A Qualitative Study of Strength, Hope, and Meaning: Multi-Stakeholder Perspectives on Spiritual Care for Breast Cancer

OBJECTIVE: To explore the multi-stakeholder experiences of spiritual care for breast cancer patients from the perspectives of patients, families, medical personnel, and religious leaders. METHODS: This qualitative descriptive study employed Braun and Clarke's reflexive thematic analysis. A purposive sample of 20 participants (five patients, five family members, five medical personnel, and five religious leaders) was recruited in Semarang, Indonesia. Data were collected through semi-structured interviews and field notes between January and April 2025, and analyzed using NVivo 12. Credibility was ensured through source triangulation, member checking, peer debriefing, and audit trail procedures. RESULTS: Four themes emerged. First, spirituality was identified as a source of strength and hope, reflected in practices such as repeated prayer recitations that helped patients cope with treatment-related fear. Second, the family served as a pillar of spiritual support, illustrated by joint family prayers that reduced chemotherapy-related distress and motivated treatment adherence. Third, spiritual care was integrated by medical personnel, including simple practices such as offering space for prayer or initiating brief spiritual discussions despite time constraints. Fourth, religious leaders played a role in reinforcing meaning, shown through personalized guidance that helped patients reinterpret illness as a meaningful life test. CONCLUSION: Effective spiritual care requires the coordinated engagement from families, medical personnel, and religious leaders. Practical implications include the need for training in spiritual care for healthcare providers and the structured collaboration among families and religious leaders. This study is limited by its single-region setting and relatively homogeneous religious background. Future studies should evaluate structured spiritual care interventions longitudinally.