Religious Coping in Cancer: A Quantitative Analysis of Expressive Writing Samples from Patients with Renal Cell Carcinoma
Open accessAbstract
Context Past religiosity/spirituality (R/S) research has mainly relied on self-report instruments, which may result in self-presentation and defensive biases.Objectives To address these limitations, we reviewed the writing samples that were generated as part of an expressive writing (EW) trial, coded the samples for R/S content, and examined cross-sectional and prospective associations between R/S content and symptom and psychosocial outcomes.Methods Participants diagnosed with renal cell carcinoma who were randomized to the EW arm completed a standard writing protocol. Before randomization, they completed validated measures of R/S, depressive symptoms, social support, fatigue, and sleep disturbances and one, four, and 10 months after completing the intervention. Writing samples were coded for positive and negative religious coping (RC), and personal (e.g., private prayer) and collective (e.g., church attendance) religious engagement (RE).Results Of the 138 patients, 117 provided at least one writing sample, and 89% of participants made at least one R/S reference with 70% including at least one positive RC statement, and 45.3% revealed personal and 42.3% collective RE. Negative RC was rare (8%). Although positive RC and RE were significantly associated with the R/S Index (P < 0.01), negative RC was not. In prospective analyses, RE was associated with reduced cancer-related symptoms over time (P = 0.04), and negative RC was associated with increased psychological distress over time (P = 0.004).Conclusion Behavioral coding of EW samples supported the literature suggesting that positive RC is common among patients with cancer. Although negative RC may be relatively rare, it may be associated with psychological distress.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Expressive writing has been proven effective in patients with chronic diseases and cancer to reduce and manage psychophysical symptoms.
“This technique has also been proven effective in patients with chronic diseases and cancer, to reduce and manage psychophysical symptoms [14,15].”
From Effectiveness of Expressive Writing in Kidney Transplanted Patients: A Randomized Controlled Trial Study (2022) · cites this paper as [14]
The Results report that renal cell carcinoma patients who wrote more about private religious engagement had lower cancer-related symptoms during follow-up. But the Methods say this analysis included only the expressive-writing arm, so it does not establish that expressive writing itself reduced symptoms compared with neutral writing. The paper also does not establish effectiveness across chronic diseases or for psychophysical symptoms generally. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
Accounting for common method variance in cross-sectional research designs
Lindell, M. K., & Whitney, D. J. (2001) · Journal of Applied Psychology · doi:10.1037/0021-9010.86.1.114 · Cited by 8,490 · see citing works
Sherbourne, C. D., & Stewart, A. L. (1991) · Social Science & Medicine · doi:10.1016/0277-9536(91)90150-b · Cited by 6,643 · see citing works
Confronting a traumatic event: Toward an understanding of inhibition and disease.
Pennebaker, J. W., & Beall, S. K. (1986) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.95.3.274 · Cited by 1,898 · see citing works
Research on Religion, Spirituality, and Mental Health: A Review
Koenig, H. G. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905400502 · Cited by 1,442 · cited 1× · see citing works
“(1, 2) In the United States, over 70% of the population endorses having a religious belief and 50% indicate that religion is a very important aspect of their lives.”
BackgroundPargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2004) · Journal of Health Psychology · doi:10.1177/1359105304045366 · Cited by 912 · see citing works
Anxiety Disorders in Cancer Patients: Their Nature, Associations, and Relation to Quality of Life
Stark, D., Kiely, M., Smith, A., Velikova, G., House, A., & Selby, P. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.08.549 · Cited by 496 · see citing works
The use of religious coping during stressful life events: Main effects, moderation, and mediation.
Tix, A. P., & Frazier, P. A. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.2.411 · Cited by 475 · see citing works
Thuné-Boyle, I., Stygall, J., Keshtgar, M., & Newman, S. (2006) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2005.11.055 · Cited by 436 · see citing works
Religion, spirituality, and physical health in cancer patients: A meta‐analysis
Jim, H. S. L., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., Merluzzi, T. V., Munoz, A. R., George, L., Snyder, M. A., et al. (2015) · Cancer · doi:10.1002/cncr.29353 · Cited by 373 · see citing works
Ironson, G., Solomon, G. F., Balbin, E. G., O’Cleirigh, C., George, A., Kumar, M., Larson, D., & Woods, T. E. (2002) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2401_05 · Cited by 337 · cited 1× · see citing works
“(26) A R/S total score is also calculated that could range from 25 to 125 (Cronbach’s alpha = 0.”
BackgroundThe use of religious coping during stressful life events: Main effects, moderation, and mediation.
Tix, A. P., & Frazier, P. A. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.2.411 · Cited by 325 · see citing works
Salsman, J. M., Pustejovsky, J. E., Jim, H. S. L., Munoz, A. R., Merluzzi, T. V., George, L., Park, C. L., Danhauer, S. C., Sherman, A. C., Snyder, M. A., et al. (2015) · Cancer · doi:10.1002/cncr.29350 · Cited by 232 · see citing works
Prayer and Health: Review, Meta-Analysis, and Research Agenda
Masters, K. S., & Spielmans, G. I. (2007) · Journal of Behavioral Medicine · doi:10.1007/s10865-007-9106-7 · Cited by 196 · see citing works
Strategies used in coping with a cancer diagnosis predict meaning in life for survivors.
Jim, H., Richardson, S. A., Golden‐Kreutz, D. M., & Andersen, B. L. (2006) · Health Psychology · doi:10.1037/0278-6133.25.6.753 · Cited by 194 · see citing works
Grafton, E. T., Gillespie, B. M., & Henderson, S. (2010) · Oncology nursing forum · doi:10.1188/10.onf.698-705 · Cited by 177 · see citing works
de Moor, C., Sterner, J., Hall, M. H., Warneke, C. L., Gilani, Z., Amato, R. J., & Cohen, L. G. (2002) · Health Psychology · doi:10.1037//0278-6133.21.6.615 · Cited by 154 · see citing works
Self-citationProspective study of religious coping among patients undergoing autologous stem cell transplantation
Sherman, A. C., Plante, T. G., Simonton, S., Latif, U., & Anaissie, E. J. (2009) · Journal of Behavioral Medicine · doi:10.1007/s10865-008-9179-y · Cited by 141 · see citing works
Hui, D., de la Cruz, M., Thorney, S., Parsons, H. A., Delgado-Guay, M. O., & Bruera, E. D. (2010) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909110385917 · Cited by 137 · see citing works
Delgado-Guay, M. O., Chisholm, G. B., Williams, J. L., Frisbee‐Hume, S. E., Ferguson, A. O., & Bruera, E. D. (2015) · Palliative & Supportive Care · doi:10.1017/s147895151500108x · Cited by 124 · see citing works
Advancing our understanding of religion and spirituality in the context of behavioral medicine
Park, C. L., Masters, K. S., Salsman, J. M., Wachholtz, A., Clements, A. D., Salmoirago-Blotcher, E., Trevino, K., & Wischenka, D. M. (2017) · Journal of Behavioral Medicine · doi:10.1007/s10865-016-9755-5 · Cited by 119 · see citing works
Are spiritual interventions beneficial to patients with cancer?
Xing, L., Guo, X., Bai, L., Qian, J., & Chen, J. (2018) · Medicine · doi:10.1097/md.0000000000011948 · Cited by 114 · see citing works
de Moor, C., Sterner, J., Hall, M. H., et al. (2002) · Health Psychology · doi:10.1037/0278-6133.21.6.615 · Cited by 111 · see citing works
Rohani, C., Abedi, H., Omranipour, R., & Langius‐Eklöf, A. (2015) · Health and Quality of Life Outcomes · doi:10.1186/s12955-015-0229-1 · Cited by 105 · see citing works
Derks, W., de Leeuw, J. R. J., Hordijk, G. J., & Winnubst, J. A. M. (2005) · Clinical Otolaryngology · doi:10.1111/j.1365-2273.2004.00938.x · Cited by 88 · see citing works
Poulakis, V., Witzsch, U., de Vries, R., Moeckel, M., & Becht, E. (2003) · Urology · doi:10.1016/s0090-4295(03)00687-3 · Cited by 86 · see citing works
Randomized Controlled Trial of Expressive Writing for Patients With Renal Cell Carcinoma
Milbury, K., Spelman, A. R., Wood, C., Matin, S. F., Tannir, N. M., Jonasch, E. W., Pisters, L. L., Wei, Q., & Cohen, L. G. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2013.50.3532 · Cited by 63 · see citing works
Self-citationPark, C. L., Sherman, A. C., Jim, H. S. L., & Salsman, J. M. (2015) · Cancer · doi:10.1002/cncr.29351 · Cited by 49 · see citing works
Perez‐Cruz, P. E., Langer, P. D., Carrasco, C., Bonati, P., Batic, B., Tupper, L., & Otaiza, M. G. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0340 · Cited by 46 · see citing works
Renal cell carcinoma: Risk assessment and prognostic factors for newly diagnosed patients
Downs, T. M., Schultzel, M., Shi, H., Sanders, C., Tahir, Z., & Sadler, G. R. (2008) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2008.08.006 · Cited by 42 · see citing works
Parker, P. A., Swartz, R. J., Fellman, B. M., Urbauer, D. L., Li, Y., Pisters, L. L., Rosser, C. J., Wood, C. G., & Matin, S. F. (2012) · The Journal of Urology · doi:10.1016/j.juro.2011.10.151 · Cited by 42 · see citing works
Expressive writing as a presurgical stress management intervention for breast cancer patients.
de Moor, J. S., Moyé, L. A., Low, M. D., Rivera, E., Singletary, S. E., Fouladi, R. T., & Cohen, L. G. (2008) · PubMed · Cited by 41 · see citing works
Self-citationMilbury, K., Lopez, G., Spelman, A. R., Wood, C. G., Matin, S. F., Tannir, N. M., Jonasch, E. W., Pisters, L. L., Wei, Q., & Cohen, L. G. (2016) · Psycho-Oncology · doi:10.1002/pon.4148 · Cited by 28 · see citing works
Self-citationAscierto, P. A., Daponte, A., Parasole, R., Perrone, F., Carac�, C., Melucci, M. T., Palmieri, G., Napolitano, M., Mozzillo, N., & Castello, G. (2000) · Cancer · doi:10.1002/1097-0142(20001001)89:7 · Cited by 9 · see citing works
The rapid assessment of fatigue severity in cancer patients
Mendoza, T. R., Wang, X. S., Cleeland, C. S., Morrissey, M., Johnson, B. A., Wendt, J. K., & Huber, S. L. (1999) · Cancer · doi:10.1002/(sici)1097-0142(19990301)85:5 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [17]Pargament KI, Koenig HG, Tarakeshwar N, Hahn J. Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study. J Health Psychol 2004; 9: 713– 30. 10.1177/1359105304045366 15367751 · DOI · Paper page
- [36]Wolfer R, Sang C. Comparing the SAS GLM and MIXED Procedures for Repeated Measures. In: Proceedings of the Twentieth Annual SAS Users Group Conference, Cary, NC., Gary, NC: SAS Institute Inc.,, 1995.
- [37]Milbury K, Lopez G, Spelman A, Examination of moderators of expressive writing in patients with renal cell carcinoma: the role of depression and social support. Psychooncology 2016; 26: 1361– 1368. 10.1002/pon.4148 27145447 PMC5094904 · DOI
Cited by
Sorted by citations
Pierro, L., Servidei, G., Pretagostini, R., Stabile, D., Nudo, F., Lai, S., Aceto, P., Poli, L., Fazzari, E., & Lai, C. (2022) · Healthcare · doi:10.3390/healthcare10081559 · Cited by 8 · see citing works
- Authors
- Narayanan, S., Milbury, K., Wagner, R., & Cohen, L.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Narayanan, Santhosshi
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 60
- Issue
- 4
- Pages
- 737-745.e3
- ISSN
- 0885-3924 (ISSN-L)
- PMC
- PMC7508963
- OpenAlex
- W3022723035
- Cited by
- 17
- References
- 36
- Citations by year
- 2026: 6 · 2025: 6 · 2023: 2 · 2022: 3
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health
- National Institutes of Health
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Keywords
- religious coping, spirituality, renal cell carcinoma, cancer patients, expressive writing, religious involvement, prayer, church attendance, psychological distress, depressive symptoms, social support, fatigue, sleep disorders, cancer symptoms
- MeSH terms
- Adaptation, Psychological, Carcinoma, Renal Cell, Cross-Sectional Studies, Humans, Kidney Neoplasms, Prospective Studies, Writing, Spirituality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
