Rosemead School of Psychology, Biola University, La Mirada, California.
Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois.
Cancer. 2019 May 15;125(10):1726-1736. doi: 10.1002/cncr.31967. Epub 2019 Jan 11.
Existing research indicates that religion, spirituality, or both are important to the quality of life of patients with cancer. The current study is the first to characterize trajectories of spiritual well-being (SWB) over time and to identify their predictors in a large, diverse sample of long-term cancer survivors.
The participants were 2365 cancer survivors representing 10 cancer diagnoses from the American Cancer Society's Studies of Cancer Survivors-I, and they were assessed at 3 time points: 1, 2, and 9 years after their diagnosis. SWB was assessed with the 3 subscales of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp; ie, Meaning, Peace, and Faith). Predictors included demographic, medical, and psychosocial variables. Latent growth mixture modeling was used to identify trajectories and test their predictors.
Four distinct trajectories of SWB were identified for each of the FACIT-Sp subscales: stable-high (45%-61% of the sample, depending on the subscale), stable-moderate (23%-33%), stable-low (7%-16%), and declining (6%-10%). Significant predictors of these trajectories included age, sex, race, education, comorbidities, symptom burden, social support, and optimism, but not always in the hypothesized direction. For some of the subscale trajectories, a recurrence of cancer, multiple cancers, or metastatic cancer was associated with lower SWB.
This is the first study to establish the existence and predictors of heterogeneous trajectories of SWB in long-term survivors of cancer. Because SWB is an important component of quality of life, the current results indicate characteristics of persons who could be at greater risk for a decline or consistently low scores in SWB and may warrant clinical attention.
现有研究表明，宗教、灵性或两者都是癌症患者生活质量的重要因素。本研究首次描述了在一个大型、多样化的长期癌症幸存者样本中，随时间推移的精神幸福感（SWB）轨迹，并确定了其预测因素。
该研究的参与者是来自美国癌症协会癌症幸存者研究 I 的 2365 名癌症幸存者，代表 10 种癌症诊断，他们在诊断后 1、2 和 9 年进行了 3 次评估。SWB 通过慢性疾病治疗的功能评估-精神幸福感（FACIT-Sp；即意义、和平和信仰）的 3 个分量表进行评估。预测因素包括人口统计学、医学和心理社会变量。使用潜在增长混合模型来识别轨迹并测试其预测因素。
为每个 FACIT-Sp 分量表确定了 SWB 的四个不同轨迹：稳定高（取决于分量表，占样本的 45%-61%）、稳定中（23%-33%）、稳定低（7%-16%）和下降（6%-10%）。这些轨迹的显著预测因素包括年龄、性别、种族、教育程度、合并症、症状负担、社会支持和乐观主义，但并不总是按照假设的方向。对于一些子量表轨迹，癌症复发、多种癌症或转移性癌症与较低的 SWB 相关。
这是第一项确定长期癌症幸存者 SWB 异质轨迹的存在及其预测因素的研究。由于 SWB 是生活质量的重要组成部分，因此目前的结果表明，存在特征可能使某些人面临 SWB 下降或持续低评分的风险更高，这可能需要临床关注。
