"Deus não da uma cruz maior do que possamos carregar" : coping religioso/espiritual em mulheres com câncer de mama

Abstract

This dissertation comprises three articles; one on literature review and two on empirical research. The study focused on religious/spiritual coping (RSC) in female breast cancer patients and was structured from a mixed delineation. Study 1 objectives were a) to examine the relation between RSC and sociodemographic, clinical and religious variables of 83 breast cancer patients (average age = 52,3 years, DP = 7,27) and b) to understand these women’s subjective perceptions of God in order to compare such perceptions against RSC styles. In Study 2, the women who had obtained the highest scores of positive RSC in Study 1 were selected to participate in two focal groups. Of these women, seven accepted the invitation to take part in the research (average age= 51,5 years, DP = 7,20).The objective of Study 2 was to understand the place that religiosity/spirituality have in these wom en’s lives, the coping strategies used during diagnosis and treatment period and p ossible changes during the course of the disease. All participants attended support gro ups for cancer patients in the metropolitan region of Porto Alegre - RS. The results of Study 1 were obtained through a questionnaire of sociodemographic, clinical and religious/spiritual data (including the open question: “For you, who is God?”) and the Religious-Spiritual Coping Scale. The results did not identify any significant association between sociodemographic and clinical variables and the total and positive RSC, whereas the education level variable showed significant association with the factor N3 (Negative meaning reappraisal) of the negative RSC dimension. On the other hand, it was possible to identify higher scores of total and positive RSC among women who more frequently attended religious meetings. A marginally significant difference [t(81) =1,749, p<0,10] was found in factor N1 (Negative reappraisal of God) between women who lived with their children (n=45) and those who did not (n=38).Women who did not live with their children showed higher average score on this RSC strategy than those who did. The women’s subjective perception about who God is allowed the identification of eight categories; of these, three showed significant association with the RSC styles. Moreover, Study 2 revealed the establishment, among the patients, of a positive relationship with God, capable of providing strength, hope and comfort. Religious beliefs helped in the understanding of the disease, increasing confidence that the illness would be cured. Family and members of religious groups proved to be potential sources of social support. Personality characteristics of the participants were also attenuated; this happened as a result of a reflection process at the moment of diagnosis. Nonetheless, it is worth point ing out that negative RSC strategies were also present, showing the need for such strategies to be monitored and addressed in order to promote better adaptation. The results endorse the necessity of an approach whereby health-care professionals address the religious/spiritual beliefs of the patients, so as to stimulate the adoption of positive RSC strategies and the reappraisal of negative ones.