The Effects of Spirituality on Well-Being of People With Lung Cancer

Martha Gene Meraviglia

ONF 2004, 31(1), 89-94. DOI: 10.1188/04.ONF.89-94

Purpose/Objectives: To examine the effects of spirituality on the sense of well-being of people with lung cancer.

Design: Descriptive, correlational study.

Setting: Urban and rural oncology and radiation centers.

Sample: 60 adults ranging from 33-83 years of age. Most participants had non-small cell lung cancer and were female, Caucasian, and older than 50.

Methods: Participants completed a questionnaire composed of six survey instruments: Life Attitude Profile-Revised, Adapted Prayer Scale, Index of Well-Being, Symptom Distress Scale, a background information sheet, and a cancer characteristics questionnaire. Correlations among study concepts were examined, and multiple regression analysis was used to determine the effects of spirituality.

Main Research Variables: Meaning in life, prayer activities and experiences, symptom distress, and psychological well-being.

Findings: Higher meaning in life scores were associated with higher psychological well-being and lower symptom distress scores. Higher prayer scores were associated with higher psychological well-being scores. Regression analysis indicated that meaning in life mediated the relationship between functional status and physical responses to lung cancer and explained 9% of the variance in symptom distress. Prayer mediated the relationship between current physical health and psychological responses and explained 10% of the variance in psychological well-being.

Conclusions: Aspects of spirituality, meaning in life, and prayer have positive effects on psychological and physical responses in this group of people with lung cancer.

Implications for Nursing: This research provides knowledge about spirituality and sense of well-being to guide the care of people with lung cancer.

Jump to a section


    Barnum, B.S. (1996). Spirituality in nursing: From traditional to new age. New York: Springer.

    Bennett, J. (2000). Mediator and moderator variables in nursing research: Conceptual and statistical differences. Research in Nursing and Health, 23, 415-420.

    Byrd, R.C. (1988). Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Medical Journal, 81, 826-830.

    Campbell, A., Converse, P.E., & Rodgers, W.L. (1976). The quality of American life: Perceptions, evaluations, and satisfactions. New York: Russell Sage Foundation.

    Cooley, M.E. (2002). Patterns of symptom distress in adults receiving treatment for lung cancer. Journal of Palliative Care, 18, 150-159.

    Duckro, P.N., & Magaletta, P.R. (1994). The effect of prayer on physical health: Experimental evidence. Journal of Religion and Health, 33, 211-219.

    Emblen, J. (1992). Religion and spirituality defined according to current use in nursing literature. Journal of Professional Nursing, 8, 41-47.

    Epperly, B.G. (1995). To pray or not to pray: Reflections on the intersection of prayer and medicine. Journal of Religion and Health, 34, 141-148.

    Erickson, H.C., Tomlin, E.M., & Swain, M.A. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Columbia, SC: R.L. Bryan.

    Flannelly, L., Flannelly, K., & Weaver, A. (2002). Religious and spiritual variables in three major oncology nursing journals: 1990-1999. Oncology Nursing Forum, 29, 679-685.

    Foster, R.J. (1992). Prayer: Finding the heart's true home. San Francisco: Harper.

    Frankl, V.E. (1962). Man's search for meaning. New York: Pocket Books.

    Gartner, J., Larson, D.B., & Allen, G.D. (1991). Religious commitment and mental health: A review of the empirical literature. Journal of Psychology and Theology, 19, 6-25.

    Halstead, M.T., & Mickley, J.R. (1997). Attempting to fathom the unfathomable: Descriptive views of spirituality. Seminars in Oncology Nursing, 13, 225-230.

    Harris, W.S., Gowda, M., Kolb, J.W., Strychacz, C.P., Vacek, J.L., Jones, P.G., et al. (1999). A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Archives of Internal Medicine, 159, 2273-2278.

    Highfield, M. (1992). Spiritual health of oncology patients. Cancer Nursing, 15, 1-8.

    King, D.G. (1990). Religion and health relationships: A review. Journal of Religion and Health, 29, 101-112.

    Kurtz, M., Kurtz, J., Stommel, M., Given, D., & Given, B. (1999). The influence of symptoms, age, comorbidity, and cancer site on physical functioning and mental health of geriatric women patients. Women and Health, 29(3), 1-12.

    Malinski, Y. (2002). Research issues: Developing a nursing perspective on spirituality and healing. Nursing Science Quarterly, 15, 281-287.

    Martsolf, D.S., & Mickley, J.R. (1998). The concept of spirituality in nursing theories: Differing world-views and extent of focus. Journal of Advanced Nursing, 27, 294-303.

    McClement, S., Woodgate, R., & Degner, L. (1997). Symptom distress in adult patients with cancer. Cancer Nursing, 20, 236-243.

    McCorkle, R. (1987). The measurement of symptom distress. Seminars in Oncology Nursing, 3, 248-256.

    McCullough, M.E. (1995). Prayer and health: Conceptual issues, research review, and research agenda. Journal of Psychology and Theology, 23, 15-29.

    Meisenhelder, J.B., & Chandler, E.N. (2000). Prayer and health outcomes in church members. Alternative Therapies in Health and Medicine, 6(4), 56-60.

    Meraviglia, M. (1999). Critical analysis of spirituality and its empirical indicators, prayer and meaning in life. Journal of Holistic Nursing, 17(1), 18-33.

    Meraviglia, M. (2002). Prayer in people with cancer. Cancer Nursing, 25, 326-331.

    Merriam-Webster Dictionary. (2003). Spirituality. Retrieved November 17, 2003, from

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

    Peacock, E.J., & Reker, G.T. (1982). The Life Attitude Profile (LAP): Further evidence of reliability and empirical validity. Canadian Journal of Behavioural Science, 14, 92-95.

    Poloma, M.M., & Pendleton, B.F. (1991). The effects of prayer and prayer experiences on measures of general well-being. Journal of Psychology and Theology, 19, 71-83.

    Reker, G.T. (1992). Life Attitude Profile-Revised. Peterborough, Canada: Student Psychologists.

    Reker, G.T. (1994). Logotheory and logotherapy: Challenges, opportunities, and some empirical findings. International Forum for Logotherapy, 17(1), 47-55.

    Reker, G.T., Peacock, E.J., & Wong, P.T. (1987). Meaning and purpose in life and well-being: A life span perspective. Journal of Gerontology, 42, 44-49.

    Skinn, B. (1994). The relationship of belief in control and purpose in life to adult lung cancer patient's information to use unproven cancer therapies. Canadian Oncology Nursing Journal, 4(2), 66-71.

    Smith, E.D., Stefanek, M.E., Joseph, M.V., Verdieck, M.J., Zabora, J.R., & Fetting, J.H. (1993). Spiritual awareness, personal perspective on death, and psychosocial distress among cancer patients: An initial investigation. Journal of Psychosocial Oncology, 11(3), 89-103.

    Stoll, R. (1989). The essence of spirituality. In V.B. Carson (Ed.)Spiritual dimensions of nursing practice (pp. 4-23). Philadelphia: Saunders.

    Tanyi, R.A. (2002). Towards clarification of the meaning of spirituality. Journal of Advanced Nursing, 39, 500-509.

    Taylor, E.J. (2001). Spirituality, culture, and cancer care. Seminars in Oncology Nursing, 17, 197-205.

    Taylor, E.J. (2002). Spiritual care: Nursing theory, research, and practice. Upper Saddle River, NJ: Prentice Hall.

    Taylor, E.J., Highfield, M.F., & Amenta, M. (1999). Predictors of oncology and hospice nurses' spiritual care perspectives and practices. Applied Nursing Research, 12, 30-37.

    Thomas, C.R., Williams, T.E., Cobos, E., & Turrisi, A.T. (2001). Lung cancer. In R.E. Lenhard, R.T. Osteen, & T. Gansler (Eds.)Clinical oncology (3rd ed., pp. 269-296). Atlanta, GA: American Cancer Society.

    Thompson, S.C., & Pitts, J. (1993). Factors relating to a person's ability to find meaning after a diagnosis of cancer. Journal of Psychosocial Oncology, 11(3), 1-21.