Cancer. 2015 Aug 10. doi: 10.1002/cncr.29353. [Epub ahead of print]
Jim HS1,
Pustejovsky JE2,
Park CL3,
Danhauer SC4,
Sherman AC5,
Fitchett G6,
Merluzzi TV7,
Munoz AR8,
George L3,
Snyder MA8,9,
Salsman JM8,9.
- 1Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
- 2Department of Educational Psychology, University of Texas at Austin, Austin, Texas.
- 3Department of Psychology, University of Connecticut, Storrs, Connecticut.
- 4Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina.
- 5Behavioral Medicine Division, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
- 6Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois.
- 7Department of Psychology, University of Notre Dame, Notre Dame, Indiana.
- 8Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
- 9Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.
Abstract
Although religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, a meta-analysis of the relation between R/S and patient-reported physical health in cancer patients was performed. A search of PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library yielded 2073 abstracts, which were independently evaluated by pairs of raters. The meta-analysis was conducted for 497 effect sizes from 101 unique samples encompassing more than 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and 'other' dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher z scores) were calculated with generalized estimating equations with robust variance estimation. Overall R/S was associated with overall physical health (z = 0.153, P < .001); this relation was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z = 0.167, P < .001), functional well-being (z = 0.343, P < .001), and physical symptoms (z = 0.282, P < .001). Cognitive R/S was associated with physical well-being (z = 0.079, P < .05) and functional well-being (z = 0.090, P < .01). 'Other' R/S was associated with functional well-being (z = 0.100, P < .05). In conclusion, the results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients' religious and spiritual needs as part of comprehensive cancer care.
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