Johns Hopkins School of Medicine, Baltimore, Maryland 21202, USA.
Int J Psychiatry Med. 2011;41(1):91-105. doi: 10.2190/PM.41.1.h.
Creative, cost-effective ways are needed to help older adults deal effectively with chronic diseases. Spiritual beliefs and practices are often used to deal with health problems. We evaluated whether a minimal intervention, consisting of a video and workbook encouraging use of patient spiritual coping, would be inoffensive and improve perceived health status.
A randomized clinical trial of 100 older, chronically ill adults were assigned to a Spiritual (SPIRIT) or Educational (EDUC--standard cardiac risk reduction) intervention. Individuals in each group were shown a 28-minute video and given a workbook to complete over 4 weeks. Selected psychosocial and health outcome measures were administered at baseline and 6 weeks later.
Participants were mostly female (62%), with a mean age of 65.8 +/- 9.6 years and had an average of three chronic illnesses. More than 90% were Christian. At baseline, frequent daily spiritual experiences (DSE) were associated with being African American (p < .05) and increased pain (p < .01) and co-morbidities (p < or = .01). Energy increased significantly (p < .05) in the SPIRIT group and decreased in the EDUC group. Improvements in pain, mood, health perceptions, illness intrusiveness, and self-efficacy were not statistically significant.
A minimal intervention encouraging spiritual coping was inoffensive to patients, associated with increased energy, and required no additional clinician time.
需要创造性且具有成本效益的方法来帮助老年人有效应对慢性病。精神信仰和实践常常被用于应对健康问题。我们评估了一种最小干预措施，包括鼓励患者使用精神应对的视频和工作簿，是否无伤害且能改善健康感知。
对 100 名患有慢性疾病的老年患者进行了一项随机临床试验，将他们分为精神（SPIRIT）或教育（EDUC-标准心脏风险降低）干预组。每组中的个体都观看了 28 分钟的视频，并完成了为期 4 周的工作簿。在基线和 6 周后，进行了特定的社会心理和健康结果测量。
参与者主要为女性（62%），平均年龄为 65.8 +/- 9.6 岁，平均患有三种慢性疾病。超过 90%为基督教徒。在基线时，频繁的日常精神体验（DSE）与非裔美国人（p <.05）和增加的疼痛（p <.01）和合并症（p < or =.01）相关。SPIRIT 组的能量显著增加（p <.05），而 EDUC 组的能量则减少。疼痛、情绪、健康感知、疾病侵扰和自我效能的改善没有统计学意义。
鼓励精神应对的最小干预措施对患者无伤害，与增加的能量相关，且不需要额外的临床医生时间。
