Abstract
We examined the relationship between intrinsic religiousness and well-being, with control-related religious coping and self-efficacy for coping with cancer as potential mediators of this relationship among cancer patients. In a cross-sectional design, 179 ambulatory cancer patients completed measures of intrinsic religiousness, religious coping, self-efficacy for coping with cancer, well-being, and demographic variables. Type of cancer, stage of cancer, and time since diagnosis were collected from electronic medical charts. In a path model, the positive association between intrinsic religiousness and three types of well-being—physical, functional, and social—was fully mediated by active religious surrender and self-efficacy for coping with cancer. In addition, the negative association between passive religious deferral and all four types of well-being—physical, functional, social, and emotional—was fully mediated by self-efficacy for coping with cancer. Finally, there was a negative direct association between pleading for God’s direct intercession and emotional well-being. These findings suggest pathways by which intrinsic religiousness and control-related religious coping are linked to various dimensions of well-being among cancer patients.
Similar content being viewed by others
References
Albrecht, K., Droll, H., Giesler, J. M., Nashan, D., Meiss, F., & Reuter, K. (2013). Self-efficacy for coping with cancer in melanoma patients: Its association with physical fatigue and depression. Psycho-Oncology, 22, 1972–1978. doi:10.1002/pon.3238
Allen, J. D., Pérez, J. E., Tom, L., Leyva, B., Diaz, D., & Torres, M. I. (2013). A pilot test of a church-based intervention to promote multiple cancer-screening behaviors among Latinas. Journal of Cancer Education (Advance online publication). doi: 10.1007/s13187-013-0560-3
Allport, G. W., & Ross, J. M. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5, 432–443. doi:10.1037/h0021212
Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26. doi:10.1146/annurev.psych.52.1.1
Bassett, R. L. (1999). Intrinsic Religious Motivation Scale. In P. C. Hill & R. W. Hood Jr (Eds.), Measures of religiosity (pp. 135–137). Birmingham, AL: Religious Education Press.
Benson, P. L., Dehority, J., Garman, L., Hanson, E., Hochschwender, M., Lebold, C., et al. (1980). Intrapersonal correlates of non-spontaneous helping behavior. Journal of Social Psychology, 110, 87–95. doi:10.1080/00224545.1980.9924226
Byrd, K. R., Hageman, A., & Isle, D. B. (2007). Intrinsic motivation and subjective well-being: The unique contribution of intrinsic religiousness. International Journal for the Psychology of Religion, 17, 141–156. doi:10.1080/10508610701244155
Caplan, L. S., Sawyer, P., Holt, C., & Allman, R. M. (2013). Religiosity and function among community-dwelling older adult survivors of cancer. Journal of Religion, Spirituality & Aging, 25, 311–325. doi:10.1080/15528030.2013.787575
Cella, D. F., Tulsky, D. S., Gray, G., Sarafian, B., Linn, E., & Bonomi, A., et al. (1993). The Functional Assessment of Cancer Therapy Scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.
Fehring, R. J., Miller, J. F., & Shaw, C. (1997). Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncology Nursing Forum, 24, 663–671.
Fox, J. (1991). Regression diagnostics. Newbury Park, CA: Sage Publications.
Gall, T. L., Guirguis-Younger, M., & Florack, P. (2009). The trajectory of religious coping across time in response to the diagnosis of breast cancer. Psycho-Oncology, 18, 1165–1178. doi:10.1002/pon.1495
Heitzmann, C. A., Merluzzi, T. V., Jean-Pierre, P., Roscoe, J. A., Kirsh, K. L., & Passik, S. D. (2011). Assessing self-efficacy for coping with cancer: Development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B). Psycho-Oncology, 20, 302–312. doi:10.1002/pon.1735
Hoge, D. R. (1972). A validated intrinsic religiousness scale. Journal for the Scientific Study of Religion, 11, 369–376. doi:10.2307/1384677
Holt, C. L., Wang, M. Q., Caplan, L., Schulz, E., Blake, V., & Southward, V. L. (2011). Role of religious involvement and spirituality in functioning among African Americans with cancer: Testing a meditational model. Journal of Behavioral Medicine, 34, 437–448. doi:10.1007/s10865-010-9310-8
Howsepian, B. A., & Merluzzi, T. V. (2009). Religious beliefs, social support, self-efficacy and adjustment to cancer. Psycho-Oncology, 18, 1069–1079. doi:10.1002/pon.1442
Hu, L.-T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. doi:10.1080/10705519909540118
Hui, V. K.-Y., & Coleman, P. G. (2013). Afterlife beliefs and ego integrity as two mediators of the relationship between intrinsic religiosity and personal death anxiety among older adult British Christians. Research on Aging, 35, 144–162. doi:10.1177/0164027512436429
Jöreskog, K., & Sörbom, D. (1996). LISREL 8: User’s reference guide. Chicago, IL: Scientific Software International.
Kenny, D. A., Kashy, D. A., & Bolger, N. (1998). Data analysis in social psychology. In D. Gilbert, S. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (vol. 1, 4th ed., pp. 233–265). Boston, MA: McGraw-Hill.
Koenig, H. G., George, L. K., & Peterson, B. L. (1998). Religiosity and remission of depression in medically ill older patients. American Journal of Psychiatry, 155, 536–542.
Kristeller, J. L., Sheets, V., Johnson, T., & Frank, B. (2011). Understanding religious and spiritual influences on adjustment to cancer: Individual patterns and differences. Journal of Behavioral Medicine, 34, 550–561. doi:10.1007/s10865-011-9335-7
Liu, E. Y., & Koenig, H. G. (2013). Measuring intrinsic religiosity: Scales for use in mental health studies in China—A research report. Mental Health, Religion & Culture, 16, 215–224. doi:10.1080/13674676.2012.672404
Masters, K. S., & Knestel, A. (2011). Religious orientation among a random sample of community-dwelling adults: Relations with health status and health-relevant behaviors. International Journal for the Psychology of Religion, 21, 63–76. doi:10.1080/10508619.2011.532450
McLaughlin, B., Yoo, W., D’Angelo, J., Tsang, S., Shaw, B., Shah, D., et al. (2013). It is out of my hands: How deferring control to God can decrease quality of life for breast cancer patients. Psycho-Oncology, 22, 2747–2754. doi:10.1002/pon.3356
Merluzzi, T. V., Nairn, R. C., Hegde, K., & Martinez Sanchez, M. A. (2001). Self-efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (Version 2.0). Psycho-Oncology, 10, 206–217. doi:10.1002/pon.511
Merluzzi, T. V., Nairn, R. C., & Martinez Sanchez, M. A. (1999). A manual for the Cancer Behavior Inventory: A measure of self-efficacy for coping with cancer (Version 2.0). Notre Dame, IN: University of Notre Dame, Department of Psychology.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York: Guilford Press.
Nairn, R. C., & Merluzzi, T. V. (2003). The role of religious coping in adjustment to cancer. Psycho-Oncology, 12, 428–441. doi:10.1002/pon.654
Nelson, C., Jacobson, C. M., Weinberger, M. I., Bhaskaran, V., Rosenfeld, B., Breitbart, W., et al. (2009). The role of spirituality in the relationship between religiosity and depression in prostate cancer patients. Annals of Behavioral Medicine, 38, 105–114. doi:10.1007/s12160-009-9139-y
Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. New York: Guilford Press.
Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543. doi:10.1002/(SICI)1097-4679(200004)56:4<519:AID-JCLP6>3.0.CO;2-1
Park, C. L., Edmondson, D., Hale-Smith, A., & Blank, T. O. (2009). Religiousness/spirituality and health behaviors in younger adult cancer survivors: Does faith promote a healthier lifestyle? Journal of Behavioral Medicine, 32, 582–591. doi:10.1007/s10865-009-9223-6
Pérez, J. E., Rex Smith, A., Norris, R. L., Canenguez, K. M., Tracey, E. F., & DeCristofaro, S. B. (2011). Types of prayer and depressive symptoms among cancer patients: The mediating role of rumination and social support. Journal of Behavioral Medicine, 34, 519–530. doi:10.1007/s10865-011-9333-9
Philip, E. J., Merluzzi, T. V., Zhang, Z., & Heitzmann, C. A. (2013). Depression and cancer survivorship: Importance of coping self-efficacy in post-treatment survivors. Psycho-Oncology, 22, 987–994. doi:10.1002/pon.3088
Ross, L. E., Hall, I. J., Fairley, T. L., Taylor, Y. J., & Howard, D. L. (2008). Prayer and self-reported health among cancer survivors in the United States, National Health Interview Survey, 2002. Journal of Alternative and Complementary Medicine, 14, 931–938. doi:10.1089/acm.2007.0788
Schreiber, J. A., & Brockopp, D. Y. (2012). Twenty-five years later—what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. Journal of Cancer Survivorship, 6, 82–94. doi:10.1007/s11764-011-0193-7
Sherman, A. C., Plante, T. G., Simonton, S., Latif, U., & Anaissie, E. J. (2009). Prospective study of religious coping among patients undergoing autologous stem cell transplantation. Journal of Behavioral Medicine, 32, 118–128. doi:10.1007/s10865-008-9179-y
Steffen, P. R., & Masters, K. S. (2005). Does compassion mediate the intrinsic religion–health relationship? Annals of Behavioral Medicine, 30, 217–224. doi:10.1207/s15324796abm3003_6
Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston, MA: Pearson Education Inc.
Thuné-Boyle, I. C. V., Stygall, J., Keshtgar, M. R. S., Davidson, T. I., & Newman, S. P. (2013). Religious/spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psycho-Oncology, 22, 646–658. doi:10.1002/pon.3048
Thuné-Boyle, I. C., Stygall, J. A., Keshtgar, M. R., & Newman, S. P. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social Science and Medicine, 63, 151–164. doi:10.1016/j.socscimed.2005.11.055
Umezawa, Y., Lu, Q., You, J., Kagawa-Singer, M., Leake, B., & Maly, R. C. (2012). Belief in divine control, coping, and race/ethnicity among older women with breast cancer. Annals of Behavioral Medicine, 44, 21–32. doi:10.1007/s12160-012-9358-5
Weisman, A. D., & Worden, J. W. (1976–77). The existential plight of cancer: Significance of the first 100 days. International Journal of Psychiatry in Medicine, 7, 1–15. doi:10.2190/UQ2G-UGV1-3PPC-6387
Acknowledgments
This study was funded by a National Cancer Institute U56 Comprehensive Cancer Partnership Program Grant (U56 CA118635). We gratefully acknowledge the contributions of Sarah Ahmad, Esteban Barreto, Katia Canenguez, Susan DeCristofaro, Rebecca Norris, Laurel Radwin, Geraldine Sanon, Max Stewart, Elizabeth Tracey, and the participants in this research. We especially thank Karen Emmons and Adán Colón-Carmona for their excellent leadership and support of the institutional partnership.
Conflict of interest
John E. Pérez and Amy Rex Smith declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients included in the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pérez, J.E., Rex Smith, A. Intrinsic religiousness and well-being among cancer patients: the mediating role of control-related religious coping and self-efficacy for coping with cancer. J Behav Med 38, 183–193 (2015). https://doi.org/10.1007/s10865-014-9593-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-014-9593-2