Year of Publication

2009

Degree Name

Doctor of Philosophy (PhD)

Document Type

Dissertation

College

Nursing

Department

Nursing

First Advisor

Dr. Dorothy Y. Brockopp

Abstract

The purpose of this dissertation was to examine whether a breast cancer survivor’s view of God influences her religious coping strategies, depression, anxiety, stress, fear of recurrence, and psychological well-being. These variables were selected based on literature that demonstrates relationships among them for breast cancer survivors. The specific aims of this dissertation were to: 1) identify religious coping strategies common to each of the four views of God; 2) examine the relationship of psychological well-being (Ryff) and religious coping strategies; and 3) examine differences in depression, anxiety, stress, fear of recurrence, and psychological well-being among women holding various views of God.

Three manuscripts comprise this dissertation. The first manuscript is a systematic review of the literature describing what is known about the relationships between psychological adjustment and religion/spirituality (R/S) in women with breast cancer. The second manuscript examines the psychometric properties of the Image of God Scale in a population responding to a crisis event, women with breast cancer. The original scale was developed from a general population survey. Finally, the third manuscript investigates the relationships between view of God, religious coping strategies, and psychological adjustment in women with breast cancer.

The systematic review identified three primary themes: 1) R/S domains and psychological adjustment; 2) dynamics of R/S conservation and struggle; and 3) reframing the cancer experience. The psychometric analysis confirmed the original 2-factor model with factor loadings ranging from .56 to .83. Cronbach’s alphas for the two subscales – belief in God’s anger (.80) and belief in God’s engagement (.89) – were consistent with those established at development. Differences were found between views of God and use of religious/spiritual coping strategies focused on Spiritual Conservation and Spiritual Struggle. Psychological Well-Being (SPWB) was inversely correlated with Spiritual Struggle. Differences were noted for psychological well-being, Fear of Recurrence, and the Stress subscale in women who viewed God as highly engaged or not. No differences were noted for the same variables in women who view God as more or less angry. Direct comparisons between groups and variations in outcomes based on common views of God could lead to effective screening for persons at risk for particular outcomes and to effective individualized interventions.

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