Women Undergoing Breast Diagnostics: The Lived Experience of Spirituality

Jo Logan

Rebekah Hackbusch-Pinto

Catherine E. De Grasse

ONF 2006, 33(1), 121-126. DOI: 10.1188/06.ONF.121-126

Purpose/Objectives: To explore perceptions of spirituality in women who had undergone a breast diagnostic experience.

Research Approach: Qualitative, phenomenologic study using Giorgi's approach.

Setting: An outpatient comprehensive breast assessment center

Participants: 20 Caucasian women, aged 30-89, who had just completed the diagnostic process, including definitive diagnosis, regarding a breast abnormality.

Methodologic Approach: In-depth, semistructured, tape-recorded, and transcribed interviews analyzed using the Giorgi method of coding, transforming, and synthesizing data.

Main Research Variables: Descriptions of spirituality, spiritual needs, and supporting spirituality.

Findings: Two themes emerged: creating a focused isolation and seeking connections. Women created a private mental world in which to concentrate on the stressful diagnostic process. Within the isolation, women explored their personal strength and their connection to God or their spiritual beliefs. When the stress began to overwhelm, they sought out loved ones for support and diversion. Women found the center's staff to be supportive; however, many did not wish to speak to an agency chaplain during the uncertain period.

Conclusions: Women needed to handle the stress alone, with reliance on spirituality and God that was balanced with a need for specific connections to family members or close friends.

Interpretation: Nurses can support women's need to focus and can assist family members to understand their role during the diagnostic period. The diagnostic period can be used to talk with women about their spiritual beliefs, their needs, and possible referral to a chaplain.

Jump to a section

    References

    Albaugh, J.A. (2003). Spirituality and life-threatening illness: A phenomenologic study. Oncology Nursing Forum, 30, 593-598.

    American Cancer Society. (2004). Cancer facts and figures 2004. Retrieved October 3, 2004, from http://www.cancer.org/downloads/STT/CAFF_ finalPWSecured.pdf

    Beck, C.T. (1994). Reliability and validity issues in phenomenological research. Western Journal of Nursing Research, 16, 254-267.

    Conner, N.E., & Eller, L.S. (2004). Spiritual perspectives, needs and nursing interventions of Christian African-Americans. Journal of Advanced Nursing, 46, 624-632.

    Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., Dold, K.H., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429-438.

    Coward, D.D., & Kahn, D.L. (2004). Resolution of spiritual disequilibrium by women newly diagnosed with breast cancer [Online exclusive]. Oncology Nursing Forum, 31, E24-E31. Retrieved October 26, 2005, from http:// www.ons.org/publications/journals/ONF/Volume31/Issue2/3102197.asp

    De Grasse, C.E., & Hugo, K. (1996). Supportive care needs of women undergoing breast diagnosis and their families: A focus for nursing interventions. Canadian Oncology Nursing Journal, 6, 185-190.

    De Grasse, C.E., Hugo, K., & Plotnikoff, R.C. (1997). Supporting women during breast diagnostics. Canadian Nurse, 93(9), 24-30.

    Fehring, R.J., Miller, J.F., & Shaw, C. (1997). Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncology Nursing Forum, 24, 663-671.

    Fitchett, G., Meyer, P.M., & Burton, L.A. (2000). Spiritual care in the hospital: Who requests it? Who needs it? Journal of Pastoral Care, 54, 173-186.

    Flannelly, L.T., Flannelly, K.J., & Weaver, A.J. (2002). Religious and spiritual variables in three major oncology nursing journals: 1990-1999. Oncology Nursing Forum, 29, 679-685.

    Gall, T.L., & Cornblat, M.W. (2002). Breast cancer survivors give voice: A qualitative analysis of spiritual factors in long-term adjustment. Psycho-Oncology, 11, 524-535.

    Giorgi, A. (1997). The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenological Psychology, 28, 235-260.

    Grant, D. (2004). Spiritual interventions: How, when, and why nurses use them. Holistic Nursing Practice, 18, 36-41.

    Halstead, M.T., & Fernsler, J.I. (1994). Coping strategies of long-term cancer survivors. Cancer Nursing, 17, 94-100.

    Halstead, M.T., & Hull, M. (2001). Struggling with paradoxes: The process of spiritual development in women with cancer. Oncology Nursing Forum, 28, 1534-1544.

    Heckman, B.D., Fisher, E.B., Monsees, B., Merbaum, M., Ristvedt, S., & Bishop, C. (2004). Coping and anxiety in women recalled for additional diagnostic procedures following an abnormal screening mammogram. Health Psychology, 23, 42-48.

    Highfield, M.E. (2000). Providing spiritual care to patients with cancer. Clinical Journal of Oncology Nursing, 4, 115-120.

    Highfield, M.F. (1997). Spiritual assessment across the cancer trajectory: Methods and reflections. Seminars in Oncology Nursing, 13, 237-241.

    Holloway, I., & Wheeler, S. (2002). Qualitative research in nursing (2nd ed.). Cambridge, MA: Blackwell Science.

    Holt, C.L., Clark, E.M., Kreuter, M.W., & Rubio, D.M. (2003). Spiritual health locus of control and breast cancer beliefs among urban African American women. Health Psychology, 22, 294-299.

    Humphreys, J. (2000). Spirituality and distress in sheltered battered women. Journal of Nursing Scholarship, 32, 273-278.

    Johnson, P. (2002). The use of humor and its influences on spirituality and coping in breast cancer survivors. Oncology Nursing Forum, 29, 691-695.

    King, M., Speck, P., & Thomas, A. (1994). Spiritual and religious beliefs in acute illness—Is this a feasible area for study? Social Science Medicine, 38, 631-636.

    King, M., Speck, P., & Thomas, A. (1995). The Royal Free interview for religious and spiritual beliefs: Development and standardization. Psychological Medicine, 25, 1125-1134.

    Kinney, A.Y., Emery, G., Dudley, W.N., & Croyle, R.T. (2002). Screening behaviors among African American women at high risk for breast cancer: Do beliefs about God matter? Oncology Nursing Forum, 29, 835-843.

    Kub, J.E., Nolan, M.T., Hughes, M.T., Terry, P.B., Sulmasy, D.P., Astrow, A., et al. (2003). Religious importance and practices of patients with a lifethreatening illness: Implications for screening protocols. Applied Nursing Research, 16, 196-200.

    Lackey, N.R., Gates, M.F., & Brown, G. (2001). African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer. Oncology Nursing Forum, 28, 519-527.

    Landis, B.J. (1996). Uncertainty, spiritual well-being, and psychosocial adjustment to chronic illness. Issues in Mental Health Nursing, 17, 217-231.

    Levine, E.G., & Targ, E. (2002). Spiritual correlates of functional well-being in women with breast cancer. Integrative Cancer Therapies, 1, 166-174.

    McEwen, M. (2004). Analysis of spirituality content in nursing textbooks. Journal of Nursing Education, 43, 20-30.

    McSherry, W., & Cash, K. (2004). The language of spirituality: An emerging taxonomy. International Journal of Nursing Studies, 41, 151-161.

    McSherry, W., & Ross, L. (2002). Dilemmas of spiritual assessment: Considerations for nursing practice. Journal of Advanced Nursing, 38, 479-488.

    Mickley, J., & Soeken, K. (1993). Religiousness and hope in Hispanic- and Anglo-American women with breast cancer. Oncology Nursing Forum, 20, 1171-1177.

    Mickley, J.R., Soeken, K., & Belcher, A. (1992). Spiritual well-being, religiousness and hope among women with breast cancer. Image—The Journal of Nursing Scholarship, 24, 267-272.

    Miller, M.A. (1995). Culture, spirituality, and women's health. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 24, 257-263.

    Miller, W.R., & Thoresen, C.E. (2003). Spirituality, religion, and health: An emerging research field. American Psychologist, 58, 24-35.

    Mueller, P.S., Plevak, D.J., & Rummans, T.A. (2001). Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinic Proceedings, 76, 1225-1235.

    Narayanasamy, A., Clissett, P., Parumal, L., Thompson, D., Annasamy, S., & Edge, R. (2004). Responses to the spiritual needs of older people. Journal of Advanced Nursing, 48, 6-16.

    National Cancer Institute of Canada. (2004). Canadian cancer statistics 2004. Retrieved October 3, 2004, from http://www.ncic.cancer.ca/vgn/images/ portal/cit_86751114/14/35/195991821ncic_stats2004_en.pdf

    Petrie, W., Logan, J., & DeGrasse, C. (2001). Research review of the supportive care needs of spouses of women with breast cancer. Oncology Nursing Forum, 28, 1601-1607.

    Post-White, J., Ceronsky, C., Kreitzer, M.J., Nickelson, K., Drew, D., Mackey, K.W., et al. (1996). Hope, spirituality, sense of coherence, and quality of life in patients with cancer. Oncology Nursing Forum, 23, 1571-1579.

    Reed, P.G. (1992). An emerging paradigm for the investigation of spirituality in nursing. Research in Nursing and Health, 15, 349-357.

    Rodgers, B.L., & Cowles, K.V. (1993). The qualitative research audit trail: A complex collection of documentation. Research in Nursing and Health, 16, 219-226.

    Spagnola, S., Zabora, J., BrintzenhofeSzoc, K., Hooker, C., Cohen, G., & Baker, F. (2003). The Satisfaction With Life Domains Scale for Breast Cancer (SLDS-BC). Breast Journal, 9, 463-471.

    Stephenson, C., & Wilson, K. (2004). Does spiritual care really help? A study of patient perceptions. Journal of Christian Nursing, 21(2), 26-29.

    Tanyi, R.A. (2002). Towards clarification of the meaning of spirituality. Journal of Advanced Nursing, 39, 500-509.

    Taylor, E.J. (2003). Nurses caring for the spirit: Patients with cancer and family caregiver expectations. Oncology Nursing Forum, 30, 585-590.

    Zinnbauer, B.J., Pargament, K.I., Cole, B., Rye, M.S., Butter, E.M., Belavich. T.G., et al. (1997). Religion and spirituality: Unfuzzying the fuzzy. Journal for the Scientific Study of Religion, 36, 549-564.