Spiritual well-being and psychological resilience in outpatients receiving chemotherapy: The multiple mediating role of symptoms


DÖNER A., Bilgin A., ÖCALAN S., KOVANCI M. S., İNANÇ M.

EUROPEAN JOURNAL OF ONCOLOGY NURSING, cilt.79, 2025 (SCI-Expanded, SSCI, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 79
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.ejon.2025.103009
  • Dergi Adı: EUROPEAN JOURNAL OF ONCOLOGY NURSING
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, MEDLINE, Psycinfo
  • Anahtar Kelimeler: Cancer, Symptoms, Spiritual well-being, Psychological resilience
  • Erciyes Üniversitesi Adresli: Evet

Özet

Purpose: This study aimed to investigate the relationship between symptom status, spiritual well-being, and psychological resilience in patients with cancer. Methods: This study employed a quantitative, cross-sectional, and correlational design. The study sample consisted of 240 cancer patients who presented to the oncology day treatment unit of a university hospital in T & uuml;rkiye. Data were collected using the Sociodemographic Information Form, Edmonton Symptom Assessment Scale, Spiritual Well-Being Scale, and Connor-Davidson Resilience Scale-Short Form. Stepwise multiple regression, and structural equation modeling were used to analyze the data. Results: The mean age was 58.93 +/- 11.21 years, and the sample was nearly equally distributed by gender. In the stepwise multiple regression analysis, spiritual well-being was the strongest positive predictor of resilience (beta = 0.601, p < 0.001). General well-being impairment, anxiety, fatigue, and pain were significant negative predictors (R-2 = 0.728, p < 0.001). Parallel mediation analysis revealed that spiritual well-being has a significant impact on resilience through multiple mediators. It had an adverse indirect effect via pain and positive indirect effects via fatigue, anxiety, and general well-being. The overall indirect effect of spiritual well-being on resilience was significant (beta = 0.159, 95 % CI [0.139, 0.262], p < 0.05), accounting for 21.01 % of the total effect, indicating partial mediation. Conclusion: These effects were not only statistically significant but also clinically meaningful, indicating the importance of interventions to enhance spiritual well-being in improving resilience. The findings demonstrated that spiritual well-being not only has a direct positive effect on resilience but also exerts indirect effects through key physical and psychological symptoms, including pain, fatigue, anxiety, and impaired general well-being.