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Item Chaplain care in pediatric oncology: Insight for interprofessional collaboration(Wiley, 2019-12) Lion, Alex H.; Skiles, Jodi L.; Newton Watson, Beth; Young, J. Daniel; Torke, Alexia M.; Pediatrics, School of MedicineBackground Although attending to spiritual and religious needs is part of high quality care of pediatric cancer patients, oncology clinicians may not understand the role of the chaplain, resulting in underutilization of resources and failure to fully integrate the chaplain into the clinical team. We provide a description of what the chaplain does in the care of pediatric oncology patients. Methods We conducted a qualitative content analysis of chaplain chart notes over a one‐year period on the pediatric oncology service at a freestanding children's hospital. Using criteria designed to capture multiple potential factors in chaplain referral, we selected 30 patients for thematic analysis. Results In 2016, 166 pediatric patients were diagnosed with cancer and received ongoing care at our institution. From the 30 patients selected, 230 chaplain encounters were documented in the medical chart. Three major themes emerged. (1) The chaplains provided a rich description of spiritual and psychosocial aspects of the patient and family's experience; (2) chaplains provided diverse interventions, both religious and secular in nature; and (3) chaplains provided care within a longitudinal relationship. All three themes depend on the empathic listening by a chaplain. Conclusions The chaplains’ observations about patient and family beliefs, experiences, and emotional/spiritual states have the potential to inform the interdisciplinary care of the patient. Chaplain documentation provides insight into how spiritual care interventions and close relationships may promote patient and family well‐being. In future work, we will explore how to give voice to their insights in caring for pediatric oncology patients.Item First Rites—A Spiritual History Case Study(AMA, 2020-01) Lion, Alex Herbert; Radiology and Imaging Sciences, School of MedicineMy patient was playing high school tennis when she noticed a painful bump on her right hand. She had heard about some players getting bone spurs, but the bump became bigger and more painful over the next few weeks. Soon it was marching band season, and she had trouble playing her trumpet. Her parents brought her to a pediatrician, who noted her symptoms of back pain, trouble breathing, and the hand mass. A chest radiographic image was taken, and she was found to have pleural effusions, fluid accumulating between the lungs and a saran wrap–like covering for the lungs (the pleura). A chest computed tomography scan was done, and the pediatrician then sent the patient to my pediatric oncology clinic.Item Gynecological cancers: an alternative approach to healing(Future Science, 2017-07-12) Saso, Srdjan; Jones, Benjamin P; Bracewell-Milnes, Timothy; Huseyin, Gulsen; Boyle, Deborah C; Del Priore, Giuseppe; Smith, James Richard; Obstetrics and Gynecology, School of MedicineGrief and hope are two conflicting emotions that a patient recently diagnosed with cancer has to master. The real challenge for gynecologic oncologists is how to reach out. Conventional wisdom states that offering patients focus and belief when combating cancer in their lives allows them to embrace hope with greater confidence, which minimizes their grief. Three pictorial models are presented: ‘4-cusp approach’ model used at the initial consultation; ‘tapestry of bereavement or landscape of grief’ model at the postsurgery consultation; and ‘Venn-diagram’ model at any time during patient management. We have applied these models in our practice and believe that they can act as a fulcrum for the patient, the family and healthcare team around which therapy should be centered., Grief and hope are two emotions that a patient faces if diagnosed with cancer. The real challenge for the doctor is how to reach out and help the patient through this process. A doctor's role may be to offer focus and belief to the patient which may allow her to embrace hope with greater confidence. This will hopefully lessen the grief. We present three models which we believe can play a crucial part: ‘4-cusp approach’ used at the initial consultation; ‘tapestry of bereavement or landscape of grief model’ at the postsurgery consultation; and ‘Venn-diagram model’ at any time during care.Item Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making(Wiley, 2022-12) Secinti, Ekin; Wu, Wei; Krueger, Ellen F.; Hirsh, Adam T.; Torke, Alexia M.; Hanna, Nasser H.; Adra, Nabil; Durm, Gregory A.; Einhorn, Lawrence; Pili, Roberto; Jalal, Shadia I.; Mosher, Catherine E.; Psychology, School of ScienceObjective: 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.Item Spiritual Experiences of Adults with Advanced Cancer in Outpatient Clinical Settings(Elsevier, 2019) Maiko, Saneta; Johns, Shelley A.; Helft, Paul R.; Slaven, James E.; Cottingham, Ann H.; Torke, Alexia M.; Medicine, School of MedicineContext Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of advanced cancer patients will help guide the provision of high-quality spiritual care. Objectives To qualitatively describe advanced cancer patients’ spiritual experiences of illness. Methods We conducted semi-structured qualitative interviews at a single cancer center with 21 patients with stage IV solid malignancies who had a prognosis of less than 12 months, as estimated by each patient’s medical oncologist. Five investigators conducted a thematic analysis of the transcribed interviews. Results We found 31 patients who were eligible for enrollment, and 21 (67.7%) participated in interviews to thematic saturation. Using a thematic-analysis approach, five major themes emerged. Relationships with family and friends was the most important theme among all 21 patients irrespective of their religious or spiritual identity. Relationship with God and faith community was frequently identified by those who considered themselves spiritually religious. Cancer often led to reflection about the meaning of life and the nature of existential suffering Patients addressed the extent to which identity was changed or maintained through the cancer experience, and some expressed acceptance as a way of coping with illness. Conclusions Spiritual care for dying cancer patients should always include the exploration of relationships with family and friends, as well as God and faith community for some patients. Relationships with family, friends, and God can be a source of strength for many. Making meaning, addressing identity concerns, supporting acceptance as a resource for coping with illness, and acknowledging existential suffering will often arise for these patients.Item Spirituality, emotional distress, and post-traumatic growth in breast cancer survivors and their partners: an actor–partner interdependence modeling approach(Wiley, 2017-10) Gesselman, Amanda N.; Bigatti, Silvia M.; Garcia, Justin R.; Coe, Kathryn; Cella, David; Champion, Victoria L.; Social and Behavioral Sciences, School of Public HealthBackground The association between spirituality and emotional health has been well documented in healthy individuals. A small literature has shown that spirituality plays a role in well-being for some breast cancer (BC) survivors; however, this link is virtually unexplored in partners/spouses of survivors. The current study aimed to assess the relationship between spirituality, emotional distress, and post-traumatic growth for BC survivors and their partners using a dyadic analyses approach. Methods A total of 498 couples who were 3–8 years post-BC diagnosis were recruited from the Eastern Oncology Group database. Results For BC survivors and their partners, greater levels of spirituality were associated with increases in their own post-traumatic growth. There was no relation between BC and partner spirituality and their own emotional distress, but partner’s spirituality was associated with reduced occurrence of intrusive thoughts in the BC survivor. In contrast, BC survivors’ spirituality was found to be wholly unrelated to partner’s mental health and adjustment. Conclusions Following diagnosis and treatment, spirituality appears to associate with positive growth in BC survivors and their partners. However, BC survivor and partner spirituality seem to be ineffective at impacting the other’s post-traumatic growth or emotional distress, with the exception of intrusive thoughts. Dyadic analysis takes into account the reciprocal influence of close relationships on health and is an important and under-utilized methodology in behavioral oncology research and clinical practice.Item Spirituality: What Does it Mean and to Whom?(Wiley, 2018-09) Steensland, Brian; Wang, Xiaoyun; Chism Schmidt, Lauren; Sociology, School of Liberal ArtsWhile there is increasing interest in the topic of spirituality, scholars have limited data on its meaning among ordinary Americans. Based on an open‐ended question in a new nationally representative survey, this article documents the elements that make up people's views of spirituality. We find that theism is the dominant focus of American spirituality, with a relatively small percentage of people offering exclusively immanent descriptions. Cognitive and relational orientations are more prominent than behavioral or ethical orientations. Using latent class analysis, we identify seven distinctive views of spirituality that vary considerably in their prevalence and social profiles. Binary logit regression shows that spiritual self‐identification, belief in God, and worship attendance are the religious factors most strongly associated with views of spirituality. Among sociodemographic predictors, significant associations with gender, race, education, and income are limited or absent. In contrast, the influences of age and political ideology are more substantial.Item The strings on David’s Harp: religious ritual as a container for spirituality(Taylor & Francis, 2019) Sasso, Sandy EisenbergReligion and spirituality have often been defined over against each other. The spontaneous, emotional and experiential nature of the spirit has been seen as preferential to the structured, fixed, and predictable nature of religious ritual. Religion education for children has moved away from the performance of ritual behaviour toward creating an environment to nurture the innate spiritual nature of children. This paper questions whether the pendulum has swung too far, neglecting rituals that have sustained religious and communal life for generations, and considers ways of reimagining traditional ritual as a way to encounter the spirit and build community.Item The Role of Spiritual Practices in the Multidimensional Impact of Religion And Spirituality on Giving and Volunteering(Indiana University Lilly Family School of Philanthropy, 2024-02) Duffy, Barbara J.; King, David P; Steensland, BrianReligion is one of the most widely recognized predictors of charitable giving and volunteering. Yet there is less agreement on how it matters and whether spirituality matters as well. We explore religion’s modes of influence through multidimensional measures of religion and spirituality, including affiliation, membership, and salience. We introduce an analysis of spiritual practices to studies of prosocial behavior and find that six diverse spiritual practices are independently associated with greater likelihood of giving or volunteering. In full models, composite measures of spiritual practices beyond regular religiosity measures are significantly associated with both outcomes. Taken collectively, our results demonstrate the value of recognizing the multiple pathways through which religion and spirituality matter for giving and volunteering, the relevance of diverse forms of spiritual practice, and, most broadly, the importance of further exploring the links between spirituality and prosocial behavior.