Intrinsic/extrinsic religious orientation of the elderly: relationship to depression and self-esteem

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice

BACKGROUND

This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD).

METHODS

Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop).

RESULTS

The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation.

CONCLUSION

Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.

[The influence of religiosity on depressive disorders and suicidal behavior]

This review of the literature is focused on the positive influence of religiosity on recovery after depression and on the protective role of religiosity against suicidal activity. Despite the inconsistent results on the role of religiosity in treatment of mental diseases, to date there is a sufficiently large body of literature showing the beneficial effect of religiosity and describing specific therapeutic approaches and suicide prevention programs.

Explaining the relationship between post-critical beliefs and sense of coherence in Polish young, middle, and late adults

The subject of the presented research is the analysis of relations between Post-Critical Belief and Sense of Coherence in women and men in early, middle, and late adulthood. Six hundred and thirty-six individuals participated in the research, 332 women and 304 men, at the age of 18-79 years. We applied the Post-Critical Belief scale by Hutsebaut (J Empir Theol 9:48-66, 1996) and the Sense of Coherence scale (SOC-29) by Antonovsky (Soc Sci Med 36:725-733, 1993). The results suggest that the salutogenic function of religiosity is related to age and gender--in women, it is most strongly marked in late, and in men, in middle adulthood.

Religious orientation and health among active older adults in the United States

This study utilizes a combination of intrinsic and extrinsic Religious Orientation Scales to explore the connection between religion and health in a sample of physically active, older adults. The revised Religious Orientation Scale and the RAND Short Form 36 (SF-36) were adopted to relate religious orientation (intrinsic, extrinsic, pro-religious, and non-religious) and self-rated mental and physical health status. Individuals of pro-religious orientation reported significantly worse health for physical functioning, role limitations due to physical health, and energy or fatigue when compared with those of all other religious orientations; however, no dose-response relationships were found between religious orientation and self-rated health. The results of this study indicate that deleterious health effects may accompany pro-religious orientation. Caution is provided for directors of religious programs for older adults.

Coping Strategies: Gender Differences and Development throughout Life Span

Development during life-span implies to cope with stressful events, and this coping may be done with several strategies. It could be useful to know if these coping strategies differ as a consequence of personal characteristics. This work uses the Coping with Stress Questionnaire with this aim using a sample of 400 participants. Specifically, the effects of gender and age group (young people, middle age and elderly), as well as its interaction on coping strategies is studied. With regard to age, on one hand, it is hypothesised a decrement in the use of coping strategies centred in problem solving and social support seeking as age increases. On the other hand, the use of emotional coping is hypothesised to increase with age. With respect to gender, it is hypothesised a larger use of emotional coping and social support seeking within women, and a larger use of problem solving within men. A MANOVA found significant effects for the two main effects (gender and age) as well as several interactions. Separate ANOVAs allowed us to test for potential differences in each of the coping strategies measured in the CAE. These results partially supported the hypotheses. Results are discussed in relation to scientific literature on coping, age and gender.

Ageing Anglican Clergy and Performance Indicators in the Rural Church, Compared with the Suburban Church

This study employs path analysis to examine the relationship between clergy age and certain quantitative indices of church life in two samples: a sample of 1,553 villages and rural communities, ranging in size from 251 to 1,250 inhabitants and a sample of 584 suburban parishes. The data indicate that clergy aged sixty or over working in rural parishes tend to have contact with a smaller number of active church members, as indicated by attendance on a normal Sunday, than younger clergy working within comparable rural parishes, although they maintain contact with the same number of nominal church members, as indicated by the electoral roll and festival communicants. Clergy aged sixty years or over working in suburban parishes, on the other hand, have contact with the same number of active church members as younger clergy working within comparable suburban parishes. These findings are discussed in the light of a growing body of research which suggests that changing patterns of rural ministry may be generating difficulties and stresses for clergy approaching the age of retirement.

Spirituality and Health: Perceptions of Older Women in a Rural Senior High Rise

The purpose of this study was to examine the essence of spirituality and health in older women living in a rural senior high-rise apartment building. The researchers used a phenomenological research design and interviewed 10 women 65 years of age and older. Data analysis using Colaizzi's (1978) method for analysis revealed three themes-health is functional and provides a sense of wholeness; the relationship with God or a higher power is a personal one; and death is a part of life. The three themes create an essential structure, which influences the way the participants live. These findings provide information for nurses on the spiritual needs of older women and how the experiences of living in a high rise affect spirituality and health.

Religious participation, interleukin-6, and mortality in older adults

This study prospectively examined the relationship between religious attendance, interleukin-6 (IL-6) levels, and mortality rates in a community-based sample of 557 older adults. Attending religious services more than once weekly was a significant predictor of lower subsequent 12-year mortality and elevated IL-6 levels (> 3.19 pg/mL), with a mortality ratio of.32 (95% confidence interval [CI] = 0.15,0.72; p <.01) and an odds ratio for elevated IL-6 of.34 (95% CI = 0.16, 0.73, p <.01), compared with never attending religious services. Structural equation modeling indicated religious attendance was significantly related to lower mortality rates and IL-6 levels, and IL-6 levels mediated the prospective relationship between religious attendance and mortality. Results were independent of covariates including age, sex, health behaviors, chronic illness, social support, and depression. Findings are consistent with a role for IL-6 in processes mediating the relationship between religious attendance and mortality.

Psychometric evaluation of the Spiritual Coping Strategies scale in English, Maltese, back-translation and bilingual versions

BACKGROUND

The little research that has been done on the topic considers spiritual coping as consisting mainly of religious coping strategies. This limits spiritual coping solely to believers. However, it is argued that spiritual coping should address both believers and non-believers. The development of the new Spiritual Coping Strategies (SCS) scale, which consists of both religious and non-religious coping strategies attempts to fill this research gap. Aim. The aim of this article is to discuss the psychometric assessment of the SCS scale designed in four versions, namely English, Maltese, back-translation and bilingual.

METHODS

The Likert-type SCS scale comprises 20 items, each represented by the frequency and helpfulness of both religious and non-religious coping strategies. Test-retest of the four versions was conducted between October 1999 and January 2000, with 55 final year nursing students, mean age of 24.5 years, recruited from the same class to facilitate supervision and prevent contamination of results. Test-retest reliability of the scale was investigated by cross-tabulations, Kappa (kappa) measures and Spearman's correlation coefficient. Internal consistency was tested by Cronbach's alpha. The correlation structure was examined by the multivariate techniques of R-type cluster analysis and direct oblimin factor analysis.

RESULTS

Cross-tabulations between tests and retests gave highly significant values of chi-squared (P < or = 0.0001) for most items in all versions of the scale. These cross-tabulations also yielded reasonably good values for kappa. Additionally, satisfactory values for Spearman's coefficient of correlation resulted between tests and retests. Twelve frequency variables and 13 helpfulness variables had test-retest correlations in the range 0.5 < or = rs < or = 0.79 in at least three of the versions. Optimum values of Cronbach's alpha were observed for the helpfulness variable in retests namely, 0.81 for the English version, 0.73 for the Maltese version, 0.79 for the back-translation, and 0.82 for the bilingual version. These values were all above the acceptable minimum value of 0.7. The correlation structure identified two factors, namely religious and non-religious coping strategies. Although the two factors together explained only between 33% and 40% of the variance in the different versions, the religious factor had good reliability, with 0.77 < or = alpha < or = 0.82 for the four versions, whilst the non-religious factor also had alpha > or = 0.71 for all versions except the Maltese one, for which alpha = 0.59.

CONCLUSION

Therefore, psychometric assessment suggests that the SCS scale, in any of the four versions, is a reliable tool which can be used in future studies on SCS in Maltese patients.

Nurturing hope and spirituality in the nursing home

Nurturing body, mind, and spirit is part of holistic care, and yet often the primary focus of care in nursing homes is physical needs. As part of a larger study examining factors related to hope among institutionalized elders, spirituality emerged as the only significant predictor of hope. Findings supported the active presence of hope despite age and functional limitations. The significant contribution of spirituality to hope calls for attention to the provision of opportunities to support and enhance spiritual practices in the nursing home setting. Nurses in nursing homes have the opportunity to establish close relationships with residents over time, often substituting for family and friends no longer available. Because length of stay is long, more time is available to enter into meaningful spirit-sharing relationships with residents. Suggestions for interventions that nurture hope and spirituality within a holistic and caring framework are presented.

Prayer and health outcomes in church lay leaders

This study examined the relationship of frequency of prayer on health outcomes in a national sample of 1,014 church lay leaders. The survey included questions on the frequency of prayer and the Medical Outcomes Study, Short Form 36 Health Survey, measuring eight categories of functional health. The results indicated a high level of functioning overall. Age was strongly related to most aspects of health in this sample. Frequent prayer was associated with poor physical functioning and poor ability to carry out role activities, but these relationships were not significant when the effect of age and gender was controlled. Frequent prayer was also significantly associated with high mental health scores, regardless of age or gender. This study supports the growing body of data suggesting a positive relationship between frequency of spiritual practices and mental health, even in a homogeneous sample of active church members.

Faith, prayer, and health outcomes in elderly Native Americans

This survey questioned 71 Native Americans over age 65 living in the general community on their frequency of prayer, importance of faith, and their health status. The researchers hypothesized that people with higher scores in faith and prayer would experience a more positive health status. Self-reports of health indicated a high level of functioning overall. Older people and those living alone had poorer physical and emotional health outcomes than younger elders and those living with one or more persons, although neither age nor living situation was related to mental health. People who prayed more often and those who indicated a high importance of their faith scored higher in the mental health subscale, confirming the hypothesis for this dimension of health.

Program planning for an assisted living community

Occupational therapy has long had a vested interest in activity programming for the elderly. During the past, this interest has been largely confined to adult day care centers for community dwelling elderly, and to nursing homes for long term care of the elderly. In light of the interest generated by the recent entry of assisted living into the housing continuum, program models and understanding of the population of people who choose this option are of interest. This article introduces one model of wellcare for assisted living residents and describes a population of 626 residents in approximately 30 Morningside assisted living communities dispersed over the Southeast. The Healthy Generation model outlined in this article emphasizes five separate but inter-related domains that have been shown to impact the quality of life of aging individuals. Through the use of a multidimensional instrument, these domains (intellectual, social, physical, spiritual and emotional) are surveyed at the time each resident moves into a Morningside community. The resulting picture of the population is utilized by the assisted living program planners to create a monthly balanced calendar that intentionally engages each domain to support and enhance resident function and well being. This model has a direct bearing on practice of geriatric occupational therapy and this emerging area of practice.

Factors related to the emotional responses of intubated patients to being unable to speak

OBJECTIVES

The purpose of the study was to examine the relationships among the intensity of intubated patients' negative emotional responses to being unable to speak and selected personal and situational variables.

DESIGN

Prospective correlational.

SETTING

Four intensive care units in a midwestern, university-affiliated medical center.

PATIENTS

A convenience sample of 48 patients intubated for 24 or more hours, alert and oriented to person, place, and situation.

OUTCOME MEASURES

Emotional responses (anger and worry/fear) to being unable to speak.

RESULTS

Multiple regression showed that self-esteem, severity of illness, difficulty with communication, and the number of days intubated at data collection were significantly associated with patients' emotional responses.

CONCLUSIONS

Results from this study extend prior research and support the need for nurses to facilitate communication and to support self-esteem in patients receiving ventilatory assistance, particularly in the early days of intubation. Implications for future research are discussed.

Religious well-being in noninstitutionalized elderly women

Spirituality is recognized as an important component of health care practice with elderly people. Yet, discussion of the role it plays in elderly women on a day-to-day basis is minimal, and it is frequently not addressed in quality-of-life studies in this population. The purposes of this study were to describe the level of religious well-being and selected characteristics of religiosity in a sample of 114 non-institutionalized, largely rural elderly women (Mdn age = 75), as well as to identify the relationship between selected factors and the level of religious well-being. Descriptive research revealed a high level of religious well-being among the participants and significant positive correlation between religious well-being and the variables of social support and hope (p < .001). Through stepwise multiple regression, hope emerged as the single significant predictor of religious well-being (p < .001), explaining 31% of the variance in the dependent variable. The majority of respondents reported regularly participating in religious activities, highly rated the value or influence of religious beliefs in their lives, and identified that religious beliefs become increasingly important with age. Conducting a comprehensive assessment and implementing focused interventions associated with religious well-being will strengthen the scope of health care practice for elderly women.

A spiritual well-being model: use with older women who experience depression

Although evidence exists to suggest an integral influence of one's spirit on one's mental health, few nurse theoreticians have attempted to delineate and include the concept of spirituality in their nursing models. In making practice decisions related to spiritual matters, mental health nurses require knowledge about the interface between spirituality and mental health. Many symptoms of depression, the most common mental health problem of older adults, parallel indications of spiritual distress. The author presents a spiritual well-being model that provides a framework to discuss the antecedents, symptoms, spiritual needs, and holistic treatment of depression as it is experienced by older women.

Relationship of religion and perceived social support to self-esteem and depression in nursing home residents

This study is an examination of the relationship of religiosity and perceived social support to depression and self-esteem in nursing home residents. Answers to questionnaires administered to 83 nursing home residents indicated that perceived social support from family, public religious activity, and length of stay in the home were related to self-esteem and to depression. Past occupational status was also associated with self-esteem. Health status and having a choice in selecting the nursing home were negatively related to depression. Intrinsic religiosity and the resident's perceived social support from friends were not significantly related to depression or self-esteem.

Religious coping and cognitive symptoms of depression in elderly medical patients

The investigators examined associations between depressive symptom type and religious coping in 832 consecutively admitted older medical inpatients. Cognitive symptoms of depression, but not somatic symptoms, were related to religious coping. Boredom, loss of interest, social withdrawal, feeling downhearted and blue, restlessness, feeling like a failure, feeling hopeless, or feeling that other people were better off were all significantly less common among religious copers. Difficulty initiating new activities was the only somatic symptom related to this coping behavior. Religious coping, a strategy heavily dependent on cognitive processes, is associated with fewer cognitive but not somatic symptoms of depression in medically ill older patients

Spirituality in aging: spiritual need or spiritual journey?

1. The current approach to spiritual assessment often makes the older client uncomfortable discussing his or her spiritual and religious orientation. 2. To provide therapeutic interventions, nurses must first become aware of themselves and their clients as spiritual beings. 3. A spiritual journey perspective views the nurse as one who can enhance the unique journey and growth of the individual client.

Plato's model of the psyche: a holistic model for nursing interventions

Plato's theory about psychodynamic forces is used to develop a holistic model for nursing practice. The dysphoric emotional state of demoralization is conceptualized as an imbalance between Spirit, Appetite, and Reason. Interventions are designed for elderly clients who show objective and subjective signs of demoralization. The objective indicators are measured with the Psychiatric Epidemiological Research Interview (PERI), before and after the implementation of individualized interventions. Results for the 23 subjects who completed the study in an assisted-living environment are suggestive of the effectiveness of basic nursing interventions in remediating the symptoms of demoralization. Plato's model of the psyche is an elegant, yet simple, conceptual tool for understanding the mental health needs of clients.