mesquita, Lopes, Valcanti, Denismar, Alves, Gerhke, Campos de Carvalho, 2013).

It is also important to pay attention to the mechanism by which religious coping

strategies become highly recurrent in their practical use. Thuné-Boyle, Stygall,

Keshtgar, Davidson, & Newman (2013) suggest examining individual coping strategies

rather than taking them as a set of a priori strategies, as high coping ability may be

beneficial and have a relationship/link to less psychological distress, negative religious

coping strategies, and catastrophic thinking. Women with fewer negative religious

coping strategies have higher levels of spiritual well-being and less distress (Gaston-

Johansson, Haisfield-Wolfe, Reddick, Goldstein & Lawal, 2013). Here, it is observed

that the use of self-affirming coping strategies is related to high spiritual well-being

development and less negative religious coping. In sum, catastrophic thinking has

negative effects on psychological distress and spiritual well-being.

R.2. Use of negative CRSs in diagnosed patients

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Interesting findings have been reported on the use of negative religious coping

resources. Thuné-Boyle, Stygall, Keshtgar, Davidson & Newman (2013) reported

cases of women who manifest feeling abandoned and punished by god being this a

predictor of negative depressive mood. In other cases, some patients may use

religious coping in a negative way because the religious theme is simply a rejection,

that is, they are not religious/spiritual people and make use of other types of non-

religious coping strategies such as acceptance/denial, instrumental support, planning,

self-blame, distraction and venting (Staton, Danoff-Burgh & Hugging, 2002).

Cases were found where negative religious coping strategies can have a negative

impact on the development of the disease as they affect women's ability to maintain a

positive perception of their health, triggering a process of internal spiritual struggle with

feelings of anger, confusion and uneasiness as they question their religious practices

and beliefs and their relationship with God when they feel that their life is in danger

(Sheerman & Simoton, 2001). In addition, Choumanova, Wanat, Barrett & Koopman

(2006) found that not all patients are optimistic when cancer is very advanced because

it is difficult to have faith in those circumstances.

Gullate, Brawley, Kinney, Powe, & Moone (2010) identified that when there are very

high levels of religiosity and spirituality these can affect the period of symptom

detection in some women by physicians, as some women only told God at the time of

discovering a symptom.

It was also found that negative religious coping is directly related to the feeling of

physical well-being, impairing it and slowing down the process of clinical intervention.

According to Fiala, Bjork & Gorsuch (2002) this is aligned with the anxiety, depression

and stress suffered by the patient.

R.2. Use of CSR in survivors

The use of CSRs was positively manifested by providing survivors with primary coping

resources of psychological (subjective well-being) and religious (prayer) coping with

illness, as well as an enhanced emphasis on the importance and significance of

religion and spirituality in their lives (Choumanova, Wanat, Barret, & Koopman, 2006):

the practice of prayer as a coping resource was used to generate peace of mind,

distracting emotional stress and negative thoughts about illness such as death or loss.

A state of relaxation is generated as a symptom reduction technique (Choumanova,

Wanat, Barret, & Koopman, 2006).

In other cases, positive aspects were observed, showing that women breast cancer

survivors improved the different dimensions of quality of life (HQQL) such as social

well-being, functional well-being and the patient-doctor relationship, being good

predictors of these (Wildes, Miller, San Miguel de Majors, & Ramirez, 2009).

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Ahmad, Muhammad, & Abdullah (2011) demonstrated a significant influence of

spirituality and religiosity in coping with illness by developing in women a positive

acceptance of illness, being more aware of life, and developing a sense of it as

preparation for the afterlife. That is, an optimism for life motivating their behaviors

beyond the disease.

Other religious practices most used by survivors were attending religious services,

prayer/meditation, Bible readings. Relying on god highlights different agency practices

to provide oneself with positive coping resources: going to church, being heard by a

clergy person, asking for prayer and prayers for/to oneself, enabling better

management of stress and fears (Lynn, Yoo, Levine, 2013).

In other cases, it was evidenced that some women, being more aware of life, realized

that their personal life possesses a fleeting nature. This positively influences their

behavior as a source of motivation for personal development, as well as awakening

the altruistic sense (Schneider, Edward (2014). From egocentrism to a sense of

altruism.

In this regard, Manning, & Radina (2014) observed that, with respect to mothers of

survivors, stress management is related to developing a sense of the unknown and

maintaining hope. Serving as a resource to caregivers of breast cancer patients.

Finally, religiosity and spirituality have significant associations in survivors' healthy

behaviors (Park, Waddington, & Abraham, 2018), with quality of life and post-traumatic

stress (Purnell, & Andersen, 2009) and, specifically, spiritual identity and coping are

established as practices more related to healthy behavior rather than prayer in some

cases (Park, Waddington, & Abraham. (2018).

Conclusions

Religiosity and spirituality in breast cancer patients can be analyzed in the whole

process of the development of the disease from diagnosis, during treatment and after

recovery and also from the positive and negative religious spiritual coping. In positive

CSR, for diagnosed patients, religiosity/spirituality is a way in which women cope with

their disease, because in it they find emotional, social and meaningful support. Patients

place their trust in a supreme being in the hope of obtaining help and strength to

manage the situation in the face of the worry, fear and uncertainty caused by the

disease when it is detected. In the context of the patients' well-being and quality of life,

the spiritual element is interpreted as a factor that influences the state of health, as

well as the recovery and improvement of pain levels, contributing to the quality of life

of the patients that allows them to incubate positive thoughts, to have faith and to

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

search for the meaning of life, all this related to the hope of recovery and with a feeling

of hope and optimism towards the future.

On the other hand, in negative coping, diagnosed patients may feel the disease as a

divine punishment, generating in them feelings of abandonment, frustration and

uneasiness, even rethinking their relationship with God. Religious practice is

questioned for some patients who do not profess a religion and instead use other

mechanisms such as acceptance to cope with the disease. On the other hand, there

are some religions such as Islam where anger towards God is not accepted, but one

must accept his design. Studies should also analyze other aspects such as the

pessimism that leads patients to expect bad results, believing in advance that things

will not go well.

The patients who have recovered from their cancer experience have made use of the

spiritual element as a support, generally through prayer, feeling that there was always

someone to trust and feel supported when the treatments were traumatic and they had

moments of fragility, finding comfort in religious and spiritual faith. Another aspect that

has helped them to overcome the disease has been the support received from religious

communities that encouraged them to endure suffering and trust in God, so that many

of the patients have transformed their lives in the face of the disease.

References

Ahmad F, Muhammad M, Abdullah A, Religion and spirituality in coping with advanced

breast cancer: perspectives from malaysian muslim women, J Relig Health 2011;

50:36-45.

Barboza F, Forero M, Anxiety and depression in breast cancer patients and their

relationship with spirituality/religiosity. Preliminary data analysis. Journal of

Psychology University of Antioquia. 2011; 3(1):7-27.

Borges M, Caldeira S, Loyola-Caetano E, A.P. de Magalhães P, Areco F. Panobianco

M. Spiritual/Religious Coping of Women with Breast Cancer. Religions. 2017; 8

(254):1-10.

Choumanova I, Wanat S, Barrett R, Koopman C, Religion and spirituality in coping with

breast cancer: perspectives of chilean women. J Breast. 2006; 12(4):349-352.

Donahue, M. J. (1985). Intrinsic and extrinsic religiousness: review and meta-analysis''.

Journal of Per- sonality and Social Psychology, 48, 400-419.

Fetzer Institute/NIA. (1999). Multidimensional measurement of

religiousness/spirituality for use in

Fiala WE, Bjorck JP, Gorsuch R. The religious support scale: construction, validation,

and cross validation. Am J Community Psychol 2002;30:761-786.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Gamboa Romero, M. A., Barros Morales, R. L., & Barros Bastidas, C. (2016).

Childhood aggressiveness, learning and self-regulation in primary school

children. LUZ, 15(1), 105-114. Retrieved from

https://luz.uho.edu.cu/index.php/luz/article/view/743

Gall T, Charbonneau C, Florack P, The relationship between religious/spiritual factors

and perceived growth following a diagnosis of breast cáncer. Psychology and

Health 2011; 26;(3): 287-305.

Gullatte M, Brawley O, Kinney A, Powe B, Mooney K, Religiosity, spirituality, and

cancer fatalism beliefs on delay in breast cancer diagnosis in african american

women. J Relig Health 2010; 49:62-7

health research: A report of the Fetzer Institute/National Institute on Aging Working

Group. Kalamazoo, MI: Author. Recuperado de

http://www.fetzer.org/research/248-dses.

Hiatt, J. F. (1986). Spirituality, medicine, and healing. Southern Medical Journal, 79(6),

736-743.

Hurtado M, Finck C. Beyond religious behavior: scale of post-critical beliefs in women

with breast cancer in Colombia. Journal of Psychology University of Antioquia.

2013; 5(2):45-62.

Khodaveirdyzadeh R, Rahimi R, Rahmani A, Ghahramanian A, Naser K, Eivazi J.

Spiritual/religious coping strategies and their relationship with illness adjustment

among iranian breast cancer patients. Asian Pac J Cancer Prev. 2016; 17

(8):4095-4099.

Khoramirad A, Mousavi M, Dadkhahtehrani T, Pourmarzi D. Relationship between

sleep quality and spiritual well-being/religious activities in muslim women with

breast cancer. J Relig Health. 2015 54:2276–2285.

Lagman R, Yoo G, Levine E, Donnell K, Lim H, Leaving it to God Religion and

Spirituality among Filipina Immigrant Breast Cancer Survivors. J Relig Health

2012.

Lim J, Yi J, The effects of religiosity, spirituality, and social support on quality of life: a

comparison between korean american and korean breast and gynecologic

cancer survivors. JC. Oncology Nursing Forum. 2009; 36 (6):699-708.

Lydia K. Manning & M. Elise Radina. The Role of Spirituality in the Lives of Mothers of

Breast Cancer Survivors. Journal of Religion, Spirituality & Aging. 2015; 27:(2-

3):125-144.

Mesquita A, Cássia Lopez É, Costa Valcanti C, Alves D, Gerhke R, Campos de

Carvalho E. The use of religious/spiritual confrontation by cancer patients under

chemotherapy treatment. Rev. Latino-Am. Enfermagem. 2013; 21(2):1-7.

Centro Sur. Social Science Journal. eISSN: 2600-5743. April - June Vol. 5 No. 2 - 2021

http://centrosureditorial.com/index.php/revista

Morgan P, Gaston-Johansson F, Mock V, spiritual well-being, religious coping, and the

quality of life of african american breast cáncer treatment: A pilot study. ABNF

Journal. 2006; 17(2):73-77.

Pargament, K. I. (1997). The psychology of religion and coping: Theory, research,

practice. New York, NY: Guilford Press

Park C, Waddington E, Abraham R. Different dimensions of religiousness/spirituality

are associated with health behaviors in Brest cáncer survivors. Psycho-

Oncology.2018;27:2466-2472.

Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Ann Behav Med. 2002

Winter; 24(1):49-58.

Puentes Y, Urrego S, Sánchez R. Spirituality, religiosity and illness: A view from

women with breast cancer. Advances in Latin American Psychology. 2015;

33(3):481-495.

PurnellJ, Andersen B, Religious practice and spirituality in the psychological

adjustment of survivors of breast cancer. Counseling and Values. 2009; 53:165-

182.

Sánchez R, Sierra F, Zárate K. Are religiosity and spirituality different dimensions?

Rev.Colomb Cancerol. 2014; 18(2):62-68.

Schreiber J, Edward J, Image of god, religion, spirituality, and life changes in breast

cancer survivors: A Qualitative Approach. J Relig Health. 2014.

Stanton AL, Danoff-Burgh S, Huggins ME. The first year after breast cancer diagnosis:

hope and coping strategies as predictors of adjustment. Psychosoc Oncol

2002;11: 93-102.

Thune-Boyle I, Stygall J, Keshtgar M, Davidson T, Newman S, The impact of a breast

cancer diagnosis on religious/spiritual beliefs and practices in the UK, J Relig

Health 2011; 50:203-218.

Thuné-Boyle I, Stygall J, Keshtgar M, Davidson T, Newman S. Religious/spiritual

coping resources and their relationship with adjustment in patients newly

diagnosed with breast cancer in the UK. Psycho-Oncology. 2013; 22:646–658.

Veit C, Kern de CastroII E, Religious/spiritual coping in women with breast cancer.

Brazilian Archives of Psychology. 2013; 65 (3):421-435.

Veit C, Kern de CastroII E. Positive Religious/Spiritual Coping in Women with Breast

Cancer: A Qualitative Study. Psycho. 2013; 44(3):331-341.

Wildes K, Miller A, Majors S, Ramirez A. The religiosity/spirituality of Latina breast

cancer survivors and influence on health-related quality of life. Psychooncology

2009; 18:831-840.