title: Associations between faith, distress and mental adjustment--a Danish survivorship study.
abstract: OBJECTIVE
  Several studies have suggested that religion and spirituality are important for overcoming psychological distress and adjusting mentally to cancer, but these studies did not differentiate between spiritual well-being and specific aspects of faith. We examined the extent to which spiritual well-being, the faith dimension of spiritual well-being and aspects of performed faith are associated with distress and mental adjustment among cancer patients.
  
  
  METHODS
  In a cross-sectional design, 1043 survivors of various cancers filled in a questionnaire on spiritual well-being (FACIT-Sp-12), specific aspects of faith ('belief in a god', 'belief in a god with whom I can talk' and 'experiences of god or a higher power'), religious community and church attendance (DUREL), distress (POMS-SF), adjustment to cancer (Mini-MAC) and sociodemographic factors. Linear regression models were used to analyze the associations between exposure (spiritual well-being and specific faith aspects) and outcome (distress and adjustment to cancer) with adjustment for age, gender, cancer diagnosis and physical and social well-being.
  
  
  RESULTS
  Higher spiritual well-being was associated with less total distress (β = -0.79, CI -0.92; -0.66) and increased adjustment to cancer (fighting spirit, anxious preoccupation, helplessness-hopelessness). Specific aspects of faith were associated with high confusion-bewilderment and tension-anxiety, but also lower score on vigor-activity, and with higher anxious-preoccupation, both higher and lower cognitive avoidance, but also more fighting spirit.
  
  
  CONCLUSIONS
  As hypothesized, spiritual well-being were associated with less distress and better mental adjustment. However, specific aspects of faith were both positively and negatively associated with distress and mental adjustment. The results illustrate the complexity of associations between spiritual well-being and specific aspects of faith with psychological function among cancer survivors.
authors.affiliation: Unit of Survivorship, Danish Cancer Society Research Center, Copenhagen, Denmark. tind@cancer.dk
authors.forename: Christine Tind
authors.initials: CT
authors.lastname: Johannessen-Henry
authors.forename: Isabelle
authors.initials: I
authors.lastname: Deltour
authors.forename: Pernille Envold
authors.initials: PE
authors.lastname: Bidstrup
authors.forename: Susanne O
authors.initials: SO
authors.lastname: Dalton
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology / Q000534:rehabilitation; D012067:Religion; D012069:Religion and Psychology; D029181:Spirituality; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data