Supplementary Material for: Hidden Resources for Cancer Patients – Interactions between spirituality, religiosity and selected factors influencing patient’s self-care

Introduction. Religiosity and spirituality (SpR) can be vital in helping people face life's challenges. While Spiritual Care (SpC) is used in palliative care, this study explores effects for cancer patient’s self-care (SC) in earlier stages .
Methods. Using validated instruments we surveyed patients about SpR (SpNQ-20, GrAw-7, SpREUK), and factors of SC: well-being (WHO-5, L-1), self-efficacy (ASKU), ability to change (PIAC), as well as lay etiology and the use of Complementary and alternative Medicine (CAM). Data were analyzed using SPSS according a three-step plan with descriptive methods, Spearman correlations and mediation analysis.
Results. We included 108 patients (41 female, 63 males, four no data) with a median age of 66 years (range 30-89). Welch tests show a less well-being, self-efficacy and ability to change in our study population (p < 0.05) compared to non-cancer controls. Whitney-U-test has documented increased well-being, CAM use if the patients were S/R+ (p < 0.05). S/R self-categorization had no impact on PIAC and ASKU. Perceptual spirituality (GrAw-7) correlates with all factors of SC (p < 0.05): WHO-5 (rs = 0.25), PIAC (rs = 0.25), ASKU (rs = 0.296), L-1 (rs = 0.35) and CAM use (rs = 0.39, p < 0.001). Mediation analysis demonstrates that the impact of Spirituality on self-care (CAM use) is mediated by religiosity, GrAw-7 and spiritual needs.
Conclusion. Spirituality and hidden spiritual needs are a valuable resource. By integrating SpC early in the treatment, we can create support ways and improve SC, well-being and coping.