Religion, Spirituality, and Health Service Use by Older Hospitalized Patients

Background: Religious and spiritual beliefs and practices are common among medical inpatients, and may impact length of hospital stay (LOS) and other health services (HSU) during hospitalization. Methods: 812 consecutively admitted patients age 50 or over to Duke University Medical Center were assessed. Measures of religiousness and spirituality included religious TV/radio (RTV), self-rated religiousness (SRR), observer-rated spirituality (ORS), and daily spiritual experiences (DSE). The primary outcome was LOS. Results: RTV and SRR predicted longer LOS, whereas ORS and DSE predicted shorter LOS (p 0.05). Effects of RTV onLOS were stronger among women, but explained by worse health status. The effects of DSE on LOS were stronger among non-whites. Among those reporting high DSE, diagnostic tests and total procedures also tended to be less common. Conclusions: Religious activities, attitudes, and spiritual experiences are weak predictors of LOS and HSU during hospitalization. Whether the prediction is positive or negative depends on the religious or spiritual characteristic.     

Who Is Afraid of Death? Religiousness,Spirituality, and Death Anxiety in Late Adulthood

SUMMARY

Data from a sample of predominantly white, Christian men and women born in Northern California in the 1920s (N = 155) were used to test the hypothesis that traditional, church-centered religiousness and de-institutionalized spiritual seeking exemplify distinct, but equally adaptive, ways of approaching fear of death in old age. Although both religiousness and spirituality were related to positive psychosocial functioning (an integrated identity and involvement in everyday activities), only religiousness served as a buffer against the fear of death. This effect was consistent with the greater emphasis on conventionality and acceptance of social norms that characterized individuals high in religiousness. The absence of a relation between spirituality and fear of death reflected the spiritual individual's emphasis on personal searching, creativity, and the positive use of reminiscence. The implications of the findings for the management of death anxiety in old age are discussed.     

Spirituality and Psychosocial Development in Middle-Age and Older Adults with Vision Loss

The purpose of this study was to examine the buffering effects of spirituality on stress resulting from vision status, health status, and from other significant life events as related to psychosocial development according to Erikson's 8-stage theory. Participants were middle-aged and older adults with recent vision loss who had applied for vision rehabilitation services (n = 195). The regression model included independent factors of sociodemographic variables, life stress measures (i.e., vision status, health status, and life experience ratings), mediating variables (i.e., spirituality, religiousness, and social support), and the outcome of psychosocial development. Spirituality was found to play a buffering role on the effects of negative life experience impact and control ratings. Vision impairment status did not appear to either promote or hinder psychosocial development.     

Understanding the Relationship Between Religiousness, Spirituality, and Underage Drinking: The Role of Positive Alcohol Expectancies

Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18–20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality’s protective influence on underage drinking is partly due to their influence on expectations about alcohol’s positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.     

Theobiology: An Analysis of Spirituality, Cardiovascular Responses, Stress, Mood, and Physical Health

The relationships of spirituality and religion to acute cardiovascular responses, physical symptoms of illness, stress and psychological mood were assessed in a community sample of adults. Nineteen men and 61 women participated in a betrayal interview, while their blood pressure and heart rate were monitored. Religious affiliation, frequency of attendance at worship and religiousness were associated with resting diastolic and mean arterial pressure. Spirituality, especially as assessed by the existential scale of the Spiritual Well-being Scale, was related to symptoms of illness, medication use, stress and negative mood states. Spirituality and involvement in organized religion may represent a means to increase the sense of purpose and meaning in life, which is related to greater resiliency and resistance to stress-related illness.     

Psychodrama: Rehearsal for Living

Abstract

The current study examined therapist characteristics that are related to the use of spiritual and religious interventions in group therapy and to perceived barriers to attending to spirituality in group therapy among a sample of experienced group therapists. Results demonstrated that greater therapist spirituality was associated with more frequent use of both spiritual and religious interventions, as well as lower perceived barriers to attending to spirituality in group therapy. Religious commitment was only uniquely related to perceived barriers, such that therapists with higher religious commitment actually perceived greater barriers. Training in religion and spirituality and comfort with spiritual discussions was also related to therapists’ use of religious and spiritual interventions and perceived barriers.     

Investigation of the Contribution of Spirituality and Religiousness to Hedonic and Eudaimonic Well-Being in Iranian Young Adults

Studies that have used both spirituality and religiousness measures to predict mental well-being are virtually nonexistent. Furthermore, in almost all of the past studies, the distinction between hedonic and eudaimonic aspects of well-being has not been taken into account. To address these limitations, the present study sought to examine the relation between spirituality and religiousness and a rather comprehensive set of well-being scales in an Iranian Muslim sample. Participants were 292 undergraduates at the University of Tehran. Results of bivariate correlation analysis showed that all aspects of hedonic and eudaimonic well-being were positively correlated with all aspects of spirituality and religiousness. Results of the multiple regression analysis demonstrated that spirituality was a stronger predictor of well-being than religiousness. In order to further examine the unique contribution of spirituality and religiousness over each other and gender, hierarchical regression analysis was applied. Findings indicated that while spirituality was a significant predictor of well-being after partialling out the effects of gender and religiousness, religiousness did not add significantly to the prediction of well-being over and above the contribution of gender and spirituality. Implications of the results are discussed, as are study limitations and directions for further research.     

Genetic and environmental influences and covariance among meaning in life,religiousness, and spirituality

Meaning in life, spirituality, and religiousness have been empirically linked in previous research. This study aimed to advance knowledge of the interrelations among these variables by examining their heritable and non-heritable sources of influence, as well as the genetic and environmental contributions to their inter-relations. A sample of 343 middle-aged twins drawn from the Minnesota Twin Registry completed measures of meaning in life and spirituality. There was evidence that religiousness, spirituality, and meaning in life shared common genetic and environmental influences, suggesting that these people's attitudes concerning these variables may arise from shared factors. These results provide novel evidence of a shared genetic substrate for meaning in life, religiousness, and spirituality, and support the possibility that people's basic attitudes about the meaning of existence are commonly rooted in evolved biological factors and conjointly influenced through people's experiences with life.     

A Review of Spiritual and Religious Measures in Nursing Research Journals: 1995--1999

Background: A series of systematic reviews has revealed relatively high levels of interest in religion and spirituality in different nursing specialties, but not in general nursing research journals. Purpose: To identify the extent to which spirituality and religiousness were measured in all quantitative and qualitative research articles published in Research in Nursing and Health, Nursing Research, Advances in Nursing Science (ANS), and Image: The Journal of Nursing Scholarship from 1995 to 1999. Methods: A full-text search was conducted of ANS and Image using the Ovid search system. Nursing Research and Research in Nursing and Health were hand searched for spiritual/religious measures. Characteristics of selected studies, the measures taken, and their uses were coded for data analysis. Results: A total of 564 research studies were identified, of which 67 (11.9%) included at least one measure of spirituality or religiousness. A significant difference was found between the percentage of qualitative and quantitative studies that contained measures of these concepts. Of the 119 qualitative studies, 23 (19.3%) contained a measure of religion or spirituality, compared to 44 of the 445 (9.9%) quantitative studies. Nominal indicators of religious affiliation were the most commonly used measures in the quantitative studies and measures of religion and spirituality were rarely used in the analyses. Although only a few quantitative or qualitative studies intended to focus on religion or spirituality, these themes often emerged spontaneously in the qualitative research. Conclusions: Research in Nursing and Health, Advances in Nursing Science, Nursing Research, and Image: The Journal of Nursing Scholarship all published research measuring spirituality and religiousness during the time-period studied. The rate at which spirituality and religion appeared in these nursing research articles is substantially higher than that found in most fields outside of nursing. Even more frequent inclusion of spiritual and religious variables and richer measures of spirituality and religiousness would help to increase the available scientific information on the role of spirituality and religion in nursing care.     

Examining Spirituality Over Time: Latent Growth Curve and Individual Growth Curve Analyses

SUMMARY

Research on spirituality and religiousness has gained growing attention in recent years; however, most studies have used cross-sectional designs. As research on this topic evolves, there has been increasing recognition of the need to examine these constructs and their effects through the use of longitudinal designs. Beyond repeated-measures ANOVA and OLS regression models, what tools are available to examine these constructs over time? The purpose of this paper is to provide an overview of two cutting-edge statistical techniques that will facilitate longitudinal investigations of spirituality and religiousness: latent growth curve analysis using structural equation modeling (SEM) and individual growth curve models. The SEM growth curve approach examines change at the group level, with change over time expressed as a single latent growth factor. In contrast, individual growth curve models consider longitudinal change at the level of the person. While similar results may be obtained using either method, researchers may opt for one over the other due to the strengths and weaknesses associated with these methods. Examples of applications of both approaches to longitudinal studies of spirituality and religiousness are presented and discussed, along with design and data considerations when employing these modeling techniques.     

Is Spirituality Detrimental to Generativity?

This article examines the relations between religiousness, spirituality, and generativity (concern for the welfare of future generations) in late adulthood using longitudinal life-course data. Religiousness and spirituality were operationalized as distinct but overlapping dimensions of individual difference measuring involvement in traditional and nontraditional religious practices, respectively. In late adulthood, both religiousness and spirituality correlated positively with overall scores on self-report and observer-based measures of generativity. However, whereas religiousness was significantly related to the communal facets of generativity, spirituality was significantly related to its self-expanding aspects. These differences were more pronounced after gender, cohort, social class, and the overlap between religiousness and spirituality were controlled. The respective relations among religiousness, spirituality, and generativity in late adulthood were also observed using religiousness scored in early, and spirituality scored in late-middle, adulthood.     

Dwelling and Seeking in Late Adulthood: The Psychosocial Implications of Two Types of Religious Orientation

SUMMARY

This article summarizes quantitative findings and presents two illustrative case studies showing how religious dwelling and spiritual seeking evolve over the adult life course and relate to psychosocial functioning in late adulthood. The data come from the Institute of Human Development (IHD) longitudinal study of men and women. Religious dwellers tend to emphasize traditional forms of religious behavior whereas spiritual seekers emphasize innovative religious practices. In the IHD study, the religious involvement of the dwellers tended to be highly stable over the life course whereas spirituality gained in salience in the second half of adulthood. In late adulthood, religious dwelling was associated with maintaining close and warm relations with others and communal involvement, and during times of adversity, religiousness served as a buffer against the loss of life satisfaction. Spiritual seeking was associated with an emphasis on personal growth, creativity, and acquiring new knowledge. Spiritual growth was particularly characteristic of introspective individuals who in early adulthood experienced stressful life events.     

Lay Conceptualizations of Spirituality and Religiousness Among Jewish Israeli Men and Women

In order to clarify the lay conceptualization of spirituality and the overlap between the constructs of spirituality and religiousness, the relations between a multidimensional measure of spirituality and overall measures of spirituality and religiousness were examined. A total of 111 Israeli Jewish men and women responded to the Spiritual Orientation Inventory (SOI), a multidimensional measure of humanistic spirituality, and to single-item overall measures of spirituality and religiousness. For both men and women, all SOI sub-scales were significantly related to spirituality. In contrast, three SOI sub-scales—Altruism, Idealism, and Awareness of the tragic—were not related to religiousness. Regression analysis indicated that for men, spirituality is a more one-dimensional construct strongly associated with the experiential aspects of spirituality. In comparison, women demonstrated a more complex perception of spirituality associated with a variety of intrinsic spiritual values. In addition, for men the overlap between religiousness and spirituality centers on life coherency whereas for women the overlap appears to be more general.     

Re-conceptualizing the Factor Structure of the Brief Multidimensional Measure of Religiousness/Spirituality

Rationale This study attempted to differentiate statistically the spiritual and religious factors of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS), which was developed based on theoretical conceptualizations that have yet to be adequately empirically validated in a population with significant health disorders. Participants One hundred sixty-four individuals with heterogeneous medical conditions [i.e., brain injury, spinal cord injury (SCI), cancer, stroke, primary care conditions]. Methods Participants completed the BMMRS as part of a pilot study on spirituality, religion, and physical and mental health. Results A principal components factor analysis with varimax rotation and Kaiser normalization identified a six-factor solution (opposed to the expected 8-factor solution) accounting for 60% of the variance in scores, labeled as: (1) Positive Spiritual Experience; (2) Negative Spiritual Experience; (3) Forgiveness; (4) Religious Practices; (5) Positive Congregational Support; and (6) Negative Congregational Support. Conclusions The results suggest the BMMRS assesses distinct positive and negative aspects of religiousness and spirituality that may be best conceptualized in a psychoneuroimmunological context as measuring: (a) Spiritual Experiences (i.e., emotional experience of feeling connected with a higher power/the universe); (b) Religious Practices (i.e., prayer, rituals, service attendance); (c) Congregational Support; and (d) Forgiveness (i.e., a specific coping strategy that can be conceptualized as religious or non-religious in context).     

Religiousness, spirituality, and psychosocial functioning in late adulthood: findings from a longitudinal study

This study used longitudinal data to examine the relations among religiousness, spirituality, and 3 key domains of psychosocial functioning in late adulthood: (a) sources of well-being, (b) involvement in tasks of everyday life, and (c) generativity and wisdom. Religiousness and spirituality were operationalized as distinct but overlapping dimensions of individual difference. In late adulthood, religiousness was positively related to well-being from positive relations with others, involvement in social and community life tasks, and generativity. Spirituality was positively related to well-being from personal growth, involvement in creative and knowledge-building life tasks, and wisdom. Neither religiousness nor spirituality was associated with narcissism. The relations between religiousness, spirituality, and outcomes in late adulthood were also observed using religiousness scored in early and spirituality scored in late middle adulthood. All analyses were controlled for gender, cohort, social class, and the overlap between religiousness and spirituality.     

Disordered eating and self-objectification in college women: clarifying the roles of spirituality and purpose in life

Spirituality and purpose in life have been associated with positive mental health outcomes. This study examined the effects of spirituality, religiousness, and purpose in life on self-objectification and disordered eating. An ethnically diverse sample of college women (N?=?161), aged 18–25, who were enrolled in the undergraduate level psychology courses, participated by completing a survey assessing relational spirituality, intrinsic religiousness, and purpose in life, as well as self-objectification and disordered eating. Results supported a relationship between self-objectification and disordered eating. Intrinsic religiousness was also associated with self-objectification after controlling for religious affiliation. In addition, women who had less purpose in their lives displayed more disordered eating. These findings suggest that a sense of purpose in life may be a key dimension of spirituality that is associated with eating disturbance.     

Five-Factor Model Personality Traits, Spirituality/Religiousness, and Mental Health Among People Living With HIV

ABSTRACT We examined the association between five-factor personality domains and facets and spirituality/religiousness as well as their joint association with mental health in a diverse sample of people living with HIV ( n =112, age range 18–66). Spirituality/religiousness showed stronger associations with Conscientiousness, Openness, and Agreeableness than with Neuroticism and Extraversion. Both personality traits and spirituality/religiousness were significantly linked to mental health, even after controlling for individual differences in demographic measures and disease status. Personality traits explained unique variance in mental health above spirituality and religiousness. Further, aspects of spirituality and religiousness were found to mediate some of the links between personality and mental health in this patient sample. These findings suggest that underlying personality traits contribute to the beneficial effects of spirituality/religiousness among vulnerable populations.     

Korean American Adolescents’ Depression and Religiousness/Spirituality: Are There Gender Differences?

The purpose of this study was to examine depression and religiousness/spirituality (R/S) in Korean American adolescents with an interest in exploring gender differences. The sample consisted of 182 adolescents attending ethnic Catholic churches in the NY and NJ metropolitan area. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale, and R/S was measured by the Brief Multidimensional Measure of Religiousness/Spirituality. Results suggest no gender difference in depression, but a high rate of depression in both genders. Additionally, girls showed higher levels of Forgiveness and boys showed higher levels of Negative Religious Coping. Further, we found four R/S variables are associated with depression in each gender: Daily Spiritual Experiences, Forgiveness, Positive Religious Coping, and Negative Religious Coping for girls; and Forgiveness, Negative Religious Coping, Congregational Support, and Overall Self-Ranking for boys. Lastly, the four R/S variables together explained 20 % and 23 % of the variance in depression for boys and girls, respectively, with Forgiveness and Negative Religious Coping remaining significant for girls, and Negative Religious Coping staying significant for boys. The current findings are discussed along with limitations and directions for future research, and clinical implications.     

Change and Stability in Religiousness and Spirituality in Emerging Adulthood

The author investigated the change and stability of different aspects of religiousness and spirituality, as well as whether personality traits may help explain why individuals increase or decrease in religiousness and spirituality during emerging adulthood. Self-report measures of childhood and current religiousness were completed by 224 college-aged participants. A subset of participants also completed a measure of personality and measures of religious and spiritual belief trajectories by rating the importance of each belief at successive age brackets across their lifespan. Analyses of mean-level, rank-order, and individual-level stability and change in religiousness indicated that while average religiousness scores decreased, there was still moderate to high rank-order stability in scores. Additionally, service attendance was less stable and decreased more than importance of religion in daily life. Examination of the trajectories of religiousness and spirituality over time showed similar differences: religiousness decreased, on average, whereas spirituality increased slightly, but significantly, across successive age brackets. Personality traits did not significantly predict change in religiousness over time, although openness predicted change in spirituality. Conclusions include the idea that religiousness in emerging adulthood is comprised on different components that change at different rates.