Spirituality in adolescents with cancer

doi:10.1016/S1130-8621(18)30032-9

Enfermería Clínica

Volume 28, Supplement 1, February–June 2018, Pages 31-35

https://doi.org/10.1016/S1130-8621(18)30032-9 Get rights and content

Abstract

Objective

As adolescents with cancer are at risk of experiencing spiritual distress, they tend to have unique spiritual needs. Spirituality plays a significant role for adolescents with cancer as it contributes to increased comfort and calmness, and better coping mechanisms when confronted with the illness, which indirectly improves the adolescent’s quality of life. This study aimed to explore spiritual experiences in adolescents with cancer.

Method

A qualitative study using a phenomenology approach was conducted. Nine adolescents with chemotherapy-treated cancer were purposefully selected to be involved in this study. The data were analyzed using thematic analysis.

Results

This study identified six spiritual themes in adolescents with cancer: a) accepting their illness; b) believing their illness in God’s will; c) improving spiritual practices; d) expressing empathy to parents; e) maintaining relationships with significant others, and f) achieving self-actualization.

Conclusions

This study demonstrated that spirituality gave hope to adolescents by helping them to overcome existential problems related to cancer. We believe it is necessary for nurses to address the spiritual needs of adolescent with cancer as this will help these young people accept their condition with more grace and humility.

Introduction

Cancer is a disease with a high mortality rate, and it is still an unresolved health problem in many countries. In Indonesia, cancer deaths are ranked seventh among all disease-induced deaths, with a prevalence of 1.4 deaths per 1000 population¹. The International Agency for Research on Cancer (IARC) revealed that there are 14 million new cases of cancer in children and adult occurring in the world today, and the World Health Organization has estimated that cancer survivors will continue to increase up to 11 million by 2030²^,³.

Cancer can strike anyone regardless of age group, including children⁴. Adolescence is a period of rapid growth and development, where an individual’s life potential also begins to manifest. A cancer diagnosis during this important period will affect an adolescent’s next stage of life⁵. Adolescents who experience cancer have unique spiritual needs related to their critical health condition, and this puts them at higher risk of experiencing spiritual distress⁶.

As adolescents with cancer tend to have unique spiritual needs, nurses should try to understand these needs. Nurses play a pivotal role in providing spiritual care to patients, by being good listeners and encouraging patients to express their beliefs⁷. The International Council of Nurses Code of Ethics for Nurses said that all nurses need to look after the spiritual needs of their patients.

Currently, the majority of nurses are mainly focused on how to meet the adolescent cancer patients’ physiological needs. Despite being aware that these patients have unique spiritual needs, nurses are still more focused on the physical needs rather than these spiritual needs⁸. The spiritual needs of adolescents with cancer need to be explored further. This will enable nurses, as caregivers, to include addressing the spiritual needs of these patients in their repertoire, which may indirectly improve each patient’s quality of life.

Section snippets

Method

A descriptive phenomenological approach was used to explore the phenomenon of those patients who were affected by cancer in the study. This approach describes the essence of the experience of adolescents with cancer⁹. The participants were nine adolescents aged between 10–19 years, all of whom had cancer and underwent chemotherapy. A purposive sampling approach was used to recruit participants from the Indonesian Pediatric Oncology Foundation. The study was presented to the eligible

Results

Nine adolescents participated on this study were aged between 14–18 years. They were diagnosed with non-Hodgkin lymphoma (2 participants), nasopharynx cancer (5 participants), acute lymphoblastic leukemia (2 participants), and ovarian cancer (1 participant).

A total of 6 themes were identified to describe the spirituality of adolescents with cancer undergoing chemotherapy. The themes were:

1. Accepting their illness. This theme describes participants’ feelings toward their cancer diagnosis and

Discussion

Cancer is a severe health conditions and poses great risk of spiritual distress. O’Conner-Von¹² stated that adolescence is a period of transition from dependent child to independent adult and if adolescence able to adapt with their illness, they will be independent and will use healthy coping strategies.

Reynolds et al¹³ stated that positive spiritual coping strategies correlate with fewer problems in adolescents with chronic illness. Someone with a negative spiritual coping strategy could be

Acknowledgement

The authors would like to thank God Almighty, the adolescents with cancer who participated in this study, the founding chairman of YOAI, and Kopertis Region VII, who assisted the authors with data collection.

References (30)

R.I. Kemenkes
Riset kesehatan dasar nasional
(2013)
World Health Organization. World Cancer Day [accessed 2016 Feb 15]. Available at:...
International Agency for Research on Cancer. Latest world cancer statistics: Extimated Cancer Incidence [accessed 2016...
A.R. Weiss et al.
Inclusion of adolescents and young adults in cancer clinical trials
Semin Oncol Nurs.
(2015)
C.R. Phillips et al.
Psychosocial interventions for adolescents and young adults with cancer
Semin Oncol Nurs.
(2015)
W. McSherry
The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice
J Clin Nurs.
(2006)
P. Mazanec et al.
Cultural considerations in end-of-life care: how ethnicity, age, and spirituality affect decisions when death is imminent
Am J Nurs.
(2003)
S. Spurr et al.
The meanings older adolescents attach to spirituality
J Spec Pediatr Nurs.
(2013)
H.J. Streubert et al.
Qualitative research in nursing: Distruption and development
(2011)
I. Holloway et al.
Qualitative research in nursing and healthcare.
(2015)

P.F. Polit et al.

Nursing research: Generating and assessing evidence for nursing practice

(2012)

S. O’Conner-Von

Coping with cancer: a Web-based educational program for early and middle adolescent

J Pediatr Oncol Nurs.

(2009)

N. Reynolds et al.

Spiritual coping and psychosocial adjustment of adolescents with chronic illness: the role of cognitive attributions, age, and disease group

J Adolesc Health.

(2013)

G.M. Tedrus et al.

Spiritual/religious coping in patients with epilepsy: Relationship with sociodemographic and clinical aspects and quality of life

Epilepsy Behav.

(2013)

E.J. Taylor et al.

Spirituality and spiritual care of adolescents and young adults with cancer

Semin Oncol Nurs.

(2015)

Cited by (14)

Perceptions of children with cancer and their parents regarding illness: A qualitative study
2023, Journal of Pediatric Nursing
The current study aims to understand inter-generational differences and similarities in the perception of illness and the available resources employed by children with cancer and their parents.
A qualitative descriptive research design was utilized, including face-to-face interviews with 108 parent-child dyads where the children had been diagnosed with cancer, by means of a semi-structured questionnaire. The participants were recruited from two pediatric hematology-oncology wards in two different hospitals in Israel. The data were analyzed using conventional qualitative content analysis. Debriefing and inter-rater reliability methods were utilized.
Similarities were found between the coping of children and parents with the illness. Children with cancer and their parents can find bright sides and support for coping, such as different perspectives on life, faith, positive thoughts, and family assistance. Most of the differences between the perceptions of children and parents relate to the difficulties encountered. While parents are mainly concerned about the long-term impact, children contend with ordeals involving the here-and-now.
Parents and children demonstrate a dual process in their challenging journey. Positive and facilitating factors are intertwined with the aggravating aspects, which exist side by side.
Nursing staff should advise children and their parents to attain and use external and internal sources of support found in this study to help them deal with cancer.
The journey of embracing life: Mothers' perspectives of living with their children with retinoblastoma
2022, Journal of Pediatric Nursing
Citation Excerpt :
Emotional support includes sympathy and empathy, love, trust, attention, and encouragement (Sarafino & Smith, 2014). Religion, which can help reduce the burden of caregiving (Lina Mahayati et al., 2018), also helped the mothers to process complicated emotions. Spirituality through prayer is an active emotion-focused coping strategy (Günay, & Özkan, 2019); and belief in divinity can give parents a sense of hope (Johns et al., 2009; Nikfarid et al., 2017).
This study aimed to explore the experience and views of mothers with children who have been diagnosed with retinoblastoma.
A descriptive qualitative study was conducted in the period of 2019–2021. Interviews were conducted with 21 mothers of children diagnosed with retinoblastoma in Indonesia. Data were collected by semi-structured interviews and examined by content analysis.
Mothers evolved from a sense of unacceptability to accepting challenges and gaining inner strength. Three themes were identified: 1) physical and psychological suffering, 2) awareness of changes and demands, and 3) keep moving forward. Mothers developed positive adaptive mechanisms for coping with the problems associated with having a child with retinoblastoma. Psychological adjustment and religious beliefs were key elements in their journeys toward embracing life in the moment.
Findings illuminated psychological adaptation and coping strategies of mothers with seriously ill children and highlighted how difficulties and cultural norms shaped the adaptative process. Religion and health beliefs played varied and important roles in helping mothers to manage their stress and enhance their coping strategies.
Our findings revealed that it is important to routinely assess social support, traditional health beliefs, and spirituality on mothers, facilitate mentoring to help mothers find their inner strengths, and develop intervention programs designed to promote psychological adjustment without delaying treatment.
Molecular and therapeutic bases of cancer
2021, Oncological Functional Nutrition: Phytochemicals and Medicinal Plants
Develop, growth and death of multicellular organisms are regulated by intricated pathways with several effectors. Over the studies of the past decades, it is clear that molecular biology has contributed to find an infinitude of molecules that take part in different mechanisms such as: gene replication, gene transcription and gene translation. In the same route, molecular biology either found that these molecules are not lonely effectors in these mechanisms. Furthermore, the same proteins that develop multicellular organisms or repair their bodies, take place in malignancies growth and cancer progression. Many of those molecules are direct or indirectly involved to other cellular mechanism such cell microenvironment and inflammation. This chapter look for a landscape view of cancer, introducing new perspectives about malignant transformation and complementary treatments.
Perception on spiritual care: Comparation of the nursing students of public university and religious-based university
2019, Enfermeria Clinica
Citation Excerpt :
Studies have shown that major life events, such as having a chronic or life-threatening illness, could have positive influence on spirituality to a greater extent.4 In return, spirituality could be the source of hope for the patients and help them cope with their illness.17–19 Spirituality is also shown as the key factor to lower stress, depression, and to impact decision-making in the medication.20,21
Poor implementation of spiritual care in nursing practice may stem from the nursing education. This study aimed to compare the perception of nursing students of a public university and a religious-based university on spiritual care.
The research used the descriptive-comparative method. 141 nursing students were recruited through consecutive sampling technique in a university in Depok, West Java and a religious-based university in Jakarta, Indonesia. Data were collected using the Spiritual Care Giving Scale (SCGS) questionnaire.
The result showed that the participants had a good perception about spiritual care with the mean score of 171.39. However, there was no significant difference in perception regarding spiritual care between nursing students from the public university and the religion-based university (p value = 0.612).
The perception on spiritual care of nursing students was fairly similar regardless of the type of their university. This may be related with the comparable religious and cultural backgrounds in the two settings, as well as the nursing education curriculum implemented nationally, yet it takes further studies to examine such factors.
Spirituality in Adolescents and Young Adults With Cancer: An Evolutionary Concept Analysis
2024, Journal of Pediatric Hematology/Oncology Nursing
Perceptions of Children with Cancer and Their Parents Regarding Illness a Qualitative Study
2023, SSRN

View all citing articles on Scopus

View full text

Spirituality in adolescents with cancer

Abstract

Objective

Method

Results

Conclusions

Introduction

Section snippets

Method

Results

Discussion

Acknowledgement

Riset kesehatan dasar nasional

Inclusion of adolescents and young adults in cancer clinical trials

Semin Oncol Nurs.

Psychosocial interventions for adolescents and young adults with cancer

Semin Oncol Nurs.

The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice

J Clin Nurs.

Cultural considerations in end-of-life care: how ethnicity, age, and spirituality affect decisions when death is imminent

Am J Nurs.

The meanings older adolescents attach to spirituality

J Spec Pediatr Nurs.

Qualitative research in nursing: Distruption and development

Qualitative research in nursing and healthcare.

Nursing research: Generating and assessing evidence for nursing practice

Coping with cancer: a Web-based educational program for early and middle adolescent

J Pediatr Oncol Nurs.

Spiritual coping and psychosocial adjustment of adolescents with chronic illness: the role of cognitive attributions, age, and disease group

J Adolesc Health.

Spiritual/religious coping in patients with epilepsy: Relationship with sociodemographic and clinical aspects and quality of life

Epilepsy Behav.

Spirituality and spiritual care of adolescents and young adults with cancer

Semin Oncol Nurs.