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Open Access Article

The Effects of Religiosity, Spirituality, and Social Support on Quality of Life: A Comparison Between Korean American and Korean Breast and Gynecologic Cancer Survivors

Jung-won Lim

Jaehee Yi

Korean American, spirituality, gynecologic cancer, breast neoplasms
ONF 2009, 36(6), 699-708. DOI: 10.1188/09.ONF.699-708

Purpose/Objectives: To examine the differences in religiosity, spirituality, and quality of life (QOL) between Korean American and Korean breast and gynecologic cancer survivors and investigate the effect of religiosity, spirituality, and social support on QOL.

Design: Cross-sectional design.

Setting: Participants were recruited from hospitals and community-based support groups in the areas of Southern California and Seoul, Korea.

Sample: 161 women diagnosed with breast and gynecologic cancer (110 Koreans and 51 Korean Americans).

Methods: Participants completed a mailed questionnaire. To identify the QOL outcomes, religiosity, spirituality, and social support, four standardized measures were used.

Main Research Variables: QOL outcomes, religiosity, spirituality, religious involvement, and social support.

Findings: Religiosity and spirituality were related to some QOL outcomes in different patterns in Korean American and Korean breast and gynecologic cancer survivors. The effect on QOL, however, was not strong after controlling for covariates. Social support partially mediated the effect of spirituality on QOL but only among the Korean American cancer survivors.

Conclusions: The findings provide evidence that the effect of religiosity and spirituality on QOL varied between Korean American and Korean survivors. The mediating effect of social support between spirituality and QOL for Korean Americans also was demonstrated.

Implications for Nursing: The results present nursing practice and research implications that religiosity, spirituality, and social support need to be considered in developing services for enhancing QOL of immigrant cancer survivors.

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    References

    Ashing-Giwa, K.T., Padilla, G., Tejero, J., & Kagawa-Singer, M. (2003). Understanding the breast cancer experience of Asian American women. Psycho-Oncology, 12(1), 38-58.
    Asianinfo. (2000). Religion in Korea. Retrieved February 15, 2008, from http://www.asianinfo.org/asianinfo/korea/rel/overview1.htm
    Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.
    Bekelman, D.B., Dy, S.M., Becker, D.M., Wittstein, I.S., Hendricks, D.E., Yamashita, T.E., et al. (2007). Spiritual well-being and depression in patients with heart failure. Journal of General Internal Medicine, 22(4), 470-477.
    Brennan, J. (2001). Adjustment to cancer—Coping or personal transition? Psycho-Oncology, 10(1), 1-18.
    Cohen, S., Underwood, L.G., & Gottlieb, B. (2000). Social support measurement and intervention: A guide for health and social scientists. London: Oxford University Press.
    Derogatis, L.R. (2000). Brief Symptoms Inventory (BSI) 18: Administration, scoring, and procedures manual. Minneapolis, MN: National Computer Systems.
    Dulin, P.L. (2005). Social support as a moderator of the relationship between religious participation and psychological distress in a sample of community dwelling older adults. Mental Health, Religion, and Culture, 8(2), 81-86.
    Ebright, R.R., & Lyon, B. (2002). Understanding hope and factors that enhance hope in women with breast cancer. Oncology Nursing Forum, 29(3), 561-568.
    Edser, S.J., & May, C.G. (2007). Spiritual life after cancer: Connectedness and the will to meaning as an expression of self-help. Journal of Psychosocial Oncology, 25(1), 67-85.
    Ferrell, B.R., Hassey, D.K., & Grant, M. (1995). Measurement of the quality of life in cancer survivors. Quality of Life Research, 4(6), 523-531.
    Ferrell, B.R., Smith, S.L., & Juarez, G. (2003). Meaning of illness and spirituality in ovarian cancer survivors. Oncology Nursing Forum, 30(2), 249-257.
    Fosarellie, P. (2008). Medicine, spirituality, and patient care. JAMA, 300(7), 836-838.
    Freud, S. (1933). The future of an illusion. New York: W.W. Norton.
    Harris, A.H.S., Thoresen, C.E., McCullough, M.E., & Larson, D.B. (1999). Spiritually and religiously oriented health interventions. Journal of Health Psychology, 4(3), 413-433.
    Hines, M.E. (2008). Commentary on "biopsychosocial benefits of spirituality in adults aging with HIV: Implications for nursing practice and research." New challenges for providing spiritual care in aging patients with HIV. Journal of Holistic Nursing, 26(2), 126-127.
    Holland, J.C., Passik, S., & Kash, K.M. (1999). The role of religious and spiritual beliefs in coping with malignant melanoma. Psycho-Oncology, 8(1), 417-428.
    Hurh, W. (1998). The Korean Americans. Westport, CT: Greenwood Press.
    Koening, H.G. (2002). An 83-year-old woman with chronic illness and strong religious beliefs. JAMA, 288(4), 487-493.
    Lengacher, C.A., Bennett, M.P., Kip, K.E., Gonzalez, L., Jacobsen, P., & Cox, C.E. (2006). Relief of symptoms, side effects, and psychological distress through use of complementary and alternative medicine in women with breast cancer. Oncology Nursing Forum, 33(1), 97-104.
    Levine, E.G., Yoo, G., Aviv, C., Ewing, C., & Au, A. (2007). Ethnicity and spirituality in breast cancer survivors. Journal of Cancer Survivorship, 1(3), 212-225.
    Lim, J.W., Yi, J., & Zebrack, B. (2008). Acculturation, social support, and quality of life for Korean immigrant breast and gynecological cancer survivors. Ethnicity and Health, 13(5), 243-260.
    Lim, J.W., & Zebrack, B. (2008). Different pathways in social support and quality of life between Korean American and Korean breast and gynecological cancer survivors. Quality of Life Research, 17(5), 679-689.
    Lowry, L.W., & Conco, D. (2002). Exploring the meaning of spirituality with aging adults in Appalachia. Journal of Holistic Nursing, 20(4), 388-402.
    McMillmurray, M.B., Francis, B., Harman, J.C., Morris, S.M., Soothill, K., & Thomas, C. (2003). Psychosocial needs in cancer patients related to religious beliefs. Palliative Medicine, 17(1), 49-54.
    Mickley, V., & Soeken, K. (1993). Religiousness and hope in Hispanic and Anglo American women with breast cancer. Oncology Nursing Forum, 20(8), 1171-1177.
    Min, J.W., Moon, A., & Lubben, J.E. (2005). Determinants of psychological distress over time among older Korean immigrants and non-Hispanic White elders. Aging and Mental Health, 9(3), 210-222.
    Moon, A., Lubben, J.E., & Villa, V. (1998). Awareness and utilization of community long-term care services by elderly Korean and non-Hispanic White Americans. Gerontologist, 38(3), 309-316.
    Mytko, J., & Knight, S.J. (1999). Body, mind, and spirit: Toward the integration of religiosity and spirituality in cancer quality of life research. Psycho-Oncology, 8(5), 439-450.
    National Cancer Policy Board. (2004). Meeting psychosocial needs of women with breast cancer. Washington, DC: National Academies Press.
    National Institute for Healthcare Research. (1997). Final report. Scientific progress in spiritual research. Rockville, MD.
    Park, S., & Bernstein, K.S. (2008). Depression and Korean American immigrants. Archives of Psychiatric Nursing, 22(1), 12-19.
    Peterman, A.H., Fitchett, G., & Brady, M.J. (2002). Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness theory—spiritual well-being scale (FACIT-Sp). Annals of Behavioral Medicine, 24(1), 49-58.
    Ramondetta, L.M., & Sills, D. (2004). Spirituality in gynecological oncology: A review. International Journal of Gynecological Cancer, 14(2), 183-201.
    Research Team of the Public Health Informatics Research Laboratory. (2005). Focus group report: Asian American health initiatives community health needs assessment. College Park, MD: Department of Public and Community Health.
    Reynolds, D. (2006). Examining spirituality among women with breast cancer. Journal of Holistic Nursing Practice, 20(3), 118-121.
    Schnoll, R.A., Knowles, J.C., & Harlow, L.L. (2002). Correlates of adjustment among cancer survivors. Journal of Psychosocial Oncology, 20(1), 37-59.
    Sherbourne, C.D., & Stewart, A.L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705-714.
    Shin, J.K. (2002). Help-seeking behaviors by Korean immigrants for depression. Issues in Mental Health Nursing, 23(5), 461-476.
    Stefanek, M., McDonald, P.G., & Hess, S.A. (2005). Religion, spirituality, and cancer: Current status and methodological challenges. Psycho-Oncology, 25(6), 450-463.
    Suh, S.A. (2004). Being Buddhist in a Christian world: Gender and community in a Korean American temple. Seattle, WA: University of Washington Press.
    Taylor, E.J. (2003). Spiritual needs of patients with cancer and family caregivers. Cancer Nursing, 26(4), 260-266.
    Thoresen, C.E. (1998). Spirituality, health, and science. In S. Roth-Roemer, S.E. Robinson-Kurpius, & C. Carmin (Eds.), The emerging role of counseling psychology in health care. New York: Norton.
    Thoresen, C.E., & Harris, A.H. (2002). Spirituality and health: What's the evidence and what's needed? Annals of Behavioral Medicine, 24(1), 3-13.
    Thune-Boyle, I.C., Stygall, J.A., & Keshtgar, M.R. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? Social Science and Medicine, 63(1), 151-164.
    Tomich, P.L., & Helgeson, V.S. (2002). Five years later: A cross-sectional comparison of breast cancer survivors with healthy women. Psycho-Oncology, 11(2), 154-169.
    Vachon, M.L.S. (2008). Meaning, spirituality, and wellness in cancer survivors. Seminars in Oncology Nursing, 24(3), 218-225.
    Ware, J.E., Snow, K.K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey: Manual and interpretation guide. Boston: Health Institute, New England Medical Center.
    Weaver, A.J., Flannelly, L.T., & Preston, J.D. (2003). Counseling survivors of traumatic events: A handbook for pastors and other helping professionals. Nashville, TN: Abingdon Press.
    Wenzel, L.B., Donnelly, J.P., Fowler, J.M., Habbal, R., Taylor, T.H., Aziz, N., et al. (2002). Resilience, reflection, and residual stress in ovarian cancer survivorship: A gynecologic oncology group study. Psycho-Oncology, 11(2), 142-153.