Screening for religious/spiritual struggle in blood and marrow transplant patients.
OBJECTIVE
A growing body of research documents the harmful effects of religious/spiritual (R/S) struggle (e.g., feeling abandoned or punished by God) among patients with a wide variety of diagnoses. Documented effects include poorer quality of life, greater emotional distress, poorer recovery, and increased disability. This study reports the use of a screening protocol that identified patients who may have been experiencing R/S struggle. We also examined the prevalence and correlates of possible R/S struggle, its association with quality of life, pain, and depressive symptoms and compared the results from the screening protocol with social workers' assessments.


METHODS
One hundred seventy-eight blood and marrow transplant patients completed the Electronic Self-Report Assessment--Cancer (ESRA-C) which included the Rush Religious Struggle Screening Protocol and other measures of quality of life, pain, and depressive symptoms prior to transplant therapy. All participants were assessed by a social worker, 90 % within 2 weeks of the ESRA-C assessment.


RESULTS
Using the Rush Protocol, 18 % of the patients were identified as potentially experiencing R/S struggle. R/S struggle was not reported in any social work assessments. In a multivariable model, potential R/S struggle was more likely in patients who were more recently diagnosed, male, and Asian/Pacific Islanders. There were no significant associations between potential R/S struggle and quality of life, pain, or depressive symptoms.


CONCLUSIONS
Early identification of patients with R/S struggle will facilitate their referral for further assessment and appropriate intervention. Further research is needed to identify the best methods of screening patients for R/S struggle.
Seattle Cancer Care Alliance, Seattle, WA 98109, USA. sking@seattlecca.org
Stephen D W
SD
King
George
G
Fitchett
Donna L
DL
Berry
D000328:Adult; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D011788:Quality of Life / Q000523:psychology; D017678:Sex Distribution; D012947:Social Work; D029181:Spirituality; D011795:Surveys and Questionnaires; D014861:Washington