Making the invisible visible: A test of mediational pathways of the spirituality, religiousness, and health connection in a sample of cancer patients.

Accumulating evidence has demonstrated strong relationships among religious and spiritual belief systems and health outcomes in a number of medical populations, including cancer patients; however, little is known regarding how faith "gets into the body", or by what pathways do religious and spiritual beliefs influence health. The current study applied both quantitative and qualitative methods to test two hypothesized mediators of this relationship, Spiritual Support and Religious Social Support. Spiritual Support refers to one's feeling of being supported through connection to a Higher Power. Religious Social Support involves supportive relationships with members of a religious community, and includes practical as well as expressive support. Ninety-two individuals in the Phoenix area with a history of cancer answered questions about their illness and sources of support. Regression analyses showed that among participants, both Spiritual and Religious Identity were correlated with Emotional, Functional and Mental Well-Being, but not with physical health. The association between faith and well-being was mediated by three mechanisms of support: Spiritual Support, Frequency of Receiving Expressive Religious Social Support and Satisfaction with Religious Social Support. That is, participants' closeness to a Higher Power or connection to individuals who shared their belief systems represented pathways by which faith influenced their emotional, functional and mental health. In the study's qualitative component, 21 individuals were interviewed about their preference with regard to discussing religious and spiritual matters with their doctors. Respondents emphasized the importance of being treated as "whole human beings" by medical staff. For a third of the sub-sample, this included a preference for doctors to ask about religious and spiritual beliefs, within the context of a trusting relationship of care. Patients articulated a number of suggestions for how to approach this discussion in a respectful, non-coercive manner. Finally, all patients in the study sample were asked whether they would find it acceptable to have their doctors inquire about their faith within an assessment of support resources; no patient objected to this suggestion. Taken together, qualitative and quantitative results of this study suggest that patients overall want connection with their doctors, and that connection may itself represent a potent healing mechanism.