SPIRITUALITY, OPTIMISM AND PESSIMISM AS PREDICTORS OF FEAR OF CANCER RECURRENCE AND QUALITY OF LIFE IN BREAST CANCER SURVIVORS
Anderson, Adrianne 1980-
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Breast cancer survivors experience a number of challenges when adjusting to life after cancer treatment, such as fear of a recurrence of the cancer and a reduction in quality of life. The endorsement of optimism or pessimism in breast cancer survivors has been shown to predict adjustment and quality of life (Carver, 2005). In addition, many breast cancer survivors have reported using spirituality to cope with and adjust in an adaptive manner to the challenges of a breast cancer diagnosis (Romero et al., 2006). Research findings suggest that spirituality may enhance the positive relation of optimism and decrease the negative relation of pessimism to well-being and adjustment among breast cancer survivors (Samsi, 2008). Therefore, the main objective of the present study was to test whether spirituality moderates the relation of optimism and pessimism to the well-being and adjustment of breast cancer survivors, assessed in terms of quality of life and fear of cancer recurrence. The present study utilized an archival data set of one hundred and eighty-three African American and Caucasian breast cancer survivors. Optimism and pessimism was measured with the Life Orientation Test (Scheier & Carver, 1985) and fear of recurrence was assessed by the Concerns about Recurrence Scale (Vickberg, 2003). The Functional Assessment of Chronic Illness Therapy-Spiritual Well Being (Peterman, et al. 2002) was used to measure spirituality and quality of life was assessed with the Functional Assessment of Chronic Illness-Breast Cancer (Brady, et al. 1997). Four hierarchical vi regression analyses were conducted to examine if spirituality moderated the association of optimism and pessimism to the quality of life and fear of recurrence in breast cancer survivors. It was hypothesized that women who reported high levels of spirituality would show a stronger positive relationship between optimism and quality of life and a stronger negative relation between optimism and fear of cancer recurrence than women who reported low levels of spirituality. It was also hypothesized that women who reported high levels of spirituality would show a weaker negative relation between pessimism and quality of life and a weaker positive relation between pessimism and fear of cancer recurrence than women who reported low levels of spirituality. Results of Pearson product moment correlation analyses indicated that time since diagnosis was negatively associated with fear of cancer recurrence and was positively correlated with spirituality. Pessimism and optimism were negatively correlated with each other while spirituality was associated with greater quality of life and less fear of cancer recurrence. Regression analysis indicated that, when controlling for race, and years since diagnosis, spirituality negatively predicted fear of cancer recurrence and positively predicted quality of life. Results also indicated that spirituality did not moderate the relation of optimism and pessimism to quality of life or to fear of cancer recurrence. Non-significant findings in the relationship between optimism or pessimism and quality of life or fear of cancer recurrence challenge the findings of established literature on the influence of dispositional cognitions and well-being outcomes in breast cancer survivors. Implications of these findings for future research and psychotherapy are discussed.