Religion, health, and psychological well-being in older adults: findings from three national surveys

Factors associated with happiness among community-dwelling older adults: a systematic review

OBJECTIVES

To identify factors associated with self-reported happiness among community-dwelling older adults.

METHODS

A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302).

RESULTS

Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness.

CONCLUSIONS

The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults.

Exploring the interplay of environmental conservation within spirituality and multicultural perspective: insights from a cross-sectional study

The need to protect and sustain environmental resources for future generation remains sacrosanct in global sustainability agenda. This study was aimed at exploring the interplay between environmental conservation and spirituality from a multicultural perspective. While studies on "spirituality" have monumentally gained global attention, a growing number of evidence underscore the critical role of spiritual resources available for ensuring environmental stewardship. In this present study, attempt was made to respond to some critical questions: Is there any significant association between spirituality and environmental responsibility? What is the impact of spiritual leadership on environmental conservation? What key messages do spiritual leaders need to prioritize to encourage environmental conservation? And what are some of the spirituality-related predictors of willingness to engage in global environmental conservation efforts among the respondents? To determine this nexus between spirituality and environmentalism, a cross-sectional study design was adopted. Primary data were collected by means of a validated and adapted instrument from various literature searches. Data collected from a sample of 1,438 respondents were entered on Excel spreadsheet and eventually exported on SPSS version 21 for further analysis. Every segment of the instrument used yielded a Cronbach's alpha reliability test result of no less than 0.70. Descriptive statistics and ordinal logistics regression analysis were employed. The findings revealed that majority of respondents expressed a high level of spirituality (p value < 0.05). Majority (70%) of the respondents believe that everyone has a duty of care toward nature. More than two-third (> 60.0%) would be more inclined to observing environmental conservative measures if their spiritual leaders would continue to give exemplary teachings on environmental conservation. While a few indicators of spirituality yielded direct correlation with the willingness to engage in global environmental conservation efforts, most of the selected indicators reflect willingness. Some of these (predictors) include how often respondents pray, meditate, and fast; caring about people, animals, and the planet; being just happy to be alive; etc. In conclusion, this study reasoned that spirituality could indeed serve as a foundation for environmental conservation campaigns and could reinforce pro-environmental behaviors.

The association between loneliness and life satisfaction: examining spirituality, religiosity, and religious participation as moderators

BACKGROUND

Future cohort of older adults may have to rely on non-family sources and forms of support, religion being one of them. This may be especially so, considering the recent longitudinal evidence that individuals are inclined to become more religious with increasing age. Thus, the purpose of the present study was to assess the association between loneliness and life satisfaction among older adults in India, and the extent to which the association between loneliness and life satisfaction is moderated by spirituality, religiosity, and religious participation.

METHODS

Data come from the Longitudinal Ageing Study in India, with a sample of 31,464 individuals aged 60 years and above. Multivariable logistic regression models were employed to examine the independent association of loneliness and life satisfaction. Further, an interaction analysis was conducted to examine the extent to which the association between perceived loneliness and life satisfaction is moderated by spirituality, religiosity and religious participation among older Indians.

RESULTS

The prevalence of low life satisfaction (LLS) was 30.84%; a total of 37.25% of participants reported feeling lonely, 12.54% reported a lack of spiritual experience, 21.24% reported not being religious, and 19.31% reported not participating in religious activities. Older adults who felt lonely had higher odds of LLS relative to peers who were not lonely. Further, the adverse impact of loneliness on LLS among older Indians is moderated by their spirituality, religiosity, and religious participation. Specifically, the adverse impact of loneliness on LLS was less negatively pronounced among older adults who were spiritual, religious, and engaged in religious activities.

CONCLUSIONS

The study found an independent association between loneliness and lower life satisfaction among older adults in India. It also revealed that religiosity, spirituality and religious participation moderate the association between loneliness and lower life satisfaction. These findings, which underscore the health promoting benefits of religiosity and religious engagement, may be used to build on the interaction between religious and faith-based groups and public health professionals.

Cardiovascular health promotion: A systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure

Globally, faith institutions have a range of beneficial social utility, but a lack of understanding remains regarding their role in cardiovascular health promotion, particularly for hypertension. Our objective was assessment of modalities, mechanisms and effectiveness of hypertension health promotion and education delivered through faith institutions. A result-based convergent mixed methods review was conducted with 24 databases including MEDLINE, Embase and grey literature sources searched on 30 March 2021, results independently screened by three researchers, and data extracted based on behaviour change theories. Quality assessment tools were selected by study design, from Cochrane risk of bias, ROBINS I and E, and The Joanna Briggs Institute's Qualitative Assessment and Review Instrument tools. Twenty-four publications contributed data. Faith institution roles include cardiovascular health/disease teaching with direct lifestyle linking, and teaching/ encouragement of personal psychological control. Also included were facilitation of: exercise/physical activity as part of normal lifestyle, nutrition change for cardiovascular health, cardiovascular health measurements, and opportunistic blood pressure checks. These demand relationships of trust with local leadership, contextualisation to local sociocultural realities, volitional participation but prior consent by faith / community leaders. Limited evidence for effectiveness: significant mean SBP reduction of 2.98 mmHg (95%CI -4.39 to -1.57), non-significant mean DBP increase of 0.14 mmHg (95%CI -2.74 to +3.01) three months after interventions; and significant mean SBP reduction of 0.65 mmHg (95%CI -0.91 to -0.39), non-significant mean DBP reduction of 0.53 mmHg (95%CI -1.86 to 0.80) twelve months after interventions. Body weight, waist circumference and multiple outcomes beneficially reduced for cardiovascular health: significant mean weight reduction 0.83kg (95% CI -1.19 to -0.46), and non-significant mean waist circumference reduction 1.48cm (95% CI -3.96 to +1.00). In addressing the global hypertension epidemic the cardiovascular health promotion roles of faith institutions probably hold unrealised potential. Deliberate cultural awareness, intervention contextualisation, immersive involvement of faith leaders and alignment with religious practice characterise their deployment as healthcare assets.

Loneliness and Social Support among the Middle-Aged and Elderly People with Visual Impairment

Loneliness is associated with depression, sleep disturbance, and an increased risk of cardiovascular disease, and it is a global public health problem. Since physical and mental health have a great impact on loneliness, middle-aged and elderly people who are blind or visually impaired may be more affected by loneliness. Previous research has confirmed that effective social support can enhance physical and mental health and alleviate the negative effects of life stress. Therefore, in this study, we applied a cross-sectional design where data were collected using questionnaires completed in person, by phone, or online for a total of 456 middle-aged and elderly people with visual impairment. We found that the enrolled participants who were unemployed, lacked a stable source of income, lived alone, or were unable to move independently were prone to experiencing high levels of loneliness and low social support, which highlights the necessity of interventions such as counseling to alleviate the sense of loneliness in such groups. During the COVID-19 pandemic, social support measures to reduce the sense of loneliness should be highly encouraged to ensure that middle-aged and elderly people with visual impairment can continue to live independently, and social support seems to be an important factor.

The Experience of LGBTQ+ Identity as Spiritual Identity

Owing to widespread condemnation of lesbian, gay, bisexual, and transgender (LGBTQ+) people among many mainstream religious and spiritual traditions, evidence suggests that many LGBTQ+ individuals face considerable conflict related to spiritual and religious identity. Some LGBTQ+ individuals manage to reconcile their LGBTQ+ and spiritual identities, while others even view their LGBTQ+ identity as a spiritual one. This qualitative research study focused on the experience of LGBTQ+ identity as spiritual identity. Ten participants were interviewed via email by the researcher, and data were analyzed using thematic analysis. The data were organized into three primary themes, each comprised of three to four subthemes. Findings indicated that LGBTQ+ identity as spiritual identity is experienced as a sense of connection and capacity for connection, a set of unique perspectives on various aspects of life, and a sense of having varied spiritual roles to play in the world. These findings and their limitations are discussed, along with suggestions for future research.

The Moderator Role of Spirituality on the Relationship between Fear of COVID-19 and Psychological Well-Being

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The Relationships among Mindfulness, Self-Compassion, and Subjective Well-Being: The Case of Employees in an International Business

This study aimed to investigate the relationships among mindfulness, self-compassion, and subjective well-being among employees. The questionnaire research method was used to collect data in this study, and the subjects included employees of Carrefour, an international business in Taiwan. A total of 629 valid questionnaires were used to evaluate the overall structure and analyze the mediating effect with the SPSS 21.0 statistical software. The results showed that mindfulness was positively related to subjective well-being, mindfulness was positively related to self-compassion, and self-compassion was positively related to subjective well-being. It was also found that self-compassion partially mediated the relationship between mindfulness and subjective well-being.

Ageism and Psychological Well-Being Among Older Adults: A Systematic Review

Ageism may have harmful effects on the psychological well-being of older adults, leading to mental health issues, such as depression and anxiety. However, there are insufficient data to establish this hypothesis, and most work on the subject has appeared only in the form of conceptual or theoretical papers. This study reviewed quantitative studies of the relationship between ageism and psychological well-being of older adults. We conducted a comprehensive review using searches of academic databases, the grey literature, hand searches, and reference mining. A total of thirteen articles were selected using the inclusion criteria. All the reviewed studies showed a negative association between ageism and the psychological well-being of older adults. The study confirmed a negative association between ageism and older adults’ psychological well-being, finding that older adults with a high level of psychological well-being may be less negatively affected by ageism, especially those who were proud of their age group, experienced less negative emotions, were more optimistic about aging and their future, were more self-confident about their bodies, and were flexible in setting goals. The identified mediators of the association can inform intervention development to the effects of ageism and improve older adults’ psychological well-being.

Spiritual Counseling During the COVID-19 Pandemic in Italy: a Qualitative Study

The COVID-19 pandemic has created profound upheavals in today's society, accompanied by psychological effects. The discomfort experienced during the pandemic accompanied by the increased availability of time has offered many people the chance to reconnect with their spiritual dimension, which is considered a vital resource in managing the stress produced by the perception of risk to their health. This study addresses the motivations that led research participants to choose to receive spiritual support via a 10-week training. The work also explores the changes perceived by the participants as they overcame the difficulties resulting from the pandemic. The research involved nine people between the ages of 19 and 59 who took part in an online experience focused on the spiritual dimension. Almost all the participants came from an area in Northern Italy most affected by the pandemic. A qualitative research design was used, with semistructured interviews designed to understand participants' views on the topic under investigation. The areas that emerged from the interviews concerned the motivations that led the participants to choose a spiritual support process, the role of spirituality in daily life, and the changes participants experienced after the conclusion of the experience related to managing the stress caused by the pandemic. In agreement with the existing literature, the results show that spiritual support can be useful in counteracting the negative effects of the pandemic, producing improvements in the quality of life.

Religious Transitions Among Baby Boomers From Young Adulthood to Later Life: Associations with Psychological Well-Being Over 45 Years

We used classification analysis to examine change in religiosity among baby boomers from young adulthood to early old age and how religiosity transition patterns are associated with psychological well-being in later life. In addition, we tested the gender difference in the above association. We applied latent class and latent transition analysis to 392 baby boomers who participated in the Longitudinal Study of Generations in Wave-1 (1971) and Wave-9 (2016). We identified three classes describing religiosity at each wave (strongly religious, doctrinally religious, and weakly religious), and considered five types of change or stability in religious class membership from Wave-1 to Wave-9. Multiple regression with gender interactions revealed that men who stayed strongly religious over the period reported better psychological well-being compared to men who declined in their religiosity; no such pattern was found for women. Our findings suggest that maintaining strong religiosity over the life course was beneficial for baby boom men in later life.

An Examination of Coping Strategies and Intent to Leave Child Welfare During the COVID 19 Pandemic

Child welfare work is inherently difficult, and child welfare agencies are known to experience high rates of turnover. We sought to expand the existing literature on intention to leave one's child welfare agency and commitment to child welfare work through examining the coping mechanisms of frontline workers. Having and utilizing healthy coping mechanisms has proved beneficial to child welfare workers in previous research. In this paper, we examine specific coping mechanisms identified in the Comprehensive Organizational Health Assessment and how they were associated with child welfare workers' intent to leave their agency and their commitment to remain in the field of child welfare during the SARS CoV-2 (COVID-19) pandemic. We surveyed over 250 child welfare caseworkers using the COHA instrument. Using both bivariate analysis and linear regression, we identify specific coping mechanisms, such as staying present with friends and family, as highly influential and discuss ways to strengthen these areas.

The Psychological Impact of Coronavirus Pandemic Restrictions in Italy. The Mediating Role of the Fear of COVID-19 in the Relationship between Positive and Negative Affect with Positive and Negative Outcomes

Italy was quickly hit hard by the coronavirus. 'Lockdown' has significantly impacted the psychological health, personal wellbeing and quality of life of the people. The study aims to explore the relationship between positive and negative affect, as well as positive (spiritual well-being and flourishing) and negative outcomes (psychological distress caused by a traumatic life event in terms of perception of PTSD symptoms) on Italian adults during the lockdown period. Data was collected between April and May 2020. The participants were 281 Italian adults aged between 18 and 73 years. The survey was composed of the following measures: Flourishing Scale, Jarel Spiritual Well-Being scale, Positive and Negative Affect Schedule, Impact of Event Scale-Revised, Fear of COVID-19. The mediational analysis shows that fear of COVID-19 fully mediates the relationship between negative affect and spiritual well-being and flourishing; fear of COVID-19 partially mediates the relationship between negative affect and PTSD symptoms; the positive affect shows only direct effects on positive outcomes. Therefore, fear of COVID-19 does not play any mediation role. Implications for psychological interventions and future research will be discussed.

Authoritarianism is good for you: Right‐wing authoritarianism as a buffering factor for mental distress

Although common knowledge seems to agree that authoritarianism is ‘bad to the self’, previous studies yielded inconclusive results with respect to the relationship between authoritarianism and mental distress. The present research explores whether the impact of facilitators of mental distress on actual mental distress depends on the level of authoritarianism. Study 1 includes a sample of 132 adults and demonstrated less negative consequences of D‐type personality on depression for individuals with high rather than low levels of authoritarianism. Study 2 conducted in a sample of 109 elderly revealed that the effects of negative stressful life events on mental distress were curbed by higher levels of authoritarianism. It is concluded that while previous studies have amply shown that authoritarianism has adverse consequences for other people, these negative effects do not appear to be particularly present for the self. Copyright © 2008 John Wiley & Sons, Ltd.

Associations Between Religious/Spiritual Practices and Well-Being in Indian Elderly Rural Women

Religion and spirituality (R/S) are embedded in all aspects of life in India, a predominantly rural economy. The aim of this mixed methods study was to assess the associations between a culturally tailored intervention and preexisting religious/spiritual (R/S) practices with indicators of well-being and factors which contribute to happiness among elderly rural women from Haryana state, India. The study consisted of three groups: field experimental group (FEG; n = 24); practitioners of preexisting R/S practices for at least 6 weeks Satsang (SG, n = 54), Brahma Kumaris (BKG, n = 54), and Radha Soami (RSG, n = 30), and non-practitioners of R/S practices (n = 64). All groups completed self-report measures of overall happiness and life satisfaction, global health, quality of life, and health status and physical health. Results revealed that FEG participants improved significantly on physical health, body balancing, and self-care; no changes were observed on the other well-being measures following the intervention. Practitioners of preexisting R/S practices were found significantly different from the non-practitioners on some indicators of health, quality of life, and well-being. Qualitative measures pointed to the importance of R/S and family and interpersonal relationships among elderly rural women.

Spirituality and Caring for the Older Person: A Discussion Paper

Holistic healthcare to the older person is important. Spirituality is considered to be the very essence of being and for some is what motivates and guides us to live a meaningful existence. Nurses caring for the older person need support in responding to their spiritual needs in order to ensure that they are appropriately and successfully met. The aim of this paper is to explore these needs and highlight some evidence indicating how this care can be implemented and therefore ultimately influence nursing practice.

The Relationship Between Spirituality, Health-Related Behavior, and Psychological Well-Being

Studies suggest a positive association of spirituality and health behaviors with well-being (especially subjective well-being), but still the precise character of such relationships between all these constructs remains unknown. The present study aims to explore the relations between spirituality, health-related behaviors, and psychological well-being in the context of acquired education. A questionnaire survey was conducted among 595 students from six different universities, whose study programs either focused on the human body or the human mind and spirit. Path analysis and linear regression were used to model the relationship between the examined constructs. The results show that both spirituality and health-related behaviors are positively related to psychological well-being, and that the relationship with spirituality is also mediated by health-related behaviors. Only spirituality is associated with the type of acquired education, especially in the group of students whose studies focus on the human mind and spirit. Moreover, spirituality in this group seems to display a stronger relationship with psychological well-being. These findings may contribute to the better understanding of some significant determinants of psychological well-being. They carry important implications for the faculty members responsible for curriculum preparation to account for teaching contents related to the conduct of a healthy lifestyle and to spiritual development.

Religion and Mental Health in Racial and Ethnic Minority Populations: A Review of the Literature

Religion has been an important source of resiliency for many racial and ethnic minority populations. Given the salience, sociohistorical context, and importance of religion in the lives of black and Latino Americans, this literature review focuses on the mental health and well-being outcomes of religion among black and Latino Americans across the adult life course and specifically in later life. This review provides an overview of religious participation and religiosity levels and an in-depth discussion of extant research on the relationship between the multiple dimensions of religiosity and mental health in these 2 populations. Racial differences between blacks, Latinos, and non-Latino whites are also examined. Suggestions for limitations of the current literature and future directions for research on religion and mental health in racial/ethnic minority populations, especially older minorities, are proposed.

Religiosity and health among Chinese older adults: a meta-analytic review

The ageing population has been rapidly growing over recent years. Theoretically, religion seemingly plays an important role in improving older people's health. This study examines whether believing in religion is related to better health conditions among Chinese older adults through a meta-analysis. Two researchers independently extracted the studies from a comprehensive database and grey literature search and evaluated their scientific quality. From the 3,777 potentially eligible papers, just 76 were selected. The pooled effect size detected no significant difference between Chinese religious and non-religious older adults’ overall health and wellbeing. Dividing the outcomes into different categories, religious older adults reported both a higher level of anxiety (Hedge's g = −0.392, 95% confidence interval (CI) = −0.494, −0.290; p = 0.004) and yet a higher level of happiness (Hedge's g = 0.342, 95% CI = 0.074, 0.610; p = 0.018). Having a higher proportion of females in the sample is related to a smaller effect size in overall health outcomes (β = −2.205, 95% CI = −3.800, −0.613; p = 0.007) and social support specifically (β = −4.660, 95% CI = −6.261, −3.058; p < 0.0001). This study is among the first to synthesise the quantitative evidence regarding health differences between older religion believers and non-believers in China. It calls for future studies investigating the pathways underlying the religion–health relationship.

Racial differences in future care planning in late life

Objectives: Although many older adults fear frailty and loss of independence in late life, relatively few make plans for their future care. Such planning is particularly limited among racial minorities. Given the benefits of future care planning (FCP), it is important to understand factors that facilitate or hamper FCP in late life. Our study explored racial, demographic, and dispositional influences on thinking about and engagement in FCP among community-dwelling older adults.Design: This study utilized data from the Elderly Care Research Center's longitudinal study of successful aging based on interviews with 409 older adults. Along with race, education and other demographic factors, we explored dispositional influences of optimism and religiosity on FCP using logistic regression.Results: African American older adults had significantly lower odds of executing FCP (β = 0.36, p < .05) when compared to White older adults. However, this estimate was no longer statistically significant after controlling for education, disability status, optimism, and religiosity. Older adults with higher education had significantly higher odds of thinking about and executing FCP. Higher level of optimism was associated with lower odds of FCP.Conclusions: Limited educational resources and the greater prevalence of dispositions of religiosity and optimism among African American older adults may contribute to their reluctance to engage in FCP in comparison to their white counterparts. Our findings offer practice implications indicating a need for interventions to encourage older adults, particularly racial minorities, to recognize and actively plan for their future care needs.

Religiosity and Subjective Well-Being of the Central and Eastern European's Elderly Population

The paper examines the relation between religiosity and cognitive appraisal of the subjective well-being of the Central and Eastern European's elderly population. The first part of the paper is dedicated to examining of the scientific literature. In the second part, the authors explore the data basis corresponding to the 6th wave of World Value Survey. The authors use the heterogeneous correlation and the multi-linear regression analysis in order to explain the relation between religiosity and subjective well-being of the old aged. Our results suggest that in the case of the Central Eastern European elderly satisfaction with life is mostly influenced by health and income. It is likely that for Central and Eastern European's elders religious practices do not sufficiently influence their life satisfaction.

Who Does Believe in life After Death? Brazilian Data from Clinical and Non-clinical Samples

Belief in afterlife is frequent, but little is known about how it relates to religiousness/spirituality (R/S) and socio-demographic variables. To investigate how the beliefs in afterlife and that "there is something beyond matter" are associated with socio-demographic, health, and R/S dimensions in a sample of medical inpatients and their companions. In multivariate analysis, afterlife belief correlated positively to educational level, religious affiliation, belief in something beyond matter, and private religious practices. Believe in something beyond matter correlated positively to afterlife belief and being spiritual. Educational level, rates of spirituality, religious affiliation, and private religious practices seem to influence the belief of afterlife and in a non-materialist cosmology.

Relations of religion with depression and loneliness in older sexual and gender minority adults

OBJECTIVES

High levels of religious involvement have been associated with positive mental health outcomes in older adults. This study investigated whether the effects of religion on healthy aging could generalize to older LGBTQ adults.

METHODS

This study examined religious affiliation in childhood versus at present, as well as the relationships of outness to religious community and religious engagement with depression and loneliness in 102 lesbian, gay, and bisexual cisgender, transgender, and questioning adults (LGBTQ) over the age of 55. As part of a larger study, participants completed several questions and measures including: one outness to religious community item, 4 religious engagement questions, the Center for Epidemiological Studies Depression Scale, and the 8-item UCLA Loneliness Scale.

RESULTS

Many older LGBTQ adults reported changes in religious affiliation from childhood to adulthood. Greater levels of outness to religious communities and lower religious engagement were related to lower levels of depression and loneliness.

CONCLUSIONS

Findings suggest that outness to religious communities may be beneficial to the mental health of older LGBTQ adults. Higher levels of distress may lead to higher levels of religious engagement.

CLINICAL IMPLICATIONS

Religion, especially those that are supportive of sexual minorities, may help to improve the well-being of older LGBTQ adults.

Religious Identity and Health Inequalities in Canada

In the past few decades, most new immigrants to Canada have originated from non-Christian countries. During the same period, the unaffiliation rates have sharply increased in Canada. This paper investigates whether there are any health inequalities associated with religious identity, including also the individuals who do not identify with organized religion in the analysis. The study uses the Canadian General Social Survey of 2012 (N = 23,093), focused on Caregiving and Care-receiving. Employing multivariate regression analysis and controlling for a large set of characteristics inclusive of the degree of religious commitment, individuals who identify as Protestant are found at a physical and mental health advantage, compared with Roman Catholics and most other groups. On the other hand, individuals who identify as Jehovah's Witnesses are found at a considerable physical health disadvantage. Among the unaffiliated individuals, those who have retained some ties with organized religion without formally identifying with it are found at a mental health disadvantage compared with all religious groups, as well as the secular individuals who are strictly committed to their nonreligious views. Possible causes and various implications are discussed.

Subjective well-being of visually impaired older adults living in the community

OBJECTIVES

Vision impairment is one of the most common disabilities among older adults, and it has a substantial impact on well-being. The present study constructs an integrative model to identify which variables derived from four dimensions of life (physical/functional, social, psychological and environmental) combined with sociodemographic variables explain the overall subjective well-being (SWB) visually impaired older adults living in the community.

METHOD

A total of 121 severe visually impaired persons, aged 60 and over (M = 77.4, range 60-95), participated in the study. Personal, face-to-face interviews were conducted with participants at social centers or at their homes. Research tools consisted of valid and reliable questionnaires.

RESULTS

Five variables explained the older adults' variability in SWB: self-rated health, sense of meaning in life, functional independence in activity of daily living (ADL), sense of control of one's environment (Mastery) and the participant's age. The explained variance percentage was found to be high (61%). In contrast to expectations, social-environmental variables proved to be only of secondary significance in explaining SWB variability.

DISCUSSION

Variables derived from the psychological dimension appear more significant than the social-environmental variables in explaining SWB among visually impaired older adults. These variables should be considered when developing intervention programs intended to increase SWB within this unique population group.

On the move in search of health and care: Circular migration and family conflict amongst older Turkish immigrants in Germany

This study focuses on circular migration amongst older Turkish immigrants to investigate two main questions: (1) How do perceived health and available healthcare systems in Turkey and Germany determine the structure of circular migration? (2) How is eldercare shaped by intergenerational conflict and exchange relations amongst older immigrants, their adult children in Germany, and their extended families in Turkey? Through the analysis of 40 in-depth interviews, this study finds that while Turkey offers healthier physical, psychological, and religious options, older circular migrants are more drawn to Germany because they perceive its healthcare system to be superior. Furthermore, contrary to conventional accounts, eldercare has mostly been navigated through intergenerational conflict and exchange relations, instead of family solidarity or traditional filial roles, and these conflicts and exchange principles around eldercare regulate family living arrangements across the two countries. In short, older Turkish immigrants encounter unique challenges in both their home and host countries, which promulgates their circular migration.

Associations between Religiosity, Spirituality, and Happiness among Adults Living with Neurological Illness

The study examined the associations between religiosity, spirituality, and happiness in 354 outpatients suffering from neurological disorders. After accounting for severity of cognitive decline, physical activity level, depression severity, and demographic variables (i.e., subject age, sex, ethnicity, and marital status) multivariate linear regression revealed a unique association between the Spiritual Well-Being Existential Spirituality scale (SWBS ES), and not the SWBS Religious Scale (SWBS RS), with both the Pemberton Remembered Happiness Index (PHI R) (p < 0.001), and the Pemberton Experienced Happiness Index (PHI E) (p < 0.001). Interventions focused on existential spirituality may improve health related quality of life among adult medical patients with neurological illness.

Importance of Religion or Spirituality and Mental Health in Canada

Using the latest mental health cycle of the Canadian Community Health Survey (N = 20,868), this paper examines how the importance of religion or spirituality in one's life associates with mental health. Based on this question, the population is divided into three groups of high religiosity, average religiosity, and secularized. Secularized individuals are shown to have large deficits in all the psychological markers suggested to mediate the relationship between religiosity and mental health, compared to the two other groups. In spite of these deficits, the secularized and the highly religious are found almost equally more likely to rate their mental health as excellent, than the individuals with average religiosity. Interestingly, these two groups are also more likely to rate their mental health as poor. Considering the ability to deal with day-to-day demands and unexpected problems in life as the dependent variable yields comparable results. Various explanations are explored.

[Impact of moderate intellectual disability on the dynamics and quality of family life: a qualitative clinical study]

This qualitative clinical study investigated the impact of moderate intellectual disability on family dynamics and quality of life. The data were collected using individual interviews with 15 mothers of children with intellectual disabilities, as a convenience sample, and examined with categorical thematic content analysis. The results were discussed using a comprehensive and interpretative approach. Analysis of the interviews showed that care for children with intellectual disabilities is centered on the mother, contributing to the change in family relations. Religious coping appeared as a common strategy for adjusting. Children with intellectual disabilities had less access to services and support than they needed in the areas of health, education, and leisure. Financial constraints and difficulties in community living had a negative impact on the quality of family life. Emotional and psychological support for all the family members, and practical and social support, including income distribution and access to adequate services, proved essential for the well-being of children with intellectual disabilities and their families.

Relationship Between Religious Belief and Happiness: A Systematic Literature Review

Happiness is a feeling that is desired by every human being. To achieve happiness, human try various routes like, to gain financial superiority, fame, entertainment, assets and so on. But on the contrary, religiosity is claimed to be a technique to attain purpose in life, mental health, physical well-being and internal peace, which ultimately leads to happiness in life. This study analyses the studies conducted in last two decades toward understanding the relationship between religiousness and happiness. These studies have been organised in terms of the religions, geographic locations, scales and significance. The study shows that the claim has proven to be true by a vast majority of the surveys irrespective of religion, gender, nationality or race. Although Muslims seems to be the happiest, it requires further verification.

The Language of Religious Affiliation

Religious affiliation is an important identifying characteristic for many individuals and relates to numerous life outcomes including health, well-being, policy positions, and cognitive style. Using methods from computational linguistics, we examined language from 12,815 Facebook users in the United States and United Kingdom who indicated their religious affiliation. Religious individuals used more positive emotion words ( β = .278, p < .0001) and social themes such as family ( β = .242, p < .0001), while nonreligious people expressed more negative emotions like anger ( β = −.427, p < .0001) and categories related to cognitive processes, like tentativeness ( β = −.153, p < .0001). Nonreligious individuals also used more themes related to the body ( β = −.265, p < .0001) and death ( β = −.247, p < .0001). The findings offer directions for future research on religious affiliation, specifically in terms of social, emotional, and cognitive differences.

Quality-of-life and spirituality

Spirituality has been identified as an important dimension of quality-of-life. The objective of this study was to review the literature on quality-of-life and spirituality, their association, and assessment tools. A search was conducted of the keyterms 'quality-of-life' and 'spirituality' in abstract or title in the databases PsycINFO and PubMed/Medline between 1979-2005, complemented by a new search at PUBMED from 2006-2016. Quality-of-life is a new concept, which encompasses and transcends the concept of health, being composed of multiple domains: physical, psychological, environmental, among others. The missing measure in health has been defined as the individual's perception of their position in life in the context of culture and value system in which they live and in relation to their goals, expectations, standards, and concerns. There is consistent evidence of an association between quality-of-life and religiosity/spirituality (R/S), through studies with reasonable methodological rigour, using several variables to assess R/S (e.g. religious affiliation, religious coping, and prayer/spirituality). There are also several valid and reliable instruments to evaluate quality-of-life and spirituality. Further studies are needed, however, especially in Brazil. Such studies will provide empirical data to be used in planning health interventions based on spirituality, seeking a better quality-of-life. In the last 10 years, research is consistently growing about quality-of-life and spirituality in many countries, and also in many areas of health research.

Good for All? Hardly! Attending Church Does Not Benefit Religiously Unaffiliated

The existing literature addressing Religion and Spirituality supports the idea that attending church is positively associated with health outcomes. However, within this literature there has been an impoverished effort to determine whether the Religiously Unaffiliated will report these positive relationships. Using representative data from Ontario (N = 3620), the relationships between Religious/Spiritual variables (Attendance, Prayer/Meditation, and Religiosity) and health outcomes (Happiness, Self-Rated Health, and Satisfaction with Life) were assessed. Results focused on three recurring trends: the Religiously Unaffiliated experienced attending church less positively than Christians; when compared at the highest level of Attendance, the Religiously Unaffiliated were less healthy than Christians; and when only considering the Religiously Unaffiliated, Religious/Spiritual variables were not significant and positive predictors of health outcomes. The discussion focused on the need to delineate between how Christians and the Religiously Unaffiliated experience Religious/Spiritual variables, and the need to stop over-generalizing the positive relationship between Religious/Spiritual variables and health.

Unbelievable?! Theistic/Epistemological Viewpoint Affects Religion-Health Relationship

Research suggests that Religion/Spirituality promotes a variety of positive health outcomes. However, despite reporting lower levels of Religion/Spirituality, non-believers report comparable levels of health to believers. The current study tested the hypothesis that Religion/Spirituality does not have a uniform effect on health for all persons, and tested theological/epistemological categories as moderators. Using the 2012 and 2014 General Social Survey (N = 2670), the relationship between Religion/Spirituality and happiness and self-rated health was investigated. Results indicated that Gnostic Theists experienced Religion/Spirituality more positively than their peers did; Agnostic Theists experienced Religion/Spirituality less positively than their peers did; and Negative Atheists experienced Religion/Spirituality less positively than their peers did. These findings suggested that Religion/Spirituality is not associated with salutary effects for all persons, and that whether a person believes in god(s) and how confident he/she was in god(s)' existence, influenced his/her experience with Religion/Spirituality.

Stressful life events, family support and successful ageing in the Biafran War generation

OBJECTIVES

Although the developing countries contribute substantially to the population of the elderly, little is known about ageing in populous countries like Nigeria, particularly the Biafran War generation (BWG). Some of those who witnessed the Biafran War (also known as Nigerian Civil War) as children are well into late adulthood, while the majority of this pre-war/wartime cohort who are in their golden years will enter into later life in less than a decade from now. The aim of the present research was to examine the role of stressful life events and family support in successful ageing of the BWG.

METHOD

Data were collected using a self-administered survey completed by 453 members of the BWG who were ≥45 years. The survey included measures such as the Successful Ageing Inventory, Life Events Inventory, and family support subscale of Family Dynamics Scale. Hierarchical multiple regression analyses were conducted to test the hypotheses of the study.

RESULTS

The three dimensions of stressful life events (health events, interpersonal events and work-related/financial events) had moderate negative relationships with successful ageing. Family support was moderately and positively associated with successful ageing. For the moderation hypotheses, family support was a significant moderator of only the relationship between work-related stressful life events and successful ageing, especially for the <65 years subgroup.

CONCLUSION

Growing old can be a very positive experience for both the individual and the society. Family support provides social protection for older people, in the face of difficult socio-economic circumstances.

The Role of Mediators in the Indirect Effects of Religiosity on Therapeutic Compliance in African Migrant HIV-Positive Patients

This research investigates the indirect effects of religiosity (practice and belief) on therapeutic compliance in 81 HIV-positive patients who are migrants from sub-Saharan Africa (23 men and 58 women). Using analyses of mediation and standard multiple regression, including a resampling procedure by bootstrapping, the role of these mediators (magical-religious beliefs and nonuse of toxic substances) was tested. The results show that, through magical-religious beliefs, religiosity has a negative indirect effect, while with the nonuse of toxic substances, religious practice has a positive indirect effect. Beyond religiosity, the role of mediators is highlighted in the interaction with therapeutic compliance.

Population Health Management for Older Adults: Review of Interventions for Promoting Successful Aging Across the Health Continuum

Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted.

Religiosity in black and white older Americans: Measure adaptation, psychometric validation, and racial difference

Racial difference of religiosity in a heterogeneous older population had long been a focal point of gerontological research. However, most religiosity measures were developed from homogenous sample, few underwent rigorous psychometric validation, and studies on racial difference of religiosity had been obstructed. This cross-sectional study adapted a religiosity measure originally designed for blacks only to a heterogeneous older population of blacks and whites, validated its psychometric properties, and examined racial difference of religiosity. Based on qualitative research of concepts, intensive literature review, and abundant experiences in this field, we adapted the original measure. Then, using the data collected from a survey of 196 black and white Americans 55 years and older in Charlotte, North Carolina, we investigated full-scale psychometric properties of the adapted measure at the item-, domain-, and measure- level. These psychometric validations included item analysis, item-scale correlations, correlation matrix among items, confirmatory factor analysis (CFA) to determine if the original factor structure held after adaptation, and reliability analysis using Cronbach's alpha. Finally, using Multiple Indicators and MultIple Causes (MIMIC) models, we examined racial difference of religiosity through regression with latent variables, while potential measurement bias by race through differential item functioning (DIF) was adjusted in the MIMIC models. In result, we successfully adapted the original 12-item religiosity measure for blacks into an 8-item version for blacks and whites. Although sacrificed few reliability for brevity, the adapted measure demonstrated sound psychometric properties, and retained the original factor structure. We also found racial differences of religiosity in all three domains of the measure, even after adjustment of the detected measurement biases in two domains. In conclusion, the original measure can be adapted to and validated for a heterogeneous older population of blacks and whites. Although the adapted measure can be used to measure the three domains of religiosity in blacks and whites, the observed racial differences of religiosity need to be adjusted for measurement biases before meaningful comparisons.

Age, Education, and the Sense of Control

Recent U.S. surveys indicate that older people report a lower sense of control. Moreover, education and impairment explain some of that association. What explains the rest? The author proposes that education, marital and employment statuses, health, financial satisfaction, and religious involvement influence the age differences in control. Using data from a 1996 sample of 1,421 U.S. residents, the author documents an inverted U-shaped association between age and control. Lower education and higher rates of widowhood and retirement account for about 67 percent of older adults’ lower control. Greater financial satisfaction and religious involvement suppresses part of that effect. Similarly, education, marital status, and employment status explain about 54 percent of the linear age effect. Were it not for lower financial satisfaction and declining self-reported health during young and middle adulthood, the age effect would be even stronger. Results support the Cumulative Advantage hypothesis: Education buffers against erosion in control during the later years.

What is the Meaning of Life? Women's Spirituality at the End of the Life Span

Spiritual exploration often occurs after the loss of a significant other or with the impending death of oneself. Twenty-six older women were intensively interviewed; none had experienced a recent loss or terminal illness. Many wanted to understand their place in the order of things and were not looking to organized religion for answers. Dominant themes that emerged from the interviews included: a need to feel connected; spiritual questioning; existential angst; thoughts about death and dying; and, to a lesser degree, reliance on organized religion. Some older women—African Americans, Latinas, and women of lower socioeconomic status—turned to the Bible, prayer, and Church for answers to their questions, but most did not. These data suggest that spiritual questioning—independent of organized religion, significant loss, or impending death—is a natural part of the aging process as one approaches the end of the life span.

Factors Affecting Disability-Related Depression in Patients with Lost Limbs: A Mediational Model

The objective of the present study was to determine the mediating role of self-efficacy between religiosity, social support, and depression in patients with lost limbs. We sampled 67 male and 33 female disabled patients who had lost limbs in accidents or amputations from four public hospitals in Lahore, Pakistan, and used Religiosity Index (Farooq and Imam, in The effect of religiosity on locus of control. Department of Psychology, Govt College University, Lahore, 1997), General Self-efficacy Scales (Tabassum et al., in Urdu adaptation of the general self-efficacy scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm , 2003), Berlin Social Support Scale (Schwarzer and Schulz, in Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm , 2000), and Siddiqui-Shah Depression Scale (Siddiqui and Shah, in Pychol Dev Soc 9(2):245-262, 1997), and used a correlation matrix and mediational analyses along with other inferential statistics to develop a model that suggested self-efficacy mediated between religiosity, social support, and depression with negative correlations that partially mediated this relationship. The findings suggest that low level of religiosity, social support, and self-efficacy may play a role in the onset and continuation of depression or its symptoms. We found no significant differences in gender, education, and cause of disability in patients with lost limbs. Results have implications for clinical psychologists, counselors, and health psychologists to develop a treatment plan for such patients with depression focusing on the factors implicated above.

Successful Aging: Perceptions of Adults Aged between 70 and 101 Years

In this research, content analysis was employed to investigate older adults' perceptions of successful aging and the relationship of these perceptions to definitions given in the literature to date. Participants were 18 males and 42 females between the ages of 70 and 101 years. Analyses revealed older adults mentioned only 1 or 2 criteria of successful aging if asked for a definition; however, when prompted, they rated almost all the criteria emerging from the literature as highly important. Participants reported adjusting to the situations they were in by compensating for losses that occurred and selecting activities that best suited their capabilities. Overall, older adults' perceptions of successful aging were similar to aspects identified in the literature. Not all aspects, however, were seen as important by all participants, and only low to moderate correlations were found between some aspects of successful aging.

Exploring Religion-Health Mediators among African American Parishioners

This qualitative study examined the religiosity-health association among African Americans, with particular attention to mediators through which religiosity positively impacts health. We conducted 31 interviews across seven African American churches of different Christian denominations. Semi-structured interviews were completed with male and female parishioners. Participants were asked to describe the religiosity-health association in their own terms, and if and how their beliefs and practices impact their health. They were also asked about specific mediators proposed in this literature, such as social support and coping with stress. Respondents spontaneously mentioned that church helps them through spiritual health locus of control, coping with stress, positive affect and scriptural influence on lifestyle. These mediators may hold promise for translation into church-based health interventions.

Quality of Life in Adults with Neurofibromatosis 1 in Brazil

Neurofibromatosis type 1 (NF1) is a neurocutaneous genetic disorder that can be associated with severe complications, and it may shorten patients' lifespan and affect their quality of life negatively. This study aimed to examine quality of life constructs among adults with NF1 in Brazil. It is an exploratory, descriptive and cross-sectional study consisting of two stages, involving thirteen adult patients with NF1. The first stage was developed using a quantitative methodology, namely the WHOQOL-100 questionnaire; responses for the 13 patients were compared to a matched control group. The second stage comprised clinical-qualitative research whereby participants took part in a semi-structured interview; these data were analyzed using the categorical thematic analysis technique. There were no statistically significant differences in the questionnaire domains between the NF1 patients and the control subjects. Eighteen main themes were extracted from the interviews, showing interference of the NF1 visibility principally in psychological aspects and social relationships. Patients mentioned curiosity about NF1 and confusion about the distinctions between NF1 and contagious diseases, which lead to prejudice. They were concerned about the future and how the disease would develop in themselves and their offspring, and emphasized difficulties acquiring proper healthcare. These findings may help in planning healthcare for Brazilian NF1 patients and improving their quality of life.