Socio-cultural variation in attitudes to adolescents’ decision-making

Little is known about cultural variation in perceptions about the age when youngsters should be regarded as competent to make decisions. This is of particular importance as research has shown the significant effect of parental influence on their children’s decision-making. A public survey of 400 adults from diverse socio-cultural backgrounds in the UK and Spain was carried out. Their attitudes regarding adolescents’ ability with regard to common areas of decision-making were assessed using case vignettes including discontinuing family traditions and religious practice. It was found that White British adults agreed for younger adolescents to make decisions about themselves compared with the other ethnic groups. High religious practice was associated with later age to make decisions. The paper argues that there is socio-cultural variation in adults’ attitudes regarding the age when youngsters should make decisions about themselves and for the need of professionals to take this into account.     

Spiritual and Religious Implications of Aging with HIV: A Conceptual and Methodological Review

ABSTRACT

Spirituality and religious practices can buffer people from stressful life circumstances and promote positive biopsychosocial outcomes. The beneficial effects of spirituality and religious practices have been documented in aging and HIV. Unfortunately, little is known about spirituality and religious practices in older adults with HIV. As the number of older adults with HIV increases, with an estimated 91,000 adults over 50 being diagnosed with this disease in the United States, spirituality and religious practices may help HIV-positive people to age successfully. Crisis competence and spiritual trajectories are ways of conceptualizing spiritual development when confronting aging with a life-changing event such as a being diagnosed with HIV. Methodological issues in studying spirituality in adults aging with HIV are identified including defining spirituality and religiosity, heterogeneity of the population, timing of diagnosis, mode of transmission, sexual orientation, religious and cultural stigma, and hardiness. Implications for possible interventions are also posited.     

Chapter Five: Aging in Rapidly Changing Chinese Societies: A Summary and Interpretation of Our Study

ABSTRACT

Older adults at a church-related continuing care retirement community perceived themselves as being more spiritual in their later years and having a stronger emotional connection to their spirituality than when they were younger. Respondents were currently stable in their religious practice and spirituality, suggesting that changes occurred prior to the recent past, possibly around the time of retirement. This may uphold the notion that increased spirituality in the later years is a natural developmental phenomenon of the aging process. The association between religious coping and perceived health was noted, suggesting that religious coping may buffer perceived health from the negative impact of medical problems. The contribution to spirituality by physical environment and pastoral care was also noted.     

Integration of Spiritual Care in Hospital Care System in Iran

There is a growing body of evidence on the positive effects of religion and spirituality on recovery from cancer and the ability to cope with it. Most spiritual interventions carried out in Iranian research are based on care and support models that have been developed in the West. With the unique cultural and religious features of the Iranian context, a more refined look at spiritual care in the hospital care system of Iran is called for. This paper examines how to implement the spiritual care of cancer patients in hospitals and oncology wards in Iran. A consensus panel of experts was used to develop guidelines for spiritually integrated care consisting of 18 primary areas, which are described in detail in this report. Health care policy makers and managers of health care in Iran and possibly other areas of the Middle East should consider implementing these guidelines. Using indigenous models and programs specific to the religion and the cultural of a region should be considered when providing spiritual care for cancer patients.

     

Mental health attitudes among Middle Eastern/North African individuals in the United States

ABSTRACT

Middle Eastern/North African (MENA) individuals may have heightened risk for developing mental health problems due to unique cultural stressors. However, traditional cultural and religious practices and beliefs socialised within the family environment may reduce the likelihood of seeking mental health services. This qualitative study aimed to better understand the intersection of cultural, religious, and mental health attitudes among MENA individuals. Semi-structured telephone interviews were conducted with MENA adults who had received therapy services (N?=?13) and were analysed for emergent themes. Respondents reported lack of understanding of mental illness within their communities, and prominent levels of perceived and self-stigma. Families and religious practices/beliefs played an important role in responding to mental illness. Results suggest that incorporating psychoeducation and community awareness campaigns alongside religious services may help to reduce barriers to receiving mental health treatment.     

Health disparities between binary and non binary trans people: A community-driven survey

Abstract

Background: Genderqueer and nonbinary () people have remained largely invisible in health research. Previous research shows worse outcomes on health indicators for trans people when compared with cisgender controls, but the differences between binary trans and GQNB individuals are inconclusive.

Aims: To compare overall health and well-being of GQNB people with controls of trans men and trans women, taking into account the impact of the additive effect of their socio-economic position, as well as their current need for gender affirming medical interventions.

Methods: A community-driven survey was conducted in 2016 in five countries (Georgia, Poland, Serbia, Spain, and Sweden). Self-reported health and general well-being were analysed for differences between binary trans and GQNB respondents. The effects of multiple control variables (age, economic situation, educational level, belonging to an ethnic, religious, sexual or ability minority group, sex assigned at birth) as well as the current need for gender affirming medical interventions were controlled for.

Results: The sample consisted of 853 respondents aged 16 and older, with 254 trans women (29.8%), 369 trans men (43.2%), and 230 GQNB people (26%). GQNB respondents showed significantly worse self-reported health and worse general well-being in comparison to binary trans respondents. Additional negative impacts of having a lower educational level, having more economic stress, and belonging to a disability minority group were found. Being in need of gender affirming medical interventions contributed significantly to worse self-reported health, whereas being younger contributed to worse general well-being.

Discussion: In understanding health disparities between binary trans and GQNB people, it is necessary to take into account the additive effect of multiple socio-economic positions, and the current need for gender affirming medical interventions. The high proportion of GQNB respondents who report worse health outcomes highlights the need for policy makers and health-care providers in creating nonbinary-inclusive environments.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality.

Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process.

Results: Korean trans women and trans men mean (mean age?=?26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts.

Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people’s internalized negative beliefs about their gender identity.     

Sexual Health Research Among Youth Representing Minority Populations: To Waive or Not to Waive Parental Consent

Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) significantly burden youth 13–24 years of age in the United States. Directly engaging youth in sexual health research is a public health priority and urgently needed to develop targeted, youth-friendly, and culturally relevant HIV/STI prevention interventions. Controversies arise, however, regarding informed assent and consent, parental permission or consent, and the definition of “child”/“minor” as it relates to medical, legal, and ethical issues. In this article, we describe challenges in the human subjects review processes that were undertaken before beginning an HIV/STI prevention research project with sexually active youth in an urban setting. These findings provide important contextual information to facilitate youth sexual health research and care, and Institutional Review Board approval processes with fewer delays.     

Religious Values in Clinical Practice are Here to Stay

Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians’ right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.

     

Physical,Psychological and Social Adaptation of African American Nuns to Their Religious Communities as They Age: Implications for Aging in Place

ABSTRACT

This study examined the association between health status, stress, depression, satisfaction with the relationship with the religious community, alienation from significant persons, racial/cultural identity and “aging in place,” as measured by length of time in the same religious community, for a purposive sample of 72 African American nuns. Aging in place was significantly associated with perceptions of better health status, less stress and depression and greater satisfaction with relationships with the religious community. However, the study also found that the longer the nuns lived in their respective communities, the less racially/culturally identified they became. These findings underscore the need for finding ways to keep nuns in their religious communities as they age and to provide avenues of racial/cultural expression for African American nuns.     

Reproductive Genetic Counseling to Asian-Pacific and Latin American Immigrants

Latin and Asian-Pacific immigrants are the fastest growing new-comer groups in the U.S. contributing to 85% of immigration totals. New immigrants experience multiple barriers to accessing genetic counseling resulting from cultural, linguistic, financial, and educational factors as well as having unique perceptions on health, illness, reproduction, and life as a whole. In addition, new immigrants lack familiarity with Western medical practices as well as genetic risk and available interventions. We provided perinatal genetic services to 2430 clients, mostly new immigrants of Latin and Asian-Pacific descent over a period of 6 years. Counseling aides sharing the clients' cultural backgrounds were employed. A study assessing the efficacy of cross-cultural education regarding advanced maternal age risk and amniocentesis was implemented and linked to a database containing demographic and clinical information. Practical observations relating to cultural beliefs in the two groups relevant to perinatal genetic counseling were made.     

Participation in Religious Education and Life Satisfaction Among Older Adults

ABSTRACT

Participation in older adult Bible study groups was investigated as a possible correlate to life satisfaction. Two hundred eighty-seven adults, 60 years of age and older, completed the Life Satisfaction in the Elderly Scale (LSES). Results of an ANCOVA indicated that participation in Bible study groups relates positively and significantly to life satisfaction in older adults when adjusted for the health variable. Older adults who participated regularly in Bible study groups scored significantly higher on the LSES than older adults who did not participate regularly in Bible study groups although they regularly attended worship services. Results suggest that religious education participation and life satisfaction may be related in such a way as to offer implications for improving quality of life in later years.     

Religion,Spirits, Human Agents and Healing: A Conceptual Understanding from a Sociocultural Study of Tehuledere Community,Northeastern Ethiopia

This paper explores the relationship among religion, spirits and healing in the Tehuledere community in the northeastern part of Ethiopia and focuses on how this knowledge can inform primary healthcare reform. The study employed qualitative ethnographic methods. Participatory observation, over a total of 5 months during the span of 1 year, was supplemented by focus group discussions (96 participants in 10 groups) and in-depth interviews (n = 20) conducted with key informants. Data were analyzed thematically using narrative strategies. The present study revealed that members of the study community perceive health, illness and healing as being given by God. Many of the Tehuledere people attribute illness to the wrath of supernatural forces. Healing is thought to be mitigated by divine assistance obtained through supplication and rituals and through the healing interventions of nature spirit actors. We found that the health, illnesses and healing were inextricably linked to religious and spiritual beliefs. Our findings suggest that religious and spiritual elements should be considered when drafting and implementing primary healthcare strategies for the study communities and similar environments and populations around the globe.

     

Roles of Religious Commitment,Emotion Regulation and Social Support in Preoperative Anxiety

Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.

     

Influence of religiosity on self-reported response to psychological therapies

There is a lack of research exploring the influence of religious or spiritual beliefs on response to psychological therapies. Our aims were to confirm the positive relationship between religiosity and psychological wellbeing, and investigate the potential synergistic impact of religiosity on self-reported response to psychological therapies. Participants were 118 adults (33 male, 85 female) aged 18 to 78 (M?=?40.01, SD?=?15.41); data was collected via online survey. Religious and psychological variables were assessed using a range of standard measures including the Depression, Anxiety and Stress Scale, the Warwick-Edinburgh Mental Well-being Scale, and the Daily Spiritual Experiences Scale. Atheists reported less psychological distress and increased personal wellbeing; participants with higher levels of religiosity experienced greater ongoing benefits from therapy in domains of coping and social functioning. Results suggest that mental health practitioners should consider the religious/spiritual beliefs and behaviours of their clients in their interventions.     

Existential and religious issues when admitted to hospital in a secular society: Patterns of change

Situated in a secular culture, this study examined the relationship between four dimensions of health and a number of existential, religious, and spiritual/religious practice variables in questionnaires sampled from 480 Danish hospital patients. Illness dimensions were: self-rated health, severity of illness, illness duration, and recent changes in illness. The results indicated the youngest age group (<36 years) to be the most active on all existence/religious/practice variables. Small overall correlations were found between the illness dimensions and existential/religious/practice variables, but results had underlying complex patterns. The dimension of severity of illness showed the most consistent results in the expected direction: the worse the illness, the more existential/religious/practice activity, but very different patterns were found for men and women. Men generally had low levels of existential/religious/practice issues, when illness was not severe, but levels heightened when illness turned worse. The opposite was the case for women who had overall higher levels, when illness was not severe, but unexpectedly lost interest and activity when the illness grew worse, especially regarding the religious faith variables. When illness turned to the better, women (re)gained religious faith. The illness duration of 1–3 months showed to be the most sensitive period for the existential/religious/practice variables involved. The patients’ experience of change in existential/religious/practice issues and the actual measured change pattern did not always follow each other. The findings might contribute to clinical reflection and planning in health care settings in secular societies like in Scandinavia.     

Adult Age Differences in Attention to Semantic Context

ABSTRACT

In three experiments age differences in attention to semantic context were examined. The performance of younger adults (ages 18–29 years) and older adults (ages 60–79 years) on a semantic priming task indicated that both age groups could use information regarding the probability that a prime and target would be related to flexibly anticipate the target category given the prime word (Experiment 1). The timing by which target expectancies were reflected in reaction time performance was delayed for older adults as compared to younger adults, but only when the target was expected to be semantically unrelated to the prime word (Experiment 2). When the target and prime were expected to be semantically related, the time course of priming effects was similar for younger and older adults (Experiment 3). Together the findings indicate that older adults are able to use semantic context and the probability of stimulus relatedness to anticipate target information. Although aging may be associated with a delay in the timing by which controlled expectancies are expressed, these findings argue against an age-related decline in the ability to represent contextual information.     

Predictors of Sexual Consent Attitudes,Beliefs, and Behaviors Among Sexual Minority Cisgender and Nonbinary Young Adults

Sexual assault is a major public health concern in the United States that disproportionately affects sexual minority cisgender and nonbinary young adults. Although sexual assault is influenced by a myriad of societal and interpersonal factors, misunderstandings during the communication and interpretation of sexual consent signals likely contribute to this public health crisis. Unfortunately, research on sexual consent miscommunication has been heavily informed by heteronormative theories and conducted primarily with cisgender heterosexual men and women. The present study attempted to help address this gap in the literature by exploring factors that contribute to sexual consent attitudes, beliefs, and behaviors in a sample of 251 cisgender and nonbinary sexual minority young adults. Nonbinary participants reported more proactive sexual consent attitudes, beliefs, and behaviors than cisgender participants. Sexual assertiveness was also a robust and unique predictor of adaptive sexual consent, particularly among those who identified as more traditionally masculine. Findings from the current study may help guide the development of more inclusive, research-informed sexual consent and sexual violence prevention programs.

     

Health,Finances, Religious Involvement,and Life Satisfaction of Older Adults

ABSTRACT

This study examines the patterns and relationships between twelve independent variables and the expressed subjective well-being of older adults within that classic community setting of the Lynds' “Middletown.” The twelve variables include measures of church attendance, religious activity, religious conservatism/liberalism, subjective health status, social participation, importance of leisure, participation in physical activity, age, sex, marital status, and level of education.