Cancer patients\u27 experiences: Exploring the biopsycosocial-spiritual model

George Engel\u27s Biopsychosocial Model states that our biological, psychological, and social systems are related and influence one another (Engel, 1980). Many clinicians argue that the model should be expanded to include spirituality, making it the biopsychosocial-spiritual model (Prest & Robinson, 2006). This study examined whether or not there is empirical evidence to support the addition of spirituality to this model. While there is strong support for significant relationships between spiritual and psychosocial well-being (O\u27Connor, Guilfoyle, Breen, Mukhardt, & Fisher, 2007; Sawatzky, Ratner, & Chiu, 2005) as well as psychosocial and biological well-being (Ross, Mirowsky, & Goldsteen, 1990; Spiegel & Kato, 1996; Weihs, Fisher, & Baird, 2002), there is less support for a relationship between spiritual and biological well-being (Matthews, McCullough, Larson, Koenig, Swyers, & Milano, 1998; Oman, Kurata, Strawbridge, & Cohen, 2002; Sephton, Koopman, Schaal, Thoresen, & Spiegel, 2001). Therefore, it was hypothesized that psychosocial well-being mediated the relationship between spiritual and biological well-being. A model was developed to test this hypothesis using structural equation modeling. An archival data set was used to test this model. One hundred ninety five patients with various types of cancer were included in the analyses. The participants filled out surveys inquiring about their demographics, as well as their spiritual, psychosocial, and physical well-being. There were significant, positive correlations between the observed variables and between the latent variables, which support the inclusion of spirituality into the biopsychosocial model. The faith subscale of the spiritual measure was not significantly correlated with three of the five observed variables (physical well-being, ECOG, and symptoms) that made up the physical well-being latent variable, but the meaning and peace subscales were significantly related to all of the physical measures. The hypothesis that psychosocial well-being mediates the relationship between spiritual well-being and physical well-being was not supported by this study. Limitations to this study, suggestions for future research, and clinical implications are discussed