title: Spiritual or religious struggle in hematopoietic cell transplant survivors.
abstract: This study describes the prevalence of religious or spiritual (R/S) struggle in long-term survivors after hematopoietic cell transplantation (HCT), demographic and medical correlates of R/S struggle, and its associations with depression and quality of life.
  
  
  
  Data were collected in conjunction with an annual survey of adult (age ≥18 years) survivors of HCT. Study measures included R/S struggle (negative religious coping, NRC, from Brief RCOPE), measures of quality of life (subscales from 36-item Short Form Health Survey and McGill), and the Patient Health Questionnaire 8. R/S struggle was defined as any non-zero response on the NRC. Factors associated with R/S struggle were identified using multi-variable logistic regression models.
  
  
  
  The study analyzed data from 1449 respondents who ranged from 6 months to 40 years after HCT. Twenty-seven percent had some R/S struggle. In a multi-variable logistic regression model, R/S struggle was associated with greater depression and poorer quality of life. R/S struggle was also associated with younger age, non-White race, and self-identification as either religious but not spiritual or spiritual but not religious. R/S struggle was not associated with any medical variables, including time since transplant.
  
  
  
  Religious or spiritual struggle is common among HCT survivors, even many years after HCT. Survivors should be screened and, as indicated, referred to a professional with expertise in R/S struggle. Further study is needed to determine causal relationships, longitudinal trajectory, impact of struggle intensity, and effects of R/S struggle on health, mood, and social roles for HCT survivors. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Chaplaincy, Seattle Cancer Care Alliance, Seattle, WA, USA.
authors.forename: Stephen Duane
authors.initials: SD
authors.lastname: King
authors.affiliation: Department of Religion, Health & Human Values, Rush University Medical Center, Chicago, IL, USA.
authors.forename: George
authors.initials: G
authors.lastname: Fitchett
authors.affiliation: Department of Religion, Health & Human Values, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Murphy
authors.affiliation: Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Pargament
authors.affiliation: Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Martin
authors.affiliation: Adolescent and Young Adult Oncology, Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Johnson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Harrison
authors.affiliation: Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Elizabeth Trice
authors.initials: ET
authors.lastname: Loggers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000073116:Cancer Survivors / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D012069:Religion and Psychology; D029181:Spirituality; D055815:Young Adult