TY - JOUR
T1 - “I'm Not a Spiritual Person.” How Hope Might Facilitate Conversations About Spirituality Among Teens and Young Adults With Cancer
AU - Barton, Krysta S.
AU - Tate, Tyler
AU - Lau, Nancy
AU - Taliesin, Karen B.
AU - Waldman, Elisha D.
AU - Rosenberg, Abby R.
N1 - Publisher Copyright:
© 2018 American Academy of Hospice and Palliative Medicine
PY - 2018/6
Y1 - 2018/6
N2 - Context: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.
AB - Context: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.
KW - Adolescent and young adult
KW - cancer
KW - hope
KW - palliative care
KW - quality of life
KW - religion
KW - spirituality
UR - http://www.scopus.com/inward/record.url?scp=85043777014&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85043777014&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2018.02.001
DO - 10.1016/j.jpainsymman.2018.02.001
M3 - Article
C2 - 29428188
AN - SCOPUS:85043777014
SN - 0885-3924
VL - 55
SP - 1599
EP - 1608
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 6
ER -