Effects of Islamic Caring Mindfulness-Based Program on Spiritual Well-Being and Fatigue in Indonesian Women with Advanced Breast Cancer Undergoing Chemotherapy: A Randomized Controlled Trial

Abstract

Research on advanced breast cancer patients undergoing chemotherapy shows that the patients suffer the threat of death and uncertainty. The disease and treatment cause fatigue, and negativity in terms of spiritual well-being. This study tested the effect of an Islamic Caring Mindfulness-based Program (ICMB) on spiritual well- being and fatigue of these women. The sample consisted of 112 women with stage III breast cancer who were undergoing chemotherapy at the Chemotherapy Unit of a teaching hospital in Indonesia. The subjects were randomly assigned to either the intervention group (n = 53) receiving both the ICMB and routine care, or the control group (n=59) receiving only routine care. The intervention consisted of Islamic caring, Islamic prayer, and breath dzikr meditation to enhance spiritual well-being, and reduce fatigue. The instrument were 1) the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), and, 2) the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Data were collected four times: at the start of chemotherapy as a baseline (T1), on days 3-4 (T2), on days 23-24 (T3), and days 44-45 (T4). Statistical analysis included descriptive statistics, chi-square test, independent t-test, one way ANOVA, and repeated measures ANOVA. The findings revealed that the spiritual well-being of all participants was significantly higher than that before receiving the program on days 3-4 (p = .001), and gradually increase until the days 44-45. In addition, there was different between two groups in term of change in spiritual well-being over time (p = .001). Moreover, the fatigue of participants on days 23-24 were significantly improved compared to before receiving the program (p < .001). Also, the participants in the intervention group had a significantly lower level of fatigue than did the control group on days 23-24 (p < .05) and days 44-45 (p < .001). Therefore, the program can be used in providing nursing services to patients with advanced breast cancer undergoing chemotherapy in terms of improving spiritual well-being and reducing fatigue Keywords: Islamic caring, Islamic prayer, dzikr meditation, spiritual well-being, fatigue, advanced breast cancer