Spirituality as a means of coping with chronic illness.Abstract: Individuals with chronic illnesses often deal with intense physical and psychological stressors as a consequence of living with an illness. The purpose of this study was to explore the relationship between spirituality and coping ability. Participants with various chronic illnesses completed the Spiritual Involvement and Belief Scale (SIBS), the Coping Styles Scale, and a demographics The attributes of people in a particular geographic area. Used for marketing purposes, population, ethnic origins, religion, spoken language, income and age range are examples of demographic data. questionnaire. A significant positive correlation Noun 1. positive correlation - a correlation in which large values of one variable are associated with large values of the other and small with small; the correlation coefficient is between 0 and +1
direct correlation was found between spirituality and the ability to cope. However, only one coping style, Intrusive Positive Thoughts, was found to be a significant predictor of spirituality. These results suggest that individuals who measure high in spirituality also tend to have a stronger and more diverse coping style and also tend to cope using a more positive outlook.
Holistic approaches holistic approach A term used in alternative health for a philosophical approach to health care, in which the entire Pt is evaluated and treated. See Alternative medicine, Holistic medicine. to health care focus upon the relationships between a patient's mind, body, and spirit as necessary components of well-being. However, the spiritual dimension of this complex relationship is often left unattended (Miller, 1985). Yet, spiritual care to help patients cope with the psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects.
Involving aspects of both social and psychological behavior. stress associated with illness is thought to be an important strategy among healthcare professionals, though research on the relationship between spirituality and coping ability remains relatively scarce. Consequently, it is important to explore the relationship between spirituality and the ability to cope with illness to aid healthcare professionals in developing useful interventions.
Patients with chronic illnesses often face an array of difficulties and stressors, such as pain, feelings of uncertainty, and changes in body image, because these illnesses cannot be cured, only managed. These kinds of stressors can lead to changes in well-being, to spiritual distress, and to the struggle with existential ex·is·ten·tial
1. Of, relating to, or dealing with existence.
2. Based on experience; empirical.
3. Of or as conceived by existentialism or existentialists: questions such as "what is the meaning of life?" (O'Neill & Kenny, 1998). Often these individuals search for relevant meaning and purpose in life, which may, in turn, bring out unresolved Not completed; not finished; not linked together. See resolve. conflicts with other people and regret about certain life choices. The inability to resolve such conflicts may then lead to greater psychological distress psychological distress The end result of factors–eg, psychogenic pain, internal conflicts, and external stress that prevent a person from self-actualization and connecting with 'significant others'. See Humanistic psychology. , such ms depression and anxiety.
How individuals cope with chronic illnesses is quite important to functioning and quality of life. Coping, defined as the process through which individuals try to understand and deal with significant personal or situational demands in their lives (Folkman, & Lazarus, 1988), can greatly impact ones perceptions about his/her own chronic illness. According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. Folkman & Lazarus (1988), two general types of coping are thought to be active in the coping response. Problem Solving problem solving
Process involved in finding a solution to a problem. Many animals routinely solve problems of locomotion, food finding, and shelter through trial and error. Efforts include strategies to do something active or constructive about the situation that is perceived by the individual as threatening, harmful, or challenging. An example of this type of coping is seeking direct help from others in order to cope with illness. Emotion-focused Coping is more passive and involves strategies to gain emotional control or understanding of a stressful event. For example, individuals who focus upon acceptance of chronic illness are using emotion-focused coping.
For centuries, philosophers have examined the various dimensions of spirituality. Smith, Stefanek, Joseph, Verdieck, Zabora & Fetting (1993) have described spirituality as an underlying dimension of the conscious in which an individual strives for meaning, union with the universe and all things, and stresses the notion that spirituality extends to a power beyond us. This definition utilizes a subconscious subconscious: see unconscious. or instinctual in·stinc·tu·al
Of, relating to, or derived from instinct. See Synonyms at instinctive.
in·stinctu·al·ly adv. component to the human psyche Psyche (sī`kē), in Greek mythology, personification of the human soul. She was so lovely that Eros (Cupid), the god of love, fell in love with her. , which drives an individual to seek meaning in his/her life. This definition also explains an individual's striving for a union with all creation and a belief in a power beyond one's control, possibly to a being or beings. In contrast, O'Neill and Kenny (1998) have proposed that when spirituality involves an individual's relationship with a higher being in connection with others, it takes on more of a 'religious' context. In this definition, a person's religion is the motivating factor in all aspects of his// her life, and spirituality emerges from religion. Hunglemann, Kenkel-Rossi, Klassen, & Stollenwerk (1996) have found spirituality to be a kind of growth process, which leads to a realization of the ultimate purpose and meaning of life. This definition is important because it suggests that spirituality is a process by which a person can grow and learn from both good and bad experiences in life.
It is important not to confuse the concept of spirituality with that of religion, because religion is a very complex variable in its own right and reflects its own distinct aspects. Religion and spirituality are said to overlap but are not conceptually the same. More specifically, religion refers to the external expression of faith, that is the inner beliefs or values that relate to God or any higher being. It is composed of beliefs, ethical codes Noun 1. ethical code - a system of principles governing morality and acceptable conduct
system of rules, system - a complex of methods or rules governing behavior; "they have to operate under a system they oppose"; "that language has a complex system , and worship practices that unite an individual with a moral community (Pargament & Jenkins 1995). Religion is a type of spiritual experience, which is part of an organized belief system, practices, and knowledge. These experiences are regarded as an expression of spirituality (O'Neill & Kenny, 1998). Spirituality, however, is broader than religion, and an individual can be spiritual without being religious. For example, those who participate in the Alcoholics Anonymous Alcoholics Anonymous (AA), worldwide organization dedicated to the treatment of alcoholics; founded 1935 by two alcoholics, one a New York broker, the other an Ohio physician. (AA) program participate in the spiritual aspects of the program, but are not, in many cases, religious at all (Hatch, Burg, Naberhaus, & Hellmich, 1998; Spalding, & Metz, 1997).
Some of the earlier research exploring the relationships between coping and religion, in which spirituality was a minor component, revealed mixed results because of the lack of an appropriate measure for religion. In fact, early research on religious coping religious coping,
n means of dealing with stress (which may be a consequence of illness) that are religious. These include prayer, congregational support, pastoral care, and religious faith. is lacking because it failed to take into account all of the complex dimensions of religion (Hathaway & Pargament, 1991). Examples of these studies include those in which religiosity re·li·gi·os·i·ty
1. The quality of being religious.
2. Excessive or affected piety.
Noun 1. religiosity - exaggerated or affected piety and religious zeal
religiousism, pietism, religionism has been simplistically measured according to the frequency of church visits (Ventura & Boss, 1983) or the number of times per day a individual prays (Zuckerman, Kasl, & Ostfeld, 1984). While these two studies were quite important to the development of research in this area, they lack exploration of the many components of religious practice, beliefs, and behavior.
More recent research on coping and spirituality involved the combination of both spirituality and religion as interchangeable in·ter·change·a·ble
That can be interchanged: interchangeable items of clothing; interchangeable automotive parts.
in concepts. This research, for the most part, has found religion to be an important resource for coping. Aspects of religion, such as religious beliefs, practices, and relationships, are often used to assist individuals in coping with physical and psychosocial stress (Hathaway & Pargament, 1991). Pargament (1990) discussed different ways that religious coping efforts potentially assist those coping with stressful experiences. First, religion may be an element of coping through one's interpretation (e.g. a tragic situation is part of God's plan). Second, religion may affect coping by shaping the coping process (e.g. religious background may help an individual to fight addiction). Third, religion may be shaped by the coping process (e.g. a near-death experience near-death experience, phenomenon reported by some people who have been clinically dead, then returned to life. Descriptions of the experience differ slightly in detail from person to person, but usually share some basic elements: a feeling of being outside one's may lead an individual to seek out organized religion). Pargament (1990) also defined three different types of religious coping. The Self-directing Style seeks to solve religious problems without God, the Collaborative Religious Coping Style involves both the individual and God solving a problem, and the Deferring Style is passive, whereas the individual waits for God to intervene in some way. Research evaluating the relationship between religion and coping in patients with cancer has identified significant correlations between religiousness and management of symptoms. Specifically, the presence of strong religious beliefs has been related to decreased levels of pain, hostility, and social isolation, as well as high levels of life satisfaction (Acklin, Brown, & Manger manger
cattle trough which served as crib for Christ. [N.T.: Luke 2:7]
See : Nativity , 1983), and less depression (Bickel, Ciarrocchi, Sheers sheers
n. (used with a sing. or pl. verb)
Variant of shear. , Estadt, Powell, & Pargament, 1998).
Research on the concept of spirituality has provided evidence that it is an important coping strategy in its own right. A study by Fehring, Brennan, & Keller (1987) investigated the relationship between spirituality mad psychological mood states in response to changes in life. In this study college students who were making the transition to living away from home for the first time completed the Spiritual Well-Being spiritual well-being,
n a sense of peace and contentment stemming from an individual's relationship with the spiritual aspects of life. scale, a spiritual maturity scale, a life change scale, and a depression scale. Results suggested an inverse relationship A inverse or negative relationship is a mathematical relationship in which one variable decreases as another increases. For example, there is an inverse relationship between education and unemployment — that is, as education increases, the rate of unemployment between negative mood states and spiritual well-being, existential well-being, and spiritual outlook. Similarly, Gurklis & Menke (1988) illustrated die importance of spirituality in coping with a chronic illness. Participants completed a hemodialysis hemodialysis /he·mo·di·al·y·sis/ (-di-al´i-sis) removal of certain elements from the blood by virtue of the difference in rates of their diffusion through a semipermeable membrane while being circulated outside the body; the process stressor scale, a coping scale, and a general stressor scale, and it was found that prayer, faith in God, and maintaining purpose in life were critical components of coping with illness. Further, Landis (1996) found a negative relationship between spiritual well-being and uncertainty; and a positive relationship between psychosocial adjustment and spiritual well-being. Smith, et. al. (1993) demonstrated that those who viewed death as a normal part of life also experienced less psychosocial distress. Additional research has noted die importance of spirituality in helping individuals cope with the anxiety associated with chronic illnesses. Kaczorowski (1989) found that in individuals with cancer, anxiety is lower in people who are highly spiritual.
These studies provide direct evidence of a potentially significant relationship between spirituality and an enhanced ability to cope with symptoms like anxiety, depression, and other forms of psychosocial distress associated with chronic illness. Consequently, the purpose of the present study was to explore the relationship between spirituality and coping with chronic illnesses in individuals with a variety of different chronic disorders. Results of this study may be important to assist health educators in the development and use of interventions in healthcare programs, which focus upon the stress associated with chronic illness.
A total of 201 individuals served as subjects. The individuals were recruited from a variety of settings including physicians' offices, a nursing staffing company, a group of med-techs from a hospital, a Catholic prayer group, a local chapter of the Arthritis Foundation This article or section needs sources or references that appear in reliable, third-party publications. Alone, primary sources and sources affiliated with the subject of this article are not sufficient for an accurate encyclopedia article. , a suburban fire company, an electrical supply company, a cancer support group, and a financial institution. This was done to recruit from a large, diverse pool of subjects.
All subjects were recruited by contacting a member from each group by phone and asking one of the members if their group would be interested in participating in a study on spirituality. Each respective member was then asked to recruit individuals at their workplace or at their monthly meetings. The recruiting was done using the same procedure for each organization. All potential subjects were asked whether or not they were living with a chronic illness. Those who answered "yes" were asked if they were interested in participating in a study on those with chronic illnesses. Employees who were interested were then given a packet containing the three questionnaires along with instructions to complete the surveys and instructions to place their responses into an envelop en·vel·op
tr.v. en·vel·oped, en·vel·op·ing, en·vel·ops
1. To enclose or encase completely with or as if with a covering: "Accompanying the darkness, a stillness envelops the city" and seal it, which were then collected by the employee who recruited the subjects.
The Spiritual Involvement and Beliefs Scale (SIBS) was used to assess spirituality (Hatch, et al., 1998). This instrument is a 39-item self-administered Likert scale Likert scale A subjective scoring system that allows a person being surveyed to quantify likes and preferences on a 5-point scale, with 1 being the least important, relevant, interesting, most ho-hum, or other, and 5 being most excellent, yeehah important, etc , which assesses spirituality. It consists of 15 underlying principles of spirituality such as, purpose in life, faith, and trust (Cronbach's alpha Cronbach's (alpha) has an important use as a measure of the reliability of a psychometric instrument. It was first named as alpha by Cronbach (1951), as he had intended to continue with further instruments. , [r.bar] = .92, test- retest re·test
tr.v. re·test·ed, re·test·ing, re·tests
To test again.
A second or repeated test. , [r.bar] = .92). Each respondent is asked to judge statements on a seven-point scale by circling how strongly he or she agrees with statements such as "Everything happens for a greater purpose." The authors contend that it consists of the following four factors of spirituality: External/Ritual, Internal/Ritual, Existential/Meditative, and Humility/Personal Application. The SIBS is the instrument used most frequently in research that measures spirituality as a relatively different construct from that of religion.
The Coping Style scale was included to measure the ability to cope (Nowack, 1990). This scale consists of a 20-item Likert scale format and assesses four coping styles. The first coping style, Intrusive Positive Thoughts (alpha, [r.bar] =.72, test-retest, [r.bar]=.62), measures one's ability to cope with a stressful situation through a positive outlook and is assessed through statements such as, "Focus my thoughts on the positive events of a situation." Intrusive negative thoughts (alpha, [r.bar] =.79, test-retest, [r.bar]=.66) includes looking at a situation in a negative way through such statements as, "Blame, criticize crit·i·cize
v. crit·i·cized, crit·i·ciz·ing, crit·i·ciz·es
1. To find fault with: criticized the decision as unrealistic. See Usage Note at critique. and put myself down for somehow creating the problem." Avoidance coping (alpha, [r.bar]=.70, test-retest, [r.bar]=.78) involves trying to ignore or escape the problem and is assessed through statements such as "Avoid thinking about it when it crosses my mind." Finally, Problem-focused coping (alpha, [r.bar]=.68, test-retest, [r.bar]=.70) is a method of dealing with stress through trying to do something active or constructive about the situation and is assessed through statements such as, "Develop an action plan and implement it to cope more effectively with situations in the future." On all items, each participant is asked to circle the response that best describes him/herself using choices including, "never", "rarely", "sometimes", "often" and "always." High scores on the scale indicate more positive and diverse coping.
Finally, a demographic questionnaire was also used and included questions on age, gender, religious affiliation, ethnic background, total income, type of chronic illness, and severity of the chronic illness.
All subjects were given instructions to complete the questionnaires and assured of their anonymity and confidentiality. Participants were then handed a packet containing the three questionnaires and asked to complete them. The participants were debriefed on the purpose of the study through a written debriefing de·brief·ing
1. The act or process of debriefing or of being debriefed.
2. The information imparted during the process of being debriefed.
Noun 1. statement, and thanked for their participation. The University Institutional Review Board approved this research for the Protection of Human Subjects in Research.
Frequency data were formulated to describe the sample. Ages of the participants ranged from 18 to 86 years old ([m.bar]=47.33, [sd.bar]= 18.77), 67.3% were female and 32.7% were male, 82.2% were Caucasian, 15.8% were Asian American A·sian A·mer·i·can also A·sian-A·mer·i·can
A U.S. citizen or resident of Asian descent. See Usage Note at Amerasian.
A , 1% were African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. , and 1% were Eastern Indian. Also, 57.4% of the participants were Catholic, 27.7% were Protestant, 3% were Jewish, 1% were Hindu, and 10.9% were "other". Relative to annual family income level, 23.8% earned less than $20,000, 30.7% earned between $20,000 and $34,999, 19.8% earned between $35,000 and $49,999, 7.9% earned between $50,000 and $74,999, 7.9% earned more than $75,000, 6.9% did not know, and 3% did not answer the question. The number of years of education ranged from 4 to 22 years ([m.bar]=14.1), with 35.7% having completed between 9 and 12 years of education, 51.4% having completed between 13 and 16 years of education, and 12.9% having completed 17 or more years of education. All participants reported having a chronic illness, with 15.1% living with diabetes, 14.9% with cancer, 10.9% with chronic back pain, 9.9% with arthritis, 8.9% with hypertension, 3.7% with asthma, and 36.6% with various other conditions such as epilepsy epilepsy, a chronic disorder of cerebral function characterized by periodic convulsive seizures. There are many conditions that have epileptic seizures. Sudden discharge of excess electrical activity, which can be either generalized (involving many areas of cells in , heart disease, and migraine headaches Migraine Headache Definition
Migraine is a type of headache marked by severe head pain lasting several hours or more.
Migraine is an intense and often debilitating type of headache. .
The participants also rated the severity of their illness using 4 possible choices. Forty-nine percent reported that their illness was not 'Very Debilitating', 25% reported that their illness was not 'Debilitating', 22% reported that their illness was 'Debilitating', and 4% reported their illness was 'Very Debilitating'.
To explore the efficacy of the SIBS as a measure of spirituality, the 39 items from the scale were analyzed an·a·lyze
tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es
1. To examine methodically by separating into parts and studying their interrelations.
2. Chemistry To make a chemical analysis of.
3. using unweighted least squares factor analysis. Two criteria were used to determine the number of factors to rotate, the scree test and previous research, which indicated that the items fell into a four-factor structure (Hatch et al. 1998). Four factors were rotated rotated
turned around; pivoted.
see rotated tibia. using a varimax rotation procedure. Results indicated that the items did not fall into a four-factor structure but instead fell into a general spirituality factor, which accounted for 52.4% of the variance (Internal consistency In statistics and research, internal consistency is a measure based on the correlations between different items on the same test (or the same subscale on a larger test). It measures whether several items that propose to measure the same general construct produce similar scores. ; [r.bar]=.87). Consequently, analyses were conducted on both the scores of the overall scale and on the scores of the subscales (as recommended by the authors).
SPIRITUALITY AND COPING
To explore the relationship between spirituality (measured using the items that loaded into a general spirituality factor on the SIBS) and coping (measured by the total coping score of all four factors), the data were then analyzed using a Pearson's r correlation. A significant positive correlation was identified between scores on the SIBS scale and total scores on the Coping Styles scale ([r.bar]= .382, [p.bar]< .05), representing a moderate correlation.
A Stepwise stepwise
incremental; additional information is added at each step.
stepwise multiple regression
used when a large number of possible explanatory variables are available and there is difficulty interpreting the partial regression Multiple Regression Multiple regression
The estimated relationship between a dependent variable and more than one explanatory variable. analysis was also conducted on the four factors of the Coping Styles scale, including Intrusive Positive Thoughts, Intrusive Negative Thoughts, Avoidance Coping, and Problem-focused Coping as predictors of spirituality. A significant prediction equation was found for Intrusive Positive Thoughts as a predictor of spirituality [[F.bar](4,96)=36.45, [MSe.bar]=566.295]. The multiple regression equation was y'= 16.93+4.80 (Intrusive Positive Thoughts). The [PIN.bar] value was .05 and the [POUT.bar] value was .10. The slope for the predictor variable Noun 1. predictor variable - a variable that can be used to predict the value of another variable (as in statistical regression)
variable quantity, variable - a quantity that can assume any of a set of values was, [b.bar]=4.795, and the y-intercept was, a=16.931. The effect size was Adj[R.sup.2]=.26 (a small effect size), and the unpredicted variance was .74. The Intercorrelation Matrix between all of the variables can be seen in Table 1 and the Means and standard deviations In statistics, the average amount a number varies from the average number in a series of numbers.
(statistics) standard deviation - (SD) A measure of the range of values in a set of numbers. of the items are reported in Table 2.
A multiple regression analysis using the Enter method was also conducted on the four factors of the Coping Styles scale, including Intrusive Positive Thoughts, Intrusive Negative Thoughts, Avoidance Coping, and Problem-focused Coping as predictors of spirituality. Again, a significant prediction equation was found for Intrusive Position Thoughts as a predictor of spirituality [[F.bar](4,96)=10.293, [MSe.bar]=559.168]. There were no significant relationships found for Intrusive Negative Thoughts (Beta=.041, [p.bar]<.05), Avoidance Coping (Beta=.145, [p.bar]<.05), or Problem-focused Coping (Beta=. 131, [p.bar]< .05) as predictors of spirituality. The multiple regression equation was [y.bar]'=29.33+4.57 (Intrusive Positive Thoughts). The [PIN.bar] value was .05 and the [POUT.bar] value was .10. The slope for the predictor variable was, [b.bar]=4.57, and the y-intercept was, a=29.33. The effect size was Adj[R.sup.2] =.27 (a small effect size), and the unpredicted variance was .73.
Finally, to explore the relationship between spirituality (measured using the items which loaded into a general spirituality factor on the SIBS) and the demographic variable of age the data were then analyzed using a Pearson's r correlation. A significant positive correlation was found between spirituality and age, [r.bar]= .36, [p.bar]< .05, representing a moderate correlation.
As predicted, a positive correlation between spirituality and the ability to cope was found. This correlation provides evidence that spirituality may be an important coping tool because it involves the use of several different coping styles. In particular, individuals who measured high in spirituality tended to show higher overall coping scores, which demonstrates more complete and diverse coping methods using all four coping styles. These findings are consistent with previous research on spirituality as a tool for coping with stress relative to chronic illness (Gurklis & Menke, 1988; Miller, 1985; Smith et al., 1993; Kaczorowski, 1989). The results of the present study also provide evidence for the success of one particular type of coping style, Intrusive Positive Thoughts, as a significant predictor of spirituality for individuals living with a chronic illness. This method of coping involves managing a stressful situation through a positive outlook. These findings indicate that, for individuals living with a chronic illness, spirituality may be very influential to psychological well-being psychological well-being Research A nebulous legislative term intended to ensure that certain categories of lab animals, especially primates, don't 'go nuts' as a result of experimental design or conditions . Finally, the results of this study demonstrated a significant correlation between spirituality and age. This relationship may imply that spirituality increases as a function of age, possibly as a way to cope with the realization of one's own mortality (Hunglemann et al., 1996; Reed, 1991).
The results of the present study should be interpreted in light of several potential limitations. First, although all of the participants in the study reported having some sort of chronic illness, only a small percentage perceived his/her illness to be very debilitating de·bil·i·tat·ing
Causing a loss of strength or energy.
Weakening, or reducing the strength of.
Mentioned in: Stress Reduction . Future research should attempt to replicate rep·li·cate
1. To duplicate, copy, reproduce, or repeat.
2. To reproduce or make an exact copy or copies of genetic material, a cell, or an organism.
A repetition of an experiment or a procedure. this study using a more debilitated de·bil·i·tat·ed
Showing impairment of energy or strength; enfeebled. See Synonyms at weak.
Adj. 1. debilitated - lacking strength or vigor
asthenic, enervated, adynamic sample of individuals. Second, minorities were not well represented in this particular sample. Clearly, it is important to address ethnicity and culture relative to spirituality and coping with chronic illnesses. Third, the specific religions of the subjects were relatively homogeneous and it would be important to evaluate the impact of various types of religion on spirituality and coping. Finally, subjects in this sample had a fairly large range of chronic illnesses. It would be important in subsequent research to explore the relationships between spirituality and coping with individual who have the same or similar chronic illnesses.
The results of this study are noteworthy and may have some practical implications to healthcare professionals helping individuals cope with chronic illnesses, especially for those who provide patient education and/ or counseling, those who teach disease management skills, and those who conduct patient and/or fatally fa·tal·ly
1. So as to cause death; mortally: fatally injured.
2. So as to result in disaster or ruin.
3. According to the decree of fate; inevitably.
Adv. 1. support groups. Any strategy or coping method that can help patients find a sense of purpose in life and connectedness to others has the potential to improve the quality of life and satisfaction for those who must cope regularly with chronic illnesses. Clearly, spirituality has a significant impact on coping and healthcare professionals may help patients better cope through the development of spirituality.
Table 1. Intercorrelation Matrix for Spirituality and 4 Coping Styles. SPIRITUALITY POSITIVE NEGATIVE AVOIDANCE PROBLEM SPIRITUALITY 1.00 .519 * .018 .042 .383 * POSITIVE 1.00 .012 .333 * .553 * NEGATIVE 1.00 -.218 * .162 AVOIDANCE 1.00 .103 PROBLEM 1.00 p <.05 * Table 2. Means and Standard Deviations for Scores on SIBS Scale and 4 Coping Styles. Variables M SD SPIRITUALITY 101.71 27.70 INTRUSIVE POSITIVE THOUGHTS 17.68 3.00 INTRUSIVE NEGATIVE THOUGHTS 13.24 3.96 AVOIDANCE COPING 16.25 2.80 PROBLEM-FOCUSED COPING 16.01 3.12
Acklin, M., Brown, E., & Mauger, P., (1983). The role of religious values in coping with cancer. Journal of Religion and Health, 22,322-333.
Bickel, C. O., Ciarrocchi, J. W., Sheers, N. J., Estadt, B. K., Powell, D. A., & Pargament, K. I. (1998). Perceived stress, religious coping styles, and depressive de·pres·sive
1. Tending to depress or lower.
2. Depressing; gloomy.
3. Of or relating to psychological depression.
A person suffering from psychological depression. affect. Journal of Psychology and Christianity, 17, 33-42.
Fehring, R.J., Brennan, P. F., Keller, M. L. (1987). Psychological and spiritual well-being in college students. Research in Nursing & Health, 10, 391-398.
Folkman, S., & Lazarus, R. S. (1988). Coping as a mediator mediator n. a person who conducts mediation. A mediator is usually a lawyer, or retired judge, but can be a non-attorney specialist in the subject matter (like child custody) who tries to bring people and their disputes to early resolution through a conference. of emotion. Journal of Personality and Social Psychology The Journal of Personality and Social Psychology (often referred to as JPSP) is a monthly psychology journal of the American Psychological Association. It is considered one of the top journals in the fields of social and personality psychology. . 54,466-475.
Gurklis, J. A., & Menke, E. M. (1988). Identification of stressors and use of coping methods in chronic hemodialysis patients. Nursing Research, 37 (4), 236-239.
Hatch, H. L., Burg, M. A., Naberhaus, D.S D.S Drainage Structure (flood protection) . & Hellmich, L. K. (1998). The spiritual involvement and beliefs scale: development and testing of a new instrument. The Journal of Family Practice, 46 (6), 476-484.
Hathaway, W.L., & Pargament, K. I. (1991). The religious dimensions of coping: implications for prevention and promotion. Religion and Prevention in Mental Health, 64, 65-92.
Hunglemann, J., Kenkel-Rossi, E., Klassen, L., & Stollenwerk, R. (1996). Focusing on spiritual well-being: Harmonious interconnectedness interconnectedness (inˈ·ter·k of mind-body-spirit-use of the JAREL JAREL Journees Audiovisuelles Rurales et Environnementales de Lema spiritual well-being scale. Geriatric Nursing Geriatric nursing is the sub-specialty that concerns itself with the provision of nursing services to geriatric or aged individuals. See also
Kaczorowski, J. M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer. Hospice hospice, program of humane and supportive care for the terminally ill and their families; the term also applies to a professional facility that provides care to dying patients who can no longer be cared for at home. Journal, 5 (4), 105-116.
Landis, B. J. (1996). Uncertainty, spiritual well-being and psychosocial adjustment to chronic illness. Issues in Mental Health Nursing, 17 (3), 217-231.
Miller, J.F. (1985). Assessment of loneliness and spiritual well-being in chronically ill and healthy adults. Journal of Professional Nursing, 1 (2), 79-85.
Nowack, K.M. (1990). Initial development and validation of a stress and health risk factor instrument. American Journal of Health Promotion, 4, 173-180.
O'Neill, D. P., & Kenny, K. K. (1998). Spirituality and chronic illness. Image: Journal of Nursing Scholarship, 30 (3) 275-280.
Pargament, K. (1990). God help me. Toward a theoretical framework of coping for psychology of religion. Research in the Social Scientific Study of Religion, 26, 182-200.
Pargament, R. A., & Jenkins, K. I. (1995). Religion and spirituality and resources for coping with cancer. Journal of Psychosocial Oncology oncology /on·col·o·gy/ (ong-kol´ah-je) the sum of knowledge regarding tumors; the study of tumors.
n. , 13 (1), 51-75.
Reed, P.G. (1991). Self-transcendence and mental health in oldest-old adults. Nursing Research, 40 (1), 5-11.
Smith, E.D., Stefanek, M. E., Joseph, M. V., Verdieck, M.J., Zabora, J. R., & Fetting, J. H. (1993). Spiritual awareness, personal perspective on death, and psychosocial distress among cancer patients: an initial investigation. Journal of Psychosocial Oncology, 11 (3), 89-103.
Ventura, J. N., & Boss, P. G. (1983). The family coping inventory applied to parents with new babies. Journal of Marriage and the Family, 45, 867-875
Zuckerman, D., Kasl, S., & Ostfeld, A. (1984). Psychological predictors of morality among the elderly poor: The role of religion, well-being and social contacts. American Journal of Epidemeology. 119, 410-423.
HEALTH EDUCATION RESPONSIBILITY AND COMPETENCY COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like.
Responsibility I--Assessing Individual and Community Needs for Health Education
Competency B--Distinguish between behaviors that foster and those that hinder hin·der 1
v. hin·dered, hin·der·ing, hin·ders
1. To be or get in the way of.
2. To obstruct or delay the progress of.
Sub-competency 1--Investigate physical, social, emotional, and intellectual factors influencing health behavior
M. Michelle Rowe, Ph.D. and Richard G. Allen, M.S. are in the Department of Health Services Department of Health Services may refer to:
in full electronic mail
Messages and other data exchanged between individuals using computers in a network. : firstname.lastname@example.org.