Illness Understanding and Religiousness in Patients with Recurrent Glioblastoma

Patients with glioblastoma (GBM) often have inaccurate perceptions of prognosis. Strong religious beliefs have been associated with limited illness understanding (IU) in patients with advanced cancer, but IU and religiousness have not been investigated in patients with GBM. The aim of this study was to evaluate the association between religiousness and spirituality and IU in patients with GBM. Patients enrolled in a prospective multicenter study of recurrent GBM (Coping with Glioblastoma, NCT02375841). Within one month of medical visits discussing MRI scans showing GBM progression, patients completed study surveys containing published measures of IU and religiousness. IU was compared between participants with moderate or high vs. slight or no religiousness based on several patient reported prompts using Fisher’s exact tests. Twenty-four patients completed surveys of religiousness and IU. Illness understanding was poor amongst our entire cohort. Fifteen participants (62.5%) acknowledged that their illness was terminal. Only 6 (25%) correctly acknowledged their prognosis (months). Eleven patients (46%) were moderately or very religious, while 9 (38%) were either slightly religious or not at all religious. High religiousness and spirituality were each associated with less IU (p=0.06 and p=0.01, respectively). A belief that God could perform a miracle to cure them of cancer and a belief in sanctity through suffering were also each associated with less IU. This prospective study that suggests religiousness, including the belief in miracles and a belief in sanctification through suffering, might influence patients’ IU. Further research is warranted to study this association.