A survey on relationship between religion, spiritual wellbeing, hope and quality of life in patients with cancer

Document Type : Original Quantitative and Qualitative Research Paper


1 Faculty of Nursing, Islamic Azad university, Uremia Branch, Uremia Iran

2 Student in Sociology, Payam Noor University of Tehran Center, Tehran, Iran


Background:Religion, spiritual well- being and hope are concepts that are frequently used as a source of coping in patients with cancer. However, few studies have examined these factors with independent measurement devices.
Aim: To determine the relationship between religion, spiritual wellbeing, hope and quality of life in cancer patients admitted to Omid’s Hospital in Urmia city from August to January 2010.
Method: In this cross sectional descriptive-analytical research, 164 patients with cancer were selected using sequential convenience sampling. Data were collected using demographic characteristics form, quality of life questionnaire EORTC QOL-C30, Ellison and Paloutzain spiritual well- being questionnaire, Duke University Religion Index, and the Herth Hope Index. Data was analyzed using SPSS Software (v.11.5), statistical test Pearson correlation coefficient and multiple regressions were done and P < 0.05 considered statistically significant.
Results: Spiritual well-being (r = 0.23, p <0.01) and hope (r = 0.23, p <0.01) had a significant positive relationship with the functional quality of life scale. Spiritual well- being (r = 0.34, p <0.01) and hope (r = 0.46, p <0.01) had a significant positive correlation with the overall quality of life. Between religious practices and the overall quality of life was significant correlation (r = 0.18, p <0.05). Also hope and religious beliefs explained 25/8 percent of changes in overall quality of life.
Conclusion: There was a significant relationship between spiritual health, religious practices, hope and quality of life. Considering some factors such as being purposeful in the life, believing in God, doing religious practices and being optimistic about the future, while providing the health cares for patients with cancer might increase their quality of life.


1. Akyuz A, Guvenc G, Ustunsoz A, Kaya T. Living with gynecologic cancer: experience of women and their partners. Journal of Nursing Scholarship. 2008; 40 (3) :241–7.
2. Hounsgaard L, Petersen LK, Pedersen BD. Facing possible illness detected through screening. Experiences of healthy women with pathological smears. European Journal Oncology Nursing. 2007;11:417–23.
3. Reb AM. Transforming the death sentence: elements of hope in women with advanced ovarian cancer. Oncology Nursing Forum. 2007; 34 (6) : E70–81.
4. Michael M, Tannok L. Measuring health related quality of life in clinical trial evaluated the role of chemotherapy in cancer treatment. Canadian Medical Association Journal 1998: 1727-34.
5. Lehto US, Ojanen M, Kellokumpu-Lehtinen P. Predictors of quality of life in newly diagnosed melanoma and breast cancer patients. Annals of Oncology 2005;16:805-16.
6. Rustøen T,Cooper BA, Miaskowski Ch. The Importance of Hope as a Mediator of Psychological Distress and Life Satisfaction in a Community Sample of Cancer Patients. Cancer Nursing. 2010;33 (4) :258-67
7. Fuller J, Schaller-Ayers J. Health assessment. 3rn ed. Philadelphia: Lippincott Co; 1999. P. 1006
8. Wonghongkul T. Uncertainty Appraisal, Hope, and Coping in Breast Cancer Survivors. Oncology Nursing Forum. 1999;23 (4) :663-71.
9. Lee E. Fatigue and hope: relationships to psychological adjustment in Korean women with breast cancer. Applied Nursing Research. 2001; 14 (2) :87-93.
10. Herth K. Enhancing hope in people with a first recurrence. Journal of Advanced Nursing. 2000; 32 (6) : 1431-41.
11. Tarakeshwar N, Vanderwerker LC, Paulk E. Religious coping is associated with the quality of life of patients with advanced cancer. Journal of Palliative Medicine. 2006; 9: 646-57.
12. Nelson CJ, Rosenfeld B, Breitbart W. Spirituality, religion, and depression in the terminally ill. Psychosomatics. Journal of Palliative Medicine 2002; 43:213-20.
13. Borman PD, Nicholas DR. Spirituality, religiosity, and the quality of life of oncology patients. Journal of Clinical Oncology. 1999;12 (6) :453-60.
14. Lamp J. Nurses at the bed side influencing outcome. Nurs Clin North Am 1997;33 (3) :583-7.
15. Slevin ML, Plant H, Lynch D, Drinkwater J, Gregory WM. Who should measure quality of life, the doctor or the patient? British Journal Cancer 1988;57: 109-12.
16. Pipe TB, Kelly A, LeBrun G, Schmidt D, Atherton P, Robinson C. A Prospective Descriptive Study Exploring Hope, Spiritual Well-Being, and Quality of Life in Hospitalized Patients. Medical Surgical Nursing 2008; 17 (4) : 247-53
17. Benzein E, Berg A. The level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care. Palliative Medicine. 2005; 19 (3) :234–40
18. Herth K, Cutcliffe JR. The concept of hope in nursing 3: Hope and palliative care nursing. British Journal of nursing. 2002; 11 (14) : 977-982.
19. Faran CJ, Herth KA, Popovich JM. Hope and hopelessness: critical clinical constructs. Journal of Advance Nursing. 1995;15:1250-9.
20. McClementa SE, Chochinovb HM. Hope in advanced cancer patients. European Journal of Cancer. 2008; 44: 1169 –1174.
21. Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan C, Peteet J, etal. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology. 2007; 25 (5) :555-60.
22. Hawks SR, Hull ML, Thalman RL, Richins PM. Review of spiritual health: definition, role, and intervention. Strategies in health promotion. American Journal of Health Promotion 1995; 9:371-8.
23. Rippentrop AE, Altmaier EM, Burns CP. The relationship of religiosity and spirituality to quality of life among cancer patients. Journal of Clinical Psychology in Medical Setting. 2006;13 (1) :31-7.
24. Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinic Proceedings. 2001; 7 (6) :1225-35.
25. McClain CS, Rosenfeld B, Breitbart W. The influence of spiritual well-being on end-of-life despair in a group of terminally ill cancer patients. Lancet. 2003; 361:1603-7.
26. Meraviglia MG. Critical analysis of spirituality and its empirical indicators: Prayer and meaning in life. Journal of Holistic Nursing. 1999; 17:18-33.
27. Brady M J,Peterman AH, Fitchett G, Mo Mo&Cella D. (1999). A case for including spirituality in quality of life measurement in oncology. Psychology-Oncology. 8 (12) : 417–28.
28. Bufford RK,Paloutzian RF, & Ellison CW. Norms for the spiritual well-being scale. Journal of Psychology and Theology. 1991; 19 (23) : 56–70.
29. Fayers P, Aaronson N, Bjordal K,Groenvold M,Curran D&Bottomley A. EORTC QLQ-C30. Scoring Manual. EORTC Quality of Life Group, EORTC Data Centre, Brussels, Belgium. 2001
30. Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ–C30) :
translation and validation study of the Iranian version. Support Care Cancer. 1999; 7: 400-6
31. Paloutzian RE, Park CL. Psychology of religion and applied areas. In: Paloutzian RE, Park CL. Handbook of the Psychology of religion and spirituality. 1th ed. Uk. Guilford press; 2005.
32. Koenig H, Parkerson GR, Meador K G. Religion index for psychiatric research. American Journal of Psychiatry. 1997;153: 885. 6
33. Allahbakhshian M, Jaffarpour M, Parvizy S, Haghani H. A Survey on relationship between spiritual wellbeing and quality of life in multiple sclerosis patients. . Zahedan Journal of Research Medical Sciences 2010; 12 (3) : 29-32 (Persian)
34. Esbensen BA, Østerlind K, Roer O, Hallberg IR. Quality of life of elderly persons with newly diagnosed cancer European Journal of Cancer Care. 2004; 13:443–53
35. John-Paul Vader. Spiritual health: the next frontier. The European Journal of Public Health. 2006; 2 (12) ;541-7.
36. Livneh H, Lott Sh, Antonak R. Patterns of psychosocial adaptation to chronic illness and disability: a cluster analytic approach. Psychology, Health & Medicine. 2004; 9 (4) : 411-30