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