Assessing adolescent spiritual health and well-being (commentary related to Social Science & Medicine - Population Health, ref: SSMPH-D-15-00089)

Effects of Lymphaticovenous Anastomosis on Quality of Life, Body Image, and Spiritual Health in Lymphedema Patients: A Prospective Cohort Study

BACKGROUND

Lymphedema is a debilitating condition that significantly affects quality of life due to its chronic nature and visible symptoms. Lymphaticovenous anastomosis (LVA) has emerged as a promising surgical intervention, yet its effects on body image and spiritual health alongside physical symptoms have not been thoroughly examined. This study evaluates the efficacy of LVA in improving symptoms, quality of life (QOL), body image, and spiritual well-being in lymphedema patients.

METHODS

A prospective cohort study was conducted at Kaohsiung Chang Gung Memorial Hospital, Taiwan, involving 44 patients with lymphedema undergoing LVA surgery. Evaluations were made pre-surgery, one month post-surgery, and six months post-surgery using the 36-Item Short Form Health Survey (SF-36), Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and a spiritual health scale. Statistical analysis was performed using one-way repeated measures ANOVA.

RESULTS

Significant improvements were observed in lymphedema symptoms and QOL measures at six months post-operation. SF-36 results showed enhanced scores in nearly all domains, particularly in physical functioning and role-physical. The appearance orientation scores from the MBSRQ-AS significantly increased, indicating improved perceptions in some dimensions of body image.

CONCLUSIONS

LVA surgery significantly enhances physical and psychological outcomes in patients with lymphedema, with marked improvements in symptoms, QOL, and body image perceptions. The findings suggest that while LVA is effective in addressing the physical and psychological aspects of lymphedema, it does not impact spiritual dimensions. This underscores the need for holistic approaches in the management of lymphedema to address all facets of patient well-being.

Spiritual Health and Its Determinants Among Urban Adolescents in Northern India: A Cross-Sectional Survey

INTRODUCTION

Spiritual health is an important dimension of positive health and is often ignored as it is not amenable to measurement. The present study was conducted to generate relevant evidence on spiritual health among adolescents living in urban areas of Northern India.

METHODS

A cross-sectional study was done from June 2019 - May 2020 in an urban area of Northern India on a sample of 300 adolescents selected purposively. After collection of demographic details of the participants, the Index of Core Spiritual Experiences (INSPIRIT) tool was used to capture their spiritual health.

RESULTS

The Cronbach's alpha for the scale was 0.832 (0.797-0.863) indicating good internal consistency of the measure. As far as spiritual health is concerned, 217 (72.3%) of the study participants scored medium-high to high, followed by 83 (27.7%) who scored medium-low to low on the spiritual health scale. Adjusted multivariate analysis using binary logistic regression showed that positive traits like caring (odds ratio (OR) 1.19, 95% CI: 1.08-1.33), connection to school (OR 1.16, 95% CI: 1.04-1.29), having positive identity (OR 1.19, 95% CI: 1.04-1.36) and having highly educated (post-graduate) parents (OR 2.18, 95% CI: 1.13-4.21) lead to significantly higher spiritual health scores.  Discussion: Although spiritual health is not routinely measured among adolescents, the current study demonstrated high levels of spiritual health among half of the urban adolescents. Parental education was found to have a positive association with spiritual health scores, indicating the indirect effect of parental spiritual inclination. The study has important implications for policy, as it demonstrates the feasibility of measuring a covert dimension of health which tends to have an indirect effect on holistic youth development.

Spiritual Well-Being and Related Factors in Children With Cancer

Introduction: There are specific gaps that call for empirical research in the experiences of spiritual well-being among children 12 years old and younger with cancer. Understanding these relationships can help to develop holistic and family centered care in pediatric oncology wards. This study assessed the spiritual well-being of children with cancer in association with their general well-being, happiness, quality of life, pain intensity, and personal characteristics. Method: The data were collected in Lithuania between June 2020 and November 2021. Children with cancer (N = 81) who were hospitalized at pediatric oncology-hematology centers participated in the study. Inclusion criteria were age (from 5 to 12 years old), diagnosis of oncologic disease for the first time, and absence of other chronic diseases. The instruments used were: Feeling Good, Living Life; Oxford Happiness Questionnaire, Short Form; Well-Being Index; PedsQL™3.0 Cancer Module, and a Wong-Baker FACES® Pain Rating Scale. Results: Communal and personal domains of spiritual well-being had the highest scores among pediatric oncology patients while both dimensions of the transcendental domain scored lowest. Age, level of education, and family composition revealed differences in children's spiritual health, happiness, and well-being, and church attendance was significant for overall spiritual well-being and its transcendental domain on lived experience dimension. Happiness had the strongest effect on all four domains of spiritual well-being. Discussion: Children emphasized the importance of spiritual aspects to feel better to a greater extent than they experienced in their lives. Despite their young age, children were familiar with family traditions, that is, religious practice and church attendance, and followed them in a particular sociocultural context.

Domains of spirituality and their importance to the health of 75 533 adolescents in 12 countries

Spirituality is an ancient concept with many contemporary applications to the field of health promotion. While recognized in the UN Convention on the Rights of the Child as a basic human right, definitional misunderstandings about what spirituality is, and is not, and the mechanisms by which it affects the health of young people, remain. In this cross-national analysis involving >75 000 adolescents from 12 countries, we examined the relative importance of each of four spiritual health domains (connections to self, others, nature and the transcendent) in the lives of young people, and how these connections relate to a standard indicator of positive mental health status. Descriptive and applied regression analyses confirmed two major findings: (i) boys and girls in all 12 countries ranked the importance of each of the four domains in the same order, with 'connections to self' identified as most important; and (ii) both direct and indirect pathways are evident that connect the remaining three domains to positive mental health status, but through strong connections to self. Based on our scale items, fostering a strong connection to self, which involves cultivating a sense of meaning, purpose and joy in the lives of adolescents, appears most fundamental to fostering optimal mental health. This may be achieved directly or, dependent upon context and culture, indirectly with emphasis on the connections afforded by the other three domains. Such findings provide important insights to guide the content of adolescent health promotion interventions.

Feeling Good, Living Life: Evaluation of Psychometric Properties of the Slovak Version in Children Age 8-11 Years

The aim of this study was to psychometrically evaluate the feeling good, living life questionnaire (FGLL) in Slovak children. Specifically, we aimed to assess the internal consistency and several proofs of the measure of the construct validity. The sample consisted of 454 children in grades 3-5, age 8-11 (mean age = 9.85, 48% boys) from state (N = 256) and Catholic school (N = 198). The internal consistency of the FGLL was assessed using Cronbach's alpha (α). Confirmatory factor analysis (CFA), correlation analysis (Pearson and Spearman r) and nonparametric Mann-Whitney U test were used to verify multiple proofs of the construct validity. The values of Cronbach's alpha, apart from the scale "Relationship with Self," show satisfactory internal consistency (α = 0.68-0.84). The results of the CFA support factor structure of both parts of the Slovak version of FGLL. Further proof of the construct validity was provided by significant interscale correlations. Depending on the type of school, there were no significant differences in the scale "Relationship with God." Slovak version of FGLL is suitable for measuring spirituality or spiritual well-being of children age 8-11 years.

Domains of spirituality and their associations with positive mental health: a study of adolescents in Canada, England and Scotland

Spirituality is a concept with ancient roots yet contemporary relevance to mental health. Its assessment in populations of young people, however, remains an immense challenge. Efforts to perform such assessments typically involve use of unidimensional scales incorporating items related to four domains (connections to "self", "others", "nature", and the "transcendent"). For adolescents, it remains unclear whether these domains equally influence mental health, or if one domain is particularly important. Here we analyzed reports from adolescents who participated in the 2014 Health Behaviour in School-aged Children (HBSC) study conducted in Canada (n = 21,173), England (n = 4339) and Scotland (n = 5603). Reports of positive mental health were modelled as a function of ordinal scores describing each spiritual health domain, controlling for age, the other domains, and potential confounders. Subsequent analyses focused on the centrality of connections to "self" in these relationships. We identified strong and consistent associations between positive mental health and higher scores for each of the four spiritual health domains. In fully adjusted models, these effects were diminished or changed direction for connections to "others", "nature", and the "transcendent", while the positive association with "connections to self" remained. While associations exist between each of the four domains of spiritual health and positive mental health, it appears that associations with connections to "others", "nature", and the "transcendent" are sometimes mediated by connections to "self". Implications for assessment, models and related interventions and health promotion strategies, based on the idea that inner connections may be central to the protective effects of spiritual health, are considered.

Spiritual Well-Being in Cancer Patients Undergoing Chemotherapy in an Outpatient Setting: A Cross-Sectional Study

Purpose: To assess the spiritual well-being (SWB) of cancer patients undergoing chemotherapy in an outpatient setting. Method: Quantitative, cross-sectional, and descriptive study. A convenience sample of 150 participants was obtained. Data collection instrument was a self-reported questionnaire that included the SWB Questionnaire (SWBQ), whose scores range from 20 to 100. SPSS software, version 21, was used in data analysis. The study was approved by the institutional ethics committee. Results: Patients’ ages ranged between 35 and 83 years; most were female (64.7%), married (68.0%), Catholic (86.7%), and with breast cancer (35.3%) and colorectal cancer (25.3%). The average SWBQ total score was 65.91 ( SD = 12.177). The highest score of the SWBQ was obtained in females, widows and singles, Evangelic and Catholic, and with lower educational level and professional occupation. The Cronbach α was 0.89, and the subscales αs ranged between 0.78 and 0.94. Conclusion: The SWBQ scores were reasonable. These results can guide nurses’ clinical reasoning, as the assessment of SWB may precede the diagnosis of risk for spiritual distress, readiness for enhanced SWB, or spiritual distress. Thus, the use of this instrument may facilitate spirituality being effectively implemented in clinical practice, favoring holistic health care.

Prediction of the Dimensions of the Spiritual Well-Being of Students at Kermanshah University of Medical Sciences, Iran: The Roles of Demographic Variables

INTRODUCTION

Spiritual well-being is one of the aspects of well-being which organize the physical, psychological, and social aspects. Given the outstanding and unique roles of students in society, providing spiritual well-being as well as identifying and eliminating the negative factors affecting their mental well-being are of the essence.

AIM

The present study aimed to predict the dimensions of the spiritual well-being of students at Kermanshah University of Medical Sciences and to investigate the roles of demographic variables in this respect.

MATERIALS AND METHODS

In this descriptive and correlational study, the statistical population was comprised of 346 doctoral students in the for-profit Schools of Medicine, Dentistry and Pharmaceuticals in Kermanshah University of Medical Sciences in 2016. For data collection, an instrument comprising the demographic questions and the 20-item spiritual well-being scale by Paloutzian and Ellison (1982) was utilized. To analyze data, the descriptive (frequency distribution, mean, and standard deviation) and inferential statistics (independent t-test, one-way ANOVA, and chi-squared test) were employed in the SPSS Statistics Software Version 21.0.

RESULTS

The results of the present study demonstrated that the spiritual well-being of students was average (71.86±4.84), and of all demographic variables under study, only the variable of gender significantly correlated with the mean score of spiritual well-being. Also, the results revealed that the students' score of religious well-being measured higher than that of their existential well-being. However, a significant correlation was found between spiritual well-being and its dimensions. Also, the religious and existential well-being were found to be significantly related (p<0.05).

CONCLUSION

The results of the present study showed the significance of addressing the issue of spirituality among the students of the for-profit Schools at Kermanshah University of Medical Sciences. Therefore, it is recommended that appropriate plans be laid by the culture and education policy makers to promote the spiritual well-being of university students.