The Relationship between Self Compassion and the Experience of Memorial Symptoms in Patients with Gastrointestinal Cancer

Kolsoom Zarei, Amir Musarezaie, Elaheh Ashouri


Background: Patients with Gastrointestinal (GI) cancer experience a range of physical and psychological memorial symptoms after developing cancer and beginning to receive medical care. The present study was conducted to investigate the relationship between self‑compassion and the experience of memorial symptoms in patients with GI cancer.

Materials and Methods: This descriptive‑correlational study was conducted in July to August 2019. The study sample included 190 patients admitted to Seyed Al‑Shohada Hospital, with GI cancer who entered the study by convenience sampling. Data were collected using a patient demographic information form, Neff’s Self‑Compassion Scale (SCS), and the Memorial Symptoms Assessment Scale (MSAS) and then analyzed by Pearson correlation coefficient in SPSS‑20.

Results: The mean (SD) total score of self‑compassion was 86.67 (16.65) out of 130, and the mean (SD) total score of memorial symptoms was 1.40 (0.64) out of 4 in patients with GI cancer. The most frequently reported physical symptom was lack of energy, with an 86.84% prevalence, and the most frequently reported psychological symptoms included worrying and feeling nervous, with 70.52% prevalence rates. The total score of self‑compassion was inversely correlated with the total score of memorial symptoms, the score of psychological symptoms, and the score of physical symptoms. Furthermore, the total score of the memorial symptoms was inversely correlated with the scores of all the self‑compassion components (p < 0.001).

Conclusions: Cancer patients had memorial symptoms in both physical and psychological domains. These symptoms decrease with an increase in self‑compassion, so compassion‑based educational interventions by nurses can be used to reduce these symptoms.


Compassion, gastrointestinal neoplasms, signs and symptoms

Full Text:



Hong JF, Zhang W, Song YX, Xie LF, Wang WL. Psychological distress in elderly cancer patients. Int J Nurs Sci 2015;2:23 7. 2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394 24.

Arnold M, Abnet CC, Neale RE, Vignat J, Giovannucci EL, McGlynn KA, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology 2020;159:335 49.e15

Facts C. Cancer Facts and Figures (2017). Atlanta: American Cancer Society; 2013.

Biglu M H, Tabatabaei S. Gastrointestinal cancers in Iran: Iranian scientists approach to gastrointestinal cancers researches in international databases. Koomesh 2017;19:1 9.

Taleghani F, Ehsani M, Farzi S, Farzi S, Adibi P, Moladoost A, et al. Nutritional challenges of gastric cancer patients from the perspectives of patients, family caregivers, and health professionals: A qualitative study. Supportive Care in Cancer 2021:1 8.

Douglas SL, Daly BJ, Lipson AR. Relationship between physical and psychological status of cancer patients and caregivers. West J Nurs Res 2016;38:858 73.

Wang Y, Hou M, Shi H. P0133 A longitudinal prospective analysis of depression, anxiety, and quality of life of breast cancer patients. Eur J Cancer 2014;50:e47.

Taghizadeh A, Pourali L, Vaziri Z, Saedi HR, Behdani F, Amel R. Psychological distress in Cancer patients. Middle East J Cancer 2018;9:143 9.

Fu L, Hu Y, Lu Z, Zhou Y, Zhang X, Chang VT, et al. Validation of the simplified chinese version of the memorial symptom assessment scale—Short form among cancer patients. J Pain Symptom Manage 2018;56:113 21.

Mehnert A, Koch U. Prevalence of acute and post traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: A prospective study. Psychooncology 2007;16:181 8.

Lavdaniti M. Assessment of symptoms in cancer patients undergoing chemotherapy in Northern Greece. Mater Sociomed 2015;27:255 8.

Piazza MF, Galletta M, Portoghese I, Pilia I, Ionta MT, Contu P, et al. Meeting psychosocial and health information needs to ensure quality of cancer care in outpatients. Eur J Oncol Nurs 2017;29:98 105.

Neff K, Leary S CIM, Hoyle R. Individual Differences in Social Behavior. New York: Guilford Press; 2009. p. 561 73.

MacBeth A, Gumley A. Exploring compassion: A meta analysis of the association between self compassion and psychopathology. Clin Psychol Rev 2012;32:545 52.

Neff KD. Self compassion, self esteem, and well being. Soc Personal Psychol Compass 2011;5:1 12.

Gilbert P. The origins and nature of compassion focused therapy. Br J Clin Psychol 2014;53:6 41.

Van Dam NT, Sheppard SC, Forsyth JP, Earleywine M.Self compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. J Anxiety Disord 2011;25:123 30.

Dunne S, Sheffield D, Chilcot J. Brief report: Self compassion, physical health and the mediating role of health promoting behaviours. J Health Psychol 2018;23:993 9.

Beaumont E, Durkin M, Martin CJH, Carson J. Compassion for others, self compassion, quality of life and mental well being measures and their association with compassion fatigue and burnout in student midwives: A quantitative survey. Midwifery 2016;34:239 44.

López A, Sanderman R, Ranchor AV, Schroevers MJ. Compassion for others and self compassion: Levels, correlates, and relationship with psychological well being. Mindfulness (N Y) 2018;9:325 31.

Schellekens MP, Karremans JC, van der Drift MA, Molema J, van den Hurk DG, Prins JB, et al. Are mindfulness and self compassion related to psychological distress and communication in couples facing lung cancer? A dyadic approach. Mindfulness (N Y) 2017;8:325 36.

Salarhaji N, Tahmasebi S. Moderating role of self compassion in relation to psychopathological symptoms and god attachment in women with breast cancer. Archives of Breast Cancer 2019:21 8.

Gallison B, Kester WT. Connecting holistic nursing practice with relationship based care: A community hospital’s journey. Nurse Leader 2018;16:181 5.

Nijboer AA, Van der Cingel MC. Compassion: Use it or lose it?: A study into the perceptions of novice nurses on compassion: A qualitative approach. Nurse Educ Today 2019;72:84 9.

Dalvandi A, Vaisi Raygani A, Nourozi K, Ebadi A, Rahgozar M. The importance and extent of providing compassionate nursing care from the viewpoint of patients hospitalized in educational hospitals in Kermanshah Iran 2017. Open Access Maced J Med Sci 2019;7:1047 52.

Hofmeyer A, Taylor R, Kennedy K. Knowledge for nurses to better care for themselves so they can better care for others during the Covid 19 pandemic and beyond. Nurse Educ Today 2020;94:104503.

Neff KD. The development and validation of a scale to measure self compassion. Self Identity 2003;2:223 50.

Odou N, Brinker J. Exploring the relationship between rumination, self compassion, and mood. Self Identity 2014;13:449 59.

Shahbazi M, Rajabi G, Maghami E, Jelodari A. Confirmatory factor analysis of the Persian version of the self compassion rating scale revised. J Psychol Models and Methods 2015;6:31 46.

Rajabi G, Gashtil K, Amanallahi A. The relationship between self compassion and depression with mediating’s thought rumination and worry in female nurses. Iran J Nurs 2016;29:10 21.

Chang VT, Hwang SS, Kasimis B, Thaler HT. Shorter symptom assessment instruments: The condensed memorial symptom assessment scale (CMSAS). Cancer Invest 2004;22:526 36.

Tantoy IY, Cooper BA, Dhruva A, Cataldo J, Paul SM, Conley YP, et al. Changes in the occurrence, severity, and distress of symptoms in patients with gastrointestinal cancers receiving chemotherapy. J Pain Symptom Manage 2018;55:808 34.

Tantoy IY, Dhruva A, Cataldo J, Venook A, Cooper BA, Paul SM, et al. Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy. J Gastrointest Oncol 2017;8:109 26.

Sullivan CW, Leutwyler H, Dunn LB, Cooper BA, Paul SM, Conley YP, et al. Differences in symptom clusters identified using symptom occurrence rates versus severity ratings in patients with breast cancer undergoing chemotherapy. Eur J Oncol Nurs 2017;28:122 32.

Brooker J, Julian J, Millar J, Prince HM, Kenealy M, Herbert K, et al. A feasibility and acceptability study of an adaptation of the Mindful Self Compassion program for adult cancer patients. Palliat Support Care 2020;18:130 40.

Latifi Z, Soltani M, Mousavi S. Evaluation of the effectiveness of self healing training on self compassion, body image concern, and recovery process in patients with skin cancer. Complement Ther Clin Pract 2020;40:101180.

Haukaas RB, Gjerde IB, Varting G, Hallan HE, Solem S. A randomized controlled trial comparing the attention training technique and mindful self compassion for students with symptoms of depression and anxiety. Front Psychol 2018;9:827.

Bender A, Ingram R. Connecting attachment style to resilience: Contributions of self care and self efficacy. Personality and individual differences 2018;130:18 20.

Sirois FM, Kitner R, Hirsch JK. Self compassion, affect, and health promoting behaviors. Health Psychol 2015;34:661 9.

Fleagle EAC. Self Compassion as a Protective Factor for Caregiver Health and Quality of Life in Family Caregivers of Cancer Patients. Spalding University: ProQuest Dissertations Publishing; 2017. p. 10618780.

Zhu L, Yao J, Wang J, Wu L, Gao Y, Xie J, et al. The predictive role of self compassion in cancer patients’ symptoms of depression, anxiety, and fatigue: A longitudinal study. Psychooncology 2019;28:1918 25.

Brown SL, Hughes M, Campbell S, Cherry MG. Could worry and rumination mediate relationships between self compassion and psychological distress in breast cancer survivors? Clin Psychol Psychother 2020;27:1 10.

Arambasic J, Sherman KA, Elder E, Australia BCN. Attachment styles, self compassion, and psychological adjustment in long term breast cancer survivors. Psychooncology 2019;28:1134 41.


  • There are currently no refbacks.