Journal of Religion and Health

, Volume 57, Issue 5, pp 1918–1930 | Cite as

Spirituality in African-American Breast Cancer Patients: Implications for Clinical and Psychosocial Care

  • Vanessa B. Sheppard
  • Robin Walker
  • Winifred Phillips
  • Victoria Hudson
  • Hanfei Xu
  • Mark L. Cabling
  • Jun He
  • Arnethea L. Sutton
  • Jill Hamilton
Original Paper


Spirituality has been shown to be important to many individuals dealing with a cancer diagnosis. While African-American breast cancer survivors have been reported to have higher levels of spirituality compared to White women, little is known about how levels of spirituality may vary among African-American breast cancer survivors. The aims of this study were to examine factors associated with spirituality among African-American survivors and test whether spirituality levels were associated with women’s attitudes about treatment or health care. The primary outcome, spirituality, was nine-item scale (Cronbach’s α = .99). Participants completed standardized telephone interviews that captured sociocultural, healthcare process, and treatment attitudes. Medical records were abstracted post-adjuvant therapy for treatment and clinical information. In bivariate analysis, age was not correlated with spirituality (p = .40). Married/living as married women had higher levels of spirituality (m = 32.1) than single women (m = 30.1). Contextual factors that were associated with higher levels spirituality were: collectivism (r = .44; p < 0.0001, Afrocentric worldview (r = .185; p = .01), and self-efficacy scale (r = .17; p = .02). In multivariable analysis, sociodemographic factors were not significant. Collectivism remained a robust predictor (p < 0.0001). Attitudes about the efficacy of cancer treatment were not associated with spirituality. The high levels of spirituality in African-American survivors suggest consideration of integrating spiritual care within the delivery of cancer treatment. Future studies should consider how spirituality may contribute to positive coping and/or behaviors in African-American women with high levels of spirituality.


Spirituality African-American Breast cancer Psychosocial care Religiosity 



This study was funded by ACS MRSGT 0613201 CPPB; R01-CA154848; and NIH-NCI Cancer Center Support Grant P30 CA016059.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Vanessa B. Sheppard
    • 1
  • Robin Walker
    • 2
  • Winifred Phillips
    • 3
  • Victoria Hudson
    • 4
  • Hanfei Xu
    • 4
  • Mark L. Cabling
    • 5
  • Jun He
    • 1
  • Arnethea L. Sutton
    • 1
  • Jill Hamilton
    • 6
  1. 1.Health Behavior and Policy, School of MedicineVirginia Commonwealth UniversityRichmondUSA
  2. 2.Sibley Memorial HospitalWashingtonUSA
  3. 3.Longwood UniversityFarmvilleUSA
  4. 4.Georgetown University Medical CenterWashingtonUSA
  5. 5.King’s College LondonLondonUK
  6. 6.Emory UniversityAtlantaUSA

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