Spiritual Intimacy, Marital Intimacy, and Physical/Psychological Well-Being: Spiritual Meaning as a Mediator.

OBJECTIVE: Intimacy is an essential part of marital relationships, spiritual relationships, and is also a factor in well-being, but there is little research simultaneously examining the links among spiritual intimacy, marital intimacy, and well-being. METHODS: Structural equation modeling was used to examine associations among the latent variables-spiritual intimacy, marital intimacy, spiritual meaning, and well-being-in a cross-sectional study of 5,720 married adults aged 29-100 years (M = 58.88, SD = 12.76, 59% female). All participants were from the Adventist Health Study-2, Biopsychosocial Religion and Health Study. RESULTS: In the original structural model, all direct associations between the three latent variables of spiritual intimacy, marital intimacy, and well-being were significantly positive indicating that there was a significant relationship among spiritual intimacy, marital intimacy, and well-being. When spiritual meaning was added as a mediating variable, the direct connections of spiritual intimacy to marital intimacy and to well-being became weakly negative. However, the indirect associations of spiritual intimacy with marital intimacy and with well-being were then strongly positive through spiritual meaning. This indicates that the relationship among spiritual intimacy, marital intimacy, and well-being was primarily a result of the meaning that spiritual intimacy brought to one's marriage and well-being, and that without spiritual meaning greater spirituality could negatively influence one's marriage and well-being. CONCLUSIONS: These findings suggest the central place of spiritual meaning in understanding the relationship of spiritual intimacy to marital intimacy and to well-being.

Using the theory of planned behavior to predict infant restraint use in Saudi Arabia.

OBJECTIVES: To determine whether the theory of planned behavior (TPB) predicted intent of child restraint system (CRS) use among pregnant women in the Kingdom of Saudi Arabia (KSA). METHODS: In this cross-sectional study conducted in Dallah Hospital, Riyadh, KSA during June-July 2013, 196 pregnant women completed surveys assessing their beliefs regarding CRS. Simultaneous observations were conducted among a different sample of 150 women to determine CRS usage at hospital discharge following maternity stay. RESULTS: Logistic regression model with TPB constructs and covariates as predictors of CRS usage intent was significant (χ2=64.986, p<0.0001) and predicted 38% of intent. There was an increase in odds of intent for attitudes (31.5%, p<0.05), subjective norm (55.3%, p<0.001), and perceived behavioral control (76.9%, p<0.001). The 3 logistic regression models testing the association of the relevant set of composite belief scores were also significant for attitudes (χ2=16.803, p<0.05), subjective norm (χ2=29.681, p<0.0001), and perceived behavioral control (χ2=20.516, p<0.05). The behavioral observation showed that none of the 150 women observed used CRS for their newborn at discharge. CONCLUSION: The TPB constructs were significantly and independently associated with higher intent for CRS usage. While TPB appears to be a useful tool to identify beliefs related to CRS usage intentions in KSA, the results of the separate behavioral observation indicate that intentions may not be related to the actual usage of CRS in the Kingdom. Further studies are recommended to examine this association.

The effects of simultaneous exercise and psychotherapy on depressive symptoms in inpatient, psychiatric older adults.

CONTEXT: Depression is the leading cause of early death, affecting 15% of Americans older than 65 y and costing $43 billion each year. The current mental health service system for seniors, particularly for the population hospitalized in acute inpatient psychiatric units, is fragmented because of poor funding and a shift to a transitory health care paradigm, leading to inadequate treatment modalities, questionable quality of care, and lack of research demonstrating the superiority of a particular treatment. These issues are likely to lead to a public health crisis in the coming years. OBJECTIVE: To investigate the effectiveness of combining exercise and psychotherapy in improving acute depressive symptoms among older adults who were receiving treatment in an inpatient psychiatric unit. DESIGN: Based on rolling admissions, inpatients were randomly assigned to 1 of 3 treatment groups. The study was blinded and controlled. SETTING: This study took place in inpatient psychiatric units at the Loma Linda University's Behavioral Medicine Center (LLUBMC) in Redlands, California. PARTICIPANTS: Participants were 78 inpatients, aged 50-89 y. INTERVENTION: Participants in the simultaneous exercise and psychotherapy (STEP) group (n = 26) took part in exercise and received psychotherapy for 30 min per session, whereas those in the TALK group (n = 26) received individual psychotherapy for 30 min per session. Participants in the control group (n = 26) served as a comparison group, receiving standard therapy. OUTCOME MEASURES: The effects of the interventions were determined by assessing differences from baseline to postintervention in the symptomatology of all 3 groups. The research team also administered the Behavioral and Symptom Identification Scale (BASIS-32) and the Geriatric Depression Scale (GDS) pre- and postintervention. RESULTS: At posttest, the STEP group (M = 4.24, SE = 0.62) had a better response than the TALK group (M = 11.34, SE = 0.62, P < .001), which in turn showed greater improvement than the control group (M = 14.84, SE = 0.62, P < .001). Overall, these results indicate that patients' posttreatment depression scores were significantly lower in those receiving the STEP treatment compared with those receiving individual psychotherapy only or standard care. CONCLUSION: A short-term exercise program consisting of 30 min of walking in conjunction with individual psychotherapy was an effective intervention for depression among older adults in inpatient psychiatric units.

Developing healthy kids in healthy communities: eight evidence-based strategies for preventing high-risk behaviour.

Australian youth engage in behaviour that threatens their health and wellbeing. National surveys report that about a third of young Australians have tried an illicit drug. High rates of substance use and risky sexual behaviour among young Australians suggest that effective prevention efforts based on empirical evidence need to be expanded. Church-associated organisations are an untapped resource that could be used to improve the health and welfare of young people. We describe eight evidence-based elements to consider in designing strategies to prevent high-risk behaviour in young people.