Examining the mediating role of cancer‐related problems on spirituality and self‐rated health among African American cancer survivors: a report from the American Cancer Society's Studies of Cancer Survivors‐II. Issue 9 (6th November 2014)

• Record Type: Journal Article
• Authors: Best, Alicia L.; Alcaraz, Kassandra I.; McQueen, Amy; Cooper, Dexter L.; Warren, Rueben C.; Stein, Kevin
• Is Part Of: Psycho-oncology. Volume 24:Issue 9(2015)
• Page Start: 1051
• Page End: 1059
• Publication Date: 2014-11-06
• Subjects: Cancer -- Psychological aspects -- Periodicals; Cancer -- Social aspects -- Periodicals; Neoplasms -- psychology -- Periodicals; 616.9940019
• DOI: 10.1002/pon.3720
• Languages: English
• ISSNs: 1057-9249

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pon3720-sec-0001" sec-type="section"> <title>Objective</title> <p>African American (AA) cancer survivors report poorer self‐rated health (SRH) compared to other racial/ethnic groups. Spirituality is often linked to positive health outcomes, with AAs reporting greater levels of spirituality. This study examined the potential mediating role of cancer‐related problems in the relationship between spirituality and SRH among AA cancer survivors compared to non‐African American (non‐AA) survivors.</p> </sec> <sec id="pon3720-sec-0002" sec-type="section"> <title>Methods</title> <p>We analyzed data on 9006 adult cancer survivors from the American Cancer Society's Study of Cancer Survivors‐II. Preliminary analyses compared characteristics of AAs and non‐AAs and identified significant covariates of SRH. We tested a path model using multi‐group structural equation modeling (SEM), and then examined race as a moderator.</p> </sec> <sec id="pon3720-sec-0003" sec-type="section"> <title>Results</title> <p>Of the three domains of spirituality assessed, AAs had higher levels of <italic>peace</italic> (<italic>p</italic> < .001) and <italic>faith</italic> (<italic>p</italic> < .001), but not <italic>meaning</italic>, compared to non‐AAs; and of four domains of cancer‐related problems assessed, AAs had greater <italic>physical distress</italic> (<italic>p</italic> < .001), <italic>emotional distress</italic> (<italic>p</italic> < .001), and <italic>employment</italic>/<italic>finance problems</italic> (<italic>p</italic> < .001), but not <italic>fear of recurrence</italic>. In SEM analyses adjusting for number of comorbidities and income, race moderated the impact of spirituality and cancer‐related problems on SRH. Specifically, spirituality had significantly stronger associations with cancer‐related problems among AAs than non‐AAs. Spirituality was positively associated with all four domains of cancer‐related problems, but only physical distress was associated with SRH among AAs.</p> </sec> <sec id="pon3720-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The negative effects of physical distress may attenuate the positive effects of spirituality on AA's SRH. Future studies should consider racial/ethnic differences in the determinants and conceptualization of SRH, which is a known predictor of survival. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>