Koenig Harold G, George Linda K, Titus Patricia
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Am Geriatr Soc. 2004 Apr;52(4):554-62. doi: 10.1111/j.1532-5415.2004.52161.x.
To examine the effect of religion and spirituality on social support, psychological functioning, and physical health in medically ill hospitalized older adults.
Cross-sectional survey.
Duke University Medical Center.
A research nurse interviewed 838 consecutively admitted patients aged 50 and older to a general medical service.
Measures of religion included organizational religious activity (ORA), nonorganizational religious activity, intrinsic religiosity (IR), self-rated religiousness, and observer-rated religiousness (ORR). Measures of spirituality were self-rated spirituality, observer-rated spirituality (ORS), and daily spiritual experiences. Social support, depressive symptoms, cognitive status, cooperativeness, and physical health (self-rated and observer-rated) were the dependent variables. Regression models controlled for age, sex, race, and education.
Religiousness and spirituality consistently predicted greater social support, fewer depressive symptoms, better cognitive function, and greater cooperativeness (P<.01 to P<.0001). Relationships with physical health were weaker, although similar in direction. ORA predicted better physical functioning and observer-rated health and less-severe illness. IR tended to be associated with better physical functioning, and ORR and ORS with less-severe illness and less medical comorbidity (all P<.05). Patients categorizing themselves as neither spiritual nor religious tended to have worse self-rated and observer-rated health and greater medical comorbidity. In contrast, religious television or radio was associated with worse physical functioning and greater medical comorbidity.
Religious activities, attitudes, and spiritual experiences are prevalent in older hospitalized patients and are associated with greater social support, better psychological health, and to some extent, better physical health. Awareness of these relationships may improve health care.
探讨宗教与精神信仰对患有疾病的住院老年患者的社会支持、心理功能及身体健康的影响。
横断面调查。
杜克大学医学中心。
一名研究护士对838名年龄在50岁及以上、连续入住普通内科病房的患者进行了访谈。
宗教信仰的测量指标包括组织性宗教活动（ORA）、非组织性宗教活动、内在宗教信仰（IR）、自评宗教信仰及他人评价宗教信仰（ORR）。精神信仰的测量指标包括自评精神信仰、他人评价精神信仰（ORS）及日常精神体验。社会支持、抑郁症状、认知状态、合作性及身体健康（自评及他人评价）为因变量。回归模型对年龄、性别、种族及教育程度进行了控制。
宗教信仰及精神信仰始终预示着更强的社会支持、更少的抑郁症状、更好的认知功能及更高的合作性（P<0.01至P<0.0001）。与身体健康的关系较弱，尽管方向相似。ORA预示着更好的身体功能、他人评价的健康状况及病情较轻。IR往往与更好的身体功能相关，ORR及ORS与病情较轻及合并症较少相关（均P<0.05）。将自己归类为既无精神信仰也无宗教信仰的患者往往自评及他人评价的健康状况较差，合并症较多。相比之下，宗教电视或广播与较差的身体功能及较多的合并症相关。
宗教活动、态度及精神体验在老年住院患者中普遍存在，并与更强的社会支持、更好的心理健康以及在一定程度上更好的身体健康相关。了解这些关系可能会改善医疗保健。
