Spiritual struggle: effect on quality of life and life satisfaction in women with breast cancer

J Holist Nurs. 2005 Jun;23(2):120-40; discussion 141-4. doi: 10.1177/0898010104272019.


Background: Women with breast cancer experience stressors affecting quality of life (QOL) and life satisfaction. Little is known about effects of spiritual struggle as a coping strategy on QOL and life satisfaction.

Purpose: Examine relationships between spiritual struggle, QOL, and life satisfaction.

Method: Nonprobablility sample of 100 participants recruited from an Internet Web site with mailed questionnaires. Three instruments were used: breast cancer-specific version of Functional Assessment of Cancer Therapy Scale (FACT-B), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12) combined for QOL, Negative Coping subscale of Religious Coping (RCOPE) for spiritual struggle, and a single-item measuring life satisfaction.

Findings: Small inverse relationships between spiritual struggle, QOL (r = -.36, p < .001), and life satisfaction (r = -.31, p < .001) existed.

Conclusions: Spiritual struggle gives voice to women's questionings implying lower QOL and life satisfaction.

Implications: Assessment of and assistance with managing spiritual struggle are necessary to promote QOL and life satisfaction among those facing difficult health problems.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Attitude to Health
  • Breast Neoplasms / nursing*
  • Breast Neoplasms / psychology*
  • Female
  • Holistic Health
  • Humans
  • Internet
  • Middle Aged
  • Quality of Life / psychology*
  • Reproducibility of Results
  • Social Support
  • Spirituality*
  • Stress, Psychological / etiology*
  • Stress, Psychological / prevention & control
  • Surveys and Questionnaires
  • Survivors / psychology*