Multidimensional Influence of Religiosity and Spirituality on Head and Neck Cancer Patients and Their Caregivers: A Scoping Review
Colambage Dona Gayashani Prabodhya, Maheeka Seneviwickrama, Ruwan Jayasinghe, Sriyani Ranasinghe, Sashini Shehana Denagamagei, Sakuntha Ratnapreya, Kehinde Kazeem Kanmodi, Simon N Rogers, Susannah Keill, Irosha PereraPURPOSE
The importance of religiosity and spirituality (R&S) in influencing cancer trajectory and outcomes garnered increased attention. R&S are important for some patients with head and neck cancer (HNC) and their carers, but are often overlooked by clinical teams, potentially leading to poorer outcomes. This review aimed to synthesise empirical evidence on the dimensions of R&S in HNC and its influence on patients and caregivers.
METHODS
This review was conducted in accordance with the Joanna Briggs Institute guidelines, using a comprehensive search strategy in the Embase, MEDLINE, CINAHL, and APA PsycINFO databases, following protocol registration (10.17605/OSF.IO/6F4EU). Additional studies were identified through searching the references of included studies and Google Scholar. Qualitative, quantitative, and mixed-methods studies examining R&S in HNC populations were included. Study selection and data extraction were performed independently by two reviewers. Extracted data were narratively synthesised across predefined outcome domains.
RESULTS
A total of 53 studies (n = 8002 participants) were included in the final synthesis. Studies were globally distributed, predominantly from Asia, with contributions from Europe, North and South America, Africa, and Oceania. Multiple domains of R&S were identified: Cognitive/existential-meaning-making, beliefs, fatalism; Emotional/psychological-coping, resilience, hope, demoralisation, anxiety, depression; Behavioural-treatment adherence, health-seeking behavior; Social-support from faith, community, or spiritual figures; Spiritual-faith practices, relationship with God/spiritual entities. Higher R&S were associated with improved quality of life, resilience, coping, and psychological adjustment. In contrast, unmet spiritual needs were linked to demoralisation, depression, anxiety, and suicidal ideation. R&S also influenced improved treatment adherence but delayed health care seeking due to fatalistic beliefs. Evidence from caregivers of patients with HNC indicates that R&S are primarily used as coping mechanisms, providing emotional strength through personal beliefs and spiritual figures, although quantitative findings show a limited and non-significant association with psychological outcomes such as post-traumatic stress disorder (PTSD).
CONCLUSION
R&S plays a complex and multidimensional role in HNC, influencing diverse health outcomes. Integrating spiritual care into oncology practice will improve holistic patient management, though further research is warranted to address existing gaps.