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The perceived effects of psycho-spiritual integrative therapy and community support groups on coping with breast cancer: a qualitative analysis

Cynthia McDonald, Kathleen Wall, Diana Corwin, Christine Brooks, Cheryl Koopman

Abstract


Background: Few studies have assessed the efficacy of interventions that specifically address the unmet spiritual needs of cancer patients. This exploratory qualitative study sought to address this gap by comparing the subjective effects of Psycho-Spiritual Integrative Therapy (PSIT) groups and community-based support groups on coping and post-traumatic growth among women diagnosed with breast cancer. Community-based breast cancer support groups generally emphasize social support, emotional expression and problem solving, whereas PSIT emphasizes spiritual as well as psychological and existential development. PSIT offers a patient-centered approach in which this personal growth can be tailored to the participant’s beliefs and values.

Methods: The study sample consisted of 24 participants; 12 from PSIT groups and 12 from community-based cancer support groups. Thematic analysis and grounded theory were used to analyze interview data.

Results: The qualitative analysis identified four phases of coping with breast cancer. Women attributed positive effects of both PSIT groups and community-based support groups on coping and post-traumatic growth in the following areas: self-acceptance, body image, life purpose and meaning, spirituality, reassessment of values and priorities and interpersonal relationships. However, women participating in PSIT reported more positive effects on spiritual and existential development and coping than did community sample participants.

Conclusion: Because of its inherent focus on spiritual and existential development, PSIT may both appeal to and help some women to better adapt to breast cancer survivorship.

Keywords


Breast cancer, cancer survivorship, coping, group, meaning, mindfulness, person-centered care, psychospiritual integrative therapy, quality of life, spiritual care, spirituality

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References


Brennan, J. (2001). Adjustment to cancer- Coping or personal transition? Psycho-Oncology 10, 1-18.

Moadel, A., Morgan, C., Fatone, A., Grennan, J., Carter, J., Laruffa, G., Skummy, A. & Dutcher, J. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psycho-Oncology 8, 378-385.

Balboni, T.A., Vanderwerker, L.C., Block, S.D., Paulk, M.E., Lathan, C.S., Peteet, J.R. & Prigerson, H.G. (2007). Religiousness and spiritual support among advanced cancer patients and associations With end-of-life treatment preferences and quality of life. Journal of Clinical Oncology 25, 555-560.

Ferrell, B. Grant, M., Funk, B., Otis-Green, S. & Garcia, N. (1998). Quality of life in breast cancer survivors: Implications for developing support services. Oncology Nursing Forum 25, 887-895.

Ferrell, B., Grant, M., Funk, B., Otis-Green, S. & Garcia, N. (1997). Quality of life in breast cancer: Part I: Physical and social well-being. Cancer Nursing 20, 398-408.

Ferrell, B., Grant, M., Funk, B., Otis-Green, S. & Garcia, N. (1998). Quality of life in breast cancer: Part II: Psychological and spiritual well-being. Cancer Nursing 21, 1-9.

Archibald, S., Lemieux, S., Byers, S.E., Tamlyn, K. & Worth, J. (2006). Chemically induced menopause and the sexual functioning of breast cancer survivors. Women & Therapy 29, 83-89.

Ferguson, R., Ahles, T., Saykin, A., McDonald, B., Furstenberg, C., Cole, B. & Mott, L.A. (2007). Cognitive-behavioral management of chemotherapy-related cognitive change. Psycho-Oncology 16, 772-777.

Halstead, M. & Hull, M. (2001). Struggling with paradoxes: The process of spiritual development in women with cancer. Oncology Nursing Forum 28, 1534-1544.

Carlson, L.E., Speca, M., Faris, P. & Patel, K.D. (2007). One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behavior Immunology 21, 1038-1049.

Lazarus, R. & Folkman, S. (1984). Stress, Appraisal, and Coping. New York, NY: Springer.

Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine 48, 1207-1221.

Golden-Kreutz, D. & Anderson, B. (2004). Depressive symptoms after breast cancer surgery: Relationships with global, cancer-related, and life event stress. Psycho-Oncology 13, 211-220.

Golden-Kreutz, D., Thornton, L., Wells-Di Gregorio, S., Frierson, G., Jim, H., Carpenter, K.M., Shelby, R.A. & Anderson, B.L. (2005). Traumatic stress, perceived global stress, and life events: Prospectively predicting quality of life in breast cancer patients. Health Psychology 24, 288-296.

Deshields, T., Tibbs, T., Fan, M. & Taylor, M. (2006). Differences in patterns of depression after treatment for breast cancer. Psycho-Oncology 15, 398-406.

Holland, J. (2002). History of Psycho-Oncology: Overcoming attitudinal and conceptual barriers. Psychosomatic Medicine 64, 206-221.

Sharpley, C. & Christie, D. (2007). “How I was then and how I am now”: Current and retrospective self-reports of anxiety and depression in Australian women with breast cancer. Psycho-Oncology 16, 752-762.

Stanton, A., Bower, J. & Low, C. (2006). Postraumatic growth after cancer. In: Handbook of posttraumatic growth: Research and practice. (eds. R. Tedeschi & L. Calhoun), p. 81-99. New York, NY: Lawrence Erlbaum.

Clarke, J. (2006). A discussion paper about ‘meaning’ in the nursing literature on spirituality: An interpretation of meaning as “ultimate concern” using the work of Paul Tillich. International Journal of Nursing Studies 43, 915-921.

Pargament, K., Desai, K. & McConnell, K. (2006). Spirituality: A pathway to posttraumatic growth or decline? In: Handbook of posttraumatic growth: Research and practice. (eds. R. Tedeschi & L. Calhoun), p. 121-137. New York, NY: Lawrence Erlbaum.

Park, C. & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology 1, 115-144.

Park, C.L., Malone, M.R., Suresh, D.P., Bliss, D. & Rosen, R.I. (2008). Coping, meaning in life, and quality of life in congestive heart failure patients. Quality of Life Research 17, 21-26.

Park, C.L. (2007). Religiousness/spirituality and health: A meaning systems perspective. Journal of Behavioral Medicine 30, 319-328.

Cordova, M.J., Andrykowski, M.A., Kenady, D.E., McGrath, P.C., Sloan, D.A. & Redd, W.H. (1995). Frequency and correlates of posttraumatic-stress-disorder-like symptoms after treatment for breast cancer. Journal of Consulting and Clinical Psychology 63, 981-986.

Cordova, M.J., Studts, J.L., Hann, D.M., Jacobsen, P.B. & Andrykowski, M.A. (2000). Symptom Structure of PTSD Following Breast Cancer. Journal of Traumatic Stress 13, 301-319.

Coward, D.D. (2003). Facilitation of Self-Transcendence in a Breast Cancer Support Group: II. Oncology Nursing Forum 30, 291.

Taylor, E.J. (2003). Spiritual Needs of Patients With Cancer and Family Caregivers. Cancer Nursing 26, 260-266.

Tomich, P.L. & Helgeson, V.S. (2004). Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychology 23, 16-23.

Yanez, B., Edmondson, D., Stanton, A.L., Park, C.L., Kwan, L., Ganz, P.A. & Blank, T.O. (2009). Facets of spirituality as predictors of adjustment to cancer: Relative contributions of having faith and finding meaning. Journal of Consulting and Clinical Psychology 77, 730-741.

Tedeschi, R.G. & Calhoun, L.G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry 15, 1-18.

Aukst-Margetic, B., Jakovljevic, M., Margetic, B., Biscan, M. & Samija, M. (2005). Religiosity, depression and pain in patients with breast cancer. General Hospital Psychiatry 27, 250-255.

Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., Dold, K.H. & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology 8, 429-438.

Lin, H.R. & Bauer-Wu, S.M. (2003). Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. Journal of Advanced Nursing 44, 69-80.

McClain, C.S., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet 361, 1603-1607.

Cox, J. & Verhagen, P.J. (2011). Spirituality, religion and psychopathology: towards an integrative psychiatry. International Journal of Person Centered Medicine 1, 146-148.

Laubmeier, K.K., Zakowski, S.G. & Bair, J.P. (2004). The role of spirituality in psychological adjustment to cancer: A test of the transactional model of stress and coping. International Journal of Behavioral Medicine 11, 48-55.

Rippentrop, A.E., Altmaier, E.M. & Burns, C.P. (2006). The relationship of religiosity and spirituality to quality of life among cancer patients. Journal of Clinical Psychology in Medical Settings 13, 31-37.

Thune-Boyle, I., Stygall, J., Keshtgar, M. & Newman, S. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social Science and Medicine 63, 75-89.

Jenkins, R.A. & Pargament, K.I. (1995). Religion and spirituality as resources for coping with cancer. Journal of Psychosocial Oncology 13, 51-74.

Bloom, J.R., Kang, S. H., Petersen, D.M. & Stewart, S. L. (2007). Quality of life in long-term cancer survivors. In: Handbook of Cancer Survivorship. (ed.: M. Feuerstein), pp. 43-65. New York, NY: Springer.

James, W. (1936). The varieties of religious experience: A study in human nature. New York, NY: Modern Library.

Miovic, M. (2004). An introduction to spiritual psychology: Overview of the literature, east and west. Harvard Review of Psychiatry 12, 105-115.

Pargament, K.I. (1997). The psychology of religion and coping: Theory, research, practice. New York, NY: Guilford.

Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences 8, 73-107.

Hayes, S.C., Follette,V.M. & Linehan, M.M. (2004). Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York, NY: Guilford.

Emmons, R.A., Colby, P.M. & Kaiser, H.M. (1998). When losses lead to gains: Personal goals and the recovery of meaning. In: The human quest for meaning: A handbook of psychological research and clinical applications. (eds.: P.T. Wong & P.S. Fry), pp. 163-178. Mahwah, NJ: Lawrence Erlbaum Associates.

Miller, W.R. (1999). Diversity training in spiritual and religious issues. In: Integrating spirituality into treatment: Resources for practitioners. pp. 253-263. Washington, DC: American Psychological Association.

Cloninger C.R. & Cloninger, K.M. (2011). Person-centered therapeutics. International Journal of Person Centered Medicine 1, 43-52.

Garlick, M.A., Wall, K., Corwin, D. & Koopman, C. (2011). Psycho-spiritual integrative therapy for women with primary breast cancer. Journal of Clinical Psychology in Medical Settings 18, 78-90.

Jim, H., Richardson, S., Golden-Kreutz, D. & Andersen, B. (2006). Strategies used in coping with a cancer diagnosis predict meaning in life for survivors. Health Psychology 25, 753-761.

Gore-Felton, C. & Spiegel, D. (1999). Enhancing women’s lives: The role of support groups among breast cancer patients. Journal for Specialists in Group Work 24, 274-287.

Wall, K., Corwin, D. & Koopman, C. (2012). Stories of survival: PSIT in women with breast cancer. In Religion, Spirituality, and Positive Psychology. (ed.: T. Plante.). Santa Barbara: Praeger. In press.

Corwin, D., Wall, K. & Koopman, C. (2012). Psycho-spiritual integrative therapy: A theoretical model for treatment. Journal for Specialists in Group Work. In press

Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77-101.

Charmaz, K. (2006). Constructing gounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage.

Verbi. (2007). MAXQDA 2007 Software. Marburg, Germany: Verbi.

Mertens, D. (2005). Research and evaluation in education and psychology: Integrating diversity with quantitative, qualitative, and mixed methods (2nd ed.). Thousand Oaks, CA: Sage.

Janoff-Bullman, R. (2006). Schema-change perspectives on posttraumatic growth. In: Handbook of posttraumatic growth: Research and practice. (eds. R. Tedeschi & L. Calhoun), p. 81-99. New York, NY: Lawrence Erlbaum.

Janoff-Bullman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York, NY: Free Press.

Nakamura, Y. & Orth, U. (2005). Acceptance as a coping reaction: Adaptive or not? Swiss Journal of Psychology 64, 281-292.

Astin J.A., Anton-Culver, H., Schwartz, C., Shapiro, D., McQuade, J.. Breuer, A.M., Taylor, T.H., Lee, H. & Kurosaki, T. (1999). Sense of control and adjustment to breast cancer: The importance of balancing control coping styles. Behavioral Medicine 25, 101-109.

Tedeschi, R. & Calhoun, L. (2004). Posttraumatic Growth: Conceptual foundations and empirical evidence. Psychological Inquiry 15, 1-18.

Tedeschi, R. & Calhoun, L. The foundations of posttraumatic growth: An expanded framework. (2006). In: Handbook of posttraumatic growth: Research and practice. (eds. R. Tedeschi & L. Calhoun), p. 81-99. New York, NY: Lawrence Erlbaum.

Shapiro, S., Carlson, L., Astin, J. & Freedman, B. (2006). Mechanism of mindfulness. Journal of Clinical Psychology 62, 373-386.

Miles, A. & Mezzich, J. (2011). The care of the patient and the soul of the clinic: Person-centered medicine as an emergent model of modern clinical practice. International Journal of Person Centered Medicine, 1, 207-222.




DOI: http://dx.doi.org/10.5750/ejpch.v1i2.663

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