Religious coping and health status in medically ill hospitalized older adults

Abstract

Associations between specific religious coping (RC) behaviors and health status in medically ill hospitalized older patients were examined and compared with associations between nonreligious coping (NRC) behaviors and health status. The sample consisted of 577 patients age 55 or over consecutively admitted to the general medical inpatient services of Duke University Medical Center (78%) or the Durham VA Medical Center (22%). Information was gathered on 21 types of RC, 11 types of NRC, and 3 global indicators of religious activity (GIRA). Health measures included multiple domains of physical health, depressive symptoms, quality of life, stress-related growth, cooperativeness, and spiritual growth. Demographic factors, education, and admitting hospital were control variables. "Negative" and "positive" types of religious coping were identified. Negative RC behaviors related to poorer physical health, worse quality of life, and greater depression were reappraisals of God as punishing, reappraisals involving demonic forces, pleading for direct intercession, and expression of spiritual discontent. Coping that was self-directed (excluding God's help) or involved expressions reflecting negative attitudes toward God, clergy, or church members were also related to greater depression and poorer quality of life. Positive RC behaviors related to better mental health were reappraisal of God as benevolent, collaboration with God, seeking a connection with God, seeking support from clergy/church members, and giving religious help to others. Of 21 RC behaviors, 16 were positively related to stress-related growth, 15 were related to greater cooperativeness, and 16 were related to greater spiritual growth. These relationships were both more frequent and stronger than those found for NRC behaviors. Certain types of RC are more strongly related to better health status than other RC types. Associations between RC behaviors and mental health status are at least as strong, if not stronger, than those observed with NRC behaviors.