Religious practices and changes in health-related quality of life after hospital discharge for an acute coronary syndrome

Psychosocial adjustment changes and related factors in young and middle-aged patients with first-episode acute myocardial infarction: a longitudinal study

AIMS

This study aimed to explore the change trend and group heterogeneity of psychosocial adjustment level and to determine its influencing factors among young and middle-aged patients with first-episode acute myocardial infarction (AMI).

METHODS AND RESULTS

The Psychosocial Adjustment Scale of Illness was used to assess the psychosocial adjustment level of the patients at 1, 3, and 6 months after discharge, respectively. Data were analysed using Pearson correlation analysis, generalized estimating equations, and growth mixed models. A total of 233 patients were included, and their psychosocial adjustment scores at the three time points were 57.18 ± 15.50, 36.17 ± 15.02, and 24.22 ± 12.98, respectively. The trajectories of changes in patients' psychosocial adjustment levels were divided into three latent categories: moderate adjustment improvement group (72.5%), low adjustment improvement group (16.3%), and persistent maladjustment group (11.2%). Among them, predictors of the persistent maladjustment group included no spouse, low monthly family income per capita, normal body mass index, never smoking, never exercising, combined with hyperlipidaemia, low social support, submission coping, and high perceived stress.

CONCLUSION

The psychosocial adjustment level of young and middle-aged patients with first-episode AMI showed an upward trend within 6 months after discharge, and there was group heterogeneity in the change trajectory of psychosocial adjustment level. It is suggested that a multicentre, large-sample longitudinal study should be carried out in the future, and the time of follow-up investigation should be extended to further clarify the change trajectory and influencing factors of psychosocial adjustment of patients with different subtypes, to provide the theoretical basis for formulating targeted intervention programmes.

Relationships between disease severity, psychological stress, and health-related quality of life among patients with acute coronary syndrome: mediation of illness perception

AIMS

Patients with acute coronary syndrome (ACS) often experience reduced health-related quality of life (HRQOL), which may be attributable to the disease severity and psychological stress. While illness perception is speculated to be a potential pathway underlying these relationships, evidence supporting this mechanism remains limited. This study aimed to investigate the relationships between disease severity, psychological stress, and HRQOL and whether these relationships are mediated by illness perception in patients with ACS.

METHODS AND RESULTS

Data were collected from June to July 2019 and June to September 2020 in the cardiology departments of four public hospitals in China. Eligible patients completed measures of disease severity, psychological stress, illness perception, HRQOL, and socio-demographic and clinical characteristics. Data were analysed employing hierarchical multiple regression and structural equation modelling. This study included 405 participants (mean age 60.63 years, 67.4% male). After controlling for socio-demographic and clinical covariates, higher levels of disease severity (β = 0.115, P = 0.024) and psychological stress (β = -0.209, P＜0.001) were associated with poorer HRQOL; however, the relationships became non-significant after adding illness perception into the regression model. Structural equation modelling analysis suggested that illness perception played a mediating role between disease severity, psychological stress, and HRQOL, accounting for 45.95% and 65.79% of the total effects, respectively.

CONCLUSION

This study found that illness perception mediated the relationships between disease severity, psychological stress, and HRQOL among patients with ACS. Improving patients' HRQOL should consider its important influencing factors with a focus on promoting positive illness perception.

The Relationship Between Religious Coping, Spirituality, and Disease Self-Management Among Parkinson's Patients in Turkey

Religion and spirituality can be important motivational tools in the management of Parkinson's disease. This study was conducted to determine the relationship between religious coping methods, spirituality, and disease self-management levels in Parkinson's patients. This descriptive, cross-sectional, and correlational study was conducted with 294 Parkinson's patients. Descriptive statistics, independent samples t test, one-way analysis of variance, Pearson correlation coefficient, and structural equation modeling were used in the analysis of the data. This study showed that Parkinson's patients adopted both positive and negative religious coping styles, demonstrated good levels of spirituality, and had high levels of disease self-management. A statistically significant relationship was found between the positive and negative religious coping levels of Parkinson's patients and their levels of spirituality and disease self-management (p < 0.05). Health professionals may consider and support Parkinson's patients' use of religion as a coping mechanism, as this may help manage Parkinson's disease.

Examining How Religion is Addressed During Preoperative Stoma Counseling

INTRODUCTION

An intestinal stoma creation is one of the most common surgical procedures. Despite benefits, a stoma can have serious effects on a patient's quality of life. Multiple dimensions of everyday life can be affected such as social life, body image, as well as ability to participate in some religious practices, with some faith groups being disproportionately affected. This study sought to understand the extent to which faith is addressed during these sessions given the integral role it plays for some patients.

METHODS

A survey was developed based on literature review and expert consultation. This was distributed to ostomy certified nursing staff, inflammatory bowel disease gastroenterologists and colorectal surgeons caring for patients requiring a permanent stoma at a high-volume academic institution. Follow-up semistructured interviews were conducted to delve deeper into themes identified in the surveys.

RESULTS

The overall survey response rate was 57%. Only 35% reported training on how stomas interface with religious practices. Religious services were either rarely or never present during preoperative counseling discussions. During interviews, it was noted that religious beliefs often impact after care but are not always discussed during preoperative sessions. Interviewees found these conversations to be difficult with minimal support or direction on how to navigate them.

CONCLUSIONS

Although very important, health-care providers are not including faith-based issues surrounding stomas in perioperative counseling partly due to lack of training or awareness of existing support systems. As our population diversifies, understanding cultural and religious practices that influence care is increasingly important.

Older Adults with Dementia: Association of Prayer with Neuropsychiatric Symptoms, Cognitive Function, and Sleep Disturbances

Protective factors that slow dementia progression and improve quality of life are needed. Neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances are commonly found in dementia, indicate progression, and increase caregiver distress. The purpose of this study was to examine the association of private prayer with NPS, cognitive function, and sleep disturbances in older adults with dementia. We analyzed data from the Health and Retirement Study in 2000, 2006, and 2008 and Aging, Demographics, and Memory Sub study in 2001-2003, 2006-2007, and 2008-2009 among 40 older adults (age 70-100 years, mean age = 84.67, 29 females and 11 males, 73.9% non-Hispanic White, and 19.2% Non-Hispanic Black, and 3% Hispanic, cognitive function = 1.169 indicating mild cognitive impairment) using correlational analysis. The results indicated that increased frequency of private prayer was significantly associated with lower NPS, better cognitive function, and lower sleep disturbances. In total, 100% of Non-Hispanic Black and Hispanic participants reported praying at least once per week. Findings could be due to use of cognitive processes used in prayer during supplication, requesting aid, and through communication with the divine, reducing loneliness. Longitudinal studies including historically underrepresented populations are needed to examine these associations over time.

Depression and Religious Coping in Patients with Acute Coronary Syndrome in Turkey

Psychological health problems such as depression, anxiety and feelings of distress are often seen in patients with acute coronary syndrome (ACS). Religious coping in dealing with psychological health problems is one of the methods commonly used by cardiac patients. This study was conducted to determine the depression levels and religious coping methods of individuals diagnosed with ACS and identify the relationship between their positive or negative religious coping methods and their depression levels. The descriptive and correlational study was conducted with 253 ACS patients. In the study, the depression levels of most patients were low, but 19.8% showed moderate-severe depressive symptoms. It was found that the patients adopted positive religious coping styles on a high level, but there was no significant relationship between positive religious coping and depression levels (p > 0.05). It is recommended that health professionals also closely monitor ACS patients for depressive symptoms after their diagnosis, encouraging patients to use positive religious coping styles to support their well-being and recovery against this life-threatening disease.

Racial and socioeconomic status differences in stress, posttraumatic growth, and mental health in an older adult cohort during the COVID-19 pandemic

Background

The COVID-19 pandemic has disproportionately impacted the most vulnerable and widened the health disparity gap in both physical and mental well-being. Consequentially, it is vital to understand how to best support elderly individuals, particularly Black Americans and people of low socioeconomic status, in navigating stressful situations during the COVID-19 pandemic and beyond. The aim of this study was to investigate perceived levels of stress, posttraumatic growth, coping strategies, socioeconomic status, and mental health between Black and non-Hispanic, White older adults, the majority over the age of 70. Additionally, we investigated which variables, if any, were associated with posttraumatic growth in these populations.

Methods

One hundred seventy-six community dwelling older adults (mean age = 76.30 ±8.94), part of two observational studies (The Harvard Aging Brain Study and Instrumental Activities of Daily Living Study) in Massachusetts, US, were included in this cross-sectional study. The survey, conducted from March 23, 2021 to May 13, 2021, measured perceived stress, behavioral coping strategies, posttraumatic growth, and mental health during the COVID-19 pandemic. We investigated associations with post-traumatic growth in a multiple linear regression model and examined their differences by race with t-tests, Wilcoxon rank-sum tests, and Fisher's exact tests. A second multiple linear regression model was used to examine which coping strategies were associated with posttraumatic growth.

Findings

Our results indicated no significant difference between the groups in terms of mental health or stress. However, Black participants showed significantly greater posttraumatic growth compared to non-Hispanic, White participants. Additionally, the coping strategies of religion and positive reframing were found to be significantly associated with posttraumatic growth. Furthermore, even with the effects of stress and coping strategies controlled for, race remained significantly associated with posttraumatic growth.

Interpretation

The COVID-19 pandemic has differentially impacted Black and non-Hispanic White older adults. These results may help encourage further analysis on geriatric psychiatry as well as understanding how cultural values and adaptations impact posttraumatic growth and mental health in diverse populations.

Funding

The Harvard Aging Brain Study (HABS) has been funded by NIH-NIA P01 AG036694 (PI: Reisa Sperling). The IADL study is funded by the National Institute on Aging (R01 AG053184, PI: Gad A. Marshall).

Religious Struggle and Life Satisfaction Among Adult Christians: Self-esteem as a Mediator

The religious dimension of life represents an important source of human strength, meaning, and coping for many people. However, the religious life is not always "smooth and easy" and can be associated with weak personal adjustment, poorer psychological well-being, and lower satisfaction. Yet, besides the direct relationship between these variables, some researchers postulate the existence of an indirect association that has not been fully explained by various psychosocial mediators. The aim of the present study was to verify whether self-esteem could be a potential mediator between religious strain and life satisfaction. The sample consisted of 607 adult Christians (49.6% women) aged between 18 and 79. We used the Religious Comfort and Strain Scale, the Satisfaction with Life Scale, and the Rosenberg Self-Esteem Scale. Consistent with our hypotheses, life satisfaction positively correlated with religious comfort and was negatively associated with fear/guilt, negative emotions toward God, and negative social interactions surrounding religion. The same pattern of results was shown in the case of self-esteem. Moreover, the outcomes obtained from bootstrap sampling (5000) with a 95% confidence interval indicated a significant role of self-esteem as a mediator in all of the relationships between: (1) religious comfort and life satisfaction; (2) fear/guilt and life satisfaction; (3) negative emotions toward God and life satisfaction; and (4) negative social interactions surrounding religion and life satisfaction.