Religious Coping and Cancer-Related Post-Traumatic Distress among Palestinian Breast Cancer Patients in the Gaza Strip

BACKGROUND: The aim was to investigate the prevalence and predictors of positive and negative religious coping in a sample of Palestinian breast cancer patients and survivors. METHOD: Participants were 489 women (mean age 43,7, response rate 76%) attending treatment or control visits for breast cancer (BC) during a 3 month period at the two departments responsible for treating cancerpatients in the Gaza Strip. Variables measured were: Demographic and disease- and treatmentrelated factors, BC-related post-traumatic stress symptoms (Impact of Events scale-Revised (IES-RBC)), Centrality of Event (CE-BC), general religiosityand religious coping measured by the Brief Religious Coping Scale (Brief RCOPE).RESULTS: Religious coping strategies were prevalent among Palestinian breast cancer patients as 61.7% reported to use positive religious coping and 61.9% used negative religious coping a moderate to high degree. Hierarchical multiple regressions were used to determine possible predictors of religious coping. Results suggested radiotherapy and perceiving cancer as a central event to be positivelyassociated with positive religious coping, while time since diagnosis, metastases and chemotherapy were negatively associated. Predictors of negative religious coping were relapse and higher education, while mastectomy was negativelyassociated. CONCLUSIONS: This study suggests that having cancer may elicit both positive and negative religious coping among Palestinian breast cancer patients. However, the predictors related differentially to these two patterns of religious coping. Positive religious coping may be a more hopeful, optimistic response to arecent diagnosis, participation in treatment, and appreciation for the profound life-shaping character of the illness. In contrast, religious struggles may grow out of greater illness severity and higher levels of hopelessness. RESEARCHIMPLICATIONS: The diagnosis and treatment of cancer may elicit positive and negative religious coping differentially among Palestinian breast cancer patients, but causal inferences cannot be made. Longitudinal research designs are called forto clarify these associations. Furthermore, future studies should be attentive to medical factors indicating more severe stages of cancer such as relapse, since the results suggest that disease severity is tied to greater religious struggles. CLINICALIMPLICATIONS: When cancer returns and treatment opportunities become fewer, Palestinian breast cancer patients may experience more hopelessness, meaningless, and lack of control. In turn, this might lead to religious struggles.Clinicians should pay closer attention to this patient group and be aware of signs of religious struggles in order to provide better psychosocial support.