Spiritual thoughts, coping and 'sense of coherence' in brain tumour patients and their spouses

When a person is diagnosed with a life-threatening disease, existential que stions are easily triggered. The aims of this study were to explore to what extent brain tumour patients and their next of kin were able to cope, unde rstand and create meaning in their situation, to explore whether spirituali ty could be supportive and to analyse whether these concepts are related to Antonovsky's concept of sense of coherence. Using a purposive sampling tec hnique, 20 patients and 16 of their next of kin look part in tape-recorded interviews. A content and context analysis was performed using a hermeneuti c approach. We found that comprehensibility was to a large extent constructed by the pa tient's own thoughts and theories, despite an insecure situation. Manageabi lity was achieved by active information-seeking strategies, by social suppo rt and by coping, including positive reinterpretation of the situation. Mea ningfulness was central for quality of life and was created by close relati ons and faith, as well as by work. A crucial factor was whether the person had a 'fighting spirit' that motivated him or her to go on. As only three p atients were believers, trust in God had generally been replaced by a belie f and confidence in oneself, in science, in positive thinking and by closen ess to nature. Sense of coherence as a concept can explain how exposed persons handle thei r situation. In its construction, sence of coherence integrates essential p arts of the stress/coping model (comprehensibility, manageability) and of s pirituality (meaning).