Do daily spiritual experiences buffer the effects of stoicism and fatalism on psychological distress and treatment seeking in a Chinese American cancer sample with pain?
The objective of this study was to examine ways in which certain Chinese spiritual and cultural worldviews (stoicism, fatalism, daily spiritual experience [DSE]) influence the cancer pain experience and treatment-seeking behaviors among Chinese American cancer patients. Eighty-six (N=86) Chinese American adult cancer patients with chronic pain (32 men, 54 women) were consented and interviewed from two community-based oncology practices in New York City. All participants were born overseas (mean years of U.S. residency=19.25 years; sd=12.07) and interviewed in Mandarin or Cantonese. Sixtynine percent (69%) were active in treatment. Three most common cancer types were breast (43%), lung (10.5%), and nasopharyngeal (9.3%). Many participants were experiencing a high level of frequent and persistent pain, moderate pain-related interference, and moderate to severe pain-related distress and psychological morbidity. Even though the average contact delay was less than a month, many experienced pain on average for four months before receiving any pain treatments (potential reasons could be due to participants’ own refusal or physicians’ negligence), and nearly one-third had not yet been treated. The main hypothesis (i.e., DSE buffering the negative effects of stoicism and fatalism on psychological distress and treatment seeking) was not supported. Participants’ DSE, fatalism, and stoicism were not statistically associated with their pain characteristics, pain-related distress, psychiatric morbidity, or delays in treatment seeking. However, religious fatalism and DSE were associated with increased utilization of CAM (Complementary and Alternative Medicine) therapies. Overall, when compared to their cultural/spiritual worldviews, participants’ pain intensity and interference were better predictors of treatment-seeking behaviors and psychological outcomes. Several demographic factors were associated with study variables. Female participants and those with frequent DSE were less likely to use conventional pain medications. Women also had more frequent DSE than men. Younger participants reported more pain-related interference, but a shorter delay in receiving pain treatments from their providers. Recent immigrants reported more psychiatric morbidity than more established immigrants. Participants with a religious affiliation were more stoic, had stronger religious fatalistic beliefs, and experienced more frequent DSE. Those who engaged in religious/spiritual practices and experienced changes in their spirituality since cancer diagnosis reported more frequent DSE. Based on the study findings, future research directions and clinical implications are presented and discussed. ^
Asian American Studies|Psychology, Clinical|Spirituality
Graciete Tingsum Lo,
"Do daily spiritual experiences buffer the effects of stoicism and fatalism on psychological distress and treatment seeking in a Chinese American cancer sample with pain?"
(January 1, 2012).
ETD Collection for Fordham University.