title: Spirituality, patients' worry, and follow-up health-care utilization among cancer survivors.
abstract: BACKGROUND
  Spirituality may aid cancer survivors as they attempt to interpret the meaning of their experience.
  
  
  OBJECTIVE
  We examined the relationship between spirituality, patient-rated worry, and health-care utilization among 551 cancer survivors with different malignancies, who were evaluated prospectively.
  
  
  METHODS
  Baseline spirituality scores were categorized into low and high spirituality groups. Patient-rated worries regarding disease recurrence/progression, developing new cancer, and developing complications from treatment were collected at baseline and at 6 and 12 months. Follow-up health-care utilization was also examined at 6 and 12 months.
  
  
  RESULTS
  Among the survivors, 271 (49%) reported low spirituality and 280 (51%) reported high spirituality. Of the cohort, 59% had some kind of worry regarding disease recurrence/progression, development of new cancers, and treatment complications. Highly spiritual survivors were less likely to have high levels of worries at both 6 and 12 months. Highly worried survivors were significantly more likely to place phone calls to their follow-up providers and had more frequent follow-up visits at 6 and 12 months. No interactions between spirituality and level of worry were noted to affect follow-up health-care utilization.
  
  
  CONCLUSIONS
  Given spirituality's effect on anxiety, spirituality-based intervention may have a role in addressing cancer survivors' worries but may not improve health-care utilization.
authors.affiliation: Department of Internal Medicine, Section of Oncology/Hematology, University of Nebraska Medical Center, Omaha, Nebraska 68198-7689, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Cannon
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Darrington
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Reed
authors.forename: Fausto R
authors.initials: FR
authors.lastname: Loberiza
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D029181:Spirituality; D017741:Survivors