The Relationship between Spiritual Wellbeing and Stress, Anxiety, and Depression in Patients with Breast Cancer

As a highly prevalent disease among women, breast cancer causes deep psychological and emotional complications such as stress, anxiety, and depression. Due to previous paradoxical findings, we performed this study to survey the relationship between spiritual wellbeing and stress, anxiety, and depression in patients with breast cancer who referred to a specialized cancer treatment center affiliated with Isfahan University of Medical Sciences (Iran) in 2012. This descriptive, analytic study was conducted on cancer patients who were selected using simple sampling. A total number of 297 hospitalized patients with breast cancer were enrolled. The depression, anxiety, and stress scale (DASS-42) and the spiritual wellbeing questionnaire (by Ellison and Paloutzian) were used to measure stress, anxiety, depression, and spiritual well-being. Data was analyzed using statistical methods such as independent t-test and Pearson's correlation coefficient in SPSS18. The mean scores of religious and existential aspects of spiritual wellbeing were 51.38 ± 8.17 and 42.47 ± 10.21 (both out of 60), respectively. The mean total score of spiritual wellbeing was 93.69 ± 10.04 out of 120. The spiritual wellbeing scores of the majority of participants (60.6%) were in the range of medium. Pearson's correlation coefficient showed statistically significant relationships between spiritual wellbeing and stress (p < 0.001, r = -0.44), anxiety (p < 0.001, r = -0.27), and depression (p < 0.001, r = -0.48) in patients with breast cancer. The 2 aspects of spiritual wellbeing were also significantly correlated with stress, anxiety, and depression. According to our findings, breast cancer patients with higher scores of spiritual wellbeing had lower levels of stress, anxiety, and depression. Therefore, the treatment of patients with breast cancer needs to pay simultaneous attention to spiritual well being and physical health.