Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making
Corresponding Author
Ekin Secinti
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Correspondence
Ekin Secinti, Department of Psychology, Indiana University–Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA.
Email: [email protected]
Search for more papers by this authorWei Wu
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorEllen F. Krueger
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorAdam T. Hirsh
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorAlexia M. Torke
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indianapolis, Indiana, USA
Center for Aging Research, Regenstrief Institute, Indianapolis, Indiana, USA
Search for more papers by this authorNasser H. Hanna
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorNabil Adra
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorGregory A. Durm
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorLawrence Einhorn
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorRoberto Pili
Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
Search for more papers by this authorShadia I. Jalal
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorCatherine E. Mosher
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorCorresponding Author
Ekin Secinti
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Correspondence
Ekin Secinti, Department of Psychology, Indiana University–Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA.
Email: [email protected]
Search for more papers by this authorWei Wu
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorEllen F. Krueger
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorAdam T. Hirsh
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorAlexia M. Torke
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indianapolis, Indiana, USA
Center for Aging Research, Regenstrief Institute, Indianapolis, Indiana, USA
Search for more papers by this authorNasser H. Hanna
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorNabil Adra
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorGregory A. Durm
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorLawrence Einhorn
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorRoberto Pili
Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
Search for more papers by this authorShadia I. Jalal
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
Search for more papers by this authorCatherine E. Mosher
Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, USA
Search for more papers by this authorAbstract
Objective
Many advanced cancer patients struggle with anxiety, depressive symptoms, and anger toward God and illness-related stressors. Patients may perceive their illness as an injustice (i.e., appraise their illness as unfair, severe, and irreparable or blame others for their illness), which may be a risk factor for poor psychological and spiritual outcomes. This study examined relations between cancer-related perceived injustice and psycho-spiritual outcomes as well as potential mediators of these relationships.
Methods
Advanced lung (n = 102) and prostate (n = 99) cancer patients completed a one-time survey. Using path analyses, we examined a parallel mediation model including the direct effects of perceived injustice on psycho-spiritual outcomes (i.e., anxiety, depressive symptoms, anger about cancer, anger towards God) and the indirect effects of perceived injustice on psycho-spiritual outcomes through two parallel mediators: meaning making and acceptance of cancer. We then explored whether these relations differed by cancer type.
Results
Path analyses indicated that perceived injustice was directly and indirectly—through acceptance of cancer but not meaning making—associated with psycho-spiritual outcomes. Results did not differ between lung and prostate cancer patients.
Conclusions
Advanced cancer patients with greater perceived injustice are at higher risk for poor psycho-spiritual outcomes. Acceptance of cancer, but not meaning making, explained relationships between cancer-related perceived injustice and psycho-spiritual outcomes. Findings support testing acceptance-based interventions to address perceived injustice in advanced cancer patients.
CONFLICT OF INTEREST
Ekin Secinti is presently employed at Eli Lilly and Company, Indianapolis, IN. This study was not financially supported by and does not necessarily represent the official views of Eli Lilly and Company. The authors declare that there is no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| pon6065-sup-0001-fig_s1.docx31.3 KB | Supplementary Material 1 |
| pon6065-sup-0002-table_s1.docx49.1 KB | Supplementary Material 2 |
| pon6065-sup-0003-table_s2.docx47 KB | Supplementary Material 3 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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