Spirituality and physical health status: a longitudinal examination of reciprocal effects in breast cancer survivors
This longitudinal study sought to examine the reciprocal relationship between spirituality and physical health status among breast cancer survivors.
Breast cancer survivors (N = 634) completed baseline assessments (T1) within 8 months of breast cancer diagnosis and 12 (T2) and 18 months (T3) after their baseline assessment. Spirituality was assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale which consists of three subscales: meaning, peace, and faith. Physical health status was measured with the SF-36 Physical Component Summary (PCS). A cross-lagged structural equation model (SEM) was used to analyze the three-wave data to examine the reciprocal relationships between the observed variable, PCS, and the three subscales of the FACIT-Sp, treated as latent variables.
The cross-lagged SEM yielded an adequate fit to the data: RMSEA = .036, CFI = 0.97, TLI = 0.96. After controlling for relevant sociodemographic and cancer-related variables, only higher PCS at T2 predicted greater meaning at T3. PCS at T1 did not predict meaning at T2 and the reciprocal relationship of meaning predicting PCS was not significant. Neither peace nor faith was reciprocally related to PCS.
Results provide evidence of a unidirectional relationship between self-reported physical health status and subsequent meaning among breast cancer survivors during the period of early to later survivorship. Additional studies are needed that examine the longitudinal and directional relationships between spirituality and physical health among diverse samples of cancer survivors.
KeywordsSpirituality Physical health Breast cancer survivors Longitudinal
National Cancer Institute R25 CA122061, Department of Defense grant DAMD17-01-1-0447, and the National Center for Advancing Translational Sciences UL1 TR001420-01.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”
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