Religious coping among self-harm attempters brought to emergency setting in India

Instruments for Assessing Spiritual/Religious Coping in Multicultural Clinical Settings

ABSTRACT

A review of literature was conducted to discover and compare various instruments that could be used in daily nursing practice to assess spiritual and religious coping in a variety of multicultural clinical settings. Fifteen spiritual and religious (S/R) instruments were identified, used in 31 studies in multiple countries. These S/R coping tools may be useful to nurses in assessment and for planning interventions.

Religious coping in the time of COVID-19 Pandemic in India and Nigeria: Finding of a cross-national community survey

BACKGROUND

Religious and spiritual coping strategies is one of the possible tools that can be used to deal with stress and the negative consequences of life problems and illnesses. The study aims to assess religious coping in the time of the COVID-19 pandemic.

METHODOLOGY

It was an online survey. The sample was collected using a snowball sampling technique as the data were collected through Google forms. The survey started on 22 April 2020 and was closed on 28 May 2020. The participants were from two countries, India and Nigeria. The inclusion criteria were age between 18 and 60 years, having completed at least 10 years of formal education, and have internet access. For data collection, Semi-structured proforma (demographic and personal characteristics) and Brief RCOPE was used to see the extent to which individuals engage in positive and negative forms of religious coping.

RESULTS

A total of 647 individuals (360 from Nigeria and 287 from India) participated in the survey. A total of 188 (65.5%) participants in India reported no change in their religious activities since they heard about COVID-19, while, 160 (44.4%) in Nigeria reported a decrease in religious activities. Positive religious coping in the Nigerian population was significantly higher than the Indian population. Similarly, negative religious coping was significantly higher (for most of the items in the brief RCOPE) in the Indian population than the Nigerian population.

CONCLUSION

Significant percentages of people after the COVID-19 pandemic took religious coping steps to overcome their problems. During this pandemic, positive religious coping among the Indian and Nigerian communities is more prevalent than negative religious coping. There is a substantial cross-national difference between Indians and Nigerians in the religious coping modes.

Religious Coping During the COVID-19 Pandemic: Gender, Occupational and Socio-economic Perspectives Among Malaysian Frontline Healthcare Workers

Objective

At the dawn of the new decade of the 20th century, the world was taken aback by the scourge of the COVID-19 pandemic. The study aimed to study the nature of religious coping of frontline healthcare workers seen through the perspective of gender, socio-economic status, and occupation.

Methods

An online-based study was carried out among frontline healthcare workers involved in the care of COVID-19 patients (n = 200). Sociodemographic data form and the Brief Religious Coping scale were used in this study.

Results

There were more female healthcare workers (60.5%) and doctors (69.5% vs. 30.5%). Healthcare workers used more positive religious coping than negative religious coping (median score: 22 vs. 9). Positive religious coping was seen more in females (median score: 23 vs. 21, P = .015). Non-doctors applied positive coping more than doctors (median score: 26 vs. 21, P < .001). There were significant differences in positive religious coping scores across income groups, with the B40 group having the highest score (median score: 24). Post hoc pairwise comparison concluded that the B40 group had significantly higher positive religious coping scores than the M40 group.

Conclusion

Positive coping was utilized more among female healthcare workers, nondoctors, and the lowest socio-economic group. As prior literature has shown that positive religious coping is desirable and has superior mental health outcomes, our findings show that more effort should be channeled into enhancing positive religious coping, particularly among male healthcare workers, doctors, and the middle and high socio-economic group.

Religiosity and Spirituality of patients with severe mental disorders

BACKGROUND

Religion and spirituality form an integral part of life, yet have been poorly studied in patients with mental illness.

AIM

This study evaluated the religious and spiritual practices, a sense of purpose/connection, religious/spiritual belief and sense of hope/control among clinically stable patients diagnosed with schizophrenia, bipolar disorder, and depression and compared the same with healthy controls. It also aimed to evaluate the association of residual psychopathology with various dimensions of religiosity and spirituality.

MATERIALS AND METHODS

Patients diagnosed with schizophrenia, bipolar disorder, and major depressive disorder, in a state of clinical remission were assessed on the Spiritual Attitude Inventory and compared with a healthy control group.

RESULTS

A total of 284 participants were recruited, which included patients with major depressive disorder (n = 72), bipolar disorder (n = 75), schizophrenia (n = 63), and healthy controls (n = 74). The groups were matched for age and gender. As compared to healthy controls, participants with any severe mental disorder had significantly lower participation in organized religious activities. In terms of existential well-being, all patient groups had significantly lower scores than the healthy control group. Patients with severe mental disorders significantly more frequently used negative religious coping than the healthy controls and also had lower scores on the sense of purpose. No significant difference was observed between the three patient groups on various dimensions of religiosity and spirituality as assessed in the present study. In patients with schizophrenia, higher use of negative religious coping was associated with greater residual psychopathology.

CONCLUSION

Considering the association of negative religious coping with residual psychopathology, there is a need to incorporate psychological interventions to address religious and spiritual issues for patients with various severe mental disorders.

Psychometric Properties of the Brief Religious Coping Scale (Brief-RCOPE) in Chilean Adults Exposed to Stressful Events

Among the different ways of coping with stress, religious coping has shown particularly the promising results; nonetheless, there are few validated instruments to assess it in non-English language. This article presents the psychometric properties of the Brief Religious Coping Scale (Brief-RCOPE) in Chilean adults exposed to stressful events. The scale shows a reliability, test-retest stability, and confirmatory factor analysis support structural validity. The scale also shows concurrent validity with another measure of religious coping. Finally, confirming predictive criterion validity, negative religious coping predicts posttraumatic stress symptoms 6 months after, but not posttraumatic growth. Positive religious coping was associated with posttraumatic growth enhancement. This study shows Brief-RCOPE as a valid and reliable instrument for measuring religious coping in this population.

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice

BACKGROUND

This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD).

METHODS

Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop).

RESULTS

The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation.

CONCLUSION

Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.

Translation and Adaptation into Hindi of Central Religiosity Scale, Brief Religious Coping Scale (Brief RCOPE), and Duke University Religion Index (DUREL)

BACKGROUND

Religion/religiosity plays an important role in the lives of most Indians. However, there are lack of validated instruments in regional languages to assess the various dimensions of religiosity in the Indian population. This limits evaluation of religion/religiosity and comparison of Indian data with western research for health-related issues.

METHODS

The CRS, BRCOPE, and DUREL scales were translated into Hindi by using the standard translation-back-translation methodology as specified by the World Health Organization. Initially, the Hindi version of each scale was completed by 132 participants, and the second time, participants completed either the Hindi or the English version of the scales after 3-7 days. Data were evaluated for cross-language equivalence, test-retest reliability, internal consistency, and split half reliability.

RESULTS

The Hindi version of CRS, DUREL, and RCOPE had good cross-language equivalence with the English version for all the items and dimensions in all three scales, which was highly significant (P < 0.001). The test-retest reliability was also high for all three scales (Cohen's Kappa value >0.67 for various items and subscales P < 0.001). Cronbach's alpha for the Hindi version of the scales was 0.95, 0.76, and 0.89 for CRS, DUREL, and BRCOPE, respectively. The Spearman-Brown coefficient was 0.89, 0.70, and 0.43 for CRS, DUREL, and BRCOPE, respectively.

CONCLUSION

The Hindi version of CRS, DUREL, and BRCOPE has good cross-language equivalence, internal consistency, split-half reliability, and test-retest reliability. It is expected that availability of these validated versions will provide impetus to research evaluating the association of clinical parameters and religiosity.

Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: A systematic review and meta-analysis

BACKGROUND

Psychiatric disorders are reported to be present in 80% to 90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC.

METHODS AND FINDINGS

PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC that reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on International classification of disease (ICD-10) criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%, China: 15%, and other LMIC: 60%) were identified, including 18 non-English articles. They included 30,030 individuals with nonfatal suicidal behaviour and 4,996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths and between 3% and 86% in those who engaged in nonfatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46%-71%) of those who died by suicide and 45% (95% CI 30%-61%) of those who engaged in nonfatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and nonfatal suicidal behaviour was mood disorder (25% and 21%, respectively). Schizophrenia and related disorders were identified in 8% (4%-12%) of those who died by suicide and 7% (3%-11%) of those who engaged in nonfatal suicidal behaviour. In nonfatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1%-36%) and 11% (7%-16%) of individuals, respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases that mainly indexed English language journals.

CONCLUSIONS

Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focussed interventions.

Comparison of the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in emergency departments of general hospitals in China

BACKGROUND

Major depressive disorder (MDD) is a known major risk factor for suicide due to the high suicide mortality. However, studies comparing the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in China are very limited. This study examined and compared the sociodemographic and psychological characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in emergency departments of general hospitals to better understand the risk factors for suicide attempts in China.

METHODS

All subjects were enrolled in the study between June 2007 and January 2008. A total of 127 suicide attempters-54 with MDD and 73 with no psychiatric diagnosis-were enrolled. The sociodemographic and clinical characteristics were compared between two groups using the statistical analysis performed using frequency distribution, Student's t test, Chi-square test, and Fisher's exact test and a logistic regression model.

RESULTS

Suicide attempters with MDD were more likely to be more depressive, older, divorced or separated, unemployed, and living alone, and more likely to write a suicide note, have suicide ideation, and be motivated by reducing pain and burden. Suicide attempters with no psychiatric diagnosis were more likely to be younger and more impulsive, have self-rescue, and be motivated by threatening or taking revenge on others. Multivariate logistic regression analysis identified the following independent predictors of suicide attempts in individuals with MDD: a lower score on the quality of life scale, more years of education, and suicide ideation.

CONCLUSIONS

The present study found both similarities and differences in the sociodemographic and clinical characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in the emergency departments of general hospitals in China. These findings will help us to recognize the characteristics of suicide attempters in both groups and develop specific interventions for the two types of suicide attempters to prevent future suicide in China. For example, the suicide attempters with MDD in the emergency departments must be advised to the psychological clinic.