title: Spirituality and well-being in cancer patients: a review.
abstract: OBJECTIVE
  Cancer places many demands on the patient and threatens the person's sense of meaning to life. It has been shown that cancer patients use their spirituality to cope with these experiences. The present literature review summarizes the research findings on the relationship between spirituality and emotional well-being. Special attention is given to the strength of the research findings.
  
  
  METHODS
  A literature search was performed in Pubmed and Web of Science. Spirituality does not necessarily coincide with religiosity. Therefore, studies were excluded that focused on religiosity. Forty publications met the inclusion criteria: Twenty-seven studies that investigated the relationship between spirituality and well-being, and 13 publications that explored the relationship between meaning in life and well-being.
  
  
  RESULTS
  The majority of the cross-sectional studies (31 of 36) found a positive association between spirituality and well-being. The four studies with a longitudinal design showed mixed results. The significance of the findings is challenged, because most spirituality questionnaires contain several items that directly refer to emotional well-being.
  
  
  CONCLUSIONS
  Despite that the majority of the studies concluded that spirituality was associated with higher well-being, no definitive conclusions on this relationship can be drawn due to major methodological shortcomings of these studies. Longitudinal research utilizing spirituality and well-being measures that do not overlap in content is recommended.
authors.affiliation: Helen Dowling Institute, Centre for Psycho-Oncology, Ultrecht, The Netherlands. a.visser@hdi.nl
authors.forename: Anja
authors.initials: A
authors.lastname: Visser
authors.forename: Bert
authors.initials: B
authors.lastname: Garssen
authors.forename: Ad
authors.initials: A
authors.lastname: Vingerhoets
mesh_terms: D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D006801:Humans; D008603:Mental Health; D009369:Neoplasms / Q000523:psychology*; D029181:Spirituality