Coping Strategies and Help Seeking Behavior among Women with Symptoms Of Postpartum Depression in Selangor

@#Introduction: Most women with postpartum depression (PPD) remain undiagnosed and untreated, despite the adverse effects known to be felt by women and children. The aim of this study was to examine the coping strategies and help seeking behavior used by women having symptoms of postpartum depression. Methods: Using a mixed-method study design, the researcher used the Edinburgh Postnatal Depression Scale (EPDS), Brief COPE and General Help Seeking Behavior (GHSQ) inventories for the quantitative approach, while the qualitative approach was conducted by a semi-structured interview based on the topics listed. A total of 30 respondents participated in the quantitative study while seven respondents were chosen for the qualitative study. Results: Data analyses identified coping strategies with domains of emotion-focused and religion-focused subscales as the main coping styles, while help seeking behavior identified that families were the main groups of people that were sought by them. Conclusion: Women with symptoms of postpartum depression tended to cope with their mental health issues by strengthening their spiritual bonds and with help and support from their family members.

La religión como afrontamiento en pacientes oncológicos: síntomas depresivos y ansiosos / Religion as coping in cancer patients: depressive and anxious symptoms

Resumen En momentos de crisis o amenaza la religión es uno de los principales recursos que utilizan las personas para hacer frente. El diagnóstico de cáncer y su tratamiento constituyen un evento especialmente demandante para cualquier persona. En concordancia con eso, el presente estudio tuvo como objetivo verificar la relación entre afrontamiento religioso por medio de RCOPE y síntomas depresivos-ansiosos por medio del DASS-21, en pacientes oncológicos y grupo no oncológico. Este estudio de carácter cuantitativo, comparativo, correlacional y transversal se llevó a cabo en una muestra de 96 pacientes oncológicos del Hospital base Valdivia, Chile y grupo control de 102 sujetos. Los principales resultados obtenidos comprueban el mayor uso del afrontamiento religioso por pacientes oncológicos en comparación a grupo control; la existencia de relación directamente proporcional entre afrontamiento religioso negativo y la presencia de síntomas depresivo-ansiosos; la ausencia de relación entre afrontamiento religioso positivo y la presencia de síntomas depresivo-ansiosos. Se concluye que la búsqueda de respaldo de medios religiosos resulta especialmente necesaria en periodos de crisis, como lo es el tratamiento de una enfermedad grave. Sin embargo, cuando hay una relación positiva con la deidad o lo religioso (afrontamiento positive), no necesariamente implicaría un efecto atenuante de síntomas ansiosos o depresivos, y más bien, el afrontamiento negativo, se puede esperar un aumento o disminución de este tipo de malestar. Por lo que resultaría conveniente en contexto de enfermedad grave enfocarse en disminuir la conflictividad religiosa como medio de atenuar síntomas depresivos y ansiosos.

Abstract In times of crisis or threat, religion is one of the primary resources that people use to cope. Cancer diagnosis and treatment are an exceptionally demanding event for anyone. By this, the present study aimed to verify the relationship between religious coping through RCOPE and depressive symptoms - anxious through DASS-21, in cancer patients. This quantitative, comparative, correlational, and cross-sectional study was carried out in a sample of 96 cancer patients from the Valdivia base Hospital, Chile, and a control group of 102 subjects. The main results obtained confirm the greater use of religious coping by cancer patients than the control group; the existence of a directly proportional relationship between negative religious coping and the presence of depressive-anxious symptoms; the absence of a relationship between positive religious coping and the presence of depressive-anxious symptoms. It is concluded that the search for support from religious media is essential in periods of crisis, such as the treatment of a severe illness. However, when there is a positive relationship with the deity or religion, it would not necessarily translate into mitigation of anxious and depressive symptoms. Instead, negative coping, an increase or decrease of this type of discomfort can be expected. Therefore, in the context of serious illness, it would be advisable to focus on reducing the religious conflict to attenuate anticipatory and anxious symptoms.

Crecimiento postraumático y variables psicosociales en víctimas de violencia política / Posttraumatic growth and psychosocial variables among victims of political violence

Resumen Antecedentes: la dictadura militar chilena (1973-1990) dejó miles de víctimas entre afectados directos y familiares, quienes pudieron desarrollar diversas secuelas en su salud mental. Objetivos: el presente estudio buscó evaluar un modelo predictivo de crecimiento postraumático (CPT) que incluía la ideología política, el afrontamiento religioso y la rumiación, en víctimas de la violencia política durante la dictadura. Método: participaron 200 personas adultas reconocidas en el Programa de Reparación y Atención Integral de Salud (PRAIS), encargada de brindar apoyo a las víctimas directas de violaciones a los derechos humanos durante la dictadura, y a sus familiares. De ellos 104 son mujeres (52%) y 96 hombres (48%), en un rango de edad entre los 30 y 91 años. Se utilizaron como instrumentos el Inventario de Crecimiento Postraumático, la Escala Breve de Afrontamiento Religioso, la Escala de Rumiación relacionada con el Evento y la Escala de Ideología Política. Resultados: los principales resultados indicaron que el afrontamiento religioso positivo y la rumiación deliberada predijeron el CPT. La rumiación deliberada media parcialmente entre el afrontamiento religioso positivo y el CPT. Conclusión: se concluye que el afrontamiento religioso positivo y el procesamiento cognitivo deliberado favorecen los cambios positivos en víctimas directas de la violencia política y sus familiares. Ante esto, se refuerza la idea que las víctimas de estas violaciones logran crecer después de estas experiencias dolorosas.

Abstract Background: The Chilean military dictatorship (1973-1990) left thousands of victims among those directly affected and their families, who were able to develop various mental health sequelae. Objective: The present study sought to evaluate a predictive model of posttraumatic growth (PTG) that included political ideology, religious coping and rumination in victims of political violence during the dictatorship. Method: The study involved 200 adults recognised in the Programme for Reparation and Integral Health Care (PRAIS), which is responsible for providing support to direct victims of human rights violations and their family members during the dictatorship. Out of these, 104 were women (52%) and 96 were men (48%) ranging in age from 30 to 91 years. The Posttraumatic Growth Inventory, the Brief Religious Coping Scale, the Event-Related Rumination Scale and the Political Ideology Scale were used as instruments. Results: The main results indicated that positive religious coping and deliberate rumination predicted PTG. Deliberate rumination partially mediates between positive religious coping and PTG. Conclusion: It is concluded that positive religious coping and deliberate cognitive processing favour positive change in those directly affected by political violence and their family members. This reinforces the idea that victims of these violations manage to grow after these painful experiences.

Resilience of People with HIV/AIDS: Influence of Religious Coping / Resiliência de Pessoas com HIV/Aids: Influência do Coping Religioso / Resiliencia de Personas con HIV/Aids: Influencia del Coping Religioso

Abstract Authors have highlighted resilience as one of the factors that allows people living with HIV/AIDS (PLHA) to persist or adapt to the medical, psychological, and social implications related to seropositivity. The process by which people, through religion, try to deal with personal or situational requirements in their lives is called religious coping. This study aimed to investigate predictors of resilience among sociodemographic, medical-clinical and religious coping strategies (positive and negative). Participants of the study were 200 seropositive people (52.5% men) monitored in an HIV/AIDS outpatient clinic, who responded to the instruments: General sociodemographic and clinical-medical questionnaire; the Brief Religious Coping Scale and the Resilience Assessment Scale. Resilience was not associated with any of the sociodemographic and medical-clinical variables, however, it was significantly and positively correlated with positive religious coping and negatively correlated with negative religious coping. In the multiple regression analysis, both negative and positive religious coping were significant predictors of resilience, with higher scores in this variable resulting from more use of positive religious coping and less use of negative religious coping in the PLH sample of this study. The results indicate important effects that religious coping can have on the process of overcoming adversities related to the experience of seropositivity.

Resumo Autores têm apontado a resiliência como um dos fatores que permite a pessoas vivendo com HIV/aids (PVHA) persistirem ou se adaptarem às implicações médicas, psicológicas e sociais relacionadas à soropositividade. O processo pelo qual as pessoas, por meio da religião, tentam lidar com exigências pessoais ou situacionais em suas vidas é denominado coping religioso (CR). Este estudo objetivou investigar preditores da resiliência entre variáveis sociodemográficas, médico-clínicas e estratégias de coping religioso (positivo e negativo). Participaram 200 pessoas soropositivas (52,5% homens) acompanhadas em ambulatório especializado em HIV/Aids que responderam aos instrumentos: questionário sociodemográfico e médico-clínico; Escala breve de enfrentamento religioso e Escala de avaliação da resiliência. Resiliência não se associou a nenhuma das variáveis sociodemográficas e médico-clínicas, mas se correlacionou significativa e positivamente ao CR positivo e negativamente ao CR negativo. Na análise de regressão múltipla, tanto o CR negativo quanto o positivo foram preditores significativos da resiliência, de modo que escores mais altos nessa variável resultaram de maior utilização de CR positivo e menor utilização de CR negativo na amostra de PVH desse estudo. Os resultados apontam para efeitos importantes que o CR pode desempenhar no processo de superação de adversidades relacionadas à vivência da soropositividade.

Resumen Autores han señalado la resiliencia como uno de los factores que permiten las personas que viven con VIH adaptarse a las implicaciones médicas, psicológicas y sociales relacionadas con la seropositividad. El proceso por el cual las personas, por medio de la religión, intentan lidiar con exigencias personales o situacionales en sus vidas es denominado coping religioso (CR). Este estudio objetivó investigar predictores de la resiliencia entre variables sociodemográficas, médico-clínicas y estrategias de coping religioso (positivo y negativo). Participaron 200 personas (52,5% hombres) acompañadas en ambulatorio especializado en SIDA que respondieron a: Cuestionario sociodemográfico y médico-clínico; Escala breve de enfrentamiento religioso y Escala de evaluación de la resiliencia. Resiliencia no se asoció a ninguna de las variables sociodemográficas y médico-clínicas, pero se correlacionó significativa y positivamente al CR positivo y negativamente al CR negativo. En el análisis de regresión múltiple, tanto el CR negativo como el positivo fueron predictores significativos de la resiliencia, de modo que los puntajes más altos en esa variable resultaron de mayor utilización de CR positivo y menor utilización de CR negativo. Los resultados apuntan a efectos importantes que el CR puede desempeñar en el proceso de superación de adversidades relacionadas con la vivencia de la seropositividad.

Envelhecimento e espiritualidade: O papel do coping espiritual/religioso em pessoas idosas hospitalizadas

Embora o índice de envelhecimento da população mundial venha crescendo, isso não implica, necessariamente, longevidade saudável. Estudos que apontem as variáveis que interferem nos resultados em saúde de pessoas idosas são relevantes nesse contexto. Com base nos referenciais da Psicologia da Religião sobre envelhecimento e sobre coping espiritual/religioso, foi empreendido um estudo junto a essa população com o objetivo de evidenciar o funcionamento da espiritualidade/religiosidade (E/R) nesse contexto de saúde ameaçada. A metodologia utilizada foi de abordagem quantitativa, descritiva, de corte transversal. Os instrumentos utilizados foram: escala breve de coping espiritual/religioso (CER), escala da centralidade da religiosidade e um questionário para levantamento dos dados sociodemográficos. Participaram do estudo 51 pessoas, com média de idade de 71,76 anos, baixa renda econômica (86,3%), predominantemente católicos (68,6%); seguidos dos evangélicos (23,5%). Os idosos são altamente religiosos (M = 4,3) e 80,4% fazem utilização alta/altíssima de CER Positivo. A despeito da relevância da E/R, 87,3% deles nunca foram abordados sobre questões ligadas à E/R e 41,2% afirmam que gostariam de ter sido. Os resultados confirmam as teorias sobre o papel da E/R nessa fase da vida e indica ser essa uma dimensão relevante a ser integrada na terapêutica por toda a equipe de saúde.

Although the rate of the world population aging is increasing, it does not imply healthy longevity. Studies that point out the variables that interfere in the health outcomes of the elderly are relevant in this context. Based on the framework of Psychology of Religion on aging and spiritual/religious coping, a study among elderly inpatients was carried out with the objective of showing the functioning of spirituality/religiosity (S/R) in the context of threatened health. The methodology used was quantitative in nature, descriptive and cross-sectional. The instruments used were: Brief Spiritual/Religious Coping Scale, Centrality of Religiosity Scale, and the Sociodemographic Questionnaire. Fifty-one elderly inpatients participated in the study, at an average age of 71,76 years old, low economic income (86.3%), predominantly Catholics (68.6%), followed by Evangelicals (23.5%). The elderly is highly religious (M = 4.3) and 80.4% make high/ higher use of Positive Spiritual Religious Coping. Despite the relevance of S/R, 87.3% of them were never asked about S/R issues and 41.2% said they would like to be approached with these issues. The results confirm the theories about the role of S/R in this phase of late life and indicate that this is a relevant dimension to be integrated in the practice of care by the multidisciplinary healthcare team.

Enfrentamento religioso-espiritual de mães com bebê em Unidade de Terapia Intensiva Neonatal / Mothers' spiritual-religious coping with baby in Neonatal Intensive Care Unit / Afrontamiento religioso y espiritual de las madres con bebé en la Unidad de Cuidados Intensivos Neonatales

A Teoria Motivacional do Coping (TMC) define o enfrentamento como a forma com que as pessoas regulam o comportamento, a emoção e a orientação motivacional frente ao estressor. A internação do filho em Unidade de Terapia Intensiva Neonatal (UTIN) é uma condição estressante, sendo frequente o uso do coping religioso-espiritual. Analisou-se o processo de enfrentamento de 20 mães (17-39 anos), com bebês internados em UTIN (M =10 dias). Foi aplicada a versão brasileira da RCOPE Scale (Religious Coping Questionnaire), denominada Escala de Coping Religioso-Espiritual - CRE (87 itens), organizados em 8 fatores de CREP (positivo) e 4 de CREN (negativo). Analisaram-se suas relações com categorias de enfrentamento adaptativas (Autoconfiança, Busca de suporte, Resolução de problemas, Busca de Informações, Acomodação, Negociação) e mal adaptativas (Delegação, Isolamento, Desamparo, Fuga, Submissão e Oposição). Os índices da Escala CRE ficaram na média, com predomínio de CREN e maior frequência de Posicionamento Negativo frente a Deus, e de estratégias mal adaptativas, como Submissão, Fuga e Oposição. Houve correlações entre CREP e famílias adaptativas; e entre CREN e famílias mal adaptativas. Foi possível identificar o uso do coping religioso-espiritual nesta amostra e analisar suas relações com o processo adaptativo, ampliando as possibilidades de análise da Escala CRE.

The Motivational Theory of Coping (MTC) defines coping as how people regulate behavior, emotion and motivational orientation against the stressor. The child's hospitalization in the Neonatal Intensive Care Units (NICU) is a stressful condition, with frequent use of spiritual and religious coping. It was analyzed the 20 mothers (17-39 years) coping process with babies admitted to NICU (M = 10 days). The Brazilian version of RCOPE, the Spiritual/Religious Coping Scale (SRCOPE) was applied (87 items), organized into 8 factors of SRCOPE-P (positive) and 4 SRCOPE-N (negative). Their relations with adaptive coping categories (Self-reliance, Support Seeking, Problem Solving, Information Seeking, Accommodation, Negotiation) and maladaptive (Delegation, Isolation, Helplessness, Escape, Submission and Opposition) were analyzed. The indices of SRCOPE were on average, with a predominance of SRCOPE-N and higher frequency of Negative Positioning front of God, and prevalence of maladaptive strategies such as Submission, Escape and Opposition. There were correlations between SRCOPE-P and adaptive families; and between SRCOPE-N and maladaptive families. It was possible identify the use of spiritual and religious coping in this sample, and analyze its relations with adaptive process, expanding the possibilities of analysis of SRCOPE Scale.

Teoría Motivacional de Afrontamiento (TMC) define afrontamiento cómo forma de regular comportamiento, emociones y orientación motivacional frente al factor estresante. La hospitalización de un hijo en la unidad de cuidados intensivos neonatales (UCIN) es una condición estresante, con uso frecuente del afrontamiento religioso-espiritual. Se analizó el proceso de afrontamiento del 20 madres (17-39 años), con bebés hospitalizados en la UCIN (M = 10 días). Se aplicó la Escala de Adaptación Religiosa-Espiritual - CRE (87 ítems), dispuestos en 8 factores de CREP (positivo) y 4 CREN (negativo). Analizamos sus relaciones con categorias adaptativas de afrontamiento (autoconfianza, búsqueda de apoyo, solución de problemas, búsqueda de información, alojamiento, negociación) y desadaptativas (Delegación, aislamiento, desamparo, la fuga, la sumisión y la oposición) propuestas por el TMC. Los índices de Escala CRE eran, en promedio, con un predominio de CREN y mayor frecuencia de posicionamiento negativo delante de Dios, y prevalencia de las estrategias desadaptativas como presentación, Escape y Oposición. Hubo correlaciones entre CREP y familias de adaptación; y entre CREN y familias desadaptativas. Fue posible no solo identificar el uso del afrontamiento religioso y espiritual en esta muestra, pero también analizar sus relaciones con proceso de adaptación, expandiendo las posibilidades de análisis de Escala CRE.

Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease

Objective:Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown.Method:This cross-sectional study recruited 147 consecutive patients with either Crohn’s disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL.Results:Positive RCOPE was negatively associated with anxiety (b = 0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p < 0.001) and self-reported adherence (b = 0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL.Conclusion:Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.

Resiliencia, peccepción de enfermedad, creenciay afrontamiento espiritual reliigioso y calidad de vida relacionada con la salud en pacientes con diagnóstico de artritis reumatoide / Resilience, illness perception, beliefs and spiritual-religious coping and health-related quality of life in patients with rheumatoid arthritis diagnosis

El objetivo de este estudio fUe evaluar las relaciones entre resiliencia, percepción de enfermedad, creencias y afrontamiento espiritual-religioso y calidad de vida relacionada con la salud en 41 pacientes con diagnóstico de artritis reumatoide de la ciudad de Medellín (Colombia). Instrumentos: Escala de Resiliencia RS, Cuestionario Breve de Percepción de Enfermedad IPQ-B, Inventario de Sistema de Creencias SBI-15R, Escala Estrategias de Afrontamiento Espirituales SCS y Cuestionario de Salud MOS SF-36. Los resultados mostraron relaciones negativas de la representación cognitiva y emocional de la enfermedad del IPQ-B con la calidad de vida física y mental, y las estrategias de afrontamiento no religioso (SCS) se asociaron positivamente con la calidad de vida mental. En el análisis de regresión lineal, las consecuencias de la enfermedad del IPQ-B y el tratamiento farmacológico tuvieron un peso negativo sobre la calidad de vida a nivel físico, mientras que la aceptación de sí mismo y de la vida de resiliencia y el estrato socioeconómico lo tuvieron positivamente sobre la salud mental. En conclusión, la percepción de la calidad de vida de los pacientes con AR es mediada por las representaciones de la enfermedad y por factores salutogénicos como un afrontamiento de tipo trascendental y la resiliencia.

The purpose of this research was to evaluate the relationship between resilience, illness perception, beliefs and spiritual-religious coping on health-related quality of life in 41 patients with a diagnosis of rheumatoid arthritis from the city of Medellín (Colombia). The Instruments used were Resilience Scale RS, The Spiritual Coping Strategies Scale SCS, System of Belief Inventory SBI-15R Illness Perception Questionnaire IPQ-B, medical outcomes study short form 36 items MOS SF-36. The results showed negative relationships of cognitive and emotional representation of the IPQ-B disease with physical and mental quality of life and non-religious coping strategies (SCS) were positively associated with the quality of mental life. In linear regression analysis the disease consequences IPQ-B and pharmacological treatment had a negative weight on the quality of life physically, while acceptance of self and life (RS) and socioeconomic stratum had positive effects on mental health. In conclusion the perception of the quality of life of patients with RA is mediated by disease representations and salutogenic factors as transcendental type coping and resilience.

Enfrentamento da incapacidade funcional por idosos por meio de crenças religiosas / Coping with functional disability among the elderly by means of religious beliefs

O modo como as pessoas lidam com o estresse da vida é conhecido como o processo de coping ou enfrentamento. Fala-se de coping religioso quando a pessoa utiliza crenças e comportamentos religiosos para facilitar a resolução de problemas, prevenir ou aliviar consequências emocionais negativas estressantes, dentre as quais a incapacidade funcional. O objetivo do presente trabalho foi investigar o papel da religiosidade como estratégia de enfrentamento da incapacidade funcional entre idosos. Foi utilizada a abordagem qualitativa, constituindo-se em um estudo etnográfico observacional, cuja amostra incluiu 57 idosos da cidade de Bambuí, Minas Gerais. O modelo dos signos, significados e ações foi utilizado na coleta e análise dos dados. A religiosidade dos idosos entrevistados sugere que suas crenças e tradições religiosas ajudam a explicar e a enfrentar o sofrimento experimentado por eles na vigência ou iminência da incapacidade funcional. O enfrentamento religioso reforça o fatalismo presente na crença religiosa que espelha a fatalidade da velhice com incapacidade como um código social aceito e naturalizado, mas também colabora para minimizar a responsabilidade social pelo cuidado do idoso e revela a descrença nos serviços públicos de saúde existentes.

The way people deal with the stress of life is known as the process of coping or confrontation. We speak of religious coping when a person uses religious belief and behavior to facilitate problem solving, to prevent or alleviate stressful negative emotional consequences, notable among which is functional disability. The objective of this study was to investigate the role of religion as a strategy for coping with disability among the elderly. A qualitative approach, consisting of an observational ethnographic study was employed, the sample for which included 57 elderly individuals from Bambuí, Minas Gerais. The model of signs, significances and actions was used in collecting and analyzing data. The religiosity of the elderly respondents suggested that their religious beliefs and traditions help explain and address the suffering experienced by them in the presence or imminence of functional disability. Religious coping reinforces the fatalism existing in the religious belief that mirrors the inevitability of old age with disability as an accepted and natural social code, but also helps to minimize the social responsibility for the care of the elderly and reveals the disbelief in existing public health services.

Creencias-prácticas y afrontamiento espiritual-religioso y características sociodemográficas en enfermos crónicos / Beliefs-practice and spiritual-religious coping and demographic characteristics in chronic patients

El propósito de este estudio fue identificar las diferencias de las creencias-prácticas y afrontamiento espiritual-religioso en función de características sociodemográficas como género, escolaridad, estado civil, con quien vive, ocupación, estrato socioeconómico y tiempo de diagnóstico de la enfermedad en 121 pacientes con diagnóstico de enfermedad crónica de la ciudad de Medellín, Colombia. Se utilizó como medición el inventario de sistema de creencias SBI-15R y la escala de estrategias de afrontamiento espirituales SCS. A nivel de resultados se encontraron diferencias estadísticamente significativas entre las creencias-prácticas y afrontamiento espiritual-religioso en función de la edad, la escolaridad, la ocupación y el estrato socioeconómico, mientras que el género y el tiempo de diagnostico de la enfermedad no fueron variables significativas. En conclusión, independientemente del tiempo de diagnóstico de la enfermedad y el género los enfermos crónicos son más espirituales y religiosos cuando son adultos mayores, no tiene una actividad laboral y pertenecen a un nivel educativo y estrato socio-económico bajo.

The aim of the study was to identify differences in the beliefs-practice and spiritual-religious coping in terms of sociodemographic characteristics such as gender, education, marital status, live with, occupation, socioeconomic status and time of diagnosis of the disease in 121 patients diagnosed with chronic illness from the city of medellin, colombia. was used as measure the systems of beliefs inventory SBI-15R y spiritual coping scale SCS. The results showed statistically significant differences between the beliefs-practice and spiritual-religious coping in terms of age, education, occupation and socioeconomic status, while gender and time of diagnosis of the disease were not variable significant. In conclusion, regardless of time of disease diagnosis and gender for the chronically ill are more spiritual and religious when are being elderly, not have a work activity and have low educational and socio-economic level.

La salud en el marco de la psicología de la religión y la espiritualidad / The health in the mark of the psychology of the religion and the spirituality

El siguiente trabajo tiene como objetivo presentar una descripción del impacto que ha tenido en la salud "la psicología de la religión y la espiritualidad". Se muestra la evolución histórica de este constructo a lo largo del siglo XX, hasta llegar a las investigaciones basadas en la evidencia de las relaciones de la religión y la espiritualidad con la salud mental y física, y de investigaciones sobre los procesos de intervención en salud, enfocadas desde la espiritualidad. En conclusión, son muchas las investigaciones que plantean que la religión y la espiritualidad son variables moderadoras y amortiguadoras ante eventos traumáticos de la vida como lo es una enfermedad.

The present work has as aim present a review of the impact that has had in the health "the psychology of the religion and the spirituality". There are examined the historical precedents of this concept from its origins up to coming in the middle of the 20th century where it begins and one gives increasing summit in the researches based on the evidence of the relations of the religion and the spirituality in the mental and physical health, equally an approximation is done to the researches on the processes of intervention in health focused from the spirituality. In conclusion, there are great the researches that raise that the religion and the spirituality are moderating and buffering variables before traumatic events of the life like it is a disease.

Medidas de afrontamiento religioso y espiritualidad en adultos mayores mexicanos

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Summary: Spiritual life seems to play an important role in coping with stress in older adults. Spiritual life has been documented to have a positive effect on the sense of personal wellbeing in seniors and it has been inversely related to depression, to low levels of loneliness and psychopathology measured by MMPI-2. It has been documented that, when spirituality forms part of the subject's personality it tends to be expressed in his/her religious coping strategies and to have a positive impact on his/her health when these strategies are effectively used against stress during hospitalization and illness and against losses common in older age that are associated with depression. Two general approaches to the study of religious coping have been emphasized: a) the specific ways of coping, in which religious coping is a multidimensional phenomenon, which may include forgiveness, purification and confession, spiritual support, etc.; b) the study of coping patterns. The second approach includes religious coping methods and the patterns of interrelation they involve. Pargament et al. have distinguished between positive religious coping and negative religious coping; the former leads the individual towards productive and efficient spiritual coping associated with better health indicators than the negative coping strategy. According to the authors above mentioned, positive religious coping includes methods such as benevolent religious appraisal, collaborative religious coping and seeking spiritual support, seeking the support of clergy and church members, religious help and religious forgiveness. Negative religious coping includes methods such as punishing religious reappraisal, demonic religious appraisal, the reappraisal of the power of God, spiritual discontent, self directed religious coping, and interpersonal religious discontent. Pargament et al. have included these coping patterns in the Scale of Positive and Negative Patterns of Religious Coping Methods (Brief-RCOPE). Our research was aimed at identifying the validity and reliability of the religious coping scale (Brief-RCOPE) proposed by Pargament et al. in two samples of older adults living in Mexico City and selected according to availability in two health clinics. Additionally, with the objective of gaining greater knowledge of the characteristics of religious coping and the spiritual life of older Mexican adults, our research explored the possible existence of significant differences in the above mentioned variables regarding sex, age, education and religious denomination, marital and employment status. The subjects answered a questionnaire containing 37 questions with dichotomic multiple choice answers (likert type) which included: 1) demographic information; 2) the Positive and Negative Methods of Religious Coping Scale, Brief- RCOPE, with two subscales (positive religious coping and negative religious coping); 3) the subscale of Religious Coping when Confronting Loneliness, ARS, from the Loneliness Multiphase Inventory, IMSOL; and 4) the subscale of the Relationship with God from the Spiritual Wellbeing Scale, EBE. The results obtained allowed us to conclude that the tools that were used have adequate internal consistency which we obtained by calculating Cronbach's alpha coefficient; however, the negative religious coping subscale gave conservative results that may indicate the need for further investigation. A significant association between the positive Brief-RCOPE, Religious Coping when confronted with loneliness and the subscale of Relationship with God was found, which supports the convergent validity of the first subscale. On the contrary, and in a way consistent with the results of the authors negative Brief-RCOPE was not significantly associated with the other scales, but had a conservative association with regard to a measurement consisting of two items in the Relationship with God subscale. These items seem to specifically evaluate the dissatisfaction of the individual in his/her relationship with God. We calculated the factorial structure of the tools through the analysis of major components with varimax rotation of eigenvalues greater than 1: For Brief-RCOPE it was only possible to confirm a well defined structure representing 49.5% of the variance explained with an internal consistency of α=.82 and which corresponded to positive religious coping. The Scale of Religious Coping when confronted with loneliness maintained a solid structure based on only one component which explained the 70.2% variance, according to the expectations of the author, with an internal consistency of α=.91. The EBE subscale of the Relationship with God presented two clearly defined components, which explained the 59.3% variance. The first component seems to evaluate a satisfactory relationship with God, whereas the second one seems to indicate an unsatisfactory one. In analyzing the socio-demographic variables, we found that the tendency to cope with feelings of loneliness through greater closeness with God was more frequent among women ( X=18.46) than among men ( X=16.47; t=2.04, p=.04). On the other hand, Religious Coping, when confronted with loneliness, seems so show a relationship that changes with the number of years of schooling: the higher the educational level, the less this coping strategy was used (elementary school, =18.66; middle school, X=17.71; high school, X=17.55; college, X=14.61; F=3.252, p=.024). Meanwhile, those subjects who were in a relationship (either married or living with their partner) tended to resort to religious coping to a lesser extent (Positive Brief-RCOPE, =19.29, ARS, X=16.72), than single people (single, widowed, separated or divorced) did (Positive Brief-RCOPE, =21.44, t=2.203, p=.030; ARS, =18.85, t=2.249, p=.026.) Finally, we compared the largest religious groups -Catholics and Christians- and we found that the latter turn more frequently to religious coping when confronted with loneliness ( X=20.45) than Catholics do ( X=17.30; t=2.667, p=.017). On the other hand, traditional christian denominations relate to God more frequently ( X=40.27) than Catholics do ( X=37.35; t=2.345, p=.032). Results reported here significantly attest to the psychometric qualities of the tools utilized. However, the negative coping subscale appears to call for further research. The IMSOL Religious Coping subscale proved to have the best psychometric properties, as regards internal consistency, validity and factorial structure for its use in research protocols dealing with older Mexican adults. Although EBE's Relationship with God subscale resulted in two clearly defined components instead of one, it was also shown to have psychometric qualities that make it useful for research. The analysis of the significant differences that exist in sociodemographic variables shows findings that are consistent with other research carried out in the Mexican context. The results obtained give empirical evidence on the way older Mexican adults live their spiritual life. Although the results described herein cannot be generalized, since they are not based on a random sample they contribute data that is consistent with other research.

Coping (enfrentamento) religioso/espiritual / Spiritual/religious coping

CONTEXTO: O coping religioso/espiritual (CRE), pouco estudado no Brasil, está associado à saúde e à qualidade de vida (QV). OBJETIVO: Apresentar revisão de literatura sobre CRE, enfocando sua base teórica, avaliação e aplicação na prática clínica. MÉTODO: Pesquisa nas bases de dados Medline, PsycINFO, Scielo e Bireme/BVS entre 1979 e 2006. RESULTADOS: O CRE é o uso da religião, espiritualidade ou fé para lidar com o estresse. Estratégias de CRE, conforme conseqüências que trazem para quem as utiliza, podem ser classificadas como positivas ou negativas, estando geralmente associadas, respectivamente, a melhores ou piores resultados de saúde física/mental e QV. Evidências apontam que as pessoas utilizam CRE especialmente em situações de crise e, também, mais CRE positivo que negativo. Existem cinco estilos de CRE: autodireção, colaboração, delegação, súplica e renúncia. CONCLUSÕES: Instrumentos como RCOPE e Escala CRE podem ajudar na avaliação espiritual do paciente, na pesquisa e no planejamento de intervenções psicoespirituais enfocando o processo de CRE. Estas podem ser efetivas, ajudando os pacientes a mais bem utilizar um importante recurso disponível, com significativo impacto na saúde e na QV populacional, e reduzindos custos de intervenção em termos de saúde pública. Assim, o estudo do CRE mereceria ser incluído na formação dos profissionais da saúde.

BACKGROUND: Spiritual/religious coping (SRC), little studied in Brazil, is associated to health and quality of life (QoL). OBJECTIVES: To present a literature review about spiritual/religious coping, focusing its theoretical background, assessment and clinical applications. METHODS: Research on Medline, PsycINFO, Scielo and Bireme/BVS databases between 1979-2006. RESULTS: The SRC is the use of religion, spirituality or faith to cope with stress. SRC methods, depending on the consequences that bring to those who use them, can be classified into positive or negative, generally associated to better or worse physical/mental health and QoL outcomes, respectively. Evidences show that people use SRC especially in crisis situations, and also, they use more positive than negative SRC. There are five SRC styles: self-directing, collaborative, deferring, pleading and surrender. CONCLUSIONS: Instruments as RCOPE and SRCOPE Scale can be helpful to patients spiritual evaluation, to researches and for planning psychospiritual interventions focused on the SRC process. Those can be effective in helping patients to better use an important available resource, with high impact on populations health and QoL, and potential to reduce public health costs. So, SRC studies would deserve to be included in health professionals graduate courses.