This book is based on triangulation research consisting of a sociological qualitative and quantitative study among people struck by cancer and a study conducted among nurses working in cancer care.
The aim of the book is to present the results of these studies, in particular those of the quantitative study.
The qualitative study aimed at identifying the religious and spiritually oriented coping methods used by cancer patients in Sweden, which serves as an example of societies in which religion is not an integrated part of the social life of individuals. The empirical data for the study were based on interviews with cancer patients. Fifty-one interviews were conducted in various parts of Sweden with patients suffering from different types of cancer. Concerning the use of religious and spiritually oriented methods by the Swedish informants, we learn that gaining control over the situation is a very important coping strategy for them. The informants show a strong tendency toward relying primarily on themselves for solving problems related to their disease. Receiving help from other sources, among others God or a supreme power, seems to primarily be a way to gain more power to help oneself, as opposed to passively waiting for a miracle. For the informants, thinking about spiritual matters and spiritual connection seems to be more important than participating in religious rituals and activities. Turning to nature as a sacred and available resource is a coping method that all informants have used, regardless of their outlook on God, their religion and philosophy of life or their age and gender. The qualitative study shows clearly the impact of culture on coping.
The qualitative study on nurses focuses on coping among Swedish oncology nurses. The research questions were close to the coping theory (Pargament, 1997) that was used for interpretation. 1. How can the stress experienced by oncology nurses be described? (Ekedahl & Wengström, 2007) 2. Which functional and dysfunctional coping strategies do nurses use to cope with work-related stress? (Ekedahl & Wengström, 2006) 3. What religious components can be identified as coping resources in oncology nurses’ orienting system and what function does religiosity have in their work? (Ekedahl & Wengström, 2010) 4. How does culture influence the coping process through different coping styles? (Ekedahl, 2011; Ekedahl & Wengström, 2012)
Four levels of stress were identified: the individual level of the nurse, a group level that is related to the team, an organizational level, and a cultural level. Nurses working in cancer care have to cope with different types of stress. They move from simpler types to the worst type of stress: multifaceted stress with an existential dimension. The most intensive stress is on the individual level and the group level, where the existential dimension is activated.
Concerning the coping strategies, the dominant one is boundary demarcation. Lack of this important strategy is dysfunctional. Religious coping is dominated by basic trust and prayer and can provide support. Using concepts from cultural psychology, individualistic and collectivistic coping are suggested as additional coping styles.
The aim of the quantitative study was to examine the extent to which the results obtained in the qualitative study among cancer patients, explained above, are applicable to a wider population of cancer patients in Sweden. In addition to questions relating to the former qualitative study, this survey also makes use of the RCOPE questionnaire (designed by Kenneth I Pargament) in designing the quantitative study. In this quantitative study, 5000 questionnaires were distributed among persons diagnosed with cancer; 2355 people responded. The results show that nature has been the most important coping method among cancer patients in Sweden.
The highest mean value (2.9) is for the factor ‘nature has been an important resource to you in allowing you to deal with your illnesses.’ Two out of three respondents (68%) affirmed that this method helped them feel significantly better during or after their illness. The second highest average (2.8) is for the factor ‘listening to “natural music” (birdsong and the wind).’ Two out of three respondents (66%) answered that this coping method helped them feel significantly better during their illness. The third highest average (2.7) is for the factor ‘walking or engaging in any activity outdoors gives you a spiritual sense.’ Concerning the role of nature as the most important coping method for cancer patients, this survey confirms the results obtained from the previous qualitative studies.
Moreover, the results of the quantitative study indicate that few informants used religious coping methods, as they were inclined to trust their own abilities to solve problems more than other sources of power, such as God or a religious authority. This result may be partly due to the predominance of secularism in Swedish society and the strong position individualism plays in Swedish culture, which fosters the idea that individuals are responsible for tackling their own problems.