S p i r i t ua l i t y S t u d i e s 7 - 1 S p r i n g 2 0 2 1 5 7 Mária DěDoVá ed to inspect perceived importance of spirituality and perceived importance of practicing of spirituality. Posttraumatic growth was measured by PTGI (Posttraumatic Growth Inventory; Tedeschi and Calhoun 1996), which consists of 21 items. In this research, the PTGI was used to measure the level of positive changes experienced after exposure to a traumatic event. In other words, this questionnaire examines whether a traumatic event can also cause a positive change in sense of positive growth (as some benefit of this negative event). PTGI comprises five subscales as follows: Relating to others (7 items; Ωtotal =.94), new possibilities (5 items; Ωtotal =.87), personal strength (4 items; Ωtotal =.86), spiritual change (2 items; rs =.74), appreciation of life (3 items; Ωtotal =.83). The items are formulated as statements that find out how a person who has overcome a traumatic situation has changed. For this work, the instruction was specified for one situation – cancer. Using a 6-point Likert scale from 0 – 5, the respondent evaluates to what extent they did not survive the change due to this traumatic event (0 – I did not experience this change as a result of this crisis; 1 – I experienced this change to a very small degree as a result of this crisis; 2 – I experienced this change to a small degree as a result of this crisis; 3 – I experienced this change to a moderate degree as a result of this crisis; 4 – I experienced this change to a great degree as a result of this crisis; 5 – I experienced this change to a very great degree as a result of this crisis. PTGI has good psychometric properties such as reliability and validity. Even if there are mentioned subscales of this questionnaire, it is possible to work with PTGI as with a unidimensional measure (Ωtotal =.96). 2.4 Data Analysis From the total of N = 756 patients, 56 patients were excluded due to missingness higher than 80% and 4 patients reported they were less than 18 years old. In effective sample, N = 696 patients, 1.4% missingness was found (missingness was inspected in measured variables). Missing data were imputed by multiple imputation (Van Burren and Groothuis-Oudshoorn 2011) by MICE package. Missing sociodemographic variables, variables related to cancer and cancer treatment, and other categorical variables were not imputed [1]. In the items, which were targeted as items that are necessary to impute, the highest missingness was 6.18% (fourth item from the Multidimensional Social Support Scale). For the imputation, 7 imputations with 10 interaction were chosen and PMM (Predictive Mean Matching) method was used. Descriptive analysis, reliability analysis, correlations, analysis of differences were computed on multiple imputed objects. For the correlations between spirituality, posttraumatic growth, and its domains, Bayes factor for correlation was also computed, using BayesFactor package (Morey et al. 2018). For the comparison reasons, the religion type variable was recoded to two groups: Cancer survivors with faith (Christianity, Reformed, and Other religions), and without faith (Atheism), with the comparison being focused on the faith factor. In case differences were found in these compared groups, the analyses from the perspective of different types of religions were also conducted by the ANOVA test with the goal of inspecting the differences based on different types of religion. After differences were found by the ANOVA test, Tukey post hoc test for detailed group comparison was used. In the Tukey post hoc test, the p value was adjusted for multiple comparison. Figures were plotted from the average dataset from 7 imputed datasets. For plotting figures, the YaRrr package was used (Phillips 2017). 3 Results 3.1 Sample From the whole effective sample (N = 696), 463 patients with cancer were females. Most of the patients were married (57.6%) and had a high school education (52.5%). The mean age of the cancer survivors was 53 (SD = 15.44) (ranged from 18 to 93). The sample was heterogeneous with respect to the type of cancer (21 different types of cancer). The most prevalent diagnosis was breast cancer (211 cases), followed by colon cancer (61 cases), leukemia (48 cases), and lymphoma (47 cases). About 5% (36 cases) of cancers survivors had combination of two and/or more types of cancer. Average time since being diagnosed with cancer was 6.48 (SD = 7.19) years (ranged from 0 to 58 years). Most cancer survivors (70%) had completed cancer treatment. As regards religion, most cancer survivors were Christians (74.7%), followed by Atheists (17.3%), Reformed Christians (6.9%), and 7 cancer survivors stated other religions (6 cases were Buddhists, 1 case Muslim). For more details, see the sample characteristics tables in the supplementary materials [2]. 3.2 Descriptive Analysis The descriptive statistics of spirituality and posttraumatic growth are shown in Table 1.
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