Do parents of children with cancer use religious coping in New Zealand?

In many countries, cancer is the second leading cause of death in children over 1 year of age, exceeded only by accidents. Fortunately, in recent years great progress has been made in the treatment of childhood cancer. Significantly, most patients with cancer can be cured.¹ It is widely accepted that over time in Aotearoa New Zealand the incidence of childhood cancer has remained low and childhood cancer survival rates have improved steadily. The age-standardised incidence rate was 169.1 per million per year, and for all childhood cancers combined, survival at 5 years was 85.6%.²

Religion can be defined as human beings’ relation to that which they regard as holy, sacred, absolute, spiritual, divine or worthy of especial reverence. It is also commonly regarded as the way people deal with ultimate concerns about their lives and their fate after death.³ Coping mechanisms are efforts to prevent or diminish threat, harm and loss, or to reduce the distress that is often associated with those experiences.⁴ Religious coping is an effort to understand and deal with life stressors in ways related to the sacred, which includes prayer, congregational support, pastoral care and religious faith.⁵ Many studies have been published about use of religious coping by parents of children with cancer in the United States and in Western and Middle Eastern countries.^6,7 To the best of our knowledge, based on a literature review, no study has been reported on this subject in New Zealand. We have raised one scenario of possible religious coping in New Zealand for the parents of children with cancer.

In New Zealand, freedom of religion has been protected since the signing of Te Tiriti o Waitangi/the Treaty of Waitangi. Religion encompasses a wide range of groups and beliefs with recent 2018 Census responses including no religion (48.6%), Christianity (37.3%), undeclared (6.7%), Hinduism (2.7%), Islam (1.3%), Buddhism (1.1%), Sikhism (0.9%), Judaism (0.1%) and others (1.3%).⁸ These data show that more than half of the population of New Zealand report a religious affiliation. A recent study with immigrant parents in New Zealand found that spiritual values were positively correlated with intrinsic goals (service, health, personal growth and developing close relationships) and that the primary role of life goals and spiritual values is to imbue parenting with a greater sense of purpose and meaning.⁹ Mulipola et al.¹⁰ reported that spirituality and religion were core to a Samoan’s faith and fostered resilience and healing when facing adverse mental health events with their family members, including relationships between a parent and a child. In a tertiary care hospital, 56% of children were reported to use complementary or alternative medicine, including 12% using spiritual practice (prayer and meditation). In that study, it was noted that 32% of the children had a chronic disease, but no detailed information about their diagnosis was reported.¹¹ Nejat et al.¹² compared the use of spirituality and religiosity in coping with colorectal cancer in 20 New Zealand and 20 Iranian adult participants. All Iranian patients (100%) and the majority of New Zealand patients (85%) used spirituality and/or religiosity in coping with colorectal cancer.¹²

In conclusion, we would like to emphasise that religious coping has been commonly used in many cultures around the world. We think that, like parents in Western countries and adult cancer patients in New Zealand, many parents of children with cancer in New Zealand may use religious coping. Therefore, we strongly recommend that comprehensive studies should be conducted on religious coping styles of parents of children with cancer, who believe in different religions and none, in New Zealand. Including methodological elements for observations of religious coping, such as parent–child interviews, positive supportive/negative aspects and the potential to make comparisons will increase the value of studies. We believe that these studies will make a helpful contribution to the literature and health professional understanding and practice.