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Screening for religious/spiritual struggle in blood and marrow transplant patients

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Abstract

Purpose

A growing body of research documents the harmful effects of religious/spiritual (R/S) struggle (e.g., feeling abandoned or punished by God) among patients with a wide variety of diagnoses. Documented effects include poorer quality of life, greater emotional distress, poorer recovery, and increased disability. This study reports the use of a screening protocol that identified patients who may have been experiencing R/S struggle. We also examined the prevalence and correlates of possible R/S struggle, its association with quality of life, pain, and depressive symptoms and compared the results from the screening protocol with social workers’ assessments.

Methods

One hundred seventy-eight blood and marrow transplant patients completed the Electronic Self-Report Assessment—Cancer (ESRA-C) which included the Rush Religious Struggle Screening Protocol and other measures of quality of life, pain, and depressive symptoms prior to transplant therapy. All participants were assessed by a social worker, 90 % within 2 weeks of the ESRA-C assessment.

Results

Using the Rush Protocol, 18 % of the patients were identified as potentially experiencing R/S struggle. R/S struggle was not reported in any social work assessments. In a multivariable model, potential R/S struggle was more likely in patients who were more recently diagnosed, male, and Asian/Pacific Islanders. There were no significant associations between potential R/S struggle and quality of life, pain, or depressive symptoms.

Conclusions

Early identification of patients with R/S struggle will facilitate their referral for further assessment and appropriate intervention. Further research is needed to identify the best methods of screening patients for R/S struggle.

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Acknowledgments

The ESRA-C trial was funded by the National Institute of Nursing Research, R01 NR008726), PI Donna Berry. We also express appreciation to Geila Rajaee who assisted with coding the social work assessments.

Conflict of interest

None of the authors have a conflict of interest to declare. We have full control of the primary data and agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Seattle Cancer Care Alliance, PO Box 19023, G-1035, Seattle, WA, 98109, USA

    Stephen D. W. King

  2. Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA

    George Fitchett

  3. Harvard Medical School, Boston, MA, USA

    Donna L. Berry

  4. Dana-Farber Cancer Institute, Boston, MA, USA

    Donna L. Berry

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  1. Stephen D. W. King
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  2. George Fitchett
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  3. Donna L. Berry
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Correspondence to Stephen D. W. King.

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King, S.D.W., Fitchett, G. & Berry, D.L. Screening for religious/spiritual struggle in blood and marrow transplant patients. Support Care Cancer 21, 993–1001 (2013). https://doi.org/10.1007/s00520-012-1618-1

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