Advancing Spiritual Care Through Research

Religion, Spirituality, and Physical Health in Cancer Patients: A Meta-Analysis

Although religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, a meta-analysis of the relation between R/S and patient-reported physical health in cancer patients was performed. A search of PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library yielded 2073 abstracts, which were independently evaluated by pairs of raters. The meta-analysis was conducted for 497 effect sizes from 101 unique samples encompassing more than 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and ‘other’ dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher z scores) were calculated with generalized estimating equations with robust variance estimation. Overall R/S was associated with overall physical health (z 5 0.153, P <.001); this relation was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z 5 0.167, P <.001), functional well-being (z 5 0.343, P <.001), and physical symptoms (z 5 0.282, P <.001). Cognitive R/S was associated with physical well-being (z 5 0.079, P <.05) and functional well-being (z 5 0.090, P <.01). ‘Other’ R/S was associated with functional well-being (z 5 0.100, P <.05). In conclusion, the results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients’ religious and spiritual needs as part of comprehensive cancer care.