Role of religion and spirituality in cancer coping among African Americans: A qualitative examination
Cheryl L. Holt1, PhD; Emily Schulz1, PhD; Lee Caplan2, PhD; Victor Blake2, MD, MTS; Penny Southward1, MPPM; Hope Lawrence1, BS; Ayanna Buckner2, MD
The University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine1; Morehouse School of Medicine2
Abstract
There is ample literature suggesting that
African American cancer patients rely on
religion and/or spirituality (RS) to cope.
However, what is yet to be determined is
which aspects of RS are important in cancer
coping. Because both religion and spirituality
are multifactorial, it is possible that some
factors are important in cancer coping and
others are less important. The present study
explored mediators of RS and cancer coping
among African Americans. This was done
through semi-structured interviews with
African American cancer patients. Interviewed
patients were six months to five years postdiagnosis. The data were analyzed using an
open-coding procedure.
Objectives
The present study examined mediators of
the RS and cancer coping relationship
among African Americans with a cancer
diagnosis. The study contributes
significantly beyond existing work in religious
coping because of the 1) focus on cancer; 2)
focus on African Americans; 3) specific role
of RS being examined; 4) inclusion of
spirituality; 5) clear potential for application
to cancer survivorship interventions.
Methods
Results
Conclusion
Sampling and eligibility criteria
Religious themes identified
•Patients identified through physician offices at
UAB and MSM
•God is a healer directly &/or through doctors
•Participants had much to say about the role
of RS in their cancer experience.
•Faith and belief are important in healing
•Clear themes emerged from the data.
•African Americans with any cancer diagnosis
6 months - 5 years ago
•Prayer and Bible study important in healing
•Data analysis is ongoing, including 15
additional patients from the MSM site.
•God helps one “get through” the illness
Interviewing and data collection
•The Devil plays a role in cancer/recurrence
•Trained interviewers conducted one-on-one
semi-structured interviews with patients
•Meaning-making of illness (e.g., Why me?)
•Patients received $25 Visa gift card
•Audio tapes of interviews transcribed verbatim
Spiritual themes identified
•Connections to others; self; God; world
Secular themes identified
•Entire research team reviewed verbatim
transcripts and identified preliminary themes
•Sense lack of control over illness
•Codebook developed based on these themes
•Coders trained on 10% random data sample
•Reliability checked until adequate
•Social support is very important
•Fear of death; realize own mortality
Mediators of RS & Cancer Coping/QOL
•Coding pairs coded data; disagreements
resolved through discussion
Participants
Stress
Religiosity
•N=15 (7 Men)
•Age 21-80
•6 breast; 4 head/neck; 2 lung; 1 prostate; 1
cervical; 1 ovarian
•In this way, more can be learned about the
specific role of RS in cancer coping and
quality of life (QOL). Interventions can then
be designed around these mediators, which
can improve survivorship.
•Cancer brings new perspective on life
Qualitative data analysis
Faith
Coping
Meaning
Spirituality
QOL
Support
•Next steps will be to identify and/or develop
instruments that assess the mediators, and
conduct analyses to provide quantitative
support for the role of the various mediators
of the RS-cancer coping relationship.
•“…just trusting and believing in His word just
and they was following up with scriptures
where you can go to the Bible and find it and
read it and you know you get more
consolation, I get more consolation in reading
his word, you know.”
References
This work was supported by a grant from the
National Cancer Institute (#1 U54 CA11894801).