Secinti, EkinWu, WeiKrueger, Ellen F.Hirsh, Adam T.Torke, Alexia M.Hanna, Nasser H.Adra, NabilDurm, Gregory A.Einhorn, LawrencePili, RobertoJalal, Shadia I.Mosher, Catherine E.2024-05-022024-05-022022-12Secinti, E., Wu, W., Krueger, E. F., Hirsh, A. T., Torke, A. M., Hanna, N. H., Adra, N., Durm, G. A., Einhorn, L., Pili, R., Jalal, S. I., & Mosher, C. E. (2022). Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making. Psycho-Oncology, 31(12), 2177–2184. https://doi.org/10.1002/pon.6065https://hdl.handle.net/1805/40455Objective: Many advanced cancer patients struggle with anxiety, depressive symptoms, and anger toward God and illness-related stressors. Patients may perceive their illness as an injustice (i.e., appraise their illness as unfair, severe, and irreparable or blame others for their illness), which may be a risk factor for poor psychological and spiritual outcomes. This study examined relations between cancer-related perceived injustice and psycho-spiritual outcomes as well as potential mediators of these relationships. Methods: Advanced lung (n=102) and prostate (n=99) cancer patients completed a one-time survey. Using path analyses, we examined a parallel mediation model including the direct effects of perceived injustice on psycho-spiritual outcomes (i.e., anxiety, depressive symptoms, anger about cancer, anger towards God) and the indirect effects of perceived injustice on psycho-spiritual outcomes through two parallel mediators: meaning making and acceptance of cancer. We then explored whether these relations differed by cancer type. Results: Path analyses indicated that perceived injustice was directly and indirectly – through acceptance of cancer but not meaning making – associated with psycho-spiritual outcomes. Results did not differ between lung and prostate cancer patients. Conclusions: Advanced cancer patients with greater perceived injustice are at higher risk for poor psycho-spiritual outcomes. Acceptance of cancer, but not meaning making, explained relationships between cancer-related perceived injustice and psycho-spiritual outcomes. Findings support testing acceptance-based interventions to address perceived injustice in advanced cancer patients.en-USPublisher Policyacceptanceadvanced canceranxietydepressive symptomsmeaning makingoncologyperceived injusticepsycho-oncologyspiritualityArticle