Spiritual/Religious Coping Strategies and their Relationship with Illness Adjustment among Iranian Breast Cancer Patients

  • Khodaveirdyzadeh, Roghieh (Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences) ;
  • Rahimi, Rabee (Department of Nursing, Islamic Azad University) ;
  • Rahmani, Azad (Hematology and Oncology Research Center) ;
  • Ghahramanian, Akram (Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences) ;
  • Kodayari, Naser (Islamic Studies Department, Tabriz University of Medical Sciences) ;
  • Eivazi, Jamal (Hematology and Oncology Research Center)
  • Published : 2016.08.01


Background: Use of spiritual/ religious resources is one important coping strategy for breast cancer patients. However, the relationship between spiritual coping and adjustment to cancer diagnosis has not been well investigated among Iranian breast cancer patients. Materials and Methods: This descriptive-correlational study was undertaken among 266 breast cancer patients referred to two educational centers in north-western Iran. They were selected using a convenience sampling method. The Iranian Religious Coping Scale and Iranian Coping Operations Preference Enquiry were used for data collection. The data were analyzed using SPSS version 13.0. Results: The study findings showed that Iranian cancer patients had a high level of spiritual coping. Also, positive religious coping strategies were used more frequently than negative approaches. In addition, there was a positive and significant correlation between spiritual coping and adjustment to cancer among study participants. Conclusions: Using spiritual coping strategies may play a vital role in adjustment process in patients with breast cancer. Therefore, having spiritual counseling and incorporating coping strategies into the treatment regimen may be effective for enhancing illness adjustment in such patients.


  1. Abdollahzadeh F, Moradi N, Pakpour V, et al (2014). Un-met supportive care needs of Iranian breast cancer patients. Asian Pac J Cancer Prev, 15, 3933-8.
  2. Aflakseir A, Coleman PG (2011). Initial development of the Iranian religious coping scale. J Muslim Mental Health, 6, 44-61.
  3. Afrooz R, Rahmani A, Zamanzadeh V, et al (2014). The nature of hope among Iranian cancer patients. Asian Pac J Cancer Prev, 15, 9307-12.
  4. Al-Azri M, Al-Awisi H, Al-Moundhri M (2009). Coping with a diagnosis of breast cancer-literature review and implications for developing countries. Breast J, 15, 615-22.
  5. Aldwin CM (2007). Stress, Coping, and Development: An Integrative Perspective, Guilford Press.
  6. Atef-Vahid MK, Nasr-Esfahani M, Esfeedvajani MS, et al (2011). Quality of life, religious attitude and cancer coping in a sample of Iranian patients with cancer. J Res Med Sci, 16, 928-37.
  7. Avestan Z, Rahmani A, Heshmati-Nabavi F, et al (2015). Perceptions of iranian cancer patients regarding respecting their dignity in hospital settings. Asian Pac J Cancer Prev, 16, 5453-8.
  8. Carver CS, Scheier MF, Weintraub JK (1989). Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol, 56, 267-83.
  9. Gall TL, Kristjansson E, Charbonneau C, et al (2009). A longitudinal study on the role of spirituality in response to the diagnosis and treatment of breast cancer. J Behav Med, 32, 174-86.
  10. Hayati FMM (2008). Coping strategies in women with breast cancer refer to hospitals affiliated to medical sciences universities of Tehran city. Iranian J Breast Disease, 1, 38-43.
  11. Hebert R, Zdaniuk B, Schulz R, et al (2009). Positive and negative religious coping and well-being in women with breast cancer. J Palliat Med, 12, 537-45.
  12. jalalinejad r, yazdkhasti f, abedi a (2012). Validity, reliability, and factor structure of carver, scheier and weinteraub's coping operations preference enquiry (COPE) in University of Isfahan Students. J Cognitive Behavioral Science Res, 3, 41-54.
  13. Janiszewska J, Buss T, de Walden-Galuszko K, et al (2008). The religiousness as a way of coping with anxiety in women with breast cancer at different disease stages. Support Care Cancer, 16, 1361-6.
  14. Koenig HG, McCullough ME, Larson DB (2001). Handbook of religion and health, Oxford University Press.
  15. Kvillemo P, Branstrom R (2014). Coping with breast cancer: a meta-analysis. PLoS One, 9, 112733.
  16. Lyon F. 2013. The international agency for research on cancer (IARC) [Online].
  17. Mesquita AC, Chaves Ede C, Avelino CC, et al (2013). The use of religious/spiritual coping among patients with cancer undergoing chemotherapy treatment. Rev Lat Am Enfermagem, 21, 539-45.
  18. Montgomery M, McCrone SH (2010). Psychological distress associated with the diagnostic phase for suspected breast cancer: systematic review. J Adv Nurs, 66, 2372-90.
  19. Paiva CE, Paiva BS, de Castro RA, et al (2013). A pilot study addressing the impact of religious practice on quality of life of breast cancer patients during chemotherapy. J Relig Health, 52, 184-93.
  20. Pargament KI, Smith BW, Koenig HG, et al (1998). Patterns of positive and negative religious coping with major life stressors. J Scientific Study Relig, 37, 710-24.
  21. Sajadiyan AS, Haghighat S, Montazeri A, et al (2011). Post diagnosis coping strategies patients with breast cancer. Iranian J Breast Disease, 4, 52-8.
  22. Schreiber JA, Brockopp DY (2012). Twenty-five years later--what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. J Cancer Surviv, 6, 82-94.
  23. Taleghani F, Yekta ZP, Nasrabadi AN (2006). Coping with breast cancer in newly diagnosed Iranian women. J Adv Nurs, 54, 265-72.
  24. Taleghani F, Yekta ZP, Nasrabadi AN, et al (2008). Adjustment process in Iranian women with breast cancer. Cancer Nurs, 31, 32-41.
  25. Thune-Boyle IC, Stygall J, Keshtgar MR, et al (2013). Religious/ spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psychooncol, 22, 646-58.
  26. Thune-Boyle IC, Stygall JA, Keshtgar MR, et al (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Soc Sci Med, 63, 151-64.
  27. Trevino KM, Balboni M, Zollfrank A, et al (2014). Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer. Psychooncol, 23, 936-45.
  28. Yoo GJ, Levine EG, Pasick R (2014). Breast cancer and coping among women of color: a systematic review of the literature. Support Care Cancer, 22, 811-24.