Introduction

Being informed about cancer is worrying for anyone and causes changes in the person affected (Baljani et al. 2011; Khoshnood et al. 2018). Cancer is one of the chronic diseases that is growing and is considered as one of the most important chronic diseases in Iran in recent years (Borji et al. 2017; Khoshnood et al. 2018) that causes side effects for patients (Borji 2017). Annually, more than 7 million people in the world die from cancer, and in 2010 (Ayatollahi et al. 2013) it was predicted that the number of new cases would increase from 10 million persons to 15 million persons. Currently, cancer is one of the main health issues in Iran and around the world the third leading cause of death and the second largest group of chronic and non-contagious diseases (Asadi et al. 2018; Safaeian et al. 2017).

Problems and complications of cancer patients are changes in health (Hughes et al. 2018; Motaghi et al. 2017), life expectancy, mental (Lloyd et al. 2018) and spiritual health (Chaar et al. 2018) so that cancer patients have lower quality of life (Hughes et al. 2018) and more problems like stress, anxiety and depression (Bronner et al. 2018). Other problems related to these patients can be their spiritual health so that the disease can reduce the spiritual health of these patients (Ahmadi et al. 2018). Disease by causing problems for a person will change their life expectancy and affect their mental health (Hoseini et al. 2017).

Mental health plays an important role in the health of the patients (Borji et al. 2018a). One of the relevant variables that affects mental health, in cancer patients, is life expectancy (Steffen et al. 2018). Mental health plays an important role in improving the lives of cancer patients. Factors such as stress, anxiety and depression affect mental health and reduce the quality of life of these patients (Pouy et al. 2018). Pain is another important issue in these patients. For this reason it is necessary for interventions to reduce it be done (Borji and Safari 2018).

Today, psychiatrists are looking to discover alternative treatments for the improvement of mental diseases, and they have been creative and innovative in the field of psychological health and well-being. So for improving mental diseases in addition to medicine therapy and other common modern medical and therapeutic facilities, praying, spirituality, spiritual medicine and spiritual therapy are used to improve mental diseases (Iranmehr and Kadkani 2017). Spiritual health is a significant factor in life and helps persons to adapt to cancer, reduce mental suffering and increase the mental health of patients. On the one hand, the feeling of comfort and power from religious beliefs can have a beneficial role in health and feeling good (Agli et al. 2018; Lai et al. 2018). In fact, the spiritual aspect is the most important aspect of the human nature that helps the human achieve the meaning and purpose of life, as well as playing a very important role in the health of patients (Ross et al. 2018). If spiritual health is compromised, the patient is at risk of mental disorders such as loneliness, depression and loss of meaning in life (Yazdi et al. 2005).

Among other problems in these patients, pain can be mentioned. Pain is one of the problems of patients that affects their quality of life and reduces their quality of life (Khezri Moghadam et al. 2018). There are many ways to reduce the pain of cancer patients. These include the use of drug and non-drug interventions. Drug interventions are both costly and cost-effective. For this reason, the use of non-pharmacological interventions is more important. Religious intervention is one of the non-pharmacological interventions that helps patients’ health (Hoseini et al. 2017).

Religious intervention is one of the health promotion interventions in patients and has had a positive effect on patients in several studies (Bagheri et al. 2018a, b). Considering the necessity of the subject, this study was conducted to determine the effect of the effect of religious psychotherapy emphasizing the importance of prayers on mental health and pain in Cancer patients.

Materials and Methods

This study is a semi-experimental study that was conducted in 2017 in Iran. According to the purpose of the study, the patients were randomly assigned into two experimental and control groups.

The research team provided a list of patients with cancer. The number of eligible patients to participate in the study was 76 patients, according to studies in this field. According to the list, we started from the first one and interviewed the patients. Before beginning the interviews, we talked to the patients and if they were willing to participate in the study, we took their consent to take part in the study. Then, the patients were randomly divided into experimental and control groups. So we started from the beginning of the list; if the first patient had signed the informed consent to participate in the study, he was placed in the experimental group and the next patient was placed in the control group, and if he did not sign the consent to participate in the study, he was excluded from the study.

One of the questionnaires used in this study was a demographic questionnaire, which included questions about age, gender, grade of education, economic status and field of study. The second tool was GHQ-28 General Health Questionnaire which had 28 questions in 4 dimensions of physical symptoms (seven items), anxiety symptoms (seven items), social function (seven items) and symptoms of depression (seven items). In total, students earned a score between zero and 84, and the higher they scored, the worse the health of the individual. In this questionnaire, earning a score of zero to 27 meant desirable general health, a score of 28–55 meant good general health, and a score of 56–84 meant undesirable general health (Goldberg and Hillier 1979; Lobo et al. 1986).The pain questionnaire was used to assess and measure the amount of pain. To measure pain, pain assessment tools numbered from 1 to 10 were used (Borji et al. 2018b).

The general outline of the meetings: while presenting a proper conception of the effects of religious attitudes to the patients, the researcher helped the patients to strengthen their religious beliefs and to pay more attention to and focus on the order of the world, the wisdom and beneficence of God, as well as the gratitude in hardship and hope for divine mercy. Then, prayers 15 and 23 of the SahifehSajjadiyeh book were read at the beginning of the treatment sessions and the patients were asked to pay attention to the meaning of prayer. In addition, the patients were asked to adopt appropriate religious strategies to increase mental health and control pain based on the Quranic teachings related to the contents of prayers 15 and 23 of the SahifehSajjadiyeh and the psychological mechanisms existing in these prayers. It should be noted that some of the religious principles of Richards and Bergin were implemented for the patients with an emphasis on Islamic teachings including prayer, reading sacred books, going to religious places and forgiving the patients (Sharifi et al. 2018) (Table 1).

Table 1 Content of training sessions (Sharifi Rigi et al. 2018)
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Result

The findings of Table 2 show the demographic characteristics of the patients under study. According to the findings, there was no significant difference between the demographic characteristics of the patients in the experimental group and the patients in the control group.

Table 2 Demographic characteristics of patients in the experimental and control group
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The findings of Table 3 show the difference in mean and standard deviation between the dimensions of mental health and pain in patients in the test and control group. According to the findings, after the intervention, the mental health of the patients in the experimental group was increased and the level of perceived pain was statistically significant.

Table 3 Comparison of mean and standard deviation of mental health and pain dimensions in patients in the experimental and control groups before and after the intervention
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Discussion

Religion is one of the most important variables in health (Dehghan et al. 2017). The results of the present study showed that the implementation of a spiritual intervention has increased the life expectancy of cancer patients. In the study by Ashvandi et al. that was conducted to determine the effect of spiritual counseling on the death anxiety in patients with renal failure, the results showed that the implementation of a spiritual intervention, which included supportive presence, support for religious services and use of supportive systems, reduced the anxiety level of death in hemodialysis patients with chronic renal failure at the end stage, which is consistent with the results of this study (Oshvandi et al. 2018).

According to the results of the present study, the implementation of a spiritual intervention has led to an increase in life expectancy in patients with cancer, which was compared with the study results of Salimi et al. about the effect of spiritual self-care program on patients’ life expectancy with coronary artery in a group. The results showed that the implementation of three sessions of one and a half hours of spirituality workshop as one other day and weekly increased the patients’ life expectancy (Salimi et al. 2016), which is consistent with the results of the present study. Also, in the study by Morasai et al. that was conducted to determine the effect of a spiritual counseling program on hope in patients with chronic renal failure, eight spiritual counseling sessions were held for the patients. The results showed that although no significant difference was found between the life expectancy scores of the patients in the experimental and control groups before implementing the intervention, the patients’ life expectancy in the experimental group was significantly increased after implementing the intervention (Morasei and Aghajani 2014), which was consistent with the results of the present study. It should be noted that the type of spiritual intervention of the present study was similar to that study but its implementation method was different.

Conclusion

According to the results of this study, the implementation of supportive spiritual intervention has led to an increase in the patients’ life expectancy in the experimental group. Regarding this improvement, it is suggested to implement a spiritual intervention in order to improve the health of these patients in a participatory way aimed to increase the patients’ life expectancy. It is also recommended that nurses train their patients in the implementation of such interventions in their nursing care and provide them with the necessary background for their recovery.