En las manos de Dios [in God's hands]: Religious and other forms of coping among Latinos with arthritis

From maca to marijuana: cultural influences on joint pain symptoms and management in urban perimenopausal and early postmenopausal Latinas

OBJECTIVE

The purpose of this qualitative study was to explore the symptom experience and coping strategies for managing joint pain during the menopause transition in urban Latina women.

METHODS

We conducted focus groups with 13 English-speaking peri and early postmenopausal Latinas living in Upper Manhattan in New York City in 2014. Eligible participants were self-identified Latinas aged 45 to 60 years with new onset or worsening joint pain and spontaneous amenorrhea, recruited through flyers and snowball sampling. Focus group interviews conducted in English were audiotaped, transcribed, and analyzed by a bilingual research team, using NVivo software (QSR International) to organize and code themes.

RESULTS

On average, participants were aged 51.7 ± 4.8 years and overweight (body mass index of 29.3 ± 6.7 kg/m2); 10 (76.9%) were Puerto Rican, and the last menstrual period was 1 month to 5 years ago. The following four themes emerged: 1) menopause and joint pain are an alarming package; 2) pain disrupts life and livelihood; 3) medical management is unsatisfactory and raises worries about addiction; and 4) home remedies for coping with pain-from maca to marijuana. Despite access to a world-class medical facility in their neighborhood, women seeking pain relief preferred to self-manage joint pain with exercise, over-the-counter products, and other culturally valued home remedies. Many suffered through it.

CONCLUSIONS

For midlife Latinas, joint pain symptoms may emerge or worsen unexpectedly as part of the menopause transition and carry distressing consequences for daily activities and quality of life. There is a need to develop more culturally specific approaches for menopause-related pain management in this underserved population.

Adaptive coping strategies among individuals living with long-term chikungunya disease: a qualitative study in Curaçao

OBJECTIVE

Long-term chikungunya disease is characterised by persistent rheumatic symptoms following chikungunya virus infection. As there is no specific treatment available, affected individuals need strategies to adapt. However, research on these is scarce. This study aimed to explore which adaptive coping strategies are employed to manage persistent rheumatic symptoms in daily life.

SETTING

The study was conducted in Curaçao.

DESIGN AND PARTICIPANTS

An explorative qualitative study was conducted between September and October 2020, among a purposive sample of adults, 19 women and 4 men affected by long-term chikungunya disease. In-depth interviews were semi-structured and transcribed verbatim. The data were analysed using inductive thematic analysis.

RESULTS

The disease duration for all participants ranged between 68 and 74 months (6 years). In narrating their experiences of coping with long-term chikungunya disease, four themes were identified: (1) learning to live with the disease; (2) resilience for dealing with pain; (3) maintaining positive self-image and attitude; and (4) coping through spirituality.

CONCLUSION

To live with long-term chikungunya disease with dignity in spite of physical pain and discomfort, participants tried to retain a sense of control of oneself and one's lives, to not let the disease take over, focusing on the positive in their lives, and finding strength and remain hopeful. Interventions such as cognitive-behavioural therapy and mindfulness exercises may be effective in strengthening or regain affected individual's sense of competence and control by fostering adaptive coping skills and resilience. Subsequently, these interventions may improve health-related quality of life when rheumatic symptoms persist following chikungunya virus infection.

Mental Health and Well-Being in Racial or Ethnic Minority Individuals After Using a Faith and Prayer Mobile App (Pray.com): Feasibility and Preliminary Efficacy Trial

BACKGROUND

Research is needed on how faith and prayer apps fit within the values of racial and ethnic minority (REM) groups, as well as whether such apps are effective in promoting mental health and well-being.

OBJECTIVE

This study aims to determine the feasibility and preliminary effectiveness of using the mobile app Pray.com on mental health and well-being among REM participants.

METHODS

This study was a single-group (N=77), 4-week feasibility trial in REM groups (65/77, 84% Black or African American). Participants were asked to use the Pray.com app at no cost for at least 5 times per week for 5 minutes per day. Participants completed questionnaires at the baseline and postintervention time points. Feasibility questionnaires were only completed at the postintervention time point, including qualitative interviews (n=15). The feasibility questions included acceptability (ie, satisfaction, intent to continue use, perceived appropriateness, and fit within culture), demand (ie, self-reported app use, expressed interest, and perceived demand), and practicality (ie, ease or difficulty of use, ability to use the app, and cost-effectiveness). Frequency and descriptive statistics were used to analyze feasibility outcomes. Changes in dependent variables were analyzed using paired-sample 2-tailed t tests. Partial correlations were conducted to explore the association between app use and outcomes, controlling for baseline scores.

RESULTS

Participants reported (54/72, 75% responded with "very likely" or "likely" to the feasibility questions) that they perceived the Pray.com app as acceptable. These findings were supported by qualitative interviews (n=15). Most participants (62/72, 86%) did not meet the app use prescription but expressed interest in using the app in the future and perceived demand for it in their communities. In addition, participants reported that the app was easy to use and perceived it to be inexpensive (US $7.99). Participants reported improved mental health (ie, stress and depressive and anxiety symptoms) and well-being (ie, satisfaction with life, spiritual well-being, religious commitment, and racial or ethnic identity development) at postintervention despite relatively low average levels and high variability of app use (average total of 45.83, SD 111.90 min over the course of the study). Greater app use was significantly associated with improvements in mental health and spiritual well-being. However, app use and study methodology limitations suggest that the study results may not accurately capture the full impact of Pray.com use.

CONCLUSIONS

This is the first study to assess the feasibility of a faith and prayer app for mental health and well-being in a sample of REM individuals. Our findings suggest that the use of a faith and prayer app (ie, Pray.com) could be feasible and significantly impactful for the improvement of mental health symptoms and well-being in REM individuals and their communities, especially Black and African American individuals with a Christian affiliation. Further research is warranted.

A Latent Class Analysis of Personal Coping Resources and Depressive Symptoms Among Middle-Aged and Older Latinx Adults

Objectives: To identify coping profiles and evaluate their implications for depressive symptoms among Latinx adults. Methods: Data come from a community-dwelling sample of Latinx adults ages 45+ in Florida (N = 461). Latent class analysis was used to identify profiles of personal coping resources based on patterns across spirituality (spiritual coping, divine fate), ethnic identity (centrality, connectedness), and personal control (mastery, self-esteem). Multivariable linear regression assessed differences in depressive symptoms across coping resource classes. Results: Four coping resource profiles were identified: (1) low resources overall, yet high spiritual coping; (2) high spirituality and personal control; (3) high spirituality and ethnic identity; and (4) high resources overall. Members of Class 4 had significantly fewer depressive symptoms than members of Class 1 and Class 3, controlling for sociodemographic characteristics, p < .001. Discussion: Results elucidate nuances in personal coping resources among aging Latinx adults, identify under-resourced groups, and suggest that resource profiles characterized by few personal coping resources are linked with more depressive symptoms. Findings clarify the underpinnings of the latent coping construct and have implications for mental health promotion interventions among aging Latinx adults.

Hope for Latino immigrant youth: A longitudinal test of Snyder's Children's Hope Scale

Objective

To examine the psychometric properties of Snyder's Children's Hope Scale (CHS) with first- and second-generation Latino immigrant youth, using item response theory, exploratory and confirmatory factor analysis, and measurement invariance tests.

Background

Stress experienced by youth in 2020 has heightened interest in resilience factors such as hope. The CHS is widely used to measure hope but has not been validated for longitudinal assessments with immigrant populations.

Methods

Participants were 233 low socioeconomic status first- and second-generation Latino immigrant youth (50.43% female, 62% U.S.-born, and 81% of Mexican heritage). Data were collected at two timepoints spanning 4 weeks.

Results

Rather than the original six-item two-dimensional scale, our results supported a four-item one-dimensional scale, with excellent model fit, strong invariance across time, by gender and generation status, good reliability (α = .81), and the expected negative association with stress.

Conclusions

The four-item Hope scale is suitable for longitudinal assessments with first- and second-generation Latino immigrant populations and can be used for examining differences by gender and generation status in research and practice to assess youth resilience.

Implications

This study underscores the need for practitioners and researchers to rigorously investigate the psychometric properties of a measure before its use with diverse populations.

Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: a mediation analysis

OBJECTIVES

Few data are available on the role of emotional distress as a possible mediator of the relationship between coping strategies and the Patient Global Assessment (PGA). This study aims to investigate, in a large cohort of patients affected by RA, the relationship between specific copying strategies and PGA, and the role of emotional distress as a mediator.

METHODS

A total of 490 patients with RA completed a set of standardized assessments including the self-reported PGA, the Coping Orientation to the Problems Experienced (COPE-NVI) and the Hospital Anxiety and Depression Scale (HADS). A mediation analysis was conducted to investigate the role of emotional distress.

RESULTS

The effect of coping strategies on the PGA score was significantly mediated by the emotional distress for religious (total effect mediated 42.0%), planning (total effect mediated 17.5%), behavioural disengagement (total effect mediated 10.5%), and focus on and venting of emotions (total effect mediated 9.8%). Seven coping strategies (acceptance, positive reinterpretation and growth, active coping, denial, humour, substance use-mental disengagement) resulted directly associated to PGA total score, but no mediation effect was found. The remaining four coping strategies were not associated to the PGA score.

CONCLUSION

This study suggests that coping strategies could be an important factor in the perceived disease severity. Consequently, in order to reduce PGA in patients with RA, a useful tool could be represented by the implementation of psychological interventions aiming to modify the specific coping styles. Moreover, to prevent or treat emotional distress seems to further reduce PGA.

A Content Analysis of the Counseling Psychology Literature on Religiousness and Spirituality

This study reviewed the literature on religiousness and spirituality (RS) published in three major journals in counseling psychology. We aimed to evaluate (a) the content and methods of RS research and (b) operational definitions of RS constructs and suggestions for research and practice. At Level 1, we reviewed 901 articles that included an RS related word(s) anywhere in the article. At Level 2, we further analyzed 108 empirical studies and 31 conceptual articles that included RS as a study variable or a primary topic. Both quantitative and qualitative (i.e., thematic analysis) methods were used for data analysis. To summarize the key findings, major topics related to RS included mental health, wellbeing, LGBTQ experiences, help-seeking, counseling process, eudaimonic wellbeing, identity, discrimination, and minority stress. Religiousness and spirituality tended to be defined in a dichotomous way. We suggest future directions for research, practice, advocacy, education, and training, building on the holistic, multicultural, and positive premises of counseling psychology.

A Protective Canopy: Religious and Social Capital as Elements of a Theory of Religion and Health

In order to help fill the gap in midrange theory for the religion-health connection, this paper reviews relevant literature on religious capital as well as social capital, a concept with which religious capital is sometimes incorrectly conflated. It identifies elements and mechanisms for each type of capital, including both quality and quantity, and describes evidence for their relationship with health. Expanding, unifying, and integrating these theoretical elements can help better understand the underlying mechanisms of the relationship between religion and health, with concomitant policy implications such as faith-based interventions as well as spur additional research on the topic.

Religious Beliefs About Health and the Body and their Association with Subjective Health

Evidence supports an association between religion and spirituality and health outcomes. The aim of this study is to examine religious beliefs related to health and their relationship to self-rated health in a large and diverse population-based sample in Chicago. Three religious beliefs were assessed-the importance of prayer for health, God's will as the most important factor in getting well, and sanctity of the body. All three beliefs were highly prevalent, especially among racial/ethnic minorities. Unadjusted models showed a significant association between two of the beliefs and self-rated health, which did not persist in the adjusted models. This study provides insight into different belief patterns among racial/ethnic groups and has practical implications for both clinicians and public health practitioners.

Depressive symptoms faced by non-native international medical students in China during COVID-19

This study examines depressive symptoms faced by non-native international medical students studying in China during the COVID-19 pandemic. The targeted population for this cross-sectional study included non-native medical students studying in Chinese universities. This study used convenience sampling. An online, self-administered questionnaire was distributed to international medical students studying in Chinese universities from February 2020 to June 2021. The questionnaire collected demographic data, information regarding struggles faced, and used the CES-D-10 Likert scale to assess both the challenges and depression symptoms, respectively. By analyzing the 1,207 students’ responses, the study found that students with poor Chinese language were two times more likely to suffer from depressive symptoms (OR = 2.67; value of p 0.00). Moreover, female students were found more prone (76.35%) than their male counterparts (44.96%). The study found that food adaptability, health issues, accommodation issues, and financial issues were related factors contributing to depressive symptoms among non-native international medical students during the COVID-19 pandemic. The study tried to highlight the factors that resulted in depressive symptoms among non-native international medical students, and the findings may help diplomatic representatives take necessary actions to help their citizens during this difficult time.

Trusting in God: Religious and Spiritual Support in Mental Health Treatment Expectations in Mexico

Religious and spiritual practices have been identified as a main source of mental health support for Latinxs to improve overall health and well-being. This qualitative secondary data analysis sought to elucidate how Mexican patients and family members engaged in religious and spiritual practices to help alleviate patients' experiences of mental illness. Three main findings are discussed: (1) positive religious coping such as entrusting God with one's suffering, consejos (i.e., emotional support and advice giving), and positive social supports through religious communities; (2) negative religious coping such as harmful views of God as punishing; and (3) indigenous healing practices such as engagement with curanderos (medicine doctor) and limpias (i.e., herb-based cleanses). The authors discuss these findings in the context of tensions between culturally sanctioned healing and the perception of psychotherapeutic effectiveness reported by Mexican patients and their family members. The authors also provide future directions for incorporating patients' religious and spiritual practices into multiculturally competent treatment.

More Prosocial, More Ephemeral? Exploring the Formation of a Social Entrepreneur's Exit Intention via Life Satisfaction

This study was designed to test if satisfaction with health and personal financial wellbeing mediates the relationship between prosocial motivations and exit intentions among social entrepreneurs. Using a sample of 317 social entrepreneurs, the partial least square structural equation modeling (PLS-SEM) revealed that prosocial motivation decreased the financial satisfaction of entrepreneurs, which increased their exit intentions. However, health satisfaction did not have a mediating effect on the relationship between prosocial motivation and exit intention. Moreover, adopting the multi-group analysis (MGA) technique, we found that the negative impact of prosocial motivation on financial satisfaction was stronger for males than for females, suggesting male entrepreneurs were more likely to experience lower financial satisfaction caused by prosocial motivation than female entrepreneurs. There was no evidence that gender moderated the relationship between prosocial motivation and health satisfaction.

Examining the association between religiosity and medical mistrust among churchgoing Latinos in Long Beach, CA

Medical mistrust among racial/ethnic minorities has been associated with decreases in health care utilization, whereas religiosity has been separately linked with increases in this behavior. However, very few studies have examined the relationship between religiosity and medical mistrust among Latinos, a group with strong religious connections and potentially high mistrust. In-person, self-administered surveys were collected among 767 adult Latinos attending three Latino churches (one Catholic and two Pentecostal) in Long Beach, CA. Measures included a previously validated 12-item medical mistrust scale, religiosity (religious denomination, length and frequency of attendance, and number of groups or ministries involved in), health care access, and sociodemographic factors. Medical mistrust score was 2.47 (standard deviation [SD] = 0.77; range 1-5). Almost two-thirds of participants (62%) attended religious services frequently (once a week or more), and the majority attended a Catholic church (80%). About half of the participants had attended their church for ≥5 years (50%) and participated in one to two church groups or ministries (53%). Multivariable analyses show that Pentecostal church congregation and those identifying as Mexican/Chicano were negatively associated with medical mistrust. On the contrary, participating in church groups or ministries and having an immigrant parent were positively associated with medical mistrust. Our findings suggest that church-based health initiatives should consider church denomination, length of attendance, participation in groups or ministries, and ethnic differences to address medical mistrust issues among Latino congregants.

Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder

LAY ABSTRACT

Little is known about parent experiences throughout the diagnostic process for autism or how these parent experiences may help explain the disparities that exist between Hispanic and non-Hispanic families in time-to-diagnosis among children identified as at risk for autism. The current study examined trajectories of parenting stress, coping, and perceived family impact over time, throughout the autism diagnostic process among Hispanic and non-Hispanic families. Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time. These differences shed light on the unique experiences and strengths of Hispanic families demonstrate. Interventions that leverage those strengths and focus on education, empowerment, and resilience might be particularly beneficial for Hispanic families and may also better inform work to increase resilience.

Influence of resilience on the relations among acculturative stress, somatization, and anxiety in latinx immigrants

OBJECTIVE

In cultures where psychological distress is stigmatized, the presentation of emotional distress as somatic complaints is a frequent occurrence. Understanding factors that contribute to the presentation of somatization in Latinx immigrants is crucial due to its tie to poor quality of life. The purpose of this study was to explore relations among acculturative stress, anxiety, somatization, and resilience in a sample of Latinx immigrants living in the United States.

METHODS

Data were collected from 204 Latinx immigrants across diverse community settings.

RESULTS

Acculturative stress was positively related to both anxiety and somatization, and the relation between acculturative stress and somatization occurred through anxiety. Resilience moderated the relations between acculturative stress and somatization, and between anxiety and somatization.

CONCLUSION

This study suggests that Latinx immigrants presenting with somatic symptoms may benefit from the examination of a possible comorbid presentation of anxiety or acculturative stressors. An integrated behavioral healthcare approach is recommended when working with Latinx immigrants evaluating the impact of minority stressors on health. Clinicians are encouraged to incorporate cultural protective factors that reinforce the development and sustenance of resilience.

How does art making work? Testing the hypothesized mechanisms of art making on pain experience

BACKGROUND

Pain is a multidimensional experience that requires a holistic pain management approach. Art making, a holistic, mind-body-spirit approach, has been used as a pain management strategy. Although findings of empirical studies point toward several potential mechanisms through which art making activity may affect the pain experience, these mechanisms have not yet been tested. Therefore, the purpose of this study is to evaluate whether perceived control, self-efficacy, spirituality, and mood mediate the effect of art making activity on pain.

MATERIALS AND METHODS

This study is a secondary analysis of cross-sectional survey data collected in 2014 for the Health and Retirement Study (HRS). Data from a national sample of 731 adults, 50 years of age or older were analyzed for the current study. Participants completed a health survey which included measures of art engagement (representing 'effect of art making' in this study), pain severity and interference, and proposed mediating variables (e.g., perceived control, self-efficacy, spirituality and mood). The joint significance test was used to test hypothesized mediation.

RESULT

We found that positive mood mediated the effects of art engagement on pain, but perceived control, self-efficacy, spirituality, and negative mood did not. Engagement in art making activity was associated with more positive mood (β = 0.213, p = .001). In turn, greater positive mood was associated with lower pain severity (β = -.147, p = .010) and pain interference (β = -.519, p = .034).

CONCLUSION

Results of this study provide preliminary evidence that engagement in art making activity impacts pain experience by enhancing positive mood. A large prospective study examining the hypothesized mediating relationship is necessary to confirm our findings.

Neighborhood and health-related outcomes: a study of adult Latinas of Caribbean and South and Central American descent in Miami

The present study investigated neighborhood effects on substance use, mental and medical health, and health-care access. We used data collected from a sample of adult Latinas of Caribbean and South and Central American descent in 2011. The findings indicate that for adult Latinas, concentrated disadvantage in neighborhoods is associated with increased risk of alcohol misuse and inability to obtain prescription drugs due to lack of money, while Hispanic/immigrant concentration in neighborhoods is associated with fewer mental disorder symptoms. Individual age, criminal justice involvement, religious involvement, intimate partner violence, and employment are also associated with one or more health-related outcomes. We provided practice implications for macro and micro social work practice. Future research is needed to examine the mechanism underlying the negative association between neighborhood Hispanic/immigrant concentration and mental disorder symptoms.

Longitudinal associations between marianismo beliefs and acculturative stress among Latina immigrants during initial years in the United States

Acculturative stress is commonly experienced among Latinx immigrants in the United States who may feel pressured to maintain their heritage cultural norms and beliefs and/or adopt norms and beliefs of the dominant culture. The present study examined longitudinal relations between acculturative stress and endorsement of traditional Latina gender role beliefs (i.e., marianismo). We determined strength of the relations and temporal precedence of acculturative stress and endorsement of marianismo across 3 time points during participants' initial 3 years in the United States using a random intercept cross-lagged panel model. Participants were 530 Latina young adult women (ages 18-23) recruited from Miami-Dade County, Florida. Results suggested that acculturative stress levels at Time 1 positively predicted endorsement of the Family Pillar belief at Time 2, but acculturative stress levels at Time 2 negatively predicted the Virtuous and Chaste and Subordinate to Others beliefs at Time 3. In terms of marianismo beliefs predicting acculturative stress levels over time, the Virtuous and Chaste belief at Time 1 positively predicted acculturative stress at Time 2, and the Silencing Self to Maintain Harmony belief at Time 2 positively predicted acculturative stress at Time 3. Findings suggest that the Family Pillar belief, or feeling responsibility for the family's unity, may be protective against acculturative stress over time. Endorsing certain gender role beliefs (i.e., Virtuous and Chaste, Subordinate to Others) may lead to greater acculturative stress, and Latina young adult women experiencing acculturative stress may alter their endorsement of marianismo beliefs in an attempt to resolve culturally conflicting stress experienced after immigration. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Racial and ethnic differences in the experience and treatment of noncancer pain

The burden of pain is unequal across racial and ethnic groups. In addition to racial and ethnic differences in the experience of pain, there are racial and ethnic disparities in the assessment and treatment of pain. In this article, we provide a nonexhaustive review of the biopsychosocial mechanistic factors contributing to racial and ethnic differences in both the experience and treatment of pain. Using a modified version of the Socioecological Model, we focus on patient-, provider- and system-level factors including coping, perceived bias and discrimination, patient preferences, expectations, patient/provider communication, treatment outcomes and healthcare access. In conclusion, we provide psychosocial factors influencing racial and ethnic differences in pain and highlight future research targets and possible solutions to reduce these disparities.

Immigration Stress among Recent Latino Immigrants: The Protective Role of Social Support and Religious Social Capital

Religious institutions can be a source of support for recent Latino immigrants struggling to adjust to a new culture. For undocumented immigrants, who are often marginalized from other formal institutions, they may symbolize a place of refuge and hope through supportive social networks that mitigate common challenges such as social isolation and other forms of immigration stress. This cross-sectional study examined the impact of religious social capital and social support on immigration stress among documented and undocumented recent Latino immigrants (N = 408). Religious social capital was associated with higher levels of social support, while social support was protective against immigration stress. Social support mediated associations between religious social capital and immigration stress, but only among undocumented immigrants. Findings suggest religious social capital may be a particularly useful resource for undocumented immigrants, aiding in the provision of social support and in decreasing levels of immigration stress. Future research directions and implications for culturally tailored service delivery are presented.

Social support and post-traumatic growth among a sample of arthritis patients: Analysis in light of conservation of resources theory

The study examined the association between social support dimensions and post-traumatic growth (PTG) among a sample of arthritis patients. In particular, we wanted to verify the mediating role of resources, as described by the Conservation of Resources (COR) theory, on the aforementioned relationship. A total of 207 patients with a clinical diagnosis of arthritis were recruited to participate in the study, including 149 females and 58 males. This was a cross-sectional study, with PTG evaluated by the Post-Traumatic Growth Inventory (PTGI) and social support assessed via the Berlin Social Support Scales (BSSS). To assess the level of subjectively possessed resources among participants, we used the COR evaluation questionnaire (COR-E). Provided support, but not received support, was positively related to the level of PTG among participants. In addition, the level of spiritual resources mediated the aforementioned relationship. The results of this contribute to the literature on the psychological aspects of arthritis. It seems that providing support may be related to positive consequences among arthritis patients, in the form of PTG, with spiritual resources being of significant value in this process.

Religious Involvement, Anxiety/Depression, and PTSD Symptoms in US Veterans and Active Duty Military

Religious involvement is associated with mental health and well-being in non-military populations. This study examines the relationship between religiosity and PTSD symptoms, and the mediating effects of anxiety and depression in Veterans and Active Duty Military (V/ADM). This was a cross-sectional multi-site study involving 585 V/ADM recruited from across the USA. Inclusion criteria were having served in a combat theater and PTSD symptoms. Demographics, military characteristics, and social factors were assessed, along with measurement of religiosity, PTSD symptoms, depression, and anxiety. Bivariate and multivariate analyses examined the religiosity-PTSD relationship and the mediating effects of anxiety/depression on that relationship in the overall sample and stratified by race/ethnic group (White, Black, Hispanic). In bivariate analyses, the religiosity-PTSD relationship was not significant in the overall sample or in Whites. However, the relationship was significant in Blacks (r = - 0.16, p = 0.01) and in Hispanics (r = 0.30, p = 0.03), but in opposite directions. In the overall sample, religiosity was inversely related to anxiety (r = - 0.07, p = 0.07) and depression (r = - 0.21, p < 0.0001), especially in Blacks (r = - 0.21, p = 0.001, and r = - 0.34, p < 0.0001, respectively); however, in Hispanics, religiosity was positively related to anxiety (r = 0.32, p = 0.02) as it was to PTSD symptoms. When anxiety/depression was controlled for in multivariate analyses, the religiosity-PTSD relationship in the overall sample reversed from negative to positive, approaching statistical significance (B = 0.05, SE = 0.03, p = 0.079). In Blacks, the inverse association between religiosity and PTSD was explained by quality of relationships, whereas the positive relationship in Hispanics was explained by anxiety symptoms. In conclusion, religiosity was inversely related to PTSD symptoms in Blacks, positively related to PTSD in Hispanics, and unrelated to PTSD in the overall sample and in Whites. Anxiety/depression partially mediated the relationship in the overall sample and in Hispanics. Although longitudinal studies will be necessary to determine how these relationships come about, consideration should be given to spiritual/religious interventions that target anxiety/depression in V/ADM with PTSD.

Are Religious Coping and Pain Perception Related Together? Assessment in Iranian Cancer Patients

Pain of cancer had various significant side effects that based on the literature it can reduced by religious coping methods. This study aimed to investigate the relationship between religious coping and pain perception in Iranian cancer patients. In this cross-sectional study (October-December, 2015), 380 hospitalized cancer patients were entered to the study using accessible sampling. Data were collected by socio-demographic, Religious Coping and McGill pain questionnaires. Males (48.39 ± 13 ± 39; CI95: 46.41-50.38) are older than females (45.33 ± 18.44; CI95: 42.79-47.87). According to results, there was a significant relationship between pain perception and positive religious coping in cancer patients. Also there was a significant relationship between pain perception and family history of cancer (P < 0.05). It seems that improving the level and quality of positive religious affiliation can be effective on the amount of stimulation and pain of cancer patients. Of course, more comprehensive studies are needed to be achieved more reliable results about the effects of religious coping on pain perception in these patients.

The longitudinal relationship between acceptance and anxiety and depression in people who have had a stroke

OBJECTIVES

The role that acceptance may play in anxiety and depression has received little attention in stroke, unlike other chronic conditions. This study aimed to clarify whether acceptance of a stroke is related to anxiety and depression post-stroke when controlling for social support.

DESIGN

A longitudinal design was employed with 35 participants completing measures at two time points: three-month and nine-month post-stroke.

METHODS

Forty-one stroke patients, who were three-month post-stroke, were recruited from a stroke service register. Participants completed measures of anxiety, depression, social support and acceptance at two time points, six months apart.

RESULTS

Acceptance was moderately and negatively correlated with anxiety and depression at three- and nine-month post-stroke. Acceptance showed a moderate and positive correlation with emotional and practical social support at Time 1 but not at Time 2. Acceptance at Time 1 was a stronger predictor of both anxiety and depression at Time 2 than emotional or practical social support.

CONCLUSIONS

Acceptance is an important area to consider in relation to rehabilitation and adjustment following a stroke.

The THRIVE model: A framework and review of internal and external predictors of coping with chronic illness

This article explores the ways in which people cope with social and clinical dimensions of their chronic conditions. Existing literature was reviewed to categorize factors identified as being key. They were sorted into six groupings which are reflected by the acronym THRIVE: therapeutic interventions, habit and routine, relational-social, individual differences, values and beliefs, and emotional factors. We found little evidence to suggest different conditions prompt unique coping responses; rather, a range of common factors were observed across diverse conditions. The THRIVE framework not only summarizes current literature but provides a starting point for further research and development of future interventions.

Alcohol use Exacerbates Acculturative Stress Among Recently Immigrated, Young Adult Latinas

Associations between theorized sociocultural factors and acculturative stress were examined among Latina immigrants (aged 18-23 years) during their initial months in the US. Participants' quantity of alcohol use was hypothesized to be linked with more acculturative stress. Using respondent-driven sampling, 530 Latinas who recently immigrated to Miami-Dade County, Florida, were recruited from community activities, Latino health fairs, advertisements at community agencies, and online postings. A path analysis revealed associations between acculturative stress and more time in the US and greater commitment to ethnic identity. Marianismo gender role beliefs differentially related with acculturative stress. Quantity of alcohol use moderated the positive association between time in US and acculturative stress, such that women in the US for less time who drank more alcohol experienced higher levels of acculturative stress than their peers. Findings suggest quantity of alcohol use may exacerbate acculturative stress during some Latina young adult immigrants' initial months in the US.

Sexual risk during initial months in US among Latina young adults

Latina young adults are disproportionately at risk for sexually transmitted infections (e.g., HIV). However, little is known about social and cultural factors contributing to sexual health disparities among young adult Latina recent immigrants. The present study examined social and cultural factors contributing to sexual risk behaviors among 530 Latina women (ages 18-23) who immigrated to Miami-Dade County, Florida, approximately 12 months before assessment. At the cultural/macrosystemic level, participants who reported more sexual risk behaviors tended to (a) be less acculturated; (b) use less positive religious coping; (c) endorse to a greater extent the marianismo belief that Latinas should be the pillar of the family; and (d) endorse less of the marianismo belief that Latinas should be virtuous and chaste (i.e., abstain from premarital sex). As for individual-level factors, participants who reported more sexual risk behaviors also indicated (e) older age, (f) being married/partnered, (g) being employed, (h) living in the US longer, and (i) drinking more alcohol. Findings indicate areas for HIV/STI prevention for this underserved population.

Cancer-Induced Bone Pain Management Through Buddhist Beliefs

Dealing with physical pain represents a huge public health expenditure, especially for cancer-induced bone pain, one of the most difficult health issues, which impairs appetite, sleep, and mobility, negatively impacting quality of life and evoking mental problems. Although some literature has reported positive correlation between religion and pain management, there is a dearth of research examining the effectiveness of Buddhism on this topic. This study investigates the usefulness of Buddhist beliefs in managing cancer-induced bone pain through a case example. It illustrates how an advanced cancer patient, with the assistance of a counsellor, perceived pain and coped with it and pain-induced mental problems via Buddhist teachings and practices, including the four noble truths, the law of dependent origination, and karma. It offers alternative perspectives for helping professionals (such as physicians, nurses, counsellors, social workers, hospice and palliative service providers, and pain management practitioners) who are keen to equip themselves with a wider worldview and life view to better serve their clients.

Psychometric Properties of the Chinese Version of the Acceptance of Chronic Health Conditions (Stoma) Scale for Patients With Stoma

BACKGROUND

Formation of a stoma is a common outcome in surgical treatment of colorectal cancer. A higher acceptance of stoma was shown to improve quality of life of patients. No instrument in Chinese is available that can be used to measure the acceptance of stoma among patients with colorectal cancer.

OBJECTIVES

The aims of this study were to translate and test the psychometric properties of Chinese version of Acceptance of Chronic Health Conditions (ACHC) (Stoma) scale.

METHODS

A sample of 100 Chinese-speaking patients with stoma was recruited from a public tertiary care hospital in Singapore. The scale was translated into Chinese and reviewed by an expert panel for semantic equivalence and content validity testing. Convergent validity was established by exploring correlations between scores of the Chinese version of the ACHC (Stoma) scale and those of the 5-level version of European Quality of Life Questionnaire-5 Dimensions. Reliability was assessed by internal consistency and test-retest reliability.

RESULTS

The newly translated scale had high content validity (content validity index = 94%) and acceptable internal consistency (Cronbach's α = .846). The test-retest reliability was satisfactory with an intraclass coefficient of 0.997. A positive correlation was found between both scores on ACHC (Stoma) scale and EQ-5D utility score (r = 0.63, P < .01) and EQ-5D global visual analog scale (r = 0.70, P < .01).

CONCLUSIONS

The Chinese version of the ACHC (Stoma) scale demonstrated satisfactory content validity, good convergent validity, and adequate internal consistency and stability.

IMPLICATIONS FOR PRACTICE

This scale can be used as a convenient screening tool in clinical settings to assess the level of acceptance in Chinese-speaking patients with stoma.

Spirituality in Rehabilitation Counseling of Adults With Physical Disabilities: Views of Practitioners Across Countries

The purpose of the study is to understand the views of practitioners across countries, on spirituality for rehabilitation counseling of adults with congenital and acquired disabilities. A survey of 1,269 practitioners in the field of disability across 15 countries was conducted. Results showed that practitioners had a favorable view of spirituality. Logistic regression results highlight several cross-country nuances in practitioners’ views toward spirituality for rehabilitation counseling, and more so, differentials in terms of adults with congenital and acquired physical disabilities. Practitioners who focused on a client-centered approach vis-à-vis those who diversified also into macro-level work of networking and advocacy, and specifically those who had high self-reported spirituality, proposed that for adults with congenital physical disabilities, spirituality enabled living with disabilities, as against a rationalization and justification of the disability. They favored mindfulness techniques as the modes of working with the clients and reported that by cultivating relational consciousness, spirituality enabled meeting the social goal of rehabilitation counseling. Furthermore, practitioners from affluent nations placed a premium on the deconstructing potential of spirituality and its facilitative role in enabling the clients themselves, and significant others, to transcend the ability/disability binary. The study foregrounds the importance of spiritually sensitive approaches in rehabilitation counseling.

Acculturative Stress, Psychological Distress, and Religious Coping Among Latina Young Adult Immigrants

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress-process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed.

Religiosity, race/ethnicity, and alcohol use behaviors in the United States

BACKGROUND

Religiosity is a protective factor against many health problems, including alcohol use disorders (AUD). Studies suggest that religiosity has greater buffering effects on mental health problems among US Blacks and Hispanics than Whites. However, whether race/ethnic differences exist in the associations of religiosity, alcohol consumption and AUD is unclear.

METHOD

Using 2004-2005 NESARC data (analytic n = 21 965), we examined the relationship of public religiosity (i.e. frequency of service attendance, religious social group size), and intrinsic religiosity (i.e. importance of religious/spiritual beliefs) to frequency of alcohol use and DSM-IV AUD in non-Hispanic (NH) Blacks, Hispanics and NH Whites, and whether associations differed by self-identified race/ethnicity.

RESULTS

Only public religiosity was related to AUD. Frequency of religious service attendance was inversely associated with AUD (NH Whites β: -0.103, p 0.05) or Hispanics (β: -0.002, p > 0.05).

CONCLUSIONS

US adults reporting greater public religiosity were at lower risk for AUD. Public religiosity may be particularly important among NH Blacks, while intrinsic religiosity may be particularly important among NH Whites, and among Hispanics who frequently attend religious services. Findings may be explained by variation in drinking-related norms observed among these groups generally, and in the context of specific religious institutions.

The role of religious attendance on mental health among Mexican populations: A contribution toward the discussion of the immigrant health paradox

In this study, we conducted a path analysis on data from the National Latino and Asian American Study to investigate the role of religious attendance on mental health among Mexican populations. Using data from 868 Latinos of Mexican origin, we further investigated the extent to which religious attendance mediated the direct path between generation status and lifetime prevalence rates of any substance use disorder, depressive disorder, and anxiety disorder. Results indicate that Mexican immigrants endorsed lower lifetime prevalence rates of depressive disorder, anxiety disorder, and substance use disorder and endorsed higher levels of religious attendance. Second, results indicate a significant negative relationship between religious attendance and prevalence rates for depressive disorder, anxiety disorder, and substance use disorder. Third, results indicate that religious attendance was a mediator for the relationship between generation status and the lifetime prevalence rates of substance use disorder only. These results provide a contribution toward the discussion of the immigrant health paradox and further highlight the role that religious attendance plays in the relationship between generational status and the lifetime prevalence rates of substance use disorder. (PsycINFO Database Record

Religious and Spiritual Beliefs and Practices of Persons With Chronic Pain

Ninety-five persons receiving treatment for chronic pain were surveyed using the Spirituality and Chronic Pain Survey (SCPS). The survey included a pain assessment, a spiritual/religious practices assessment, and questions related to spiritual/religious beliefs and attitudes. Most participants reported experiencing constant, higher-level pain. The most frequent responses to pain were taking medication (89%) and praying (61%). Results indicated the majority of respondents perceived God or a Spiritual Power as helping them cope with pain and as a source of happiness, connection, and meaning in life. A factor analysis on attitude items of the SCPS identified 4 factors that accounted for 60% of the variance: (a) Spiritual Connection and Meaning, (b) Spiritual Increase and Hopefulness, (c) Spiritual Decrease and Punishment, and (d) Spiritual Power. Results suggest the relevance and utility of spirituality assessment for persons who live with chronic pain. Implications for practice, education, and future research are discussed.

"I Told Myself to Stay Positive" Perceptions of Coping Among Latinos With a Cancer Diagnosis Living in the United States

PURPOSE

This study contributes to the sparse body of literature examining perceptions of coping among Latino men and women with a cancer diagnosis living in the United States. There are currently 50 million Latinos in the United States and, by 2050, projected to grow to 128 million. Although some research indicates that Latinos have unique sociocultural beliefs that influence their cancer care, very little is known about their perceptions of coping after being diagnosed with cancer. We examined Latino men and women's perceptions of coping to understand the meaning of their experience with cancer Method: Using criterion sampling technique, 60 immigrant and migrant Latino men and women diagnosed with cancer within the past 5 years were recruited from community-based organizations, clinics, and churches. The study consisted of 60- to 90-minute semistructured interviews asking open-ended questions pertaining to coping. The qualitative design facilitated an understanding of coping within the participants' social and cultural contexts.

RESULTS

Median age of the participants was 55 years. Among the women, 80% had breast cancer; 12% had ovarian cancer; and 8% had throat, thyroid, stomach, or skin cancers. Among the men, 94% had prostate cancer and 6% had brain, colorectal, or lung cancers. Emerging themes associated with the development of coping strategies involved positive reframing, family support, religion and spirituality, and support from health care providers. The term "positive reframing" relates to finding meaning and positive emotions that help sustain the coping process, despite having a cancer diagnosis. In addition, when medical and helping professionals provided tangible support, participants engaged in meaning-based coping.

CONCLUSION

This study provides insights regarding the existing coping strategies which Latinos utilize and provides clinician-tangible information pertaining to participant's engagement in meaning-based coping. Family support facilitated coping among the Latino men and women. The role of religion and spirituality in the lives of the participants enabled them to cope with the cancer diagnosis. Future research is necessary to examine coping strategies regarding specific cancers at end of life.

The Impact of Religious Coping on the Acculturative Stress and Alcohol Use of Recent Latino Immigrants

Religion plays a prominent role in Latino culture and could be influential during difficult life transitions, such as those experienced during the immigration process. This study examines relations between religious coping, acculturative stress, and alcohol use in a sample of 415 recent Latino immigrants. Higher levels of acculturative stress were associated more positive and negative religious coping. Positive religious coping was related to lower alcohol use. Negative religious coping moderated the relationship between acculturative stress and alcohol use. Participants who used more negative religious coping had higher rates of alcohol use when experiencing high levels acculturative stress. Implications for culturally tailored prevention/interventions are discussed.

Missed Opportunity: Spirituality as a Bridge to Resilience in Latinos with Cancer

Going through adverse life events can help a person learn how to cope with life's challenges, overcome them, learn from the adverse experiences, grow, and be positively transformed by them. Spirituality is a resource that supports adaptation and resilience to improve quality of life in patients with cancer or other chronic illnesses. For Latinos, spirituality is an important core cultural value. As such, it is crucial to pay close attention to how cultural values play a role in health-related concerns when caring for Latino cancer patients, and to how spirituality, being an important aspect of Latino culture, influences how Latinos adjust and cope with cancer. Understanding how to facilitate resilience in the face of potentially negative life events, such as cancer, can not only help Latino cancer patients in active treatment, but can also impact effectiveness of managing and coping with the consequences of cancer during survivorship.

A randomized controlled trial examining the effectiveness of a STOMA psychosocial intervention programme on the outcomes of colorectal patients with a stoma: study protocol

AIMS

To report a study protocol that evaluates the effects of a psychosocial intervention on patients with a newly formed stoma.

BACKGROUND

With the loss of a significant body function and distorted body image, stoma patients experience physical, psychological and social challenges. Nurses have an important role in helping patients' make a smooth transition to living with their stoma. Limited studies have examined the effects of psychosocial interventions on improving stoma-related health outcomes.

DESIGN

A randomized controlled trial is planned.

METHODS

Eighty-four patients with newly formed stoma in a tertiary hospital in Singapore (Research Ethics Committee approval obtained in January 2013) will be recruited. Participants will be randomly assigned to either a control group who receive routine care or an intervention group who receive STOMA psychosocial intervention besides routine care. Outcome variables include stoma care self-efficacy, days to stoma proficiency, length of hospital stay, acceptance of stoma, anxiety and depression and quality of life. Data will be collected at four time points: before randomization and intervention (baseline), on the day of discharge (mid-intervention), at 4 weeks after discharge (postintervention 1) and at 4 months after discharge (postintervention 2).

DISCUSSION

This study will develop a psychosocial intervention programme, which may improve patients' stoma-related outcomes. The findings will provide direction to health professionals about education and the type of support that could be offered to patients concerning stoma care in the hospital setting, which will eventually improve their quality of life.

Choice of nonpharmacological pain therapies by ethnically diverse older adults

SUMMARY 

Aim: This study compared nonpharmacological pain therapies used by ethnically diverse older adults with recommendations of family physicians and identified factors associated with nonpharmacological pain therapies use. Methods: Using a descriptive cross-sectional design, 281 participants in four ethnic groups (European Americans, Hispanics, African–Americans, Afro-Caribbeans) with chronic pain were surveyed. Binary logistic regression analyses were employed to determine associated factors. Results & conclusion: Nonaquatic exercise and physical therapy were most frequently recommended by physicians, and nonaquatic exercise was most commonly used by participants. Lower pain levels predicted use of nonaquatic exercise, and ethnicity predicted use of prayer to manage chronic pain. Future research should examine barriers to use of psychological treatments and assess the value of combined physical and psychological treatments.