Spiritual well-being in long-term colorectal cancer survivors with ostomies

Joanna Bulkley, Carmit K. McMullen, Mark C. Hornbrook, Marcia Grant, Andrea Altschuler, Christopher S Wendel, Robert S Krouse

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods: Two-hundred-eighty-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Results: Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Conclusions: Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging.

Original languageEnglish (US)
Pages (from-to)2513-2521
Number of pages9
JournalPsycho-Oncology
Volume22
Issue number11
DOIs
StatePublished - Nov 2013

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Ostomy
Survivors
Colorectal Neoplasms
Quality of Life
Hope
Neoplasms
Emotions
Learning
Survival
Surveys and Questionnaires

Keywords

  • cancer
  • HRQOL
  • oncology
  • ostomy
  • spiritual well-being
  • stoma
  • survivorship

ASJC Scopus subject areas

  • Oncology
  • Psychiatry and Mental health
  • Experimental and Cognitive Psychology

Cite this

Bulkley, J., McMullen, C. K., Hornbrook, M. C., Grant, M., Altschuler, A., Wendel, C. S., & Krouse, R. S. (2013). Spiritual well-being in long-term colorectal cancer survivors with ostomies. Psycho-Oncology, 22(11), 2513-2521. https://doi.org/10.1002/pon.3318

Spiritual well-being in long-term colorectal cancer survivors with ostomies. / Bulkley, Joanna; McMullen, Carmit K.; Hornbrook, Mark C.; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S; Krouse, Robert S.

In: Psycho-Oncology, Vol. 22, No. 11, 11.2013, p. 2513-2521.

Research output: Contribution to journalArticle

Bulkley, J, McMullen, CK, Hornbrook, MC, Grant, M, Altschuler, A, Wendel, CS & Krouse, RS 2013, 'Spiritual well-being in long-term colorectal cancer survivors with ostomies', Psycho-Oncology, vol. 22, no. 11, pp. 2513-2521. https://doi.org/10.1002/pon.3318
Bulkley J, McMullen CK, Hornbrook MC, Grant M, Altschuler A, Wendel CS et al. Spiritual well-being in long-term colorectal cancer survivors with ostomies. Psycho-Oncology. 2013 Nov;22(11):2513-2521. https://doi.org/10.1002/pon.3318
Bulkley, Joanna ; McMullen, Carmit K. ; Hornbrook, Mark C. ; Grant, Marcia ; Altschuler, Andrea ; Wendel, Christopher S ; Krouse, Robert S. / Spiritual well-being in long-term colorectal cancer survivors with ostomies. In: Psycho-Oncology. 2013 ; Vol. 22, No. 11. pp. 2513-2521.
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abstract = "Objective: Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods: Two-hundred-eighty-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Results: Open-ended responses from 52{\%} of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as {"}positive attitude{"}, {"}I am fortunate{"}, {"}appreciate life more{"}, and {"}strength through religious faith{"}. Negative themes, expressed by only 29{\%} of respondents, included {"}struggling to cope{"}, {"}not feeling 'normal' {"}, and {"}loss{"}. Fifty-five percent of respondents expressed ambivalent themes including {"}learning acceptance{"}, {"}an ostomy is the price for survival{"}, {"}reason to be around despite suffering{"}, and {"}continuing to cope despite challenges{"}. The majority (64{\%}) had a high SpWB sub-scale score. Conclusions: Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging.",
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N2 - Objective: Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods: Two-hundred-eighty-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Results: Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Conclusions: Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging.

AB - Objective: Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods: Two-hundred-eighty-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Results: Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Conclusions: Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging.

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KW - survivorship

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