Spirituality and Social Support: How They Influence Quality of Life in Cancer Patients

Background and Purpose: A diagnosis of cancer has significant effects on psychosocial functioning. Psychosocial distress manifests as anxiety or depression, and concern over quality of life (QOL) often accompany diagnosis and treatment. Research suggests nearly 45% of cancer patients report distress, yet less than 10% receive psychosocial interventions (Carlson & Bultz, 2003). Extant research suggests that spiritual and social support contribute to reductions in distress in cancer patients. The objective of this study was to examine the relationship between social support and spirituality on emotional well-being, social functioning and QOL after controlling for gender, race, and marital status of individuals with cancer. Methods: Secondary data analyses were conducted using data from 431 patients participating in the development of a Psychosocial Cancer Registry at a National Cancer Institute designated Comprehensive Cancer Center. Upon enrollment patients completed standardized cancer-specific measures assessing QOL (Functional Assessment of Cancer Therapy (FACT-G) and Spirituality (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp). Social support was assessed with the Medical Outcome Study (MOS).Participants were interviewed upon enrollment (T1) then again at three months (T2) and 12 months (T3). Data were analyzed using cross-sectional analyses at T1 & T2 assessing change over time while assessing the relationship between spirituality and social support on QOL. Results: Women were 57% of the enrolled patients while 76% of the enrollees were Caucasian. Eighty-two percent of the patients were diagnosed as having either stage III or IV cancer at enrollment. Acceptable reliability was established for the FACT-G (ƒÑ=.69) while also for the subscales of social well-being [SWB] (ƒÑ=.73), functional well-being [FWB] (£\=.83) and emotional well-being [EWB] (ƒÑ=.77). FACIT-Sp reliability was £\=.76. MOS reliability was £\=.89. A significant difference was found between females and males on EWB (p=.033) at T1 and T2 (p=.031). On spirituality, significant differences were found between females and males on comfort in spiritual beliefs (p=.009) and strength of spiritual beliefs (p=.015). African Americans reported higher spirituality than Caucasians (p<.05). There was also a significant difference at T1 between those with local and advanced cancer when asked about the illness strengthening their faith (p=.035), however, at T2 this significance disappeared. Significant correlations were found when examining the relationships between social support and spirituality on QOL. SWB was correlated with MOS at r=.533 (p=.000) while FWB was correlated with MOS at r=.325 (p=.000). Spirituality was correlated with SWB at r=.441 (p=.001) and with FWB at r=.474 (p=.000).

Conclusion and Implications: Findings indicating social and spiritual support as positively influencing QOL continues to strengthen the importance of those factors in coping with cancer. Further research into how spirituality and social support interact with other variables such as age and cancer type is needed. It is clear that intervention for cancer survivors on the physiological, psychological, and social levels is paramount following diagnosis and treatment. This discussion will also present a psychosocial oncology research agenda for social workers as well as how social workers can effectively practice and intervene with cancer patients.