Cancer Survivorship: Religion in Meaning Making and Coping Among a Group of Black Prostate Cancer Patients in South Africa

The purpose of the study was to explore the role of religion in meaning making and coping among a group of black patients receiving some form of prostate cancer treatment at a public hospital in Limpopo Province, South Africa. A sample of 20 prostate cancer survivors, with ages ranging from 67 to 85 years (mean_age = 76yrs; SD = 5.3) selected through purposive sampling. Data were collected through in-depth, semi-structured individual interviews and analysed using interpretative phenomenological analysis (IPA). The findings demonstrated that religion is an important factor in meaning making and coping by prostate cancer survivors. The findings suggest that healthcare practitioners need to pay close attention to the meanings that cancer patients assign to their illness to provide the appropriate care and support.

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.

Can You Teach Medical and Nursing Students About Spirituality?

Spirituality is a central principle in complementary and alternative medical prac tice. Important spiritual issues, which are personal to the patient as well as to the practitioner, can be taught and modeled. This article describes a lecture and small group-based curriculum that can be adapted to teach spirituality. Medical and nursing students were jointly taught using this curriculum. They learned to take a spiritual history using one of three models, to reflect on clinical and personal situations involving spirituality, and to present evidence on the clinical relevance of spirituality. Samples from the syllabus including cases and references are presented.

Effects of Religious Orientation and Gender on Cardiovascular Reactivity Among Older Adults

Recent attention has focused on the relationship between religiosity and health. Although many pathways have been proposed to account for this relationship, little empirical research has investigated specific pathways in relation to specific physiological functions. This study assessed the roles that religious orientation and gender play in moderating psychophysiological reactivity to laboratory stressors among older adults. Those participants characterized by an intrinsic religious orientation (IO) demonstrated less reactivity than did those characterized by an extrinsic religious orientation. Gender did not influence reactivity. There was some evidence that the effect of religious orientation is more pronounced for interpersonal than cognitive-type stressors, although the strongest findings were evident when stressors were aggregated. The magnitude of these effects suggests that they are of practical significance. Given these results and the known relationship between reactivity and hypertension, it is proposed that IO may result in decreased risk of developing hypertension in older adults.

The Ways of Religious Coping Scale: Reliability, Validity, and Scale Development

Ample evidence suggests stress can have serious effects on both physical and mental health. This has motivated researchers to investigate which coping strategies lead to more adaptive responses. One such strategy receiving an increasing amount of attention is religious coping. However, the measurement of religious coping needs further development. The present study reports the development and preliminary reliability and validity studies of the Ways of Religious Coping Scale (WORCS). This scale is a self-report instrument for assessing the degree and kind of religious cognitions and behaviors people use to cope with stress. Results indicate the WORCS is psychometrically sound and may be a useful tool for future research in the area of religious coping.

Religiosity, Religious Coping, and Distress

Religious involvement was measured in a sample of 49 lower socio-economic status Hispanic women who were newly diagnosed with early-stage breast cancer. Religious coping and emotional distress were assessed at pre-surgery, post-surgery, and at 3-, 6-, and 12-month follow-ups. Among Catholic women, greater religiosity tended to be associated with more distress throughout the year; among Evangelical women, in contrast, greater religiosity tended to be associated with less distress throughout the year. These correlations were significantly different at two measurement points. Similarly, religious coping tended to have divergent effects in the two groups. Among Catholics, church attendance at 6 months predicted greater distress at 12 months; among Evangelical women, obtaining emotional support from church members at 6 months predicted less distress at 12 months. These various differences are interpreted in terms of differences in the ideologies of the two religious groups.

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.

Spirituality, religiosity, aging and health in global perspective: A review

Persistent population aging worldwide is focusing attention on modifiable factors that can improve later life health. There is evidence that religiosity and spirituality are among such factors. Older people tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide. Despite increasing research on religiosity, spirituality and health among older persons, population aging worldwide suggests the need for a globally integrated approach. As a step toward this, we review a subset of the literature on the impact of religiosity and spirituality on health in later life. We find that much of this has looked at the relationship between religiosity/spirituality and longevity as well as physical and mental health. Mechanisms include social support, health behaviors, stress and psychosocial factors. We identify a number of gaps in current knowledge. Many previous studies have taken place in the U.S. and Europe. Much data is cross-sectional, limiting ability to make causal inference. Religiosity and spirituality can be difficult to define and distinguish and the two concepts are often considered together, though on balance religiosity has received more attention than spirituality. The latter may however be equally important. Although there is evidence that religiosity is associated with longer life and better physical and mental health, these outcomes have been investigated separately rather than together such as in measures of health expectancy. In conclusion, there is a need for a unified and nuanced approach to understanding how religiosity and spirituality impact on health and longevity within a context of global aging, in particular whether they result in longer healthy life rather than just longer life.

Health and healing: spiritual, pharmaceutical, and mechanical medicine

Modern medical practice is identified as a relatively recent way of approaching human ill health in the wide scope of how people have addressed sickness throughout history and across a wide range of cultures. The ideological biases of medical or "allopathic" (disease as "other" or "outsider") practice are identified and grafted onto other perspectives on how people not engaged in modern medicine have achieved healing and health. Alternative forms of healing and health open a consideration of ethnomedicine, many forms of which are unknown and, hence, untested by modern medical research. Ethnomedicine the world over and throughout human history has displayed unique spiritual (vitalism), pharmaceutical (herbs/drugs), and mechanical (manipulation/surgery) approaches to treating illness. The argument is that modern allopathic medicine would do well to consider such "world medicine" as having valuable alternative and complementary therapies, the use of which could enhance contemporary medical advice and practice.

Expansion and validation of the spiritual health locus of control scale: factorial analysis and predictive validity

The present study reports on the development and validation of an expanded scale assessing spiritual health locus of control beliefs. Additional items were developed, and the scale was pilot tested among 108 church-attending African American women. The scale was multidimensional, comprised of the original Active and Passive Spiritual dimensions, and additional subscales reflecting 'Spiritual Life and Faith' and 'God's Grace'. Internal consistency was acceptable, and predictive validity was evidenced by negative correlations between the Passive Spiritual dimension and knowledge about mammography, breast cancer, and breast cancer treatment, and mammography utilization. This instrument provides an in-depth assessment of beliefs regarding the role of God in one's health, and may be useful for the development of church-based health education serving African Americans.

Reservations of the spirit: the development of a culturally sensitive spiritual beliefs scale about organ donation

This study investigated whether spiritual beliefs offered any explanation for why participants from Korea (N = 146), Japan (N = 134), and the United States (N = 146) were willing or reluctant to register as organ donors. A culturally appropriate measure of spiritual beliefs about organ donation, the Spiritual Beliefs Scale, was developed consisting of 2 factors: (a) Spiritual Connection and (b) Spiritual Concern. Spiritual Connection was a significant predictor of behavioral intention to become an organ donor for Korean respondents, whereas Spiritual Concern was a significant predictor of reluctance to become an organ donor for American respondents. Spiritual beliefs correlated as predicted with attitude toward organ donation and fear of bodily mutilation, showing that the Spiritual Beliefs Scale exhibited internal, external, and predictive validity. Across the 3-country sample, Spiritual Connection was associated with greater willingness to become an organ donor for women, whereas Spiritual Concern inhibited participation for men. Implications of these findings are discussed for developing culturally effective education and procurement campaigns.

The role of religiosity in dietary beliefs and behaviors among urban African American women

The relationship between religiosity and health has been investigated in many studies, with most finding positive associations. However, little is known about the role of religiosity in dietary factors, particularly among African American women. We used a self-administered questionnaire to examine the association between religiosity and dietary beliefs and behaviors among African American women. Women with strong religious beliefs and behaviors reported more interest in eating more fruits and vegetables, perceived their consumption as being more important, and consumed more fruits and vegetables than women low in religious beliefs and behaviors. These findings highlight the role of both religious beliefs and behaviors as they relate to diet-related beliefs and behaviors in this population.

Perceptions of the religion-health connection among African American church members

In this qualitative study, the authors examine perceptions of the religiosity-health connection among African American church members. They conducted 33 interviews with members of predominately African American churches. The clergy and members from each congregation completed semistructured interviews. Participants described the religiosity-health connection in their own words and talked about whether and how their religious beliefs and practices affect their health. The authors derived an open coding scheme from the data using an inductive process. Themes that emerged spontaneously and consistently included but were not limited to spiritual health, mental health's effects on physical health, importance of the church family, giving problems up to God, and the body as a temple of God. These religion-health themes might hold promise for integration into church-based health promotion interventions for this population.

Religious Struggle and Religious Comfort in Response to Illness: Health Outcomes among Stem Cell Transplant Patients

Growing interest has focused on relationships between health and religious coping among cancer patients. However, little is known about the health correlates of negative or conflicted religious responses. The current study examined general religiousness and two modes of cancer-specific religious coping, drawing closer to faith (positive) and struggling with faith (negative), among 213 multiple myeloma patients evaluated at the same point in treatment, during their initial work-up for autologous stem cell transplantation. The outcomes assessed included standardized measures and clinician ratings of depression, general distress, physical functioning, mental health functioning, pain, and fatigue. Results indicated that, after adjusting for relevant control variables, negative religious coping was associated with significantly poorer functioning on all outcomes but one: depression, distress, mental health, pain, and fatigue. Neither general religiousness nor positive religious coping was significantly related to any of the outcomes measured. Results highlight the role of negative or ambivalent religious responses to illness.

Spirituality, breast cancer beliefs and mammography utilization among urban African American women

Spirituality has been shown to be associated with health, and is an important component in the lives of many African Americans. Recent research proposes that spirituality is a multidimensional construct. The present study proposes a two-dimensional model in which spirituality encompasses a belief and behavioral dimension. This hypothesis was examined, as were relationships between these dimensions and spiritual health locus of control, breast cancer beliefs and mammography utilization among African American women. The belief dimension played a more important role in adaptive breast cancer beliefs and mammography utilization that did the behavioral dimension. These findings suggest the importance of spiritual belief systems for health, and implications for spiritual cancer communication interventions are discussed.

Families' use of religion/spirituality as a psychosocial resource

The hospitalization of a child is stressful for a family. Turning to religion/spirituality (R/S) is a potential coping mechanism. Using an integration of Antonovsky's salutogenic model and human ecological theory, this study sought to determine if there is a relationship between the use of R/S as a psychosocial resource and the ability of the family to cope with the stress of child hospitalization. Although findings were inconclusive, a majority of families believed that R/S was important in helping them cope and that their beliefs and practices influenced their choice to use R/S as a resource. Implications for health care providers and administrators are discussed.

Factors affecting African-American participation in AIDS research

BACKGROUND

Although African Americans are disproportionately affected by the AIDS epidemic, they are underrepresented in AIDS research, particularly in AIDS clinical trials. This study examines a multidimensional construct of distrust and other factors that may affect willingness to participate in AIDS research.

METHODS

A total of 301 African Americans (aged >/=18 years) in Durham, North Carolina participated in a cross-sectional survey. In-person interviews, 20 to 25 minutes in length, were conducted with participants. Structural equation modeling was used to develop models exploring distrust and other factors affecting willingness to participate in AIDS research among African Americans.

RESULTS

Distrust was the strongest inverse predictor of willingness to participate in AIDS clinical trials. Distrust was not significantly associated with willingness to participate in AIDS surveys and educational interventions. Altruism, facilitators/barriers, religiosity, and economic group membership were also significantly associated with willingness to participate in AIDS clinical trials. Only altruism was significantly associated with willingness to participate in AIDS surveys and educational interventions.

CONCLUSIONS

Distrust about research institutions is a significant barrier to recruiting African Americans in AIDS clinical trials. Issues of distrust need to be acknowledged by researchers to develop better recruitment and retention strategies when conducting AIDS clinical trials in African-American communities.

Age, pain, and coping with rheumatoid arthritis

The purpose of this study was to examine the relationship of age and pain severity (i.e. mild versus severe pain) in predicting coping strategies of individuals with rheumatoid arthritis (RA). An age-stratified sample (N = 121) of individuals diagnosed with rheumatoid arthritis completed a modified version of the Coping Strategies Questionnaire (CSQ). Individuals were asked to report the coping strategies used for mild versus severe pain. Findings included: (1) older adults were more likely than younger adults to report use of maladaptive coping strategies in the context of mild, but not severe, RA pain, (2) older adults' reported patterns of coping reflected less-than-anticipated expertise in dealing with RA pain, and (3) individuals, regardless of age, reported use of more active coping strategies in the context of mild pain and use of more maladaptive coping strategies in the context of severe pain. The present study suggests that research regarding illness and coping is most informative when it captures the individual-situational interaction of dealing with stressors such as chronic pain.

"God brought all these churches together": issues in developing religion-health partnerships in an Appalachian community

This study explored health-related and organizational religious activities in an Appalachian community and identified cultural issues in the development of religion-health partnerships. Partnerships between religious groups and health providers are a channel for health promotion efforts to vulnerable populations and must be approached from the culture of the community. An ethnographic, exploratory study of health-related and organizational activities in nonmainline religious groups yielded the use of prayer requests, anointing, testimonial, and denominational links as potential health resources. Organizational decisions were by congregational consensus and theological interpretation. The communal setting of worship as an informal resource to a community of believers, especially the vulnerable, was a viable model for religion-health partnerships in central Appalachia. Implications for nursing practice, education, and research also are addressed.

Public health and health education in faith communities

This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

Differences in religiousness among black and white women with breast cancer

Black women are less likely to be diagnosed with breast cancer than white women but more likely to be adversely affected. However, little attention has been paid to how these women cope with the disease. Using a comparative design, this study analyzes the differences in religiousness between black and white women with breast cancer. Findings suggest that black women rely on religiousness as a coping resource to a greater extent than white women. Implications for how this information can be used in social work practice with black women are discussed.

The unique challenges faced by psychiatrists and other mental health professionals working in a multicultural setting

This article describes and analyzes the unique challenges that face psychiatrists and other mental health professionals serving a multicultural population in a limited geographic setting, based on the author's experiences working as a psychiatrist on a mobile crisis unit from 1984 through 1991 on the Lower East Side of Manhattan. Of special importance, the paper presents and provides support for the "interaction hypothesis", which proposes that sociocultural background factors interact with mental disorders to produce dissimilar behavioral expressions of the same disorder among members of different ethnic groups. Concern is voiced that mental health professions, in order to provide effective treatment in multicultural settings, need to understand and accept each ethnic group's idiosyncracies, identity, and background.