Positive Spiritual Coping Research Articles

Exploring gender dynamics and predictors of resilience among nursing students

AimThis study examined the gender differences in contributing factors to resilience among university nursing students, controlling for the age and year of study. BackgroundResilience is a behavioral pattern learned through personal and professional experiences. Resilience is crucial in nursing education and shapes clinical proficiency and care quality that may best target during college years, preparing nursing students for their future careers. DesignCross-sectional design was used in the current study MethodsOnline surveys were used to collect the data from 623 nursing students. Validated instruments assessed resilience, decision fatigue, spiritual well-being, stress overload and spiritual and religious coping. Two regression models were generated to examine gender dynamics in predicting resilience. ResultsThe results showed that more than half of our sample has low resilience (n = 285, 45.7 %). The regression model significantly predicted more than 60 % of the variance in resilience among male nursing students (F(3, 234) = 123.87, p <.001), with religious well-being, negative spiritual and religious coping and stress overload being significant predictors in the model. The regression model predicting resilience among female nursing students showed that the model significantly predicted about half of the variance (F(4, 378) = 123.87, p <.001) with positive spiritual and religious coping, existential well-being, negative spiritual and religious coping and stress overload being significant contributors in the model. ConclusionGender disparities echoed existing literature, advocating gender-sensitive strategies in promoting resilience. Early resilience nurturing through diverse modalities can foster a resilient nursing cohort adept at tackling multifaceted healthcare challenges.

The Role of Dominant Spiritual and Religious Coping Modality on Psychological Predictors Among Nursing Students.

Purpose: The current study aimed to examine the role of the dominant spiritual and religious coping modality on health-related variables and determinants, including stress overload, mindfulness, and impulsivity, among nursing students. Methods: A cross-sectional design was used to achieve the study goal. The authors recruited 1199 nursing students. The results showed that the mean for positive spiritual and religious coping was higher compared to negative spiritual and religious coping. Results: In the current study, 73.3% of nursing students predominantly used positive spiritual and religious coping compared to 17.6% in the neutral group and 9.1% in the negative spiritual and religious coping group. Positive spiritual and religious coping was positively correlated with mindfulness and stress overload and negatively correlated with impulsivity. According to the ANOVA results, students with positive spiritual and religious coping tended to have a significantly higher stress overload, higher mindfulness, and lower impulsivity compared to the neutral and negative spiritual and coping groups. Negative spiritual and religious coping group significantly differed from the neutral groups only in terms of impulsivity. Conclusion: The current study's findings help nursing students by determining dominant spiritual and religious coping modalities and provide valuable information in directing counseling efforts. Results and implications were discussed.

Ways of Coping with Stress during Pregnancy: Differences Revealed through Meta-Analysis

Substantial research demonstrates that high stress during pregnancy is a potent risk factor for adverse maternal, infant, and child outcomes. Strategies to cope with prenatal maternal stress have the potential to alleviate or exacerbate stress impacts. Yet we lack sufficient understanding of how frequently pregnant women use various ways of adaptive and maladaptive coping and whether coping practices differ by individual characteristics or by the circumstances of pregnancy. This meta-analysis evaluated 21 studies of commonly used instruments that assess coping with prenatal stressors: the Prenatal Coping Inventory (PCI; k = 6) and its successor, the Revised Prenatal Coping Inventory (NuPCI; k = 15). Across studies, pregnant women used adaptive coping strategies most frequently: [Planning-]Preparation and Spiritual-Positive coping. They used Avoidant coping least often. There were also differences in ways of coping by study trimester, racial and ethnic composition of samples, parity, and gravidity. Coping factors from the PCI and NuPCI exhibited good internal consistency in different countries and languages. Findings confirm that these instruments are reliable tools to assess prenatal coping and indicate that coping during pregnancy is influenced by individual and contextual factors. Understanding how women cope with prenatal stress can improve the ability of interventions to promote resilience.

GENDER AND AGE EFFECTS ON PTG EXPLAINED BY PSYCHOLOGICAL FACTORS IN CARDIAC PATIENTS

Abstract The present study explored the role of gender on posttraumatic growth (PTG) 30-months after cardiac surgery and mediation of preoperative psychosocial factors. Two previous meta-analyses found that woman tended to have more growth than men, and that PTG was associated with improved overall health, but most studies were cross-sectional and small-scale. Using a prospective design, we followed 262 patients undergoing cardiovascular operations with surveys and objectively measured medical indices from the Society of Thoracic Surgeons’ (STS) national database. Participants completed a follow-up survey on PTG 30-month after surgery. Bivariate correlations related PTG with female gender, age, minority race, marriage, and faith-based factors, but no medical or other psychosocial factors. In hierarchical regressions, gender and age were linked with PTG, alongside other demographics in Step-1. These effects sustained after entry of STS indices, in Step-2, but the gender role diminished after adding medical comorbidities, preoperative depression, optimism, hope, and social support in Step-3. No other factor in these steps had an impact. The age effect vanished when faith factors were entered, but only positive spiritual coping (PSC) was related to PTG. Finally, the role of PSC on PTG was mediated by perceived spiritual support. The final model was significant, accounting for one-third of the variance [F (20, N = 215) = 4.896, p &amp;lt; .001, R2 = .334] in PTG. This suggests that more research should aim to explore the effect of gender and age on PTG in general. For cardiac patients, care providers may encourage positive faith-based coping prior to cardiovascular surgery.

Stress Management in Emergency Nurses during the COVID-19 Pandemic: Scooping Article

Nurses are health professionals on the front lines during the COVID-19 pandemic, especially those in the ER, where nurses are the key to controlling virus transmission. This article aims to do a scooping review on how to manage stress in emergency room nurses during the COVID-19 pandemic. This Scooping review explores the literature from the point of view of relevance by assessing the quality of the research, then the data is mapped to identify the main themes found in the literature. We observed that stress on nurses is a burden of excess factors, having a family or children, lifestyle changes, lack of access to PPE, lack of self-confidence, nurses also have feelings and fatigue. We also observed how nurses managed stress, namely strengthening training, positive spiritual coping, social support, and access to mental health services.

The Religious Schizophrenic: Why Spirituality is Crucial for Recovery

Up to 80% of schizophrenic patients use religion to cope with their illness. These positive spiritual coping strategies are the primary predictor of mental wellness in patients with schizophrenia. Yet, most medical professionals have no religious training and are often ill-equipped to guide their schizophrenic patients in spiritual matters. Typically, religious institutions and modern medicine are not associated together, but what happens when mental health professionals lack the training to assist 80% of their schizophrenic patients who use religion as a coping strategy? Schizophrenic patients whose beliefs are not respected have a higher rate of suicide, face increased stigma and report a lower overall quality of life. Such patients are more likely to decline mentally and drop out of treatment. Some scholars, psychologists and philosophers are now arguing that ignoring the connection between religion and mental wellness is unethical because practitioners are failing to take patient diversity into account. This paper will attempt to answer the following questions: In an increasingly diverse world, is it the responsibility of mental health professionals to learn about their patients’ religious beliefs, especially when their beliefs are so closely intertwined with their chances at successfully managing their illness, such as the case with schizophrenics? Why is it a good idea to consider combining religion and healthcare? Should the increase in diverse patients require additional training for mental health professionals? Is it unethical for a mental health care professional to be ignorant of diverse cultures and religions? What are the dangers of allowing medical professionals, who largely have no training in religious affairs, to guide mentally ill patients? What are the potential solutions for this problem? Which solutions are more effective and why? Are the current practiced healthcare models, which combine medicine and religion, effective? Keywords: schizophrenia, religion, treatment, therapy, psychosis, stigma

Coping with chronic stress during COVID-19 and beyond – A faith perspective

Spiritual coping has been defined as an individual’s ability to utilise faith in God combined with certain Christian beliefs and religious practices to appraise, understand, and effectively cope with stress. We aimed to show the Christian how specific spiritual coping strategies and religious practices could be used to effectively assess and handle chronic stress from a faith perspective amid the ongoing coronavirus disease 2019 (COVID-19) pandemic and beyond. A literature study was conducted to identify positive and negative coping strategies during the COVID-19 era and highlighted the adverse effects of chronic stress and defensiveness. Recent findings on religion, the validated bio-engineered chronic stress phenotype, the Coping Strategy Indicator (CSI), Africultural Coping Systems Inventory (ACSI) and the effect of spiritual coping skills were assessed. In addition, certain Bible passages and theological perspectives regarding spiritual coping were explored to identify traces of the fight-or-flight response in the Garden of Gethsemane. The novel chronic stress phenotype reflecting stroke risk, could determine the prevalence of chronic stress. Positive coping strategies were identified, to show how positive spiritual coping skills could be utilised from a faith perspective, in coping with chronic stress amid COVID-19 and beyond. The Believe-Belong-Behave pastoral model, consisting of individual skills, corporate practices, and practical action steps, showed the Christian how certain spiritual coping skills and practices could be implemented during stress coping. The scriptural insights gained from this study, combined with the pastoral model reviewed, could offer a harmonious contribution toward the Christian’s ability to utilise spiritual coping strategies amid COVID-19 chronic stress-induced symptoms and complexities.Contribution: This article used an inter-disciplinary approach to compare recent findings within Theology, Neurophysiology, Bio-engineering, and Psychology regarding religion, stress-phenotyping, positive stress-coping and mental health. The scriptural foundation encouraged a faith-in-action response to chronic stress during the ongoing COVID-19 pandemic and beyond.

Hope and depression: the mediating role of social support and spiritual coping in advanced cancer patients

BackgroundDepression is the most common mental disorder in patients with advanced cancer, which may lead to poor prognosis and low survival rate. This study aims to explore the serial multiple mediating roles of social support and spiritual coping between hope and depression among patients with advanced cancer.MethodsA cross-sectional study was conducted in China between May and August 2020. A total of 442 advanced cancer patients were investigated by the following self-reported questionnaires: Herth Hope Index (HHI), Spiritual Coping Questionnaire (SCQ, Chinese version), Social Support Rating Scale (SSRS), Hospital Anxiety and Depression Scale (HADS).ResultsDepression was negatively correlated with hope, social support, and positive spiritual coping (P < 0.01), and positively correlated with negative spiritual coping (P < 0.01). Hope explained 16.0% of the variance in depression. Bootstrap analyses of the hope--social support--positive spiritual coping--depression showed that there were direct [B = -0.220, 95%CI(− 0.354, − 0.072)] and indirect effects of hope on depression mediated solely by social support [B = -0.122, 95%CI(− 0.200, − 0.066)] and positive spiritual coping [B = -0.112, 95%CI(− 0.217,-0.025)], or by both together [B = -0.014, 95%CI(− 0.038,-0.003)]. Similarly, the hope--social support--negative spiritual coping--depression showed that there were direct [B = -0.302, 95%CI(− 0.404, − 0.190)] and indirect effects of hope on depression mediated solely by social support [B = -0.126, 95%CI(− 0.205, − 0.071)] and negative spiritual coping [B = -0.033, 95%CI(− 0.080,-0.002)], or by both together [B = -0.010, 95%CI(− 0.030,-0.001)].ConclusionsThis study proves the hypothesis that social support and spiritual coping play intermediary roles between hope and depression. Interventions established through hope, social support and spiritual coping can effectively prevent depression from occurring.

Occupational stress and its relationship with spiritual coping among emergency department nurses and emergency medical services staff

IntroductionEmergency Department (ED) nurses and Emergency Medical Services (EMS) Staff are faced with several stressors daily, such as the COVID 19 pandemic situation, which affects the health and the quality of services to patients. Spiritual coping with stress is an attempt to overcome the stress on the basis of what is transcendent. The use of spiritual coping strategies helps a person to overcome tensions caused by the work environment. ObjectiveThe current study aimed to investigate occupational stress and its relationship with spiritual coping among ED nurses and EMS staff. Materials and methodsThis study was descriptive-correlational research. Using convenience sampling methods, 516 ED nurses and EMS staff were enrolled in the study. The study instruments included demographic information, HSE Occupational Stress, and spiritual coping questionnaires. Data were analyzed using SPSSv.22 software and the descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression. ResultsThe highest and lowest levels of occupational stress were the dimensions of “demand” (2.96 ± 0.65) and “role” (3.89 ± 0.81) respectively. Multiple linear regression analysis showed that positive spiritual coping, negative spiritual coping, workplace, service location, type of employment, and work position were important factors affecting the occupational stress of ED nurses and EMS staff, which accounted for 0.34% of the variance. ConclusionThe findings showed the need to improve the work environment for ED nurses and EMS staff, including changes in physical working conditions, salaries, and better employment conditions. Training programs are recommended to reduce stress through the use of positive spiritual coping strategies.

Spiritual Coping of Emergency Department Nurses and Emergency Medical Services Staff During the COVID-19 Pandemic in Iran: An Exploratory Study.

Emergency department (ED) nurses and emergency medical services (EMS) staff have been recently exposed to high levels of stress due to the new Coronavirus (COVID-19) pandemic. This increased stress level may influence the physical and mental health of ED nurses and EMS staff and the quality of caregiving to the patients. A spiritual coping approach is one of the most commonly used strategies to help healthcare workers manage stressful events or situations. This study explores the spiritual coping (positive or negative) among ED nurses and EMS staff during the COVID-19 pandemic. A descriptive cross-sectional study was performed on 494 ED/EMS nurses in Ardabil Province in the northwest of Iran, using a convenience sampling method. The spiritual coping questionnaire (SCQ) was used to assess spiritual coping in the subjects. The results of this study showed that ED nurses and EMS staff generally used positive spiritual coping methods to reduce stress during the COVID-19 pandemic. Multiple linear regression indicated that workplace (β = 0.22, p < 0.001), service location (β = 0.16, p < 0.001), and type of employment (β = − 0.13, p = 0.012) were significant predictors of positive spiritual coping, and older age (β = 0.13, p = 0.045), overtime work (β = 0.12, p = 0.01), and marital status (β = − 0.12, p = 0.021) were predictors of negative spiritual coping. Our findings indicated that positive religious behavior was the main spiritual coping strategy used by healthcare workers. The findings could help emergency nurse managers to propose future strategies to minimize stress based on the use of spiritual coping strategies and provide time and facilities to pray.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10943-022-01523-7.

The Role of Age, Religion/Spirituality, and Humor in the Optimism of Community-Dwelling Older Adults

Current literature reveals that perceived optimism decreases with age (D’Argembeau et al., 2011; Newby-Clark & Ross, 2003). However, replication of these studies is limited. In particular, a lack of investigations exists in examining optimism as individuals transition across older adulthood. Considering the dearth of literature that examines the influence of religion/spirituality and humor on the optimism of older adults, 203 members of Osher Lifelong Learning Institutes, age 65 years and older, from Idaho and California completed pen and paper or electronic surveys. The study used hierarchical multiple regression analysis to examine the impact of age, positive religion/spirituality coping skills, and humor on the optimism of community-dwelling older adults. The participant’s gender significantly explained a 19.3% variance in the optimism scores, whereas age did not significantly contribute to the model (R Change =.000). Positive religious or spiritual coping skills and humor significantly contributed to the variance in optimism scores, explaining a 2.3% and 21.6% variance, respectively. In the final model (F (1, 202, = 13.78, p = .000), all variables except age significantly contributed to the model with humor revealing the highest beta value (beta = .467, p = .000). The findings suggest that optimism is perceived differently by gender but does not change with age. While positive religious coping skills influence optimism, internal or external humor strategies may be more helpful to instill, promote or maintain optimism in older adults. The addition of humor assessment items in wellness evaluations and humor-infused interventions may foster optimism in community-dwelling older adults.

Abstract 002: Assessing Profiles Of Cardiometabolic Risk Among South Asians Living In The United States Using A Syndemic Framework And Acculturation

Background: South Asians (SA) are the second largest US immigrant group and have excess cardiometabolic (CM) disease. While acculturation is associated with increased CM risk among immigrants and refugees, the role of acculturation on SA CM risk is relatively unknown. CM disease presents as a syndemic or synergistic epidemic involving multiple disease clusters as well as the biological, social, and psychological interactions from the acculturative process to worsen morbidity within subgroups. Methods: We used latent class analysis to identify SA CM risk based on acculturation subgroups using data from adults aged 40-84 in the Mediators of Atherosclerosis in South Asians Living in America study (N=771). The distal outcome of CM risk was constructed using hypertension, type 2 diabetes, and body mass index. Proxies of acculturation included years lived in the US, English proficiency, cuisine eaten at home, cultural traditions, ethnicity of friends, social and neighborhood support, and experienced discrimination; as well as mental health indicators, which included depression, trait anxiety, anger, and positive and negative spiritual coping. Covariates included demographic characteristics, family income, education, study site, exercise, smoking, alcohol use, religiosity and spirituality. Results: Four CM risk profiles and acculturation subgroups were identified: 1) lowest risk [73.8%] were the most integrated with both SA and US culture; 2) intermediate-low risk [13.4%] had high mental health distress and discrimination and separated from SA and US culture; 3) intermediate-high risk [8.9%] were more assimilated with US culture; and 4) highest risk [3.9%] were more assimilated with US culture [Figure]. Conclusion: Our approach identified distinct nuanced profiles of syndemic CM risk to understand how acculturation and sociocultural factors cluster with health in US South Asians. Our syndemic framework will further understanding of CM risk among SA to best design tailored prevention and intervention programs.

Fight, flight or faith: A pastoral model for spiritual coping

This article is dedicated to Professor Gert Breed who had an indelible influence in the expansion of Pastoral Theology in South Africa: first as minister, and second as Professor in Practical Theology. In line with Professor Breed’s keen interest in the interdisciplinary approach between Theology and, for instance, Physiology and Psychology, the main aim of this article is to show how utilising spiritual coping strategies could help the Christian to cope with stress from a faith perspective. Spiritual coping was defined as an individual’s ability to utilise faith in God and Judeo-Christian religious beliefs, as well as active practices to appraise, understand and effectively cope with stressful life events. A literature study was conducted on human defence response and spiritual coping to demonstrate the adverse effects of chronic defensiveness and stress. Spiritual coping was assessed from a scriptural approach to determine what biblical perspectives regarding coping, defensiveness and spirituality may be revealed. Effective coping strategies were explored to indicate how positive spiritual coping skills could be utilised as an alternative to chronic defensives. The Believe-Belong-Behave pastoral model was proposed for the utilisation of spiritual coping methods and skills that could improve psychophysiological well-being. The Believe-Belong-Behave model consists of three categories that each highlight different individual skills, corporate practices, and practical action steps, which, when applied consistently, could all function in harmony to promote psychophysiological well-being. The components of the proposed pastoral model could offer a harmonious contribution towards spiritual coping and the Christian’s spiritual formation within the local church.Contribution: This article assessed theological perspectives and biblical practices within the basic tenets of Reformed theology to identify resemblances to stress appraisal and human defensiveness throughout the historical course of Scripture. This study in Practical Theology highlighted the importance of combining a strong scriptural or theological foundation with certain practical skills to respond to stressors from a faith-in-action perspective. The proposed pastoral model showed the modern-day Christian how faith in God could be used to cope with stress more effectively.

ADL and IADL Following Open-Heart Surgery: The Role of a Character Strength Factor and Preoperative Medical Comorbidities.

Open-heart surgery (OHS) is common in late life and is expected to improve functioning despite aging of OHS patients. Few studies have explored the influence of both psychosocial strength factors, metal health, and pre- and peri-OHS medical factors, including cardiac indices, on post-OHS functioning. This study explores the role of character strengths (e.g., hope and spirituality) in post-OHS activities of daily living (ADL) and instrumental ADL (IADL), along with cardiac indices used by all cardio-thoracic surgeons, after controlling for self-reported pre-OHS depression, quality of life indicators, and non-cardiac medical comorbidities. Three waves of interview data and cardiac/surgical indices in the Society of Thoracic Surgeon (STS) national database were collected for a cohort of 481 patients (age = 62 +, female 42%). Multiple linear regression was used to identify pre-OHS predictors of post-OHS functional status. ADL and IADL statuses after OHS were better among those who pursued pre-OHS positive spiritual/religious coping than those who did not. Outcomes were poorer for those reporting poor pre-OHS, higher numbers of medical comorbidities, and use of more post-OHS prayer for coping. Perfusion time, a proxy for surgical complexity, was associated with poor IADL only. Pre-OHS positive spiritual coping, a common coping means used among cardiac patients in medical crises, could have played a positive role in better post-OHS functional status during the post-OHS recovery month. Cardiac health providers should pay more attention to patient-centered character strengths and coping and non-cardiac conditions. More nuanced interdisciplinary research is necessary to identify mechanisms underlying these associations.

Validation of the Italian version of the Revised Prenatal Coping Inventory (NuPCI) and its correlations with pregnancy-specific stress

BackgroundPregnancy is a period of happiness but also of physical and psychological changes that can lead to distress. Functional coping strategies can reduce the pregnancy specific-stress. This study aimed to assess the psychometric properties of the Revised Prenatal Coping Inventory (NuPCI) in an Italian sample and to investigate how coping strategies were associated with pregnancy-specific stress.MethodsIn this cross-sectional study, low-risk pregnant women (N = 211) were assessed with NuPCI, NuPDQ (Revised-Prenatal Distress Questionnaire), Brief-COPE (Coping Orientation to the Problems Experienced), and STAI (State-Trait Anxiety Inventory). The reliability of NuPCI was evaluated by assessing its internal consistency and factor structure (with a Confirmatory Factor Analysis, CFA). The concurrent validity between NuPCI and Brief-COPE and NuPDQ and STAI was investigated. Lastly, the relationship between NuPCI and NuPDQ was analyzed, as well as the ability of these scales to predict Apgar score at birth.ResultsInternal consistency of NuPCI scales was good for Planning-Preparation (ɑC=0.84) and Spiritual-Positive Coping (ɑC=0.81) scales, acceptable for Avoidance (ɑC=0.76) scale. Moreover, the original three-factor structure was confirmed using a CFA with 29 of the 32 items (χ2374 = 618.06; RMSEA = 0.056, 95% confidence interval: [0.048, 0.063]); CFI = 0.920; and TLI = 0.913). Statistically significant correlations between NuPCI scales and Brief-COPE subscales ranged between r = + 0.217 and r = + 0.624; also, NuPDQ score was positively correlated with STAI scales (State scale: r = + 0.539; Trait scale: r = + 0.462). Concurrent validity was confirmed reporting that NuPDQ score was predicted by NuPCI scores (R2 = 0.423, p < 0.001), positively by Avoidance (β=+0.572) and Planning-Preparation (β=+0.215) and negatively by Spiritual-Positive Coping (β=-0.132). Finally, considering the stress, the effect of the Avoidance and Spiritual-Positive Coping scores respectively in decreasing (+ 155%) and increasing (+ 16%) the Apgar score became stronger.ConclusionsItalian NuPCI has sound psychometric properties and it is a useful coping measure. NuPDQ showed also a good validity. Our results may suggest a significant role for coping strategies, particularly in modulating the condition of the newborn at birth.

Spiritual Coping with Stress Among Emergency and Critical Care Nurses: A Cross-Sectional Study.

A cross-sectional study using Spiritual Coping Questionnaire (SCQ) to explore the spiritual stress coping among Muslim Emergency and Critical Care nurses. 113 Participants were recruited. SCQ demonstrated good validation estimates. Positive religious behavior was the main spiritual coping with job stress. Likewise, spiritual coping was highly perceived as religious. Critical care nurses reported significantly higher positive social coping. Nurses with longer work experiences were significantly better in positive spiritual coping. Spiritual coping practices are highly prevalent in healthcare settings despite still lacking integration of spiritual components in its physical infrastructure, health policy and management.

The Relationship of Spiritual Coping with Resilience and Perceived Stress: Validation of the Dutch Spiritual Coping Questionnaire

The aim of this study is to translate and validate the Spiritual Coping Questionnaire in Dutch (SCQ-nl), compare this questionnaire with a religious coping questionnaire, and assess the levels of religious and spiritual coping in association to resilience and perceived stress because these are important determinants in mental health issues. The Dutch-speaking respondents (N = 651, Mage = 45, SDage = 14, range = 18-80) answered the SCQ, Brief RCOPE, Perceived Stress Scale, and Brief Resilience Scale. Validation of the SCQ shows it to be a reliable and valid questionnaire for assessing positive and negative spiritual coping in Dutch-speaking individuals. Although the positive and negative religious coping scales are associated with positive and negative spiritual coping questionnaires, religious coping was not predictive of perceived stress or resilience. Multiple regression analyses demonstrate positive spiritual coping to be associated with lower perceived stress and higher resilience levels and negative spiritual coping to be associated with higher perceived stress and lower resilience levels in Dutch-speaking individuals. The outcome of this study is that the SCQ-nl is a valid and reliable measure for assessing positive and negative spiritual coping in scientific psychological research and descriptively in clinical practice.

Spirituality and Mental Well-Being in Combat Veterans: A Systematic Review.

Many veterans experience significant compromised spiritual and mental well-being. Despite effective and evidence-based treatments, veterans continue to experience poor completion rates and suboptimal therapeutic effects. Spirituality, whether expressed through religious or secular means, is a part of adjunctive or supplemental treatment modalities to treat post-traumatic stress disorder (PTSD) and is particularly relevant to combat trauma. The aim of this systematic review was to examine the relationship between spirituality and mental well-being in postdeployment veterans. Electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, JSTOR) were searched from database inception to March 2016. Gray literature was identified in databases, websites, and reference lists of included studies. Study quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool and Critical Appraising Skill Programme Qualitative Checklist. From 6,555 abstracts, 43 studies were included. Study quality was low-moderate. Spirituality had an effect on PTSD, suicide, depression, anger and aggression, anxiety, quality of life, and other mental well-being outcomes for veterans. "Negative spiritual coping" was often associated with an increase mental health diagnoses and symptom severity; "positive spiritual coping" had an ameliorating effect. Addressing veterans' spiritual well-being should be a routine and integrated component of veterans' health, with regular assessment and treatment. This requires an interdisciplinary approach, including integrating chaplains postcombat, to help address these issues and enhance the continuity of care. Further high-quality research is needed to isolate the salient components of spirituality that are most harmful and helpful in veterans' mental well-being, including the incorporating of veterans' perspectives directly.

The Factor Structure and Psychometric Properties of the Persian Version of the Revised Prenatal Coping Inventory (Nu-PCI).

Familiarity with coping strategies is essential for stress management during pregnancy. The Revised Prenatal Coping Inventory (Nu-PCI) was developed to assess coping strategies during pregnancy. This study aimed to assess the factor structure and psychometric properties of the Persian version of the Nu-PCI. After forward-backward translation, the Nu-PCI was administered to 210 pregnant women who were enrolled in two teaching referral clinics in the North of the Islamic Republic of Iran (Babol). The participants completed the Persian Nu-PCI and Ways of Coping Questionnaire (WCQ), which was used to determine the validity of the Persian Nu-PCI. To test construct validity of the Persian Nu-PCI, a principal components factor analysis was performed. Principal components analysis with varimax rotation showed a best fitting 3-factor structure similar to the original with three coping subscales: planning-preparation, avoidance, and spiritual-positive coping. The Persian Nu-PCI was internally consistent and within the acceptable range (α=0.89-0.97). The alpha coefficients for the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping were high. Test-retest coefficients for the Nu-PCI and subscales were 0.98-0.99. The Nu-PCI and its subscales correlated with the WCQ in the entire sample and within each trimester. The Persian version of the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping represent the first reliable standardized tool for measuring coping strategies during pregnancy in the Islamic Republic of Iran. Therefore, it can be applied as a quick and accurate preliminary screening tool for evaluating coping strategies throughout pregnancy in clinics and other medical and research settings.

Relationship Between Spiritual Coping and Survival in Patients with HIV.

Studies of spirituality in initially healthy people have shown a survival advantage, yet there are fewer research studies in the medically ill, despite the widespread use of spirituality/religiousness to cope with serious physical illness. In addition, many studies have used limited measures such as religious service attendance. We aimed to examine if, independent of medication adherence, the use of spirituality/religiousness to cope with HIV predicts survival over 17years. This was a longitudinal study, started in 1997. Study materials were administered semi annually. A diverse sample of 177 HIV patients initially in the mid-stage of disease (150-500 CD4-cells/mm(3); no prior AIDS-defining symptoms) participated in the study. Participants were administered a battery of psychosocial questionnaires and a blood draw. They completed interviews and essays to assess current stressors. Spiritual coping (overall/strategies) was rated by qualitative content analysis of interviews regarding stress and coping with HIV, and essays. Controlling for medical variables (baseline CD4/viral load) and demographics, Cox regression analyses showed that overall positive spiritual coping significantly predicted greater survival over 17years (mortality HR = 0.56, p = 0.039). Findings held even after controlling for health behaviors (medication adherence, substance use) and social support. Particular spiritual coping strategies that predicted longer survival included spiritual practices (HR = 0.26, p < 0.001), spiritual reframing (HR = 0.27, p = 0.006), overcoming spiritual guilt (HR = 0.24, p < 0.001), spiritual gratitude (HR = 0.40, p = 0.002), and spiritual empowerment (HR = 0.52, p = 0.024), indicating that people using these strategies were 2-4 times more likely to survive. To our knowledge this is the first study showing a prospective relationship of spiritual coping in people who are medically ill with survival over such a long period of time, and also specifically identifies several strategies of spirituality that may be beneficial.