Spiritual Intervention in Newly Diagnosed Cancer Patients Undergoing Chemotherapy

2007·17.1 MB·English

by  JAMES PATRICK DAUGHERTY

SPIRITUALINTERVENTION IN NEWLYDIAGNOSEDCANCER PATIENTS
UNDERGOINGCHEMOTHERAPY
ATHESIS
SUBMITTEDTOTHE FACULTYOF
GORDON-CONWELLTHEOLOGICALSEMINARY
IN PARTIALFULFILLMENTOFREQUIREMENTS FOR THEDEGREE
DOCTOR OFMINISTRY
BY
JAMESPATRICKDAUGHERTY
MAY2007
Copyright ©2007byJames PatrickDaugherty
All rights reserved
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DEDICATEDTO:
Mygrandchildren forteachingmehowtoliveinthenow;
Mypatients forshowingmehowtolivewithdifficulties;
Mychildrenfor revealingGod’s love;
Mymentor Louis Beach forseeingwhat nooneelsesaw;
Mywifeforintroducingmetograce andacceptance;
Myparents forinstillingaloveoftruth;
MyfriendTommyPirkle forvaluable guidance; and
Mrs. JudyBynum fordirectingmetoGordon-Conwell Theological Seminary.
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TABLEOFCONTENTS
LISTOF FIGURES.........................................................................................................viii
LISTOFTABLES..............................................................................................................x
ABSTRACT.......................................................................................................................xi
CHAPTER I THEPROBLEM...........................................................................................1
What is theProblem?...................................................................................................1
Whyis this aProblem?................................................................................................2
HowWill theProblem beApproached?......................................................................4
CHAPTER II BIBLICALANDTHEOLOGICALFRAMEWORK................................6
Introduction.................................................................................................................6
AllaMetamorphousthete Anakainosei TouNous......................................................7
Alla......................................................................................................................7
Metamorphousthe................................................................................................7
Anakainosi ........................................................................................................11
Nous..................................................................................................................12
Theological Themes..................................................................................................14
WorkEnvironment Enhances Spiritual Transformation...................................14
Sufferingas aCatalyst forTransformation.......................................................16
Transformationas aCooperativeEndeavor......................................................19
MindRenewal usingPatient Narratives............................................................20
CHAPTER III LITERATURESURVEY........................................................................23
Historical Aspects......................................................................................................23
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DefinitionofKeyWords...................................................................................23
RelationshipofHealthcareandSpirituality......................................................26
ImportanceofSpirituality/ReligioninHealthcare....................................................29
Current StateofSpiritualityandCancerCare...........................................................34
TheCancerProblem..........................................................................................34
Anecdotal Evidence..........................................................................................35
PublishedNarratives.........................................................................................37
ScientificStudies...............................................................................................39
Methods ofClinical Intervention...............................................................................45
CHAPTER IV PROJECTDESIGN..................................................................................50
Introduction...............................................................................................................50
Patient Selection........................................................................................................52
Patient Enrollment.....................................................................................................54
Methodology..............................................................................................................55
Patient Protection.......................................................................................................59
InformedConsent......................................................................................................60
Confidentiality...........................................................................................................61
CHAPTER V RESULTS ANDDISCUSSION................................................................63
Humans UseApproval..............................................................................................63
TheQuestionnaires....................................................................................................64
Patient Accrual...........................................................................................................67
Religious OrientationScale.......................................................................................73
BasicMultidimensional Religion/Spiritual Scale.....................................................75
DailySpiritual Experiences Scale.............................................................................82
DepressionScale.......................................................................................................99
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PositiveandNegativeAffect Scale.........................................................................101
Functional Assessment ofCancer Therapy.............................................................116
Functional Assessment ofChronic Illness Therapy-Spiritual Well-Being.............122
Spiritual Transformation Scale................................................................................122
CompletionofStudyQuestionnaire........................................................................126
Impact ofCurrent StudyonMinistry......................................................................130
Appendix A PerformanceStatus Scales.........................................................................133
Appendix B InformedConsent.......................................................................................134
Appendix C DataElement CollectionSchedule.............................................................137
Appendix D Demographic Information..........................................................................138
Appendix E Clinical DataCollectedEach Visit.............................................................139
Appendix F BriefMultidimensional Measurement ofReligiousness/Spirituality.........140
Appendix G FACIT-G(Version4).................................................................................148
Appendix H CES-D........................................................................................................150
Appendix IPANAS-X………………………………………………………………….153
AppendixJ Religious OrientationScale........................................................................153
Appendix K DailySpiritual Experiences Scale..............................................................155
Appendix L FACIT-Sp...................................................................................................156
Appendix M Spiritual TransformationScale..................................................................157
Appendix N CompletionofStudyQuestionnaire...........................................................160
Appendix O AdverseEvent Report................................................................................165
Appendix P CaseReport Forms......................................................................................167
Appendix Q StudyIdentification Log.............................................................................168
Appendix R IRBApproval Letter..................................................................................169
Appendix S SpirituallyOrientedNarratives..................................................................171
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Appendix T FactuallyOrientedNarratives....................................................................189
Appendix U SpirituallyOrientedNarratives.................................................................189
Appendix V FactuallyOrientedVideos..........................................................................202
REFERENCES................................................................................................................203
AUTHOR NOTE.............................................................................................................225
VITA................................................................................................................................226
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FIGURES
Figure1Weeklytotal scoreondailyspiritual experiences (DSE). Alower number
is indicativeofmorespiritual experiences. ………………………………..……83
Figure2Weeklyscoreforconnectionwiththedivingortranscendent…….……..…….85
Figure3Weeklyscoreforjoy/transcendencesense ofself……………….…….……….86
Figure4Weeklyscoreforstrength/comfort…………………………………….………88
Figure5 Weeklyscoreforpeace……………………………………………….………89
Figure6Weeklyscorefordivinehelp………………………………………….……….90
Figure7Weeklyscorefordivineguidance……………………………………………...92
Figure8Weeklyscoreforperceptions ofdivinelove…………………………….……..93
Figure9Weeklyscoreforawe……………………………………………………..……94
Figure10Weeklyscoreforthankfulness and appreciation……………….…….….……96
Figure11Weeklyscoreforcompassionatelove…………………………………………97
Figure12Weeklyscoreforunionandcloseness…………………………………..…….98
Figure13Weeklydepressionscores as measured bytheCenterforEpidemiologic
Studies DepressionScale(CES-D)…………………………………………..100
Figure14Weeklydepressionscores as measured bytheCenterforEpidemiological
Studies DepressionScale(CES-D)ofpatients scoringclinical depression
at anytimeduringthe periodofintervention………………………………..102
Figure15Weeklypositiveaffect scores measured byPANAS-X……………………..103
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Figure16Weeklynegativeaffect scores measuredbyPANAS-X…………………….104
Figure17 Weeklyfearscore………….…………………………………………..……106
Figure18Weeklyhostilityscore…………………………………………………….…107
Figure19Weeklyguilt score……………………………………………………….…..108
Figure20Weeklysadness score………………………………………………………..109
Figure21Weeklyjovialityscore……………………………………………………….110
Figure22Weeklyself assurancescore………………………………………………....111
Figure23Weeklyattentionscore………………………………………………………112
Figure24Weeklyshyness score……………………………………………………..…113
Figure25Weeklyfatiguescore………………………………………………………...114
Figure26Weeklyserenityscore……………………………………………………..…115
Figure27Weeklysurprisescore..............................................................................…....116
Figure28Weeklyphysical well beingscore………………………………………..….118
Figure29Weeklysocial well beingscore………………………………………….….119
Figure30Weeklyemotional well beingscore………………………………………….120
Figure31Weeklyfunctional well beingscore……………………………………….....121
Figure32Weeklymeaningandpurposescore………………………………………....123
Figure33Weeklyfaithscore…………………………………………………….…..…124
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TABLES
Table1TimetoCompletetheQuestionnaires byFormerPatients...................................66
Table2 Patient Accrual at OfficeOne..............................................................................68
Table3 Patient Accrual at OfficeTwo.............................................................................69
Table4 Clinical Characteristics ofPatients CompletingStudy........................................70
Table5 Religious andotherCharacteristics ofPatients CompletingStudy.....................71
Table6 Religious OrientationSystem Scores..................................................................74
Table7 BriefMultidimensional MeasureofReligiousness/SpiritualityScores...............77
Table8 Spiritual TransformationScaleScores after Intervention..................................125
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