“I'm Not a Spiritual Person.” How Hope Might Facilitate Conversations About Spirituality Among Teens and Young Adults With Cancer

Supporting patients' spiritual needs is central to palliative care. Adolescents and young adults (AYAs) may be developing their spiritual identities; it is unclear how to navigate conversations concerning their spiritual needs. To 1) describe spiritual narratives among AYAs based on their self-...

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Bibliographic Details
Published in:Journal of pain and symptom management 2018-06, Vol.55 (6), p.1599-1608
Main Authors: Barton, Krysta S., Tate, Tyler, Lau, Nancy, Taliesin, Karen B., Waldman, Elisha D., Rosenberg, Abby R.
Format: Article
Language:English
Subjects:
Adolescent
Adolescent and young adult
Cancer
Cohort analysis
Communication
Content analysis
Emotions
Female
God
Hope
Humans
Identity
Interviews as Topic
Longitudinal Studies
Male
Meaning
Medical diagnosis
Narratives
Neoplasms - psychology
Neoplasms - therapy
Newly diagnosed
Palliative Care
Prospective Studies
Quality of Life
religion
Religion and Medicine
Religiosity
Retrospective Studies
Self-Control
Spirituality
Teenagers
Young Adult
Young adults
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Summary:Supporting patients' spiritual needs is central to palliative care. Adolescents and young adults (AYAs) may be developing their spiritual identities; it is unclear how to navigate conversations concerning their spiritual needs. To 1) describe spiritual narratives among AYAs based on their self-identification as religious, spiritual, both, or neither and 2) identify language to support AYAs' spiritual needs in keeping with their self-identities. In this mixed-methods, prospective, longitudinal cohort study, AYAs (14–25 years old) with newly diagnosed cancer self-reported their “religiousness” and “spirituality.” One-on-one, semistructured interviews were conducted at three time points (within 60 days of diagnosis, six to 12 months, and 12–18 months later) and included queries about spirituality, God/prayer, meaning from illness, and evolving self-identity. Post hoc directed content analysis informed a framework for approaching religious/spiritual discussions. Seventeen AYAs (mean age 17.1 years, SD = 2.7, 47% male) participated in 44 interviews. Of n = 16 with concurrent survey responses, five (31%) self-identified as both “religious and spiritual,” five (31%) as “spiritual, not religious,” one (6%) as “religious, not spiritual,” and five (31%) as neither. Those who endorsed religiousness tended to cite faith as a source of strength, whereas many who declined this self-identity explicitly questioned their preexisting beliefs. Regardless of self-identified “religiousness” or “spirituality,” most participants endorsed quests for meaning, purpose, and/or legacy, and all included constructs of hope in their narratives. AYA self-identities evolve during the illness experience. When words such as “religion” and “spirituality” do not fit, explicitly exploring hopes, worries, meaning, and changing life perspectives may be a promising alternative.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2018.02.001