背景：癌症倖存者面臨許多挑戰，包括因疾病和治療副作用而產生的身體、心理、社會和財務問題。這些困難在長期生存過程中持續存在，增加了醫療費用並對他們的生活品質產生負面影響。為了應對這些持續的挑戰，有效的壓力適應策略至關重要。現有文獻強調靈性和正念在提高生活品質方面的好處；然而，探索這些概念之間關係的研究有限，這兩個概念都與自我超越密切相關。由於正念被認為可以增強靈性，因此了解兩者之間的聯繫可以幫助改善癌症倖存者的生活品質並加深他們對這些做法的認識。
目的：本研究探討了癌症患者在存活階段的靈性、正念、壓力和生活品質之間的關係。採用串列中介模型來研究這些變數之間的交互作用。
方法：對中爪哇省的癌症倖存者進行了一項橫斷面研究。共有274名接受化療的癌症患者參與了這項研究。 WHOQOL-BREF、FMI、FACIT-Sp 和 PSS 工具分別用於評估受訪者的生活品質、正念、靈性和壓力。進行多元迴歸分析以確定靈性、正念和壓力是否可以預測生活品質。 SPSS v. 2.13 的 PROCESS 巨集用於測試變數之間的串列中介模型。
結果：靈性、正念和壓力被認定為生活品質的重要預測因素，係數分別為 b: 0.94 (p:0.01)、b:0.60 (p:0.01) 和 b: -0.82 (p:0.01)，分別。靈性對生活品質的整體影響是顯著的（b：1.79；p：0.01）。第一個間接效應（#1）是顯著的，其中靈性透過正念調解影響生活品質（b：0.49：CI：0.32-0.67）。第二個間接效果（#2），即靈性透過壓力調節影響生活質量，也很顯著（b：0.48；CI：0.22-0.74）。第三個間接效應（#3）是顯著的，其中靈性透過正念和壓力調解影響生活品質（b：-0.13；CI：-0.21至-0.06）。
結論：靈性、正念和壓力是接受化療的癌症患者生活品質的重要預測因子。靈性對生活品質產生直接影響，透過正念和壓力的連續調解也具有顯著的間接影響。

Background: Cancer survivors face numerous challenges, including physical, psychological, social, and financial issues stemming from their illness and the side effects of treatment. These difficulties persist throughout long-term survivorship, increasing healthcare costs and negatively impacting their quality of life. To navigate these ongoing challenges, effective strategies for stress adaptation are essential. Existing literature highlights the benefits of spirituality and mindfulness in enhancing the quality of life; however, limited research has explored the relationship between those concepts, both of which are closely linked to self-transcendence. Since mindfulness is thought to enhance spirituality, understanding the connection between these two can help improve the quality of life for cancer survivors and deepen their awareness of these practices.
Objective: This study examined the relationships among spirituality, mindfulness, stress, and quality of life in cancer patients during the survivorship phase. A serial mediation model was employed to investigate the interplay between those variables.
Method: A cross-sectional study was conducted with cancer survivors in Central Java. A total of 274 cancer patients undergoing chemotherapy participated in the research. The WHOQOL-BREF, FMI, FACIT-Sp, and PSS instruments were used to assess the respondents’ quality of life, mindfulness, spirituality, and stress, respectively. Multiple regression analyses were performed to determine if spirituality, mindfulness, and stress predicted quality of life. The PROCESS macro for SPSS v. 2.13 was utilized to test the serial mediator model among the variables.
Results: Spirituality, mindfulness, and stress were identified as significant predictors of quality of life, with coefficients of b: 0.94 (p:0.01), b:0.60 (p:0.01), and b: -0.82 (p:0.01), respectively. The total effect of spirituality on quality of life was significant (b:1.79; p:0.01). The first indirect effect (#1), where spirituality influenced the quality of life through mindfulness mediation, was significant (b: 0.49: CI: 0.32-0.67). The second indirect effect (#2), where spirituality impacted the quality of life through stress mediation, was also significant (b:0.48; CI: 0.22-0.74). The third indirect effect (#3), where spirituality influenced quality of life thorough mindfulness and stress mediation, was significant (b: -0.13; CI: -0.21 to -0.06).
Conclusion: Spirituality, mindfulness, and stress are significant predictors of quality of life among cancer patients undergoing chemotherapy. Spirituality exerts a direct effect on quality of life and also has significant indirect effects thorough the serial mediation of mindfulness and stress.

Agrimson, L. B., & Taft, L. B. (2009). Spiritual crisis: a concept analysis. Journal of Advanced Nursing, 65(2), 454-461. https://doi.org/10.1111/j.1365-2648.2008.04869.x
Aldahadha, B. (2013). The effects of Muslim praying meditation and transcendental meditation programs on mindfulness among the university of nizwa students [Article]. College Student Journal, 47(4), 668-676. http://search.ebscohost.com/login.aspx?direct=true&db=tfh&AN=93813996&site=ehost-live
Alfano, C. M., Leach, C. R., Smith, T. G., Miller, K. D., Alcaraz, K. I., Cannady, R. S., Wender, R. C., & Brawley, O. W. (2019). Equitably improving outcomes for cancer survivors and supporting caregivers: a blueprint for care delivery, research, education, and policy. CA: a Cancer Journal for Clinicians, 69(1), 35-49. https://doi.org/10.3322/caac.21548
Anggorowati, A., Munawaroh, S., & Dwidiyanti, M. (2019). Effects of ‘STOP’Mindfulness on Decreasing Cortisol in Primigravida Mothers. Jurnal Keperawatan Soedirman, 14(3). https://doi.org/10.20884/1.jks.2019.14.3.893
Archer, K. (2009). Program gives free training to CNAs: Fines collected from substandard nursing homes will fund the program [Article](Tulsa World, Issue.
Avis, N. E., Levine, B., Goyal, N., Crawford, S. L., Hess, R., Colvin, A., Bromberger, J. T., & Greendale, G. A. (2020). Health‐related quality of life among breast cancer survivors and noncancer controls over 10 years: Pink SWAN. Cancer, 126(10), 2296-2304. https://doi.org/10.1002/cncr.32757
Baer, R. A., Carmody, J., & Hunsinger, M. (2012). Weekly change in mindfulness and perceived stress in a mindfulness‐based stress reduction program. Journal of Clinical Psychology, 68(7), 755-765. https://doi.org/10.1002/jclp.21865
Balboni, T. A., VanderWeele, T. J., Doan-Soares, S. D., Long, K. N., Ferrell, B. R., Fitchett, G., Koenig, H. G., Bain, P. A., Puchalski, C., & Steinhauser, K. E. (2022). Spirituality in serious illness and health. Jama, 328(2), 184-197. https://doi.org/10.1001/jama.2022.11086
Balducci, L. (2019). Geriatric oncology, spirituality, and palliative care. Journal of pain and symptom management, 57(1), 171-175. https://doi.org/10.1016/j.jpainsymman.2018.05.009
Beatty, L., Lee, C., & Wade, T. D. (2009). A prospective examination of perceived stress as a mediator of the relationship between life-events and QOL following breast cancer [Article]. British Journal of Health Psychology, 14(4), 789-804. https://doi.org/10.1348/135910709X412459
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. C., & Carmody, J. (2004). Mindfulness: A proposed operational definition. Clin Psychol: Science and Practice, 11. https://doi.org/10.1093/clipsy.bph077
Borges, C. C., Dos Santos, P. R., Alves, P. M., Borges, R. C. M., Lucchetti, G., Barbosa, M. A., Porto, C. C., & Fernandes, M. R. (2021). Association between spirituality/religiousness and quality of life among healthy adults: a systematic review. Health and Quality of Life Outcomes, 19, 1-13. https://doi.org/10.1186/s12955-021-01878-7
Bower, W. F., Vlantis, A. C., Chung, T. M., & Van Hasselt, C. A. (2010). Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care. Acta Oto-Laryngologica, 130(10), 1185-1192. https://doi.org/10.3109/00016481003667366
Brearley, S. G., Stamataki, Z., Addington-Hall, J., Foster, C., Hodges, L., Jarrett, N., Richardson, A., Scott, I., Sharpe, M., Stark, D., Siller, C., Ziegler, L., & Amir, Z. (2011). The physical and practical problems experienced by cancer survivors: A rapid review and synthesis of the literature. European Journal of Oncology Nursing, 15(3), 204-212. https://doi.org/10.1016/j.ejon.2011.02.005
Canada, A. L., Fitchett, G., Murphy, P. E., Stein, K., Portier, K., Crammer, C., & Peterman, A. H. (2013). Racial/ethnic differences in spiritual well-being among cancer survivors. Journal of Behavioral Medicine, 36(5), 441-453. https://doi.org/10.1007/s10865-012-9439-8
Canada, A. L., Murphy, P. E., Fitchett, G., Peterman, A. H., & Schover, L. R. (2008). A 3-factor model for the FACIT-Sp. Psycho-oncology, 17(9), 908-916 909p. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105553472&site=ehost-live
Canada, A. L., Murphy, P. E., Fitchett, G., & Stein, K. (2016). Re-examining the contributions of faith, meaning, and peace to quality of life: a report from the American Cancer Society’s Studies of Cancer Survivors-II (SCS-II) [journal article]. Annals of Behavioral Medicine, 50(1), 79-86. https://doi.org/10.1007/s12160-015-9735-y
Canada, A. L., Murphy, P. E., Stein, K. D., Alcaraz, K. I., & Fitchett, G. (2019). Trajectories of spiritual well-being in long-term survivors of cancer: A report from the American Cancer Society's Studies of Cancer Survivors-I. Cancer, 125(10), 1726-1736. https://doi.org/10.1002/cncr.31967
Carlson, L. E. (2013). Mindfulness-based cancer recovery The development of an evidence-based psychosocial oncology intervention [Article]. Oncology Exchange, 12(2), 21-25. http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=88033149&site=ehost-live
Carlson, L. E. (2016). Mindfulness-based interventions for coping with cancer [Article]. Annals of the New York Academy of Sciences, 1373(1), 5-12. https://doi.org/10.1111/nyas.13029
Carlson, L. E. (2016). Mindfulness‐based interventions for coping with cancer. Annals of the New York Academy of Sciences, 1373(1), 5-12.
Carmody, J. (2009). Evolving conceptions of mindfulness in clinical settings [Article]. Journal of Cognitive Psychotherapy, 23(3), 270-280. https://doi.org/10.1891/0889-8391.23.3.270
Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64(4), 393-403. https://doi.org/10.1016/j.jpsychores.2007.06.015
Chávez, L. M., & Canino, G. (2005). Toolkit on translating and adapting instruments. Availiable at: http://www. hsri. org/files/uploads/publications/PN54_Translating_and_Adapting. pdf.
Cillessen, L., Schellekens, M., Van de Ven, M., Donders, A., Compen, F., Bisseling, E., Van der Lee, M., & Speckens, A. (2018). Consolidation and prediction of long-term treatment effect of group and online mindfulness-based cognitive therapy for distressed cancer patients. Acta Oncologica, 57(10), 1293-1302. https://doi.org/10.1080/0284186X.2018.1479071
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Behavioral Journal of Health and Social Behavior, 24(4), 385-397. https://doi.org/10.2307/2136404
Culbertson, M. G., Bennett, K., Kelly, C. M., Sharp, L., & Cahir, C. (2020). The psychosocial determinants of quality of life in breast cancer survivors: a scoping review. BMC Cancer, 20, 1-36. https://doi.org/10.1186/s12885-020-07389-w
Cullen, M. (2011). Mindfulness-Based Interventions: An emerging phenomenon [journal article]. Mindfulness, 2(3), 186-193. https://doi.org/10.1007/s12671-011-0058-1
Decker, C. L., Haase, J. E., & Bell, C. J. (2007). Uncertainty in adolescents and young adults with cancer. Oncology Nursing Forum, 34(3), 681-688 688p. https://doi.org/10.1188/07.ONF.681-688
Dehghan, M., Jazinizade, M., Malakoutikhah, A., Madadimahani, A., Iranmanesh, M. H., Oghabian, S., Mohammadshahi, F., Janfaza, F., & Zakeri, M. A. (2020). Stress and Quality of Life of Patients with Cancer: The Mediating Role of Mindfulness. Journal of Oncology, 2020(1), 3289521. https://doi.org/10.1155/2020/3289521
Departemen Kesehatan RI. (2015). Situasi Penyakit Kanker. Jakarta: Departemen Kesehatan Retrieved from http://www.depkes.go.id/resources/download/pusdatin/infodatin/infodatin-kanker.pdf
Dobos, G., Overhamm, T., Büssing, A., Ostermann, T., Langhorst, J., Kümmel, S., Paul, A., & Cramer, H. (2015). Integrating mindfulness in supportive cancer care: a cohort study on a mindfulness-based day care clinic for cancer survivors. Supportive Care in Cancer, 23(10), 2945-2955 2911p. https://doi.org/10.1007/s00520-015-2660-6
Duijts, S. F. A., Egmond, M. P., Spelten, E., Muijen, P., Anema, J. R., & Beek, A. J. (2014). Physical and psychosocial problems in cancer survivors beyond return to work: a systematic review [Article]. Psycho-oncology, 23(5), 481-492. https://doi.org/10.1002/pon.3467
Durosini, I., Triberti, S., Savioni, L., Sebri, V., & Pravettoni, G. (2022). The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review. International Journal of Environmental Research and Public Health, 19(19), 12704. https://www.mdpi.com/1660-4601/19/19/12704
Effendy, C., Vissers, K., Tejawinata, S., Vernooij‐Dassen, M., & Engels, Y. (2015). Dealing with symptoms and issues of hospitalized patients with cancer in Indonesia: the role of families, nurses, and physicians. Pain Practice, 15(5), 441-446. https://doi.org/10.1111/papr.12203
Farren, A. T. (2010). Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors. Nursing Science Quarterly, 23(1), 63-71. https://doi.org/10.1177/0894318409353793
Fekih-Romdhane, F., Hakiri, A., Fendri, S., Balti, M., Labbane, R., & Cheour, M. (2021). Evaluation of religious coping in Tunisian Muslim women with newly diagnosed breast cancer. Journal of religion and health, 60(3), 1839-1855. https://doi.org/10.1007/s10943-020-01066-9
Ferrel, B. R., & Dow, K. H. (1997). Quality of life among long term cancer survivors. Cancer Network. Retrieved April 23rd from http://www.cancernetwork.com/survivorship/quality-life-among-long-term-cancer-survivors
Fink, G. (2010). Stress: Definition and history. In G. Fink (Ed.), Stress science: Neuroendocrinology (Vol. 3, pp. 3-14). Elsevier.
Fish, J. A., Ettridge, K., Sharplin, G. R., Hancock, B., & Knott, V. E. (2014). Mindfulness‐Based Cancer Stress Management: Impact of a mindfulness‐based programme on psychological distress and quality of life. European Journal of Cancer Care, 23(3), 413-421. https://doi.org/10.1111/ecc.12136
Fowler, J. W., & Levin, R. W. (1984). Stages of faith: The psychology of human development and the quest for meaning. Horizon, 9(1), 123-126. https://doi.org/10.1017/S0360966900022052
Garcia-Romeu, A., & Alto, P. (2010). Self-transcendence as a measurable transpersonal construct. Journal of Transpersonal Psychology, 42(1), 26. http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=c56840ac-5aff-4ebe-9f24-ab83bcf2f7da%40sessionmgr4008
Gatchel, R. J., Ray, C. T., Kishino, N., & Brindle, A. (2020). The biopsychosocial model. In S. B. Gulliver & L. M. Cohen (Eds.), The Wiley encyclopedia of health psychology (pp. 1-8). Wiley. https://doi.org/10.1002/9781119057840.ch182
Gebauer, J. E., Bleidorn, W., Gosling, S. D., Rentfrow, P. J., Lamb, M. E., & Potter, J. (2014). Cross-cultural variations in Big Five relationships with religiosity: A sociocultural motives perspective. Journal of Personality and Social Psychology, 107(6), 1064.
Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2018). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review, 59, 52-60. https://doi.org/10.1016/j.cpr.2017.10.011
Gotink, R. A., Chu, P., Busschbach, J. J. V., Benson, H., Fricchione, G. L., & Hunink, M. G. M. (2015). Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs [Article]. PLoS ONE, 10(4), 1-17. https://doi.org/10.1371/journal.pone.0124344
Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased symptoms of depression after mindfulness-based stress reduction: potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age. Journal of Alternative and Complementary Medicine (New York, N.Y.), 21(3), 166-174. https://doi.org/10.1089/acm.2014.0285
Greeson, J. M., Webber, D. M., Smoski, M. J., Brantley, J. G., Ekblad, A. G., Suarez, E. C., & Wolever, R. Q. (2011). Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction. Journal of Behavioral Medicine, 34(6), 508-518. https://doi.org/10.1007/s10865-011-9332-x
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12. https://doi.org/10.1016/j.cpr.2015.01.006
Haidar, A., Nwosisi, E., & Burnett-Zeigler, I. (2023). The role of religion and spirituality in adapting mindfulness-based interventions for Black American communities: A scoping review. Mindfulness, 14(8), 1852-1867. https://doi.org/10.1007/s12671-023-02194-5
Hamilton, J. B., Best, N. C., Barney, T. A., Worthy, V. C., & Phillips, N. R. (2021). Using spirituality to cope with COVID-19: The experiences of African American breast cancer survivors. Journal of Cancer Education, 1-7. https://doi.org/10.1007/s13187-021-01974-8
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.
Heng, P. H., Hutabarat, F., & Lathiifah, S. (2021). Relationship between spiritual well-being and quality of life among students in Southeast-Asia countries.Advances in Social Science, Education and Humanities Research International Conference on Economics, Business, Social, and Humanities (ICEBSH 2021),
Ho, S. M. Y., Chan, C. L. W., & Ho, R. T. H. (2004). Posttraumatic growth in chinese cancer survivors [Article]. Psycho-oncology, 13(6), 377-389. https://doi.org/10.1002/pon.758
Hodge, D. R., & Reynolds, C. (2019). Spirituality among people with disabilities: A nationally representative study of spiritual and religious profiles. Health & Social Work, 44(2), 75-86. https://doi.org/10.1093/hsw/hly035
Huang, I. C., Wu, A. W., & Frangakis, C. (2006). Do the SF-36 and WHOQOL-BREF measure the same constructs? Evidence from the Taiwan Population. Quality of Life Research, 15(1), 15-24. https://doi.org/10.1007/s11136-005-8486-9
Hull, T. H. (2022). The importance of the 2020 Population Census for health data. In F. Witoelar & A. Utomo (Eds.), In Sickness and in Health: Diagnosing Indonesia (pp. 56-70). ISEAS.
İnan, F. Ş., Günüşen, N., Özkul, B., & Aktürk, N. (2020). A dimension in recovery: return to working life after breast cancer. Cancer Nursing, 43(6), E328-E334. https://doi.org/10.1097/NCC.0000000000000757
Inhestern, L., Beierlein, V., Bultmann, J. C., Möller, B., Romer, G., Koch, U., & Bergelt, C. (2017). Anxiety and depression in working-age cancer survivors: a register-based study. BMC Cancer, 17, 1-8. https://doi.org/10.1186/s12885-017-3347-9
Iskandarsyah, A., de Klerk, C., Suardi, D. R., Soemitro, M. P., Sadarjoen, S. S., & Passchier, J. (2013). The Distress Thermometer and its validity: a first psychometric study in Indonesian women with breast cancer. PLoS ONE, 8(2), e56353. https://doi.org/10.1371/journal.pone.0056353
Jiayan, H., & Lu, S. (2016). The effectiveness of mindfulness-based stress reduction (MBSR) for survivors of breast cancer: study protocol for a randomized controlled trial [Article]. Trials, 17, 1-9. https://doi.org/10.1186/s13063-016-1335-z
Jim, H. S. L., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., Merluzzi, T. V., Munoz, A. R., George, L., Snyder, M. A., & Salsman, J. M. (2015). Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer, 121(21), 3760-3768. https://doi.org/10.1002/cncr.29353
Joseph, H. J., Thibault, G. P., & Ruttle-King, J. (2006). Perceived stress and quality of life among prostate cancer survivors. Military Medicine, 171(5), 425-429. https://doi.org/10.7205/MILMED.171.5.425
Kabat‐Zinn, J. (2003). Mindfulness‐based interventions in context: past, present, and future. Clinical psychology: Science and practice, 10(2), 144-156. https://doi.org/10.1093/clipsy.bpg016
Kamijo, Y., & Miyamura, T. (2020). Spirituality and associated factors among cancer patients undergoing chemotherapy. Japan Journal of Nursing Science, 17(1), e12276. https://doi.org/10.1111/jjns.12276
Khodaveirdyzadeh, R., Rahimi, R., Rahmani, A., Ghahramanian, A., Kodayari, N., & Eivazi, J. (2016). Spiritual/religious coping strategies and their relationship with illness adjustment among Iranian breast cancer patients. Asian Pacific Journal of Cancer Prevention, 17(8), 4095-4099. https://doi.org/10.14456/apjcp.2016.220/APJCP.2016.17.8.4095
Kim, M. (2020). Finding meaning in life threatening illness. Korean Journal of Hospice and Palliative Care, 23(2), 39. https://doi.org/10.14475/kjhpc.2020.23.2.39
Kim, S.-S., Hayward, R. D., & Reed, P. G. (2014). Self-transcendence, spiritual perspective, and sense of purpose in family caregiving relationships: A mediated model of depression symptoms in Korean older adults. Aging & Mental Health, 18(7), 905-913. https://doi.org/10.1080/13607863.2014.899968
Koch, L., Bertram, H., Eberle, A., Holleczek, B., Schmid-Höpfner, S., Waldmann, A., Zeissig, S. R., Brenner, H., & Arndt, V. (2014). Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the Cancer Survivorship-a multi-regional population-based study [Article]. Psycho-oncology, 23(5), 547-554. https://doi.org/10.1002/pon.3452
Koch, L., Jansen, L., Herrmann, A., Stegmaier, C., Holleczek, B., Singer, S., Brenner, H., & Arndt, V. (2013). Quality of life in long-term breast cancer survivors – a 10-year longitudinal population-based study. Acta Oncologica, 52(6), 1119-1128. https://doi.org/10.3109/0284186X.2013.774461
Koenig, H., King, D., & Carson, V. B. (2012). Handbook of religion and health. Oxford university press.
Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. International Scholarly Research Notices, 2012. https://doi.org/10.5402/2012/278730
Koenig, H. G. (2021). Mechanisms: Religion’s impact on mental health. In Spirituality and mental health across cultures. (pp. 129-146). Oxford University Press. https://doi.org/10.1093/med/9780198846833.003.0009
Komariah, M., Firdaus, M. K. Z. H., Aryal, K. P., & Latif, M. A. (2021). Correlation between spiritual well-being and level of fatigue among patients suffering from breast cancer. Jurnal Keperawatan Padjadjaran, 9(1), 52-60. https://doi.org/10.24198/jkp
Kreitler, S., Peleg, D., & Ehrenfeld, M. (2007). Stress, self-efficacy and quality of life in cancer patients [Article]. Psycho-oncology, 16(4), 329-341. https://doi.org/10.1002/pon.1063
Labelle, L. E., Campbell, T. S., Faris, P., & Carlson, L. E. (2015). Mediators of Mindfulness-Based Stress Reduction (MBSR): Assessing the timing and sequence of change in cancer patients. Journal Of Clinical Psychology, 71(1), 21-40. https://doi.org/10.1002/jclp.22117
Lai, Y. H. (2016). Perspectives on cancer survivorship: Care and challenges. Journal of Nursing Research, 24(2), 190-192. https://doi.org/10.1097/jnr.0000000000000163
Larsen, J. L. (2012). Analysis of the concept of spirituality [Disertation, The University of Wisconsin - Milwaukee]. ProQuest Central; ProQuest Dissertations & Theses A&I. Ann Arbor. http://search.proquest.com/docview/1033820709?accountid=12719
Levkovich, I., Cohen, M., & Karkabi, K. (2019). The experience of fatigue in breast cancer patients 1–12 month post-chemotherapy: A qualitative study. Behavioral Medicine, 45(1), 7-18. https://doi.org/10.1080/08964289.2017.1399100
Lewandowska, A., Rudzki, G., Lewandowski, T., Próchnicki, M., Rudzki, S., Laskowska, B., & Brudniak, J. (2020). Quality of life of cancer patients treated with chemotherapy. International Journal of Environmental Research and Public Health, 17(19), 6938. https://doi.org/10.3390/ijerph17196938
Lewinson, L. P., McSherry, W., & Kevern, P. (2015). Spirituality in pre-registration nurse education and practice: A review of the literature. Nurse Education Today, 35(6), 806-814. https://doi.org/10.1016/j.nedt.2015.01.011
Lewis, S., Salins, N., Rao, M. R., & Kadam, A. (2014). Spiritual well-being and its influence on fatigue in patients undergoing active cancer directed treatment: a correlational study. Journal Of Cancer Research And Therapeutics, 10(3), 676-680. https://doi.org/10.4103/0973-1482.138125
Louis, J., Adams, L., & Brown, T. (2017). Treating depression in the caregivers of cancer patients. Journal of Psychology and Clinical Psychiatry, 7(5), 00455. https://doi.org/10.15406/jpcpy.2017.07.00455
Matchim, Y., Armer, J. M., & Stewart, B. R. (2011a). Effects of Mindfulness-Based Stress Reduction (MBSR) on health among breast cancer survivors. Western Journal of Nursing Research, 33(8), 996-1016. https://doi.org/10.1177/0193945910385363
Matchim, Y., Armer, J. M., & Stewart, B. R. (2011b). Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion. Oncology Nursing Forum, 38(2), E61-71. https://doi.org/10.1188/11.ONF.E61-E71
McBrien, B. (2006). Spirituality: A concept analysis of spirituality. British Journal of Nursing, 15(1), 42-45. https://doi.org/10.12968/bjon.2006.15.1.20309
McSherry, W., & Jamieson, S. (2013). The qualitative findings from an online survey investigating nurses' perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 22(21-22), 3170-3182. https://doi.org/10.1111/jocn.12411
Meraviglia, M. G. (2004). The effects of spirituality on well-being of people with lung cancer. Oncology Nursing Forum, 31(1), 89-94 86p. https://doi.org/10.1188/04.ONF.89-94
Mueller, P. S. (2019). Finding Hope and Healing When Cure Is Not Possible: An Oslerian Perspective From 100 Years Ago. Mayo Clinic Proceedings,
Mulyono, W. A., & Purwandari, H. (2022). Spirituality: A Concept Analysis. International Journal of Biomedical Nursing Review, 1(1), 26-31. https://doi.org/10.20884/1.ijbnr.2022.1.1.6577
Murphy, P. E., Canada, A. L., Fitchett, G., Stein, K., Portier, K., Crammer, C., & Peterman, A. H. (2010). An examination of the 3-factor model and structural invariance across racial/ethnic groups for the FACIT-Sp: a report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II). Psycho-Oncology, 19(3), 264-272. https://doi.org/10.1002/pon.1559
Mystakidou, K., Tsilika, E., Parpa, E., Hatzipli, I., Smyrnioti, M., Galanos, A., & Vlahos, L. (2008). Demographic and clinical predictors of spirituality in advanced cancer patients: A randomized control study. Journal of Clinical Nursing, 17(13), 1779-1785. https://doi.org/10.1111/j.1365-2702.2008.02327.x
Naughton, M. J., & Weaver, K. E. (2014). Physical and mental health among cancer survivors: considerations for long-term care and quality of life. North Carolina medical journal, 75(4), 283. https://doi.org/10.18043/ncm.75.4.283
Ness, S., Kokal, J., Fee-Schroeder, K., Novotny, P., Satele, D., & Barton, D. (2013). Concerns across the survivorship trajectory: Results from a survey of cancer survivors. Oncology Nursing Forum, 40(1), 35-42 38p. https://doi.org/10.1188/13.ONF.35-42
Ng, G. C., Mohamed, S., Sulaiman, A. H., & Zainal, N. Z. (2017). Anxiety and depression in cancer patients: the association with religiosity and religious coping. Journal of religion and health, 56, 575-590. https://doi.org/10.1007/s10943-016-0267-y
Ozkan, M. (2019). Psychosocial Adaptation During and After Breast Cancer. In A. Aydiner, A. Igci, & A. Soran (Eds.), Breast Disease: Management and Therapies, Volume 2 (pp. 705-727). Springer International Publishing. https://doi.org/10.1007/978-3-030-16792-9_46
Palitsky, R., & Kaplan, D. M. (2021). The role of religion for mindfulness-based interventions: Implications for dissemination and implementation. Mindfulness, 12(8), 2076-2089. https://doi.org/10.1007/s12671-019-01253-0
Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. Guilford Press.
Pargament, K. I. (2013). Spirituality as an irreducible human motivation and process. The International Journal for the Psychology of Religion, 23(4), 271-281. https://doi.org/10.1080/10508619.2013.795815
Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of clinical psychology, 56(4), 519-543.
Park, C. L., Lim, H., Newlon, M., Suresh, D. P., & Bliss, D. E. (2014). Dimensions of religiousness and spirituality as predictors of well-being in advanced chronic heart failure patients. Journal of religion and health, 53(2), 579-590. https://doi.org/10.1007/s10943-013-9714-1
Paulson, S., Davidson, R., Jha, A., & Kabat-Zinn, J. (2013). Becoming conscious: the science of mindfulness. Annals of the New York Academy of Sciences, 1303, 87-104. https://doi.org/10.1111/nyas.12203
Perwitasari, D. A., Atthobari, J., Mustofa, M., Dwiprahasto, I., Hakimi, M., Gelderblom, H., Putter, H., Nortier, J. W. R., Guchelaar, H.-J., & Kaptein, A. A. (2012). Impact of chemotherapy-induced nausea and vomiting on quality of life in indonesian patients with gynecologic cancer. International Journal of Gynecological Cancer, 22(1), 139-145. https://doi.org/10.1097/IGC.0b013e318234f9ee
Peteet, J. R., & Balboni, M. J. (2013). Spirituality and religion in oncology. CA: a cancer journal for clinicians, 63(4), 280-289. https://doi.org/10.3322/caac.21187
Peteet, J. R., & Balboni, M. J. (2013). Spirituality and religion in oncology. CA:A Cancer Journal for Clinicians, 63(4), 280-289. https://doi.org/10.3322/caac.21187
Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) [Article]. Annals of Behavioral Medicine, 24(1), 49. https://doi.org/10.1207/S15324796ABM2401_06
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. Lippincott Wiliams & Wilkins.
Porter, M. E., Larsson, S., & Lee, T. H. (2016). Standardizing patient outcomes measurement. New England Journal of Medicine, 374(6), 504-506. https://doi.org/10.1056/NEJMp1511701.
Prati, G., & Pietrantoni, L. (2009). Optimism, Social Support, and Coping Strategies As Factors Contributing to Posttraumatic Growth: A Meta-Analysis. Journal of Loss and Trauma, 14(5), 364-388. https://doi.org/10.1080/15325020902724271
Purwaningsih, I., Aziz, A., Istiqomah, I., & Rosyadi, I. (2022). Spiritual and religious characteristics in cancer patients. KnE Life Sciences, 412–420-412–420. https://doi.org/10.18502/kls.v7i2.10335
Ranaweera, S. (2022). The Role of Mindfulness and Positive Reappraisal in Stress and Quality of Life (Publication Number 29214872) [Ph.D., The University of North Carolina at Greensboro]. ProQuest Dissertations & Theses A&I. United States -- North Carolina. http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29214872
Reed, P. G. (1996). Transcendence: Formulating nursing perspectives. Nursing Science Quarterly, 9(1), 2-4. https://doi.org/10.1177/089431849600900102
Reed, P. G. (2014). Theory of self-transcendence. In M. J. Smit & P. R. Liehr (Eds.), Middle Range Theory for Nursing (3rd ed., pp. 109-139). Springer.
Reed, P. G. (2021). Self-transcendence: moving from spiritual disequilibrium to well-being across the cancer trajectory. Seminars in Oncology Nursing,
Reed, P. G. (2024). Theory of self-transcendence. In M. J. Smith, P. R. Liehr, & R. D. Carpenter (Eds.), Middle Range Theory For Nursing (5th ed., pp. 103-1124). Springer.
Reed, P. G., & Sherarer, N. B. C. (Eds.). (2012). Perspectives on nursing theory (6th ed.). Lippincott Wiliam & Wilkins.
Ricciardi, W. (2022). Major Cancer Problems and Prospects for Prevention: A European Perspective. Journal of Moral Theology, 2(CTEWC Book Series 2), 137-150.
Rochmawati, E., Wiechula, R., & Cameron, K. (2016). Current status of palliative care services in Indonesia: a literature review. International Nursing Review, 63(2), 180-190. https://doi.org/10.1111/inr.12236
Rochmawati, E., Wiechula, R., & Cameron, K. (2018). Centrality of spirituality/religion in the culture of palliative care service in Indonesia: An ethnographic study. Nursing & health sciences, 20(2), 231-237.
Roland, K. B., Rodriguez, J. L., Patterson, J. R., & Trivers, K. F. (2013). A literature review of the social and psychological needs of ovarian cancer survivors [Article]. Psycho-oncology, 22(11), 2408-2418. https://doi.org/10.1002/pon.3322
Rouleau, C. R., Garland, S. N., & Carlson, L. E. (2015). The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer management and research, 121-131. https://doi.org/10.2147/CMAR.S64165
Rudaz, M., Ledermann, T., & Grzywacz, J. G. (2018). Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors. Journal of psychosocial oncology, 36(5), 609-623. https://doi.org/10.1080/07347332.2018.1464091
Salim, O., Sudharma, N., Kusumaratna, R., & Hidayat, A. (2007). Validitas dan reliabilitas World Health Organization Quality of Life-BREF untuk mengukur kualitas hidup lanjut usia. Universa Medicina, 29(1). https://doi.org/10.18051/UnivMed.2007.v26.27-38
Schnitker, S. A., & Emmons, R. A. (2013). Spiritual striving and seeking the sacred: Religion as meaningful goal-directed behavior. The International Journal for the Psychology of Religion, 23(4), 315-324. https://doi.org/10.1080/10508619.2013.795822
Schreiber, J. A. (2011). Image of god: Effect on coping and psychospiritual outcomes in early breast cancer survivors. Oncology Nursing Forum, 38(3), 293-301 299p. https://doi.org/10.1188/11.ONF.293-301
Seiler, A., & Jenewein, J. (2019). Resilience in cancer patients. Frontiers in psychiatry, 10, 208. https://doi.org/10.3389/fpsyt.2019.00208
Shapiro, S. L. (2009). The integration of mindfulness and psychology. Journal of Clinical Psychology, 65(6), 555-560. https://doi.org/10.1002/jclp.20602
Sharif, S. P., Lehto, R. H., Amiri, M., Ahadzadeh, A. S., Nia, H. S., Haghdoost, A. A., Fomani, F. K., & Goudarzian, A. H. (2021). Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment. Palliative & supportive care, 19(1), 55-61. https://doi.org/10.1017/S1478951520000383
Shaw, J. A. (2005). A pathway to spirituality. Psychiatry, 68(4), 350-362. http://search.proquest.com/docview/220665526?accountid=12719
Shonin, E., Van Gordon, W., & Singh, N. N. (Eds.). (2015). Buddhist foundations of mindfulness. Springer. http://www.springer.com/978-3-319-18590-3.
Simonelli, L. E., Fowler, J., Maxwell, G. L., & Andersen, B. L. (2008). Physical sequelae and depressive symptoms in gynecologic cancer survivors: Meaning in life as a mediator [Article]. Annals of Behavioral Medicine, 35(3), 275-284. https://doi.org/10.1007/s12160-008-9029-8
Skevington, S. M., Lotfy, M., & O'Connell, K. A. (2004). The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299-310. https://doi.org/10.1023/B:QURE.0000018486.91360.00
Soriano, G. P., & Calong, K. A. C. (2021). Spiritual well-being, self-transcendence, and spiritual practices among Filipino women with breast cancer. Palliative & supportive care, 19(6), 723-726. https://doi.org/10.1017/S1478951521000079
Stovall, E., Greenfield, S., & Hewitt, M. (2005). From cancer patient to cancer survivor: Lost in transition. National Academies Press. http://nap.edu/11468
Swinton, J. (2012). Health care spirituality: a question of knowledge. In M. Cobb, C. M. Puchalski, & B. Rumbold (Eds.), Oxford Textbook of Spiritulity in Healthcare (pp. 99-104). Oxford.
Swinton, J., Bain, V., Ingram, S., & Heys, S. D. (2011). Moving inwards, moving outwards, moving upwards: The role of spirituality during the early stages of breast cancer. European Journal of Cancer Care, 20(5), 640-652. https://doi.org/10.1111/j.1365-2354.2011.01260.x
Tiew, L. H., & Creedy, D. K. (2011). Student nurses' spiritual education perspectives: a literature review. Singapore Nursing Journal, 38(3), 39-54. http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2011322469&site=ehost-live
Trevino, K. M., Balboni, M., Zollfrank, A., Balboni, T., & Prigerson, H. G. (2014). Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer. Psycho-oncology, 23(8), 936-945 910p. https://doi.org/10.1002/pon.3505
Trevino, K. M., Naik, A. D., & Moye, J. (2015). Perceived and actual change in religion/spirituality in cancer survivors: Longitudinal relationships with distress and perceived growth. Psychology of Religion and Spirituality. https://doi.org/10.1037/rel0000030
Wahyuningsih, F. E., Sofro, M. A. U., & Dwidiyanti, M. (2019). Spiritual well being of breast cancer patients undergoing chemotherapy through Mindfulness Based Spiritual. Media Keperawatan Indonesia, 2(3), 83–89. https://doi.org/10.26714/mki.2.3.2019.83-89
Walach, H., Buchheld, N., Buttenmüller, V., Kleinknecht, N., & Schmidt, S. (2006). Measuring mindfulness—the Freiburg Mindfulness Inventory (FMI). Personality and Individual Differences, 40(8), 1543-1555. https://doi.org/10.1016/j.paid.2005.11.025
Whitford, H. S., Olver, I. N., & Peterson, M. J. (2008). Spirituality as a core domain in the assessment of quality of life in oncology. Psycho-oncology, 17(11), 1121-1128. https://doi.org/10.1002/pon.1322
Widyaningsih, S., Petpichetchian, W., & Kitrungrote, L. (2014). The quality of life of Indonesian patients with advanced cancer. Songklanagarind Journal of Nursing, 34(Suplement), 98-108. www.nur.psu.ac.th/journal/file/149file2842.pdf
Wiggins, M. I., Uphold, C. R., Shehan, C. L., & Reid, K. J. (2008). The longitudinal effects of spirituality on stress, depression, and risk behaviors among men with HIV infection attending three clinics in the Southeastern United States [Article]. Journal of Spirituality in Mental Health, 10(2), 145-168. https://doi.org/10.1080/19349630802081210
World Health Organization. (2020). Cancer Indonesia 2020 country profile. In C. C. P. 2020 (Ed.): WHO.
Wu, H.-S., & Harden, J. K. (2015). Symptom burden and quality of life in survivorship: a review of the literature. Cancer Nursing, 38(1), E29-E54. https://doi.org/10.1097/NCC.0000000000000135
Wu, S.-F. V., Tung, H.-H., Liang, S.-Y., Lee, M.-C., & Yu, N.-C. (2014). Differences in the perceptions of self-care, health education barriers and educational needs between diabetes patients and nurses. Contemporary Nurse: A Journal for the Australian Nursing Profession, 46(2), 187-196. https://doi.org/10.5172/conu.2014.46.2.187
Wu, T.-Y., Chang, T.-W., Chang, S.-M., Lin, Y.-Y., Wang, J.-D., & Kuo, Y.-L. (2019). Dynamic changes of body image and quality of life in breast cancer patients. Cancer management and research, 10563-10571.
Yanez, B., Edmondson, D., Stanton, A. L., Park, C. L., Kwan, L., Ganz, P. A., & Blank, T. O. (2009). Facets of spirituality as predictors of adjustment to cancer: Relative contributions of having faith and finding meaning. Journal of Consulting and Clinical Psychology, 77(4), 730-741. https://doi.org/10.1037/a0015820
Yilmaz, M., & Cengiz, H. Ö. (2020). The relationship between spiritual well-being and quality of life in cancer survivors. Palliative & supportive care, 18(1), 55-62. https://doi.org/10.1017/S1478951519000464