Correlates of Self-Transcendence in Cancer Patients: A Systematic Review

Öz

Objective: The aim of this systematic review is to analyse studies investigating factors associated with self-transcendence in cancer patients. Material and Method: The study was conducted by electronically searching EBSCOhost, Web of Science, PubMed, Scopus and Wiley Online Library databases, limiting the date range beginning until December 2023, and keywords "neoplasm”, “cancer", "tumour", "carcinoma", "self-transcendence", "correlation", "factors", "predictive", "relationship", "association" and "determinant" to identify eligible studies reporting correlations. Results: This systematic review included eight articles involving 1013 patients who met the inclusion criteria. All the studies had a descriptive design. The "Self-Transcendence Scale (STS)" and "Temperament and Character Inventory Revised-Self-Transcendence (TCI-R-ST)” data-collection tools were used in these studies. The results showed that self-transcendence was positively correlated with optimism, social support, problem-focused coping, emotional well-being, quality of life, power, spiritual well-being, cognitive avoidance, fighting spirit, fatalism, and resilience among cancer patients. On the other hand, a negative correlation was found between uncertainty, pain frequency, pain severity, insomnia, fatigue, concentration, appearance, outlook, helplessness-hopelessness, anxious preoccupation, and self-transcendence. Finally, there was a correlation between cancer stage and self-transcendence. Conclusion: Health-related, disease-related, and psychosocial variables are associated with self-transcendence in patients with cancer. Our research suggests that these insights could be used to inform the development of health promotion and prevention strategies by oncology nurses for patients with cancer.

Anahtar Kelimeler

• cancer
• self-transcendence
• correlation
• systematic review

Kanser Hastalarında Öz Aşkınlığın Korelasyonları: Bir Sistematik Derleme

Öz

Amaç: Bu sistematik derlemenin amacı, kanser hastalarında öz-aşkınlık ile ilişkili faktörleri araştıran çalışmaları analiz etmektir. Gereç ve Yöntem: Çalışma, EBSCOhost, Web of Science, PubMed, Scopus ve Wiley Online Library veri tabanlarında, Aralık 2023'e kadar olan tarih aralığı sınırlandırılarak ve "neoplazm", "kanser", "tümör", "karsinom", "öz aşkınlık", "korelasyon", "faktörler", "öngörücü", "ilişki", "birliktelik" ve "belirleyici" anahtar kelimeleri ile elektronik olarak arama yapılarak gerçekleştirilmiştir. Bulgular: Bu sistematik incelemeye, dahil edilme kriterlerini karşılayan 1013 hastayı içeren sekiz makale dahil edilmiştir. Tüm çalışmalar tanımlayıcı bir tasarıma sahiptir. Bu çalışmalarda "Öz Aşkınlık Ölçeği (STS)" ve "Mizaç ve Karakter Envanteri Gözden Geçirilmiş-Öz Aşkınlık (TCI-R-ST)” veri toplama araçları kullanılmıştır. Sonuçlar, öz aşkınlığın kanser hastalarında iyimserlik, sosyal destek, sorun odaklı başa çıkma, duygusal iyi olma hali, yaşam kalitesi, güç, manevi iyi olma hali, bilişsel kaçınma, mücadele ruhu, kadercilik ve dayanıklılık ile pozitif yönde ilişkili olduğunu göstermiştir. Öte yandan, belirsizlik, ağrı sıklığı, ağrı şiddeti, uykusuzluk, yorgunluk, konsantrasyon, dış görünüş, çaresizlik-umutsuzluk, endişeli meşguliyet ile öz aşkınlık arasında negatif bir korelasyon bulunmuştur. Son olarak, kanser evresi ile öz aşkınlık arasında bir korelasyon bulunmuştur. Sonuç: Sağlığa ilişkin, hastalığa ilişkin ve psikososyal değişkenler kanserli hastalarda öz aşkınlık ile ilişkilidir. Araştırmamız, bu bulguların onkoloji hemşireleri tarafından kanserli hastalara yönelik sağlığı geliştirme ve önleme stratejilerinin geliştirilmesinde kullanılabileceğini göstermektedir.

Anahtar Kelimeler

• Kanser
• öz aşkınlık
• korelasyon
• sistematik derleme

Kaynakça

1. Yılmaz M, Yazgı ZG. Onkoloji hastalarının yaşadığı psikososyal sorunlarla baş etmesinde hemşirenin rolü. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2020; 4(1), 60-70.
2. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer. 2021; 127(16):3029-30. DOI: 10.1002/cncr.33587.
3. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-49. DOI: 10.3322/caac.21660.
4. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021. DOI: 10.1002/ijc.33588.
5. World Health Organisation [Internet]. [cited 2023 Feb 1]. Available from: https://www.who.int/
6. Turkish Statistical Institute [Internet]. [cited 2023 May 23]. Available from: https://data.tuik.gov.tr/
7. Grassi L, Spiegel D, Riba M. Advancing psychosocial care in cancer patients. F1000Res. 2017; 6:2083. DOI: 10.12688/f1000research.
8. Ebob-Anya BA, Bassah N. Psychosocial distress and the quality of life of cancer patients in two health facilities in Cameroon. BMC Palliat Care. 2022; 21(1):96. DOI: 10.1186/s12904-022-00981-w.

9. Harorani M, Noruzi Zamenjani M, Golitaleb M, Davodabady F, Zahedi S, Jadidi A, et al. Effects of relaxation on self-esteem of patients with cancer: a randomized clinical trial. Support Care Cancer. 2020; 28(1):405–11. DOI: 10.1007/s00520-019-05025-3.
10. Hwang HL, Tu CT, Chan HS. Self-transcendence, caring and their associations with well-being. J Adv Nurs. 2019; 75:1473–83. DOI: 10.1111/jan.13937.
11. Reed PG. Toward a nursing theory of self-transcendence: deductive reformulation using developmental theories. ANS Adv Nurs Sci. 1991; 13(4):64-77. DOI: 10.1097/00012272-199106000-00008.
12. Reed PG. Theory of self transcendence. In: Smith MJ, Liehr PR, editors. Middle range theory for nursing. New York: Springer Pub; 2014. p. 109-40.
13. Walker K, Lippard C. Adolescent cancer survivors’ oncology camp experience. J Child Life Psychosoc Theory Pract. 2021, 2:1–10. DOI: 10.55591/001c.27915.
14. Kang Y, Son H. Age Differences in the coping strategies of patients with colorectal cancer. Cancer Nurs. 2019; 42(4):286-294. DOI: 10.1097/ncc.0000000000000604.
15. Bovero A, Pesce S, Botto R, Tesio V, Ghiggia A. self-transcendence: Association with spirituality in an Italian sample of terminal cancer patients. Behav Sci (Basel). 2023; 13(7):559. DOI: 10.3390/bs13070559.
16. Zhao CC, Lv CC, Hao GL, Song J, Zhang W, Zhao SS, et al. A study on the correlation between self-transcendence and survival quality of tumor patients in a hospital in Wei fang. Med Soc. 2019; 32:110–4. DOI: 10.13723/j.yxysh.2019.05.028.
17. Xia Y, Zeng L. A study on the correlation between the level of self-transcendence and self-efficacy and family function in patients with lung cancer. J Nurs Continuing Educ. 2021; 36:2029–32. DOI: 10.16821/j.cnki.hsjx.2021.22.003.
18. Pehlivan Sarıbudak T. Compassion fatigue in nurses providing palliative cancer care and coping strategies to prevent and manage it. Semin Oncol Nurs. 2023; 39(6):151501. DOI: 10.1016/j.soncn.2023.151501.
19. Joyce M, Itano J. Critical event debriefing: Impacts on clinical practice and implications for oncology nurses. Clin J Oncol Nurs. 2024; 28(1):33-41. DOI: 10.1188/24.CJON.33-41.
20. Abidin I, Yamin A, Juniarti N. Faktor-faktor yang mempengaruhi self transcendence perawat: Scoping review. Moluccas Health Journal, 2021; 3(3), 65–71. DOI: 10.54639/mhj.v3i3.801.
21. Wang Z, Zhu Y, Wang T, Su T, Zhou H, Zhang S, et al. Innovative behavior and organizational innovation climate among the Chinese clinical first-line nurses during the Omicron pandemic: The mediating roles of self-transcendence. PLoS One. 2024; 19(6):e0306109. DOI: 10.1371/journal.pone.0306109.
22. Matthews EE, Cook PF. Relationships among optimism, well-being, self-transcendence, coping, and social support in women during treatment for breast cancer. Psychooncology. 2009; 18(7):716-26. DOI: 10.1002/pon.1461.
23. Farren AT. Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors. Nurs Sci Q. 2010; 23(1):63-71. DOI: 10.1177/0894318409353793.
24. Thomas JC, Burton M, Griffin MT, Fitzpatrick JJ. Self-transcendence, spiritual well-being, and spiritual practices of women with breast cancer. J Holist Nurs. 2010; 28(2):115-22. DOI: 10.1177/0898010109358766.
25. Matthews EE, Schmiege SJ, Cook PF, Sousa KH. Breast cancer and symptom clusters during radiotherapy. Cancer Nurs. 2012; 35(2):E1-11. DOI: 10.1097/NCC.0b013e3182277222.
26. Soriano GP, Calong Calong KA. Spiritual well-being, self-transcendence, and spiritual practices among Filipino women with breast cancer. Palliat Support Care. 2021; 19(6):723-26. DOI: 10.1017/S1478951521000079.
27. Er S, Şahin-Bayındır G, Kayış A, Buzlu S. The effect of psychosocial distress and self-transcendence on resilience in patients with cancer. Perspect Psychiatr Care. 2022; 58(4):2631-38. DOI: 10.1111/ppc.13103.
28. Fasano J, Shao T, Huang HH, Kessler AJ, Kolodka OP, Shapiro CL. Optimism and coping: do they influence health outcomes in women with breast cancer? A systemic review and meta-analysis. Breast Cancer Res Treat. 2020; 183(3):495-501. DOI: 10.1007/s10549-020-05800-5.
29. Coward DD. Self-transcendence and emotional well-being in women with advanced breast cancer. Oncol Nurs Forum. 1991; 18:857–63.
30. Delgado-Guay MO, Palma A, Duarte E, et al. Association between spirituality, religiosity, spiritual pain, symptom distress, and quality of life among Latin American Patients with advanced cancer: A multicenter study. J Palliat Med. 2021; 24(11):1606-1615. DOI :10.1089/jpm.2020.0776
31. Haugan G, Moksnes UK, Løhre A. Intrapersonal self-transcendence, meaning-in-life and nurse-patient interaction: powerful assets for quality of life in cognitively intact nursing-home patients. Scand J Caring Sci. 2016; 30(4):790-801. DOI: 10.1111/scs.12307.
32. Kim SM, Ahn S. Development and application of a self-transcendence enhancement program for the well-being of elderly women living alone in Korea. Korean J Women Health Nurs. 2021; 30;27(2):128-40. DOI: 10.4069/kjwhn.2021.06.07.
33. Norberg A, Lundman B, Gustafson Y, Norberg C, Fischer RS, Lövheim H. Self-transcendence (ST) among very old people--its associations to social and medical factors and development over five years. Arch Gerontol Geriatr. 2015; 61(2):247-53. DOI: 10.1016/j.archger.2015.04.003.
34. He C, Yang T, He Y, et al. Relationship between family functioning and self-transcendence in patients with breast cancer: A network analysis. Front Public Health. 2022; 10:1028860. DOI: 10.3389/fpubh.2022.1028860
35. Haugan G, Kuven BM, Eide WM, et al. Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents?. BMC Geriatr. 2020; 20(1):168. DOI: 10.1186/s12877-020-01555-2
36. Den Hollander D, Albertyn R, Ambler J. Palliation, end-of-life care and burns; practical issues, spiritual care and care of the family - A narrative review II. Afr J Emerg Med. 2020; 10(4):256-260. DOI: 10.1016/j.afjem.2020.07.011.
37. Aydın A, Isık A, Kahraman N. Mental health symptoms, spiritual well-being and meaning in life among older adults living in nursing homes and community dwellings. Psychogeriatrics. 2020;20(6):833-43. DOI: 10.1111/psyg.12613.
38. Coward DD. The lived experience of self-transcendence in women with advanced breast cancer. Nurs Sci Q. 1990; 3(4):162-9. DOI: 10.1177/089431849000300408.
39. Aryuwat P, Asp M, Lövenmark A, Radabutr M, Holmgren J. An integrative review of resilience among nursing students in the context of nursing education. Nurs Open. 2023; 10(5):2793-2818. DOI: 10.1002/nop2.1559.
40. Ozcetin YSU, Hicdurmaz D. Posttraumatic growth and resilience in cancer experience. Current Approaches in Psychiatry. 2017; 9(4), 388–97. DOI:10.18863/pgy.290285.