Main Article Content

Abid Ali
Niaz Muhammad
Ihsan Ullah Khan


OBJECTIVE: To investigate the level of spirituality and social support along with its impact on health related quality of life (QoL) in cancer patients.
METHODS: This cross-sectional study was conducted from 15th July to 31st August 2018 on 200 patients selected through purposive sampling. Pre-validated questionnaires were used to collect the data on spirituality, social support and QoL, which were analyzed using SPSS v.20.0. Descriptive and inferential statistics were applied where needed.
RESULTS: In 200 patients, 151 (75.5%) were male, majority (n=70; 35%) were from >48 to 58 years of age group, maximum (n=116; 58%) were unmarried, while majority had primary education (n=62; 31%). Laryngeal carcinoma (n=24; 12%), was the commonest clinical presentation followed by breast cancer (n=23; 11.5%). Majority (n=77; 38.5%) presented at Stage III, 140 (70%) reported it to be diagnosed at first evaluation, 161 (80.5%) had no family history, 109 (54.5%) reported to start spiritual treatment after diagnosis, and 117 (58.5%) reported family as their main support during the whole phase. In spirituality distinctiveness, 68 (34%) patients showed very high spiritual level, 72 (36%) reported to recite specific Quranic verses in religious practice, in which 112 (56%) reported to recite واذا مرضت فهو يشفين, 168 (84%) leaned towards spiritual practices after diagnosis. In correlation, spirituality (2.42±0.596) and social support (2.19±0.568), both had a significant correlation with QoL (2.37±0.494) with values of r=0.289, p=0.000 and r=0.238, p=0.001 respectively.
CONCLUSION: Spirituality and social support are the key coping mechanisms that have supportive influences on the patients’ overall health-related QoL.

Article Details

How to Cite
Original Articles


World Health Organization. Health statistics and information systems: WHO Latest global cancer data; 2018 [Accessed on: November 4, 2019]. Available from URL: https://gco.iarc.fr/

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424. DOI:10.3322/caac.21492.

Byrne SK. Healthcare avoidance: a critical review. Holist Nurs Pract 2008;22(5):280-92. DOI: 10.1097/01.HNP.0000334921.31433.c6.

Tuck I, Wallace D, Pullen L. Spirituality and spiritual care provided by parish nurses. West J Nurs Res 2001;23(5):441-53. DOI: 10.1177/01939450122045294.

Stefanek M, McDonald PG, Hess SA. Religion, spirituality and cancer: current status and methodological challenges. Psychooncology 2005;14(6):450-63. DOI: 10.1002/pon.861.

Tuck I. Development of a spirituality intervention to promote healing. J Theory Const Test 2004;8(2):67-70

de Jager Meezenbroek E, Garssen B, van den Berg M, van Dierendonck D, Visser A, Schaufeli WB, et al. Measuring spirituality as a universal human experience: a review of spirituality questionnaires. J Relig Health 2012;51(2):336-54. DOI: 10.1007/s10943-010-9376-1.

Lim JW, Yi J. The effects of religiosity, spirituality, and social support on quality of life: a comparison between Korean American and Korean breast and gynecologic cancer survivors. Oncol Nurs Forum 2009;36(6):699-708. DOI: 10.1188/09.ONF.699-708.

Shahmoradi N, Kandiah M, Loh SP. Quality of life and functional status in patients with advanced cancer admitted to hospice home care in Malaysia: a cross-sectional study. Eur J Cancer Care 2012;21(5):661–66. DOI: 10.1111/j.1365-2354.2012.01338.x.

Kim Y, Seidlitz L. Spirituality moderates the effect of stress on emotional and physical adjustment. J Individ Differ 2002 Jun 1; 32 (8):1377-90. DOI: 10.1016/S0191-8869(01)00128-3.

Rawdin B, Evans C, Rabow MW. The relationships among hope, pain, psychological distress, and spiritual well-being in oncology outpatients. J Palliat Med 2013;16(2):167-72. DOI: 10.1089/jpm.2012.0223.

Thuné‐Boyle IC, Stygall J, Keshtgar MR, Davidson TI, Newman SP. Religious/spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psychooncology 2013;22(3):646-58. DOI: 10.1002/pon.3048.

Smith AR, DeSanto-Madeya S, Pérez JE, Tracey EF, DeCristofaro S, Norris RL, et al. How women with advanced cancer pray: a report from two focus groups. Oncol Nurs Forum 2012;39(3):E310-6. DOI:10.1188/12.ONF.E310-E316.

Kroenke K, Johns SA, Theobald D, Wu J, Tu W. Somatic symptoms in cancer patients’ trajectory over 12 months and impact on functional status and disability. Support Care Cancer 2013;21(3):765-73. DOI: 10.1007/s00520-012-1578-5.

Schroevers MJ, Helgeson VS, Sanderman R, Ranchor AV. Type of social support matters for prediction of posttraumatic growth among cancer survivors. Psychooncology 2010;19(1):46-53. DOI: 10.1002/pon.1501.

Barber FD. Social support and physical activity engagement by cancer survivors. Clin J Oncol Nurs 2012;16(3): :E84-98. DOI: 10.1188/12.CJON.E84-E98.

Ganz PA, Greendale GA, Petersen L, Kahn B, Bower JE. Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol 2003;21(22):4184-93. DOI: 10.1200/JCO.2003.04.196.

Andreu Y, Galdón MJ, Durá E, Martínez P, Pérez S, Murgui S. A longitudinal study of psychosocial distress in breast cancer: prevalence and risk factors. Psychol Health 2012;27(1):72-87. DOI: 10.1080/08870446.2010.542814.

Hill J, Holcombe C, Clark L, Boothby MR, Hincks A, Fisher J, et al. Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychol Med 2011;41(7):1429-36. DOI: 10.1017/S0033291710001868.

Thompson T, Rodebaugh TL, Pérez M, Schootman M, Jeffe DB. Perceived social support change in patients with early stage breast cancer and controls. Health Psychol 2013;32(8):886-95. DOI: 10.1037/a0031894.

Sekaran U. Research methods for business: A skill building approach. John Wiley; 2003. [Accessed on: November 11, 2019]. Available from URL: https://iaear.weebly.com/uploads/2/6/2/5/26257106/research_methods_entiree_book_umasekaram-pdf-130527124352-phpapp02.pdf.

Peterman AH, Fitchett G, Brady MJ, Pharm D, Cella D. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49-58. DOI: 10.1207/S15324796ABM2401_06.

Schwarzer R, Schulz U. Berlin Social Support Scales (BSSS). Measurement Instrument Database for the Social Science. 2013. [Accessed on: November 11, 2019] Available from URL: https://www.midss.org/sites/default/files/bsss_brief_documentation.pdf.

Cella DF. Quality of life: Concepts and definitions. J Pain Symptom Manage 1994 Apr;9(3):186-92. DOI: 10.1016/0885-3924(94)90129-5.

Burt N. Hope and spirituality and their relationship to the overall quality of life in cancer patients. [Doctoral Dissertation] Department of Communication Disorders and Counseling, School, and Educational Psychology, Indiana State University, Terre Haute, Indiana. 2010.

McSherry W. Making sense of spirituality in nursing practice: An interactive approach. WB Saunders Company; 2000. [Accessed on: November 14, 2019]. Available from URL: https://www.hpb.com/products/making-sense-of-spirituality-in-nursing-practice-9780443063565.

Kim HS, Sherman DK, Taylor SE. Culture and social support. Am Psychol 2008;63(6):518-26. DOI: 10.1037/0003-066X.

Melo Filho MR, Rocha BA, Pires MB, Fonseca ES, Freitas EM, et al. Quality of life of patients with head and neck cancer. Braz J Otorhinolaryngol 2013;79(1):82-8. DOI: 10.5935/1808-8694.20130014.

Jassim GA, Whitford DL. Understanding the experiences and quality of life issues of Bahraini women with breast cancer. Soc Sci Med 2014;107:189-95. DOI: 10.1016/j.socscimed.2014.01.031.

Sawatzky R, Ratner PA, Chiu L. A meta-analysis of the relationship between spirituality and quality of life. J Soc Indic Res 2007;72(2):153-88. DOI: 10.1007/s11205-004-5577-x

Samsi M. A cognitive model of spiritual beliefs and breast cancer recurrence fears: implications for psychological functioning. Dissertation, University of Houston. 2008. [Accessed on: November 19, 2019]. Available from URL: https://uh-ir.tdl.org/bitstream/handle/10657/917/ANDERSON-DISSERTATION-2012.pdf?sequence=1&isAllowed=y.

Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry 2012;2012:278730. DOI: 10.5402/2012/278730.

Yamagishi A, Sato K, Miyashita M, Shima Y, Kizawa Y, Umeda M, et al. Changes in quality of care and quality of life of outpatients with advanced cancer after a regional palliative care intervention program. J Pain Symptom Manage 2014;48(4):602-10. DOI: 10.1016/j.jpainsymman.2013.11.016.

Lim JW, Zebrack B. Different pathways in social support and quality of life between Korean American and Korean breast and gynecological cancer survivors. Qual Life Res 2008;17(5):679-89. DOI: 10.1007/s11136-008-9343-4.

Filazoglu G, Griva K. Coping and social support and health-related quality of life in women with breast cancer in Turkey. Psychol Health Med 2008;13(5):559-73. DOI: 10.1080/13548500701767353.

Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, et al. Quality of life after breast cancer diagnosis and survival. J Clin Oncol 2011;29(4):406-12. DOI: 10.1200/JCO.2010.30.6951.