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Self-Forgiveness, Spirituality, and Psychological Adjustment in Women with Breast Cancer

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We evaluated whether a self-forgiving attitude and spirituality were related to psychological adjustment among 81 women being treated for breast cancer at a medical oncology clinic in a county general hospital. Both a self-forgiving attitude and spirituality were unique predictors of less mood disturbance and better quality of life (p's < 0.001). These results are consistent with previous research that has demonstrated a positive relationship between spirituality and well-being. The findings also suggest that self-forgiveness should be explored experimentally to determine whether it can protect against the psychological effects of breast cancer-related stress. Interventions targeting these characteristics could improve the quality of life and alleviate stress, especially in women with breast cancer in public sector settings.

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Correspondence to Catherine Romero.

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Romero, C., Friedman, L., Kalidas, M. et al. Self-Forgiveness, Spirituality, and Psychological Adjustment in Women with Breast Cancer. J Behav Med 29, 29–36 (2006). https://doi.org/10.1007/s10865-005-9038-z

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