Inter-relationships among sense of coherence, hope, and spiritual perspective (inner resources) of african-american and european-american breast cancer survivors

doi:10.1016/S0897-1897(03)00053-3

Applied Nursing Research

Volume 16, Issue 4, November 2003, Pages 236-244

https://doi.org/10.1016/S0897-1897(03)00053-3 Get rights and content

Abstract

This descriptive study compared sense of coherence (SOC), hope, and spiritual perspective in African-American and European-American breast cancer survivors. Five African-American and five European-American survivors completed multiple self-report instruments. Nonparametric statistical analyses included the Spearman rho and Mann-Whitney U tests. As hypothesized, there were significant positive relationships between SOC and spiritual perspective (r_s = .768, p = .005) and hope and spiritual perspective (r_s = .561, p = .046). There were no significant differences in SOC, hope, or spiritual perspective scores in the African-American compared with the European-American survivors. Results justify a larger study to explore inner resources of African-American breast cancer survivors.

Section snippets

Significance

Within the past 10 years, psychosocial researchers in adult oncology have called attention to the urgent need to examine the psychosocial functioning of African-American cancer survivors Andersen 1992, Rodrigue 1997. The existing literature on the psychological status of adult cancer survivors focuses primarily on European-American, middle-class men, and women residing in large metropolitan areas (Rodrigue, 1997). Given these sample characteristics, the application of these findings to

Literature review

Much of the cancer-related research in the last 10 to 15 years has identified three inner resources, namely, SOC, hope, and/or spiritual perspective Fehring et al 1997, Forsberg and Bjorvell 1996, Forsberg et al 1996, Guillory 1992, Herth 1991, Kurtin 1990, Mickley and Soeken 1993, Mickley et al 1992, Mullen et al 1993, Post-White 1998, Post-White et al 1996, Reed 1987. In cancer survivors, these three constructs have been associated with positive, successful PWB or coping Fehring et al 1997,

Research questions

The research questions asked for African-American and European-American breast cancer survivors were (1) What are the relationships among sense of coherence (SOC), hope, spiritual perspective and psychological well-being (PWB)? and (2) Are there differences in SOC, hope, or spiritual perspective between the two groups?

Sample

After university institutional review board approval was granted, women meeting the following criteria were recruited: 18 years and older, confirmed diagnosis of breast cancer, knowledge of breast cancer diagnosis, no previous diagnosis of other cancer, and ability to participate in the interview. African-American and European-American breast cancer survivors were women who defined themselves as African American and European American, respectively, and had been diagnosed with breast cancer.

Results

Results of the Spearman correlation analyses are found in Table 3. Research question one asked whether there were significantly positive relationships among SOC, hope, spiritual perspective, and PWB. There was a positive relationship between SOC and hope that was not significant (r = .184, p = .305). There was a moderately significant, positive relationship between hope and spiritual perspective (r = .561, p = .046). There was a strong, significant positive relationship between SOC and

Discussion

The purpose of this pilot study was to describe the interrelationships among SOC, hope, spiritual perspective, and PWB in African-American and European-American breast cancer survivors. Findings for research question one were similar to findings from the literature. The positive relationship between SOC and hope was similar to that found by Post-White 1998, Post-White et al 1996. The relationship resulting in the current study was not significant. This is likely to be attributed to the small

Study limitations

The small sample size and nonrandom methods limit this study; hence, the findings are limited to the 10 women in the study. In addition, the possibility of social desirability and self-selection, limit the ability to apply the findings to other groups. The positive relationships between SOC and hope and SOC and spiritual perspective may have been attributed to the finding that 8 of 10 participants were self-identified Baptists. There is the potential that other extraneous variables not

Research implications

Despite limitations, this study justifies further study because of the significant findings between SOC and spiritual perspective, hope and spiritual perspective, and hope, spiritual perspective, and PWB. Also, because there were differences between African-American and European-American breast cancer survivors in each of these variables and because there are few studies describing these constructs in African-Americans, future study is warranted that describes the interrelationships in larger

Practice implications

Nursing interventions to promote PWB or coping have been developed largely based on European-American breast cancer survivors. It is largely unknown which nursing interventions promote PWB in African-American breast cancer survivors. Enhanced understanding of inner resources in African-American breast cancer survivors may lead to the identification and testing of culturally sensitive ways to tap SOC, hope, and spiritual perspective to effect their PWB.

Inner resources such as SOC, hope, and/or

Acknowledgements

The author thanks Dr Cornelia Porter, past Executive Director of the American Nurses Association Ethnic Minority Fellowship Program for her assistance in editing this article.

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The EPDS is also commonly used and well validated to screen for antenatal anxiety (Brouwers et al., 2001; Jomeen and Martin, 2005; Austin and Highet, 2011) and postnatal anxiety (Ross et al., 2003; Jomeen and Martin, 2005; Austin and Highet, 2011). The EPDS was chosen for this study because it is well validated, easy to administer and score, and there is a strong association between depression and anxiety and low SOC (Eriksson, 2000; Gibson, 2003; Matsuura et al., 2003; Sekizuka et al., 2006; Konttinen et al., 2008). The EPDS is validated for use as a continuous measure of depressive symptoms (Gibson et al., 2009) with an acceptable Cronbach׳s alpha of .80 (Brouwers et al., 2001).
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high sense of coherence in pregnant women is associated with half the likelihood of caesarean section compared to women with low sense of coherence. Women׳s sense of coherence is raised and lowered by degree of satisfaction with their births and lowered by some labour interventions.
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^☆: Supported in part by the American Nurses Association Ethnic Minority Fellowship, Substance & Mental Health Services Association, #5T06SM1515522 and the Greenville Hospital System Multidisciplinary Research Committee Award.

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Original articleInter-relationships among sense of coherence, hope, and spiritual perspective (inner resources) of african-american and european-american breast cancer survivors☆

Abstract

Section snippets

Significance

Literature review

Research questions

Sample

Results

Discussion

Study limitations

Research implications

Practice implications

Acknowledgements

Social Science and Medicine

Nursing Clinics of North America

Psychological interventions for cancer patients to enhance the quality of life

Journal of Consulting and Clinical Psychology

Unraveling the mystery of healthHow people manage stress and stay well

Quality of life and psychosocial outcomes in long-term survivors of breast cancerA focus on African-American women

Journal of Psychosocial Oncology

Understanding the breast cancer experience of women

Journal of Psychosocial Oncology

Cross-cultural validation of Antonovsky’s SOC Scale

Journal of Clinical Psychology

Differences in religiousness among black and white women with breast cancer

Social Work in Health Care

Predisposing, enabling, and need factors related to patterns of help seeking among women

Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer

Oncology Nursing Forum

Quality of Life Scale (Breast Cancer Version)

Living with cancerPerceptions of well-being

Scandinavian Journal of Caring Science

Well-being and its relation to coping ability in survivors with colo-rectal and gastric cancer before and after surgery

Scandinavian Journal of Caring Science

Relationships of selected physiological, psychosocial and spiritual variables associated with survivorship in socioeconomically disadvantaged women with breast cancer (dissertation)

Simultaneous concept analysis of spiritual perspective, hope, acceptance and self-transcendence

ImageJournal of Nursing Scholarship

Development and refinement of an instrument to measure hope

Scholarly Inquiry for Nursing PracticeAn International Journal

An abbreviated instrument to measure hopeDevelopment and psychometric evaluation

Journal of Advanced Nursing

Alcohol abuse and stress among African-American women

Multiple jeopardy, multiple consciousnessThe context of a feminist ideology

SignsJournal of Women in Culture and Society

Relationship of life-change, spiritual perspective and perceived well-being to hope in adults with recurrent cancer. (Doctoral Dissertation, University of Arizona, 1990)

Dissertation Abstracts International

Women’s experiences with the initial discovery, diagnosis, and treatment of breast cancer

Oncology Nursing Forum

Original article
Inter-relationships among sense of coherence, hope, and spiritual perspective (inner resources) of african-american and european-american breast cancer survivors☆