Breast cancer survivors' spirituality as a moderator of their motivation to engage in risk reduction behaviors

Background: Breast cancer recurrence is a significant public health problem. To reduce the risk of recurrence, breast cancer survivors should engage in recommended risk reduction behaviors.

Purpose: To assess how survivors' spirituality and fear of cancer recurrence were associated with their motivation to engage in risk reduction behaviors.

Methods: A valid, reliable questionnaire was mailed to 800 randomly selected breast cancer survivors in Ohio. A total of 559 survivors returned completed surveys (72%).

Results: Nearly 90% of survivors were very spiritual and found strength and meaning via spiritual practices. Relieving stress and anxiety through spirituality was an important coping mechanism for respondents (49%). One in four survivors believed that their breast cancer was caused by fate and that faith in God and prayer were effective ways to prevent a recurrence. Those who became more spiritual after diagnosis had stronger motivation to engage in risk reduction behaviors than those who did not become more spiritual. High levels of spirituality were positively correlated with stronger motivation to engage in risk reduction behaviors (r=.345, n=468, p<0.001). Those who were currently engaged in moderate exercise and who drank less than 3 alcoholic drinks per week were more spiritual than those who did not exercise and who drank more. In contrast, fear of cancer recurrence was associated with significantly lower levels of motivation to engage in risk-reduction behaviors.

Conclusion: Spirituality and fear of cancer recurrence should be included in patient-provider communication and in programs designed for breast cancer survivors.