The longitudinal effects of faith and meaning on quality of life in US women with breast cancer undergoing chemotherapy

Objectives This study examined longitudinal associations between spirituality and quality of life (QoL) in women newly diagnosed with breast cancer and undergoing chemotherapy at a large tertiary cancer center. Methods Women ( N = 114) completed measures of spirituality (3 subscales of the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale: Meaning, Peace, and Faith) and health-related QoL (36-Item Short Form Health Survey) at study entry and 3- and 15-months later. Bias-corrected bootstrap tests were used to examine whether baseline Faith was indirectly associated with mental and physical QoL 15 months later via Meaning and Peace at 3 months. Results Baseline Faith was positively associated with Meaning ( β = .31, p = .001) and Peace ( β = .38, p < .001) at 3 months. Both Meaning [ n = 94, effect = .07 (95% CI: .002, .17)] and Peace [ n = 93, effect = .13 (95% CI: .02, .28)] mediated the association between Faith and mental QoL at 15 months. When baseline Meaning was controlled, the indirect effect of baseline Faith on mental QoL remained significant, [ n = 94, effect = .07 (95% CI: .001, .18)], and increases in Meaning over the first 3 months became an even stronger predictor of later mental QoL ( β = .36, p = .004), suggesting that change in meaning during active treatment is an especially important predictor of mental QoL. Significance of results Overall, findings demonstrate that Faith is indirectly associated with long-term QoL through early increases in Meaning and Peace. Because 90% of participants were within 6 weeks of diagnosis, the study provided a unique perspective on spirituality during the early treatment period. Clinically, results highlight the importance of early assessment of spiritual well-being and suggest that meaning-focused interventions may enhance long-term QoL for women undergoing chemotherapy.