Meaning, Spirituality, and Wellness in Cancer Survivors

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Objectives

To explore the concepts of meaning, spirituality, and wellness in cancer survivors.

Data Sources

Review and research articles, books, and personal experience as a nurse psychotherapist and as a cancer survivor.

Conclusion

Cancer survivors often rely on their religious and spiritual beliefs as a way of deriving meaning during their illness experience and survivorship, as well as a way of coping with and coming to terms with the concept of death. The measurement of religion and spirituality in health and cancer survivorship is challenging because of the difficulty in defining terms and in developing ways of measuring the concepts.

Implications for Nursing Practice

Nurses have the opportunity to explore the meaning of cancer and spirituality in the lives of their patients. Such discussions can allow for the introduction of concepts of wellness including changes in lifestyle habits and social support that may improve quality of life for cancer survivors.

Section snippets

Meaning-Making and Cancer

Meaning in life refers to the value and purpose of life, important life goals, and for some, spirituality.3, 4, 5 The nature and extent of psychosocial vulnerability to potentially life-threatening illness is specific to individuals and depends on the personal meaning of the disease. Fife6 explored meaning in 38 cancer patients and identified four domains: 1) the individual's response to the illness; 2) changes that occurred relative to identity as a consequence of the illness; 3) the impact of

Spirituality and Religion

Spirituality is a construct composed of faith and meaning,5 an attempt to make contact with or become aware of the “deep knowing” of our being.9 It has been defined as being “that which allows a person to experience transcendent meaning in life.” This is often expressed as a relationship with God, but it can be about nature, art, music, family, or community–whatever beliefs and values give a person a sense of meaning and purpose in life.”10,p.129 It may emerge from religious belief or it may

Research on Spirituality and Religion

The study of religion and spirituality in health is difficult because of the challenge in defining ‘religion’ and ‘spirituality.’ Most of the literature has addressed religion and health, while the literature on spirituality and health is sparse. Religion is often represented as an institutional, structural variable and spirituality as more existential and individual, but this is not always the case.

Questions have been raised about whether religious attendance was really a surrogate marker for

Cancer as a Spiritually Transforming Experience

Some cancer survivors find their disease results in spiritual transformation. Hirshberg and Barasch33 noted that some type of spiritual experience or awakening was common to long-term survivors diagnosed with incurable disease and who had exceeded their initial prognosis of survival time. Kason34 speaks of spiritually transforming experiences that involve near-death experiences that connect individuals with another realm. People who are being transformed will find that their lives have a more

Meaning, Spirituality, and Wellness

How can cancer survivors attain maximum wellness even as they live with the residual effects of their illness and treatment? Wellness has been described as a deliberate and conscious approach by the individual to participate and advance their physical, psychosocial, and spiritual health.35, 36 Wellness programs encourage self-care to help survivors recover some control over their health and health care.36 The principles of wellness promotion are based on subjective evidence and supported by

Implications for Nurses

Although nurses often have difficulty with conflicting work demands, and may feel unsupported in meeting patients’ needs,41 much of their job satisfaction comes from contact with patients.42 However, an earlier study showed that many nurses providing spiritual care did so with some discomfort.28 In a study of Swedish nurses,28 nurses were willing to meet the spiritual and existential needs of patients but had difficulty in defining what such care should include and needed more education to

Conclusion

Programs for long- term survivors need to look not only at the very important issues of coping with long-term side effects of the disease and its treatment, financial, social and occupational issues, but also wellness for the ‘whole person.’ Issues of meaning and spirituality and their importance have been reviewed. Research issues include problems with instruments that are seen as being too Christianity-oriented and need to be broadened to include Eastern and other approaches to spirituality,

Mary L.S. Vachon, RN, PhD: Psychotherapist and Consultant in Private Practice; Professor, Departments of Psychiatry and Public Health Sciences, University of Toronto; Clinical Consultant, Wellspring, Toronto, Ontario, Canada.

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    Mary L.S. Vachon, RN, PhD: Psychotherapist and Consultant in Private Practice; Professor, Departments of Psychiatry and Public Health Sciences, University of Toronto; Clinical Consultant, Wellspring, Toronto, Ontario, Canada.

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