Medicine for the Spirit: Religious Coping in Individuals with Medical Conditions

Racial Discrimination, Religious Coping, and Cardiovascular Disease Risk Among African American Women and Men

OBJECTIVE

This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors-systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol-in a sample of African American women and men.

METHODS

Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30-64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed.

RESULTS

In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination.

CONCLUSION

Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.

Multidimensional Religiousness and Spirituality Are Associated With Lower Interleukin-6 and C-Reactive Protein at Midlife: Findings From the Midlife in the United States Study

BACKGROUND

Religiousness and spirituality (R/S) are associated with lower morbidity and mortality, yet the physiological mechanisms underlying these associations are under-studied. Chronic inflammation is a plausible biological mechanism linking R/S to downstream health given the sensitivity of the immune system to the social environment and the role of inflammation in many chronic diseases.

PURPOSE

The purpose of the present study was to examine associations between multiple R/S dimensions and two markers of chronic inflammation, interleukin-6 (IL-6) and C-reactive protein (CRP).

METHODS

In this cross-sectional study, data came from biological subsamples of two cohorts from the Midlife in the United States (MIDUS) Study (combined N = 2,118). Predictors include six R/S measures (service attendance, spirituality, private religious practices, daily spiritual experiences, religious coping, and R/S-based mindfulness). Outcomes include log-transformed IL-6 and CRP. Covariates include age, gender, cohort, race, educational attainment, body mass index (BMI), smoking status, and physical activity.

RESULTS

Older adults, women (vs. men), non-White (vs. White) adults, those with higher BMIs, current smokers, and those not meeting physical activity guidelines had significantly higher IL-6 and CRP. In fully adjusted models, greater spirituality, daily spiritual experiences, religious coping, and R/S-based mindfulness were associated with lower IL-6. Higher spirituality was also associated with lower CRP.

CONCLUSIONS

Many dimensions of R/S may be health protective for adults given their associations with lower levels of chronic inflammation. Findings underscore the importance of examining multiple dimensions of R/S to understand mechanistic pathways.

Posttraumatic Growth in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study

Despite increasing recognition that positive psychological changes or posttraumatic growth (PTG) may develop after highly stressful or traumatic events, contemporary population-based data on the epidemiology of PTG in high-risk samples such as U.S. military veterans are lacking. Additionally, in light of emerging evidence suggesting an 8-factor model of posttraumatic stress disorder (PTSD) symptoms, an up-to-date characterization of how these symptom clusters relate to PTG can help inform efforts to help promote PTG. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 3,847 trauma-exposed U.S. veterans. Participants completed assessments of potentially traumatic events, PTSD symptoms, and PTG, as well as a broad range of sociodemographic, military, trauma, health, personality, and psychosocial characteristics. Results revealed that 63.2% of trauma-exposed veterans and 86.4% of veterans who screened positive for PTSD endorsed moderate-or-greater PTG; these prevalences are higher than those reported in an independent U.S. veteran sample in 2011 (50.1% and 72.0%, respectively). An inverted U-shaped association was observed between PTSD symptom severity and PTG levels, with scores of 31 to 51 on the PTSD Checklist for DSM-5 associated with the highest likelihood of PTG. Intrinsic religiosity and internally- and externally-generated intrusive symptoms of PTSD were identified as the strongest correlates of PTG. Results suggest that prevention and treatment efforts to mitigate severe PTSD symptoms, and help promote intrinsic religiosity, and more deliberate and organized rumination about traumatic experiences may help foster PTG in veterans.

I did not scream. i could not; i was terrified. i just followed them. . .i blocked my mind. then they all raped me: A narrative inquiry on the onset of tonic immobility among women rape victims in Nigeria

Tonic immobility (TI) is a common uncontrollable autonomic mammalian response to an extremely fearful situation. It is one of the most immediate devastating consequences of rape and remains poorly understood. While controversies over its definition persist among researchers, this also reflects on the care for and support to victims. The study aimed to explore and describe the onset of TI and the meaning attached to the experience among women raped victims in Nigeria. The study design was the qualitative narrative inquiry approach. Criterion and purposive sampling were conducted across four post-rape care facilities in Lagos, Nigeria, to recruit 13 participants. In-depth face-to-face interviews were conducted using a semi-structured interview guide to generate data that were thematically analysed. The findings of the study revealed five themes relating to the onset of TI as follows: the first two focused on the experience of TI: (1) the onset of TI prior to rape due to perceived imminent danger, (2) the onset of TI as a self-protection mechanism from further harm) while the last three relate to the meaning-making of the experience of TI (3) self-loathing as a meaning attached to TI, (4) suicidal ideations as a meaning attached to TI, and (5) divine intervention as a meaning attached to TI. Conclusion: The findings underscore the experiences and meanings that participants attach to TI following rape. There is a strong likelihood that tonic-immobility is not an uncommon experience amongst rape victims, but that in the absence of research, specialized care on the condition, and its associated consequences will haunt many women, affecting their psychological well-being and their entire quality of life. Describing the phenomenon as it is experienced by the participants is critical because understanding the condition is the first step toward effective appropriate management.

What's your religious coping profile? Differences in religious orientation and subjective sleep among religious coping groups in the United States

OBJECTIVES

To determine various profiles/subgroups of religious copers based on indices of positive and negative religious coping; and to determine whether religious copers differ in their religious orientations, subjective sleep characteristics, and strategies used to cope with sleep problems.

METHOD

Six hundred and ninety-five adults (77.3% female, 70.4% White) in the United States completed a 20-minute online questionnaire in January 2020.

RESULTS

Results of a latent profile analysis, based on 8 indicators of positive and negative religious coping, indicated a 5-class solution: (i) "Absent" (n = 101, 14.5%); (ii) "Anxious" (n = 122, 17.6%); (iii) "Ambivalent" (n = 101, 14.5%); (iv) "Secure" (n = 200, 28.8%); and (v) "Conflicted" copers (n = 171, 24.6%). Results of MANOVA tests indicated that Secure copers reported the least religious doubt and highest religious-based social support. Conflicted and Anxious copers had the worst sleep quality, while Secure, Ambivalent, and Absent copers had healthier sleep profiles. In terms of strategies used to cope with sleep problems, Secure and Conflicted copers reported the greatest use of prayer and meditation, while the use of technology was most prevalent among Conflicted and Anxious copers.

CONCLUSIONS

Individuals differ in their combined use of positive and negative religious coping, which is related to differences in their religious orientation, sleep characteristics, and strategies used to cope with sleep problems. Religious leaders should be mindful of the diverse ways in which religious coping strategies are harnessed to effectively cater to the unique religious and sleep needs of their members.

Spiritual Well-being, Diabetes Burden, Self-management, and Glycemic Control Among Patients with Type 2 Diabetes in Turkey: A Descriptive and Correlational Study

Spiritual well-being is considered a significant factor in helping to manage chronic diseases and cope with the disease process. This descriptive-correlational study aimed to investigate the relationship between spiritual well-being, diabetes burden, self-management, and among 300 outpatients with type 2 diabetes in Turkey. A significant relationship was found between the diabetes burden and self-management levels and the spiritual well-being of patients with diabetes (p < 0.005). Multiple linear regression analyses found that a high diabetes burden (ß = -0.106) decreased well-being, and high self-management increased well-being (ß = 0.415). Additionally, the results revealed that marital status, household members, performing daily life activities alone, hospitalization due to complications, diabetes burden, self-management, glycemic control, and blood lipid parameters explained 29% of the total variance in the spiritual well-being level. Accordingly, the present study recommended that health professionals should consider spiritual well-being to support disease management with a holistic approach to diabetes patients.

Investigation of the Relationship Between Religious Attitude and Postpartum Physical and Perineal Pain in Iran

Postpartum pain is one of the most important and common problems of postpartum mothers who resort to non-pharmacological strategies to relieve it due to the side effects of painkillers. This study was conducted to investigate the relationship between religiosity and postpartum physical and perineal pain. The sample size in this cross-sectional study was 101 women giving birth in educational and medical centers of Shiraz, Iran, that was selected by purposive-convenience sampling. Then, a questionnaire was completed for each of them including demographic characteristics, religious attitude, and visual scale of postpartum pain. Data were analyzed by SPSS software. The frequency of the majority of the research population was found at moderate religious attitudes 65.4% (72 individuals). There is a positive and Statistical inverse correlation between religious attitude and perineal pain. According to Fisher's test, in mothers with a high religious attitude, 9.7% had severe perineal pain, 41.9% had moderate pain, and 48.4% had mild pain (p = 0.001). Besides, in the case of physical pain, 3.2%, 35.5%, and 61.3% had severe, moderate, and mild pain, respectively. Regarding physical pains, with the increase in the level of mothers' religious attitude, physical pains also decreased, but the statistical relationship was not significant (p = 0.32). The results showed that the religiosity and spirituality of pregnant women have relieving effects on postpartum pain. Therefore, more attention to the spiritual dimension of human existence and planning to improve it using prayer therapy, dhikr, and meditation is suggested as a strategy to deal with the fear of pain and childbirth and reduce psychological and physical changes before and after childbirth. These findings apply to women with ectopic pregnancies in Iran.

Between Life and Death: How do Muslim Terminal Patients in Pakistan cope with Hepatitis C utilizing their Beliefs and Social Support?

Life-threatening events including terminal illness intensify the search for meaning and incite individuals to get closer to religion. Terminal patients can often find religious practices as helpful as medical therapy for bettering both physical and mental health. The present research aims to explain the interaction between religion, spirituality, and social support in coping with terminal illness among Muslim hepatitis C patients in Pakistan. A semi-structured open-ended interview guide was utilized to collect the data. Participants expressed that the deployment of religious and spiritual beliefs along with socio-emotional support during illness fostered medical therapy. Participants also revealed that belief in God provided them the strength to be steadfast during the terminal stage of the disease. Religious beliefs enabled terminal participants to accept death as an eventual reality and a normal part of their lives. Furthermore, participants put forward their longing for those kinds of religious practices that terminal diseases usually restrained them from receiving. The emotional support stemming from social relationships also improved resilience to cope with the terminal stage of illness. The study concludes that the interplay of religion, spirituality, and social support normalizes the fear of death, lessens pain, and improves resilience among Muslim hepatitis C patients in Pakistan.

Reproducibility of the brief religious coping inventory with African athletes' sample using ordinal factor analytical approach

Background

Previous studies have revealed that religious coping strategy is common among athletes due to the stressful experiences before and during competitions as part of the mental preparations they go through, the uncertainty of sporting outcomes, and other organizational issues they encounter. This research assessed the reproducibility of the Brief Religious Coping (RCOPE) instrument in an African setting using athletes' samples from different countries. Particularly, the research sought to assess the (1) factor structure of Brief RCOPE with an African sample, (2) construct validity of the RCOPE measure, and (3) measurement invariance of the RCOPE instrument based on gender and nationality.

Methods

The study surveyed a convenient sample of 300 athletes, including 164 male and 136 female athletes, from 3 African countries (Benin, Ghana, and Nigeria) who participated in the 2018 West African University Games. The Brief RCOPE instrument was administered to the athletes for validation purposes before the competition. Exploratory and confirmatory factor analyses were conducted using the ordinal factor analytic approach.

Results

This validation study confirmed the two-factor dimension (positive and negative religious coping) of the Brief RCOPE measure. Further, all items for each of the dimensions of the inventory contributed significantly to the measure of the Brief RCOPE domains. The positive and negative religious coping dimensions contributed more than half of the variance of their respective indicators. Measurement invariance across gender and nationality was confirmed.

Conclusion

Sufficient evidence was gathered to support the interpretation and use of the Brief RCOPE measure. Coaches and sports psychologists could adopt the Brief RCOPE measure to understand the mental or thought patterns of religious athletes based on existential concerns or stress accrued from impending competitions to inform appropriate religious coping interventions. This notwithstanding, the Minimum Clinical Important Difference (MCID) of the Brief RCOPE should be further investigated to enhance the utility of the instrument for use in intervention-based studies.

Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity

(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon’s governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size > |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p < 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.

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.

Instruments for Assessing Spiritual/Religious Coping in Multicultural Clinical Settings

ABSTRACT

A review of literature was conducted to discover and compare various instruments that could be used in daily nursing practice to assess spiritual and religious coping in a variety of multicultural clinical settings. Fifteen spiritual and religious (S/R) instruments were identified, used in 31 studies in multiple countries. These S/R coping tools may be useful to nurses in assessment and for planning interventions.

Potential influences of religiosity and religious coping strategies on people with diabetes

Diabetes is a significant health issue that threatens patients’ overall wellbeing and quality of life. Critical public health concerns center on creating the best approach for diabetes management. Patients and caregivers have different approaches to diabetes management; however, this and the associated physiological, physical and mental health issues remain challenging. This review explores the potential influences of religiosity and religious coping strategies on people with diabetes. This study used a literature review approach to investigate how religiosity and religious coping strategies can influence the effective management of diabetes among patients. Based on the literature search, the researchers were able to identify and cite published papers that were analyzed using the descriptive-narrative analysis. An important goal of the descriptive-narrative analysis was to provide descriptions of the selected literature and take implications from the literature. The results of studies reviewed show some religious coping strategies for managing chronic diseases such as diabetes. The studies did establish a relationship between religiosity and diabetes management and suggest that religious coping strategies could positively impact the management of diabetes; however, they reported some adverse effects. Hence, we propose a pathway for the development of religion-oriented interventions and support framework for the management of diabetes.

The Effect of Religious Coping on Disease Acceptance and Management Among Patients with Diabetes in Turkey

Religious coping is considered an important factor for assisting with the management of chronic diseases. This study was conducted to determine the relationship between religious coping and disease acceptance and management among patients with diabetes. A total of 504 individuals with type 2 diabetes were included in this descriptive-correlational study. In this study, individuals who did not use their medications regularly, those who did not pay attention to their diet and those who did not exercise regularly had higher levels of positive religious coping. No significant relationship was found between the level of acceptance of illness and religious coping styles among participants with diabetes. However, it was found out that there was a positive relationship between HbA₁C levels and the mean score of positive religious coping and positive religious coping accounted for 7% of the total variance in the glycemic control parameter.

Validation of the Brief RCOPE in Portuguese Family Caregivers of Adults with Health Conditions

Background: Coping is a multifactorial and individual process related to responding to stressful situations, such as being a caregiver of a relative with health conditions. Spiritual/religious coping is an important internal resource used by individuals enduring stressful situations. The 14-item Brief RCOPE is a widely used instrument but not available in European Portuguese. Objective: To translate, adapt and validate the 14-item Brief RCOPE in Portuguese caregivers of an adult relative with a health condition. Method: The methodological guideline provided by Sousa and Rojjanasrirat was used to examine the psychometric properties of the Brief RCOPE. Results: The linguistic and conceptual equivalence of the scale was determined. The internal consistency was acceptable (Cronbach’s α = 0.86). The Principal Axis Factor (PAF) analysis with varimax rotation identified two factors made up of 13 items, and one item was excluded from the scale. Conclusion: The European Portuguese version of the Brief RCOPE is a reliable and valid measure for assessing religious coping of family caregivers of adults with health conditions.

The Relationship Between Death Anxiety and Religious Coping Styles in Patients Diagnosed With COVID-19: A Sample in the East of Turkey

This study was conducted to find out the relationship between death anxiety and religious coping styles in patients diagnosed with COVID-19. This cross-sectional and relational study was carried out with snowball sampling technique between May 15 and June 15, 2021. It was found that the participants had a mean Death Anxiety Scale total score of 10.42 ±2.77, they had a mean positive religious coping sub-scale score of 23.44±2.66 and a mean negative religious coping sub-scale score of 12.82 ±3.08. Statistically significant positive association was found between Death Anxiety Scale and Religious Coping Questionnaire's both positive and negative coping sub-scale scores (p < .05). It was found that patients diagnosed with COVID-19 had high level of death anxiety and positive religious coping styles. It was also found that death anxiety levels increased in the patients as their use of positive and negative coping increased.

Validation of a Scale of Religious and Spiritual Coping (RCOPE) for the Portuguese Population

The scale of religious and spiritual coping (RCOPE) is one of the most used measures in the evaluation of coping strategies based on faith. Despite being validated for the Portuguese language in the Brazilian context, there was still no validation for European Portuguese, which seems important considering the cultural differences. We aimed at examining the validity and reliability of the RCOPE with a Portuguese sample. The present study used cross-sectional data from 1103 volunteers that completed the online survey. After randomly splitting the sample (1:1) for cross-validation purposes, an ordinal exploratory factor analysis and confirmatory factor analysis were performed. McDonald's omega, Cronbach's alpha and mean inter-item correlations were used to determine the internal consistency and homogeneity of the RCOPE. The convergent and discriminant validity of the scale was assessed using standardized factor loadings, the average variance extracted and the squared correlation between latent factors, respectively. In the current study, the final structure of the scale included 17 items aggregated into two correlated latent factors. The Portuguese version of the RCOPE showed acceptable psychometric proprieties, which will be an advantageous instrument for the practice and research of psychology in religion and spirituality.

Psychological Distress Among a Tunisian Community Sample During the COVID-19 Pandemic: Correlations with Religious Coping

Despite advances in medicine and technology, when facing epidemics people continue to turn to religion to deal with such unpredictable life-threatening events. We aimed to assess psychological distress in the general population of Tunisia during the COVID-19 pandemic and to examine the contribution of religious coping (RC) in the reports of anxiety and depression at the time of the survey. We carried out and online cross-sectional study using a non-probability snowball sampling technique. A total of 603 responses were recorded. The "Depression Anxiety Stress Scales," the "Brief religious coping scale" and the "Arabic religiosity scale" were used. We found that 28.3%, 24.4% and 19.4% of the participants reported severe or extremely severe levels of depression, anxiety and stress, respectively. The mean score for positive RC was 22.8 ± 5.3, while that for negative RC was 14 ± 5.8. After controlling for confounders, multivariate analysis showed that negative RC significantly and positively contributed to depression and anxiety scores in our respondents, indicating that greater use of negative RC was associated with higher levels of psychological distress. No significant relationship was found between overall religiosity or positive religious coping and either depression or anxiety symptoms. Religious beliefs may have an impact on how people cope with emerging infectious disease outbreaks. Religion should be considered by professionals as an important variable to consider in therapy for individuals who engage in RC or perceive religious needs.

Racializing the Religious during the COVID-19 Pandemic

In this article, we propose more research attention to an important dimension of social life that bears considerably on the racial patterns of the Coronavirus Disease (COVID-19) pandemic: religion. Drawing from recent insights into the complex relationship between religious affiliation and other intersecting social identities (namely race, gender and class), we argue that understanding the racial inequities of COVID-19 requires consideration of the religious beliefs, participation and the collective resources of racial minorities. We suggest that religion can simultaneously offer a salve for vulnerable communities during this outbreak and can exacerbate the spread of the disease without solving the problem of insufficient access to care. We describe how religion helps and hurts during these turbulent times.

Perceptions of dementia amongst the general public across Latin America: a systematic review

Introduction: Perceptions of dementia are important determinants of support, treatment and care received in the dementia community. Understanding these perceptions are vital for regions such as Latin America, where there is a rapid increase in people living with dementia. The aim of this study is to review and synthesise the general public's perceptions of dementia in Latin America, what factors are associated with these perceptions, and how they differ between countries in the region.Methods: Searches were completed across five databases (Medline, SCOPUS, PsychINFO, SciELO, and WoS). Studies were required to capture attitudes or knowledge of dementia in the general public residing within Latin America. English, Spanish and Portuguese search terms were used. Results were synthesised narratively.Results: About 1574 unique records were identified. Following lateral searches, de-duplication and screening, six articles (four studies) met the inclusion criteria for this review. All the studies were quantitative research from Brazil (median, n = 722). There was evidence of a limited to moderate knowledge of dementia, though a significant minority had negative or stigmatising attitudes. Only higher levels of education were consistently associated with better attitudes and knowledge of dementia in the region.Conclusion: There is a need for more in-depth research about attitudes of the general public across Latin America, particularly outside of São Paulo state, Brazil. There appears to be a greater need to raise awareness of dementia amongst less educated Latin American groups.

Psychometric evaluation of the brief RCOPE and relationships with psychological functioning among caregivers of children undergoing hematopoietic stem cell transplant

OBJECTIVE

Spiritual and religious (S/R) coping is a relevant yet understudied domain of coping among caregivers of children undergoing hematopoietic stem cell transplantation (HCT). The aims of this manuscript are to: (1) conduct the first psychometric evaluation of the Brief RCOPE in this population; (2) examine levels of and changes in S/R coping over time; and (3) explore the relationship between S/R coping trajectories and psychological functioning post-HCT.

METHODS

Caregivers (n = 170) of children (ages ≤12 years, n = 170) undergoing HCT completed the Brief RCOPE and the Brief Symptom Inventory (BSI) pre- and at multiple time points post-HCT discharge. Factor structure, internal consistency, and validity were examined. Growth mixture models were used to identify subgroups with similar S/R coping trajectories, with group memberships added to mixture models to explore relationships between group membership and caregiver psychological functioning trajectories.

RESULTS

The Brief RCOPE exhibited the previously-supported two factor structure and each subscale demonstrated strong internal consistency (α = 0.85 and 0.92). Validity was supported by significant correlations with BSI scores. There were distinct subgroups of caregivers with different patterns of positive (n = 4 subgroups) and negative (n = 3 subgroups) S/R coping, with negative coping subgroup membership predicting changes in psychological functioning.

CONCLUSIONS

The Brief RCOPE is a promising measure for assessing S/R coping among caregivers of children undergoing HCT and has the potential to identify caregivers at risk for poorer long-term psychological functioning.

Religious Coping, Depression and Anxiety among Healthcare Workers during the COVID-19 Pandemic: A Malaysian Perspective

Anxiety and depression have been prevalent among Healthcare Workers (HCWs) amidst the COVID-19 pandemic. This study aims to evaluate the prevalence of anxiety and depression among HCWs amid the pandemic and their association with religious coping. A cross-sectional study design was applied. The scales utilized were Malay versions of the Brief Religious Coping Scale (Brief RCOPE M) and Hospital Anxiety and Depression Scale (HADS M). In total, 200 HCWs were recruited. HCWs scored higher in positive religious coping (mean: 21.33) than negative religious coping (mean: 10.52). The prevalence of anxiety and depression was 36.5% and 29.5%. Both positive and negative religious coping were significantly associated with anxiety (p < 0.01) and depression (p < 0.05, p < 0.01). Positive coping predicted reduction in anxiety (adjusted b = −0.15, p = 0.001) and log-transformed depression score (adjusted b = −0.019, p = 0.025). Negative coping predicted increment of anxiety (adjusted b = 0.289, p < 0.001) and log-transformed depression score (adjusted b = 0.052, p < 0.001). Positive religious coping is vital in reducing anxiety and depression among HCWs amid the pandemic. Strategies which increase positive religious coping and reduce negative religious coping must be emphasized to boost mental health among HCWs.

African Americans' and Black Caribbeans' Religious Coping for Psychiatric Disorders

This study investigates the use of religious coping among African Americans and Black Caribbeans with 12-month DSM-IV psychiatric disorders. Data from the National Survey of American Life is used to examine three indicators of religious coping: 1) using prayer and other spiritual practices for mental health problems, 2) the importance of prayer in stressful situations, and 3) looking to God for strength. Three out of four respondents who had a mental health problem reported using prayer as a source of coping. Agoraphobia and drug abuse disorder were associated with the importance of prayer during stress. Individuals with generalized anxiety disorder were more likely to report that prayer was important during stressful experiences and that they looked to God for strength. These findings contribute to the limited, but growing body of research on the ways that African Americans and Black Caribbeans cope with psychiatric disorders.

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.

'Maybe we are losing sight of the human dimension' - physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study

Objective

Research suggests that existential, spiritual, and religious issues are important for patient’s psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients’ needs.

Design

Physicians’ experiences with and approaches to existential, spiritual, and religious needs when treating chronic pain or multiple sclerosis were studied in eight semi-structured interviews and analysed using interpretative phenomenological analysis (IPA).

Results

Physicians found that only few patients had spiritual and religious needs; however, they experienced that every patient were struggling with existential challenges related to the illness and rooted in a changed identity and approaching death. How the physicians approached these needs appeared to be influenced by six conditions: Their medical culture, training, role, experiences of time pressure, their personal interests, and interpersonal approach.

Conclusion

Physicians’ training seems better suited to meet biomedical objectives and their patients’ concrete needs than patients’ wish for a relational meeting focused on their subjective lifeworld. This challenge is discussed in relation to modern patient-centeredness, doctor-patient relationship, culturally constructed experiences of privacy, and future clinical practice and research needs.

Spirituality Needs in Chronic Pain Patients: A Cross-Sectional Study in a General Hospital in Malaysia

Evidence-based practices that rely upon pain relieving medications and interventional strategies for symptom alleviation in chronic pain survivors have shown modest benefits. The recent emphasis of spiritual care as a new dimension of treatment strategy incorporated within the biopsychosocial model has inspired new hopes to mediate mental and physical health for illness coping. This study aimed to explore the factors associated with spirituality needs among chronic pain patients in a general hospital in Malaysia. An analytical cross-sectional study was conducted among 117 chronic pain patients in a general hospital in Malaysia. Clinical features and assessments were evaluated by an experienced pain physician and retrieved from patient medical records. An interviewer-administered questionnaire that consisted of items on socio-demographics, the validated 19-items spiritual needs questionnaire and the visual analog scale was utilized. Multivariate linear regression analysis was conducted to identify the factors associated with spiritual needs in chronic pain patients. Patients had higher actively giving score as compared to other spirituality need domains. Central neuropathic pain (β = 1.691, p = 0.040) predicted existential. Renal problems (β = 5.061, p = 0.019) highly predicted religiosity; followed by head pain (β = 3.774, p = 0.036), central neuropathic pain (β = 2.730, p = 0.022), heart problems (β = 1.935, p = 0.041), income (β = 0.001, p = 0.003), living arrangement (β = - 3.045, p = 0.022), face (β = - 3.223, p = 0.005) and abdominal (β = - 4.745, p = 0.0001) pains. Predictors of inner peace include renal problems (β = 3.752, p = 0.021), shoulder pain (β = 1.436, p = 0.038) and pain duration (β = - 0.012, p = 0.027). Predictors of actively giving were renal problems (β = 3.803, p = 0.001), central neuropathic pain (β = 1.448, p = 0.017), heart problems (β = 1.004, p = 0.042), income (β = 0.001, p = 0.0001), age (β = - 0.046, p = 0.004) and abdominal pain (β = - 2.617, p = 0.0001). Chronic pain patients had higher actively giving score compared to other spirituality needs. Their spirituality needs were significantly influenced by pain type, duration and site, co-existing medical conditions and socio-demographics.

Belief in God's Help During Hepatitis C: A Qualitative Study on Muslim Patients in Pakistan

Religious/spiritual beliefs play an important role in nursing of patients during chronic condition. Religion comprises an institutionalized set of transcendent ideas, while spirituality is personal and subjective dimension of religious experience in search of sacred (Hill and Pargament in Psychol Relig Spiritual S(1):3-17, 2008). The prevailing literature describes the influential impact of religiosity/spirituality on coping with chronic disease, but specifically patients with chronic liver disease (CLD) have not been studied in Pakistani context. This study examined the patients' belief in religious/spiritual coping, role of religious/spiritual beliefs and prayer as coping strategy. Furthermore, it explored the importance of religious/spiritual beliefs in diverting attention from pain and other needs of CLD patient. A total of 20 patients with chronic liver disease were selected through an appropriate screening process. Subsequently, in-depth detailed interviews were conducted to gather experiences of the hepatitis patients. Religious/spiritual beliefs put forth multiple positive effects that help in coping with chronic hepatitis C. It has been found that patients of hepatitis C use prayer as a coping strategy. Religious/spiritual beliefs have been found as source of diverting attention from pain for the patients suffering from chronic hepatitis C.

The Role of Religious Behavior in Health Self-Management: A Community-Based Participatory Research Study

Prevalence of chronic disease, mental health problems, and risk behaviors in San Bernardino (SB) County reflect some of the worst health outcomes in the State of California and the United States. Using the Integrated Theory of Health Behavior Change (ITHBC) as the theoretical framework, this community-based participatory research (CBPR) study aimed to determine how religious self-regulation skills and ability, and religious behaviors, jointly affect health promotion behaviors among socio-economically challenged residents of southwest SB County, California. A convenience sample of adult residents (N = 261) completed a series of inventories to measure the relationship between modified ITHBC constructs of religious self-regulation skills, religious self-management behaviors, and health outcomes. Structural Equation Modeling (SEM) analysis was conducted to validate the strong positive effect of religious self-regulation skills and ability on how frequently individuals engage in both organized and non-organized religious activities. Results also indicated a significant positive impact of religious behaviors towards healthy eating behaviors. However, without the engagement in religious activities, high religious self-regulation skills and ability inhibited the likelihood of healthy food intake. This faith-related theoretical model provides an avenue for faith-based organizations’ capacity for contributing to community health promotion.

On the links between positive religious coping, satisfaction with life and depressive symptoms among a multinational sample of Muslims

This study tested the levels and consequences of positive religious coping among a multinational sample of Muslims. The sample consisted of 706 university students recruited in three Muslim countries: Israel/Palestine, Turkey and Malaysia. Participants' average age was 22.61, and 65% of them were females. This investigation applied a cross-sectional comparative methodology. Measures used: demographics, positive religious coping, satisfaction with life and depressive symptoms. The findings indicated that (a) participants reported high levels of positive religious coping usage, and Malaysians scored significantly higher in this regard than both Palestinians and Turks; (b) positive religious coping correlated positively with satisfaction with life but was not linked to depressive symptoms and (c) the magnitude of correlation between positive and satisfaction with life was significantly higher among Malaysians than among both Palestinians and Turks. The findings suggest that to understand the implications of positive religious coping for the health and well-being of Muslims, a detailed and nuanced analysis is needed.

Cancer-Induced Bone Pain Management Through Buddhist Beliefs

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

The Prevalence and Antecedents of Religious Beliefs About Health Control in the US Population: Variations by Race and Religious Background

The ways in which religious beliefs influence beliefs about health have important implications for motivation to engage in positive health behaviors and comply with medical treatment. This study examines the prevalence of two health-related religious beliefs: belief in healing miracles and deferral of responsibility for health outcomes to God. Data came from a representative nationwide US survey of religion and health (N = 3010). Full-factorial ANOVA indicated that there were significant differences in both dimensions of belief by race, by religious background, and by the interaction between the two. Black people believed religion played the largest role in health regardless of religious background. Among White and Hispanic groups, Evangelical Protestants placed more responsibility for their health on God in comparison with other religious groups. ANCOVA controlling for background factors socioeconomic status, health, and religious involvement partially explained these group differences.

Influence of coping strategies on oral health-related quality of life in patients with myalgia

OBJECTIVE

To identify coping strategies used by patients with myalgia and to assess the influence of pain characteristics and coping attitudes on their oral health-related quality of life (OHRQoL).

METHODS

One hundred patients diagnosed with myalgia due to temporomandibular disorders were included in this study. They were administered a three-part questionnaire. For preselecting associated coping variables, correlation analysis was performed between coping strategies and OHRQoL domains. A block-wise hierarchical multiple regression analysis was carried out to evaluate whether coping strategies had any influence on OHRQoL.

RESULTS

Notable trends were found between coping strategies and demographic variables and pain characteristics. OHRQoL appeared to worsen with pain severity and with coping strategies that reveal passive or avoidant attitudes of the patient.

DISCUSSION

Individual coping strategies should be considered while managing myalgia. A multidisciplinary approach that aims to help these patients acquire suitable coping strategies may be useful in improving their OHRQoL.

Advancing our understanding of religion and spirituality in the context of behavioral medicine

Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

Enhancing Sense of Coherence and Mindfulness in an Ecclesiastical, Intercultural Group Training Context

Sense of coherence (SOC) and mindfulness (MI) are believed to promote the health and well-being of individuals and organisations. The aim of this longitudinal study was to contribute to the literature on the development of SOC through training and interventions and thereby explore the development of these constructs in a group of senior professionals in the German Catholic Church. A sample of eight participants voluntarily enrolled for a 12-day training programme spread over a period of nine months to develop intercultural and inter-religious competencies, SOC and MI. Quantitative scores of the pre- and post-test SOC and MI questionnaires were qualitatively analysed. Results indicate that the majority of participants scored lower in the post-test on SOC and slightly higher in MI. The discussion explores the pitfalls in the development of these constructs in the study's participants and highlights the implications for theory and practice. Practical training implications for developing SOC and MI are offered.

The Spiritism as therapy in the health care in the epilepsy

OBJECTIVE

to present a brief history of Spiritism, the vision of epilepsy by Spiritism, and the potential of spirituality and religiosity care as complementary and coadjutants treatments in epilepsy.

METHOD

this is a brief review about the impact of faith, spirituality, and religiosity, particularly the Spiritism philosophy as complementary treatment to neurological disorders (particularly focusing on epilepsy) and mental health. We conduct a review of published articles (about religion/spirituality and epilepsy) in the Pubmed and SciELO databases.

CONCLUSION

the exercise of spirituality and religiosity can be a positive coping strategy to support the traditional therapy of patients with epilepsy and other neurological disorders. However, it is necessary to demystify myths and beliefs about the epilepsy and improve knowledge about this important health dimension among professionals, patients, and caregivers to explore their full treatment and supportive potential.

Effects of Religiosity Dimensions on Physical Health across Non-elderly Black and White American Panels

This investigation-based on a three-wave national panel of Black and White Americans aged 64 or younger at wave one-gauges variation across races in the indirect, moderating, and direct effects of public and subjective religiosity on a latent physical health outcome comprising chronic illnesses, subjective health, and functional limitations. The multi-population LISREL model specifically addresses the mechanisms through which religiosity is typically presumed to indirectly foster health: enhancement of social support and self-appraisals, and suppression of stress-exposure and unhealthy habits. The extent to which religiosity buffers or exacerbates the impact of specific stressors is also examined. The impact of religiosity on health appears to hinge on race and religiosity dimension: Public religiosity indirectly enhances Blacks' health slightly, and apparently buffers any negative impact of financial strain on their health. Public religiosity does not influence Whites' health; and subjective religiosity does not influence health in either race. The models control for multiple socio-demographic factors.

Spirituality and Religiousness are Associated With Fewer Depressive Symptoms in Individuals With Medical Conditions

BACKGROUND

The increased prevalence of depressive symptoms among adults diagnosed with chronic health issues has been largely documented.

OBJECTIVES

Research is needed to clarify the effect of religiousness/spirituality in relation to chronic health conditions and depression, to establish whether these variables can serve as protective factors.

METHODS

Self-report data from a nationwide study of spirituality and health were used. Individuals with at least 1 chronic illness (N = 1696) formed the subsample for this study. Religiousness/spirituality variables included frequency of church attendance, prayer, religious meaning, religious hope, general meaning, general hope, peace, and view of God. Other variables included depressive symptoms and demographics (age, gender, ethnicity, and education).

RESULTS

A series of hierarchical regression analyses revealed that chronic conditions were consistently associated with more depressive symptoms. Greater religiousness/spirituality was significantly associated with fewer depressive symptoms, contributing 16% of the variance above demographics and the number of chronic illnesses. The religiousness/spirituality variables conferring the greatest protection against depression were psychospiritual variables (general meaning and general hope, followed by peace). Also significant but making a smaller contribution to less depression were church attendance, religious meaning, religious hope, and positive view of God. Only prayer did not relate significantly to less depression.

CONCLUSION

Maintaining a sense of spirituality or religiousness can benefit well-being of individuals diagnosed with a chronic health condition, especially having meaning, maintaining hope, and having a sense of peace. Patients could potentially benefit from being offered the resources that support their spiritual/religious practices and beliefs as they cope with chronic illness.

Optimal Health (Spirit, Mind, and Body): A Feasibility Study Promoting Well-Being for Health Behavior Change

Faith-based programs have shown beneficial effects for health and behaviors. Few have specifically intervened on the spiritual, mental (i.e., stress), and physical dimensions of well-being combined for health and healthy behaviors (i.e., exercise and diet). The purpose of this report is to describe the feasibility of executing a spirituality-based health behavior change, program founded upon the Spiritual Framework of Coping. This study was a quasi-experimental one group pretest-posttest design. Feasibility objectives were assessed, and limited efficacy of pretest and posttest measures was analyzed using paired t test (p < .05). Acceptance of the program was positive, and modest demand was shown with initial interest and an average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy measures showed no pre-post changes. This study provided preliminary support for the design and further testing of the theoretical components of the Spiritual Framework of Coping that informed the program.

Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth

Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy with spiritual visualization (IPT + SV) in group appears to be a feasible and potentially useful treatment option for promoting improved mental health.

Health-related quality of life and the predictive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast cancer: a prospective study with comparative design

Background

There is disagreement among studies of health-related quality of life (HRQoL) changes in breast cancer patients over time. Reportedly, assessment of HRQoL prior to diagnosis may be crucial to provide a clear point of comparison for later measurements. The aims of this study were (1) to investigate changes in HRQoL, sense of coherence (SOC), spirituality and religious coping in a group of women with breast cancer from the pre-diagnosis phase to 6 months later in comparison with a control group, and (2) to explore the predictor role of SOC, spirituality, and religious coping within the breast cancer group at the 6-month follow-up.

Methods

A sample of women with breast cancer (n = 162) and a matched control group (n = 210) responded to the following instruments on both occasions: the European Organization for Research and Treatment of Cancer QLQ-C30, the SOC Scale, the Spiritual Perspective Scale and the Brief Religious Coping Scale. A series of General Linear Model (GLM) Repeated Measures was used to determine changes between the groups over time. Also, Multiple Linear Regression analyses were applied to each of the HRQoL dimensions, as dependent variable at the 6 months follow-up.

Results

Physical and role function, fatigue, and financial difficulties were rated worse by the women with breast cancer during the first 6 months in comparison to the controls, which was both a statistically (p < 0.001) and clinically significant difference. Women had better scores for global quality of life (p < 0.001), and emotional functioning (p < 0.01) during the same period of time. The degree of SOC (p < 0.01) and baseline ratings of several dimensions of HRQoL (p < 0.05) were the most important predictors of HRQoL changes.

Conclusions

Collecting HRQoL data before a final diagnosis of breast cancer is important to identify women at risk of deterioration in HRQoL during and after treatment. Special attention should be paid to physical and role functioning impairment, fatigue, and financial difficulties experienced by these women. These results underscore that the degree of SOC may be more important as a predictor for HRQoL changes in this sample than spirituality and religious coping.

Exploring the association of sense of coherence, and spiritual and religious beliefs in a rural population group on the island of Crete, Greece

OBJECTIVES/AIM

This article reports the results of an observation study, aimed at exploring an association between spirituality, religiousness, and sense of coherence in a population group residing in a rural area of Crete, Greece.

STUDY DESIGN AND METHODS

The study was conducted during the period 2007-2009. Subjects aged 65 years and older (n = 118) living in two remote and rural villages in the Heraklion county (Crete) were eligible. Eighty-nine people (51 women and 38 men) participated. Demographic data were obtained, and all participants were asked to complete the Greek version of the self-reported Royal Free Interview for Spiritual and Religious Beliefs, and the Sense of Coherence Scale.

RESULTS

Most participants reported strong religious beliefs and this was found to be related with increased age. Widowed participants expressed greater religiousness and spirituality (p = 0.029). The total score for Sense of Coherence was negatively correlated with gender (women have lower scores, p < 0.05), marital status (widows presented lower scores, p < 0.001), and increased age. A strong positive correlation of the Sense of Coherence score with the Spiritual Scale as measured by three questions of the Royal Free Interview was also identified (p = 0.039).

CONCLUSIONS

The impact of gender and marital status seem to be emerging determinants in defining sense of coherence among inhabitants of rural Crete. The positive association between religious/spiritual beliefs and sense of coherence deserves further attention to promote a multidimensional approach in its study.