The Effects of Spiritual Care on Anxiety in Adolescents with Cancer

Faezeh Torabi, Moosa Sajjadi, Manighea Nourian, Nasrin Borumandnia, Azam Shirinabadi Farahani



Introduction: Anxiety is one of the psychological complications of cancer in adolescents and it is due to various factors. Since this complication leaves undesirable effects on physical and mental health and also on the adolescents’ quality of lives, one of the main nursing cares in adolescents with cancer is using various strategies to reduce the anxiety. Experience of living with cancer shows spirituality creates purpose and meaning in life for patients.

Objectives: This study aimed to investigate the effects of spiritual care on anxiety in adolescents with cancer.

Methods: This is a quasi-experimental study with one- group time-series design. 32 hospitalized adolescents were selected by purposeful sampling method based on the inclusion criteria. The spiritual care program was performed for adolescents in 6 sessions of 45 minutes class during their hospitalization. Data was collected by questionnaires of “personal and clinical characteristics” and “Speilberger State-Trait Anxiety Inventory”. The data were analyzed with the SPSS-19 software using descriptive and inferential statistical tests.

Results: According to the results of this study, the difference between the mean score of pretest (55.96±11/34) and posttest (42.84±6/19) was significant. However the difference between mean scores of posttest and follow up (48.40±7/18) was not significant (P < 0.001).

Conclusion: Implementation of spiritual care by nurses may affect the mental situation of adolescents with cancer and is a suitable method to reduce anxiety. Therefore it is necessary for nurses to use spiritual interventions during implementation of comprehensive nursing care.



Cite to Article: Torabi F, Sajjadi M, Nourian M, Borumandnia N, Shirinabadi Farahani A. The effects of spiritual care on anxiety in adolescents with cancer. Supportive and Palliative Care in Cancer 2016; in press.


Spiritual therapies, anxiety, adolescent, neoplasms

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Rajabpour H, Tavakolizadeh J. [The relationship between emotional intelligence and adjusment in cancer patients in Mashhad]. Ofoghe Danesh. 2012;18(1):17-26.

Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014;64(2):83-103. DOI: 10.3322/caac.21219 PMID: 24488779

Baljani E, Khashabi J, Amanpour E, Azimi N. [Relationship between spiritual well- being, religion, and hope among patients with cancer]. Hayat 2011;17(3):27-37.

Mohammadi S, Tajvidi M. [Relationship between spiritual well-being with hopelessness and social skills in Beta-thalassemia major adolescents]. Mod Care J. 2011;8(3):116-24.

Pendley JS, Dahlquist LM, Dreyer Z. Body image and psychosocial adjustment in adolescent cancer survivors. J Pediatr Psychol. 1997;22(1):29-43. PMID: 9019046

Lima NN, do Nascimento VB, de Carvalho SM, Neto ML, Moreira MM, Brasil AQ, et al. Spirituality in childhood cancer care. Neuropsychiatr Dis Treat. 2013;9:1539-44. DOI: 10.2147/NDT.S42404 PMID: 24133371

Katz ER, Jay SM. Psychological aspects of cancer in children, adolescents, and their families. Clin Psychol Rev. 1984;4(5):525-42. DOI: 10.1016/0272-7358(84)90042-4

Bassak Nejad S, Niazi Z, Davoudi I. [The effectiveness of kendall's coping Cat therapy on reducing anxiety among female adolescent students]. J Res Behav Sci. 2011;9(4):241-9.

Cartwright-Hatton S. Anxiety of childhood and adolescence: Challenges and opportunities. Clin Psychol Rev. 2006;26(7):813-6. DOI: 10.1016/j.cpr.2005.12.001 PMID: 16472896

Aghebati N, Mohammadi E, Pour Esmaeil Z. [The effect of relaxation on anxiety and stress of patients with cancer during hospitalization]. Iran J Nurs. 2010;23(65):15-22.

Ashbury FD, Findlay H, Reynolds B, McKerracher K. A Canadian survey of cancer patients' experiences: are their needs being met? J Pain Symptom Manage. 1998;16(5):298-306. PMID: 9846024

Bolhari C, Naziri G, Zamaniyan S. [Effectiveness of group therapy, spiritual approach to the treatment of depression, anxiety and stress in women with breast cancer]. Women J Sociol. 2012;3(1):85-116.

Bazmi N, Nursi M. [The effects of play therapy on reduce anxiety and general coping of children 9- 12 years with Leukemia]. Psychol Stud. 2012;8(4):1-24.

Momeni Ghale Ghasemi T, Musarezaie A, Moeini M, Naji Esfahani H. [The effect of spiritual care program on ischemic heart disease patients' anxiety, hospitalized in CCU: a clinical trial]. J Res Behav Sci. 2012;10(6554-564).

Delaney C, Barrere C. Blessings: the influence of a spirituality-based intervention on psychospiritual outcomes in a cardiac population. Holist Nurs Pract. 2008;22(4):210-9. DOI: 10.1097/01.HNP.0000326004.57687.74 PMID: 18607234

Rezaei M, Seyed Fatemi N, Hoseyni F. [Spiritual health in cancer patients receiving chemotherapy]. J Nurs Midwifery. 2009;14(3-4):33-9.

Timmins F, Neill F. Teaching nursing students about spiritual care - a review of the literature. Nurse Educ Pract. 2013;13(6):499-505. DOI: 10.1016/j.nepr.2013.01.011 PMID: 23491611

Khorami Markany A, Yaghmaei F, Eizadi A. [Spirituality and spiritual care in nursing education: a challenge for curricula]. J Fac Nurs Midwifery. 2010;20(68):41-9.

Lotfi Kashani F, Vaziri S, Gheysar S, Mosavi M, Hashemiye M. [Efectiveness of spiritual intervention to improve the quality of life of mothers of children with cancer]. Med Ethics. 2012;11(12):125-49.

Falah R, Golzari M, Dastani M, Zahiroddin A, Mosavi M, Akbari M. [Effect of the intervention group method to promote spiritual and mental health expectancy in women with breast cancer]. J Thought Behav Clin Psychol. 2011;5(19):69-80.

Karekla M, Constantinou M. Religious Coping and Cancer: Proposing an Acceptance and Commitment Therapy Approach. Cogn Behav Pract. 2010;17(4):371-81. DOI: 10.1016/j.cbpra.2009.08.003

Mazaheri M, Falahi Khoshknab M, Madah B, Rahgozar M. [Attitude of nursing of spirituality and spirituality care]. Payesh J. 2008;8(1):31-7.

Moreira-Almeida A, Neto FL, Koenig HG. Religiousness and mental health: a review. Rev Bras Psiquiatr. 2006;28(3):242-50. DOI: 10.1590/s1516-44462006005000006 PMID: 16924349

Livneh H, Antonak RF. Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors. J Counsel Dev. 2005;83(1):12-20. DOI: 10.1002/j.1556-6678.2005.tb00575.x

Koenig HG, George LK, Titus P. Religion, spirituality, and health in medically ill hospitalized older patients. J Am Geriatr Soc. 2004;52(4):554-62. DOI: 10.1111/j.1532-5415.2004.52161.x PMID: 15066070

Allahbakhshian M, Jaffarpour M, Parvizy S, Haghani H. [A survey on relationship between spiritual wellbeing and quality of life in multiple sclerosis patients]. J Zahedan Univ Med Sci. 2010;12(3):29-33.

Puchalski CM. Spirituality in the cancer trajectory. Ann Oncol. 2012;23 Suppl 3:49-55. DOI: 10.1093/annonc/mds088 PMID: 22628416

Burkhart L, Schmidt W. Measuring effectiveness of a spiritual care pedagogy in nursing education. J Prof Nurs. 2012;28(5):315-21. DOI: 10.1016/j.profnurs.2012.03.003 PMID: 23006654

Gumus AB, Cam O. Effects of emotional support-focused nursing interventions on the psychosocial adjustment of breast cancer patients. Asian Pac J Cancer Prev. 2008;9(4):691-7. PMID: 19256761

Arjmand S, Lotfi Kashani F, Vaziri S, Mousavi M, Hashemiye M. [Effect of spiritual intervention to reduce moral distress in mothers of children with cancer]. Med Ethics 2012;6(20):173-86.

Hamid N, Ahmadian A, Akbari Shaye Y. [Effectiveness of cognitive behavior therapy based on religious believes on hope and quality of life in the patients suffering breast cancer]. J Homozgan Univ Med Sci. 2012;16(3):213-21.

Rassouli M. [Spiritual coping in institutionalized adolescents: a structural equation modeling]. Tehran: Shahid Beheshti University of Medical Sciences; 2008.

McSherry W. Making sense of spiritual in nursing and health care practice: An interactive approach. 2nd ed. London: Jessica Kingsley Publisher; 2006.

Karimallahi M, Abedi H. [Patients' experience of prayer in hospital]. Nurs Res. 2008;3(10-11):63-73.

Chassin M, Conway JB, Umbdenstock RJ, Dwyer J, Langberg ML, Petasnick WD. Accreditation. Chassin and Joint Commission aim to inspire. Interview by Howard Larkin. Hosp Health Netw. 2010;84(3):24-8, 2. PMID: 20377090

Rahnama M, Falahi Khoshknab M, Madah B, Ahmadi F. [Perception of patients with cancer of spiritual care: a qualitative study]. Iranian J Med Ethics Hist Med. 2012;5(3):59-74.

Hanson LC, Dobbs D, Usher BM, Williams S, Rawlings J, Daaleman TP. Providers and types of spiritual care during serious illness. J Palliat Med. 2008;11(6):907-14. DOI: 10.1089/jpm.2008.0008 PMID: 18715183

Hummel L, Galek K, Murphy KM, Tannenbaum HP, Flannelly LT. Defining spiritual care: an exploratory study. J Health Care Chaplain. 2008;15(1):40-51. DOI: 10.1080/08854720802698509 PMID: 19424912

Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc. 2001;76(12):1225-35. DOI: 10.4065/76.12.1225 PMID: 11761504

Carson V, Koeing H. Spiritual dimensions of nursing practice. West Conshohocken, Pennsylvania: Templeton Foundation Press; 2008.

Villagomeza LR. Mending broken hearts: the role of spirituality in cardiac illness: a research synthesis, 1991-2004. Holist Nurs Pract. 2006;20(4):169-86. PMID: 16825919

Wilkins V. Religion, Spirituality, and Psychological Distress in Cardiovascular Disease. Pennsylvania PA: Drexel University; 2004.

Yoon M, Park J. The effect of spiritual nursing intervention on anxiety and depression of the hospice Patients. J Kor Acad Adult Nurs. 2002;14(3):337-47.

Rowe M, Allen R. Spirituality as a means of coping with chronic illness. Am J Health Stud. 2004;19(1):62-7.

Rassouli M, Sajjadi M. Palliative care in the Islamic Republic of Iran. In: Silbermann M. Palliative Care to the Cancer Patient: The Middle East as a Model for Emerging Countries. New York: Nova Scientific Publisher; 2014.

Heidarzadeh M, Rassouli M, Mohammadi Shahbolaghi F, Alavi Majd H, Karam A, Mirzaee H, et al. Posttraumatic growth and its dimensions in patients with cancer. Mid East J Cancer. 2014;5(1):23-30.



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