The associations between spirituality/religiosity, positive appraisals. and internal adaptive coping strategies indicate that the utilization of spirituality/religiosity goes far beyond fatalistic acceptance, but can be regarded as an active coping process. The findings support the need for further research concerning the contributions of spiritual coping in adjustment to chronic pain.

ObjectiveWe intended to determine the reliability of a brief life satisfaction scale in a sample of patients with chronic diseases, and to analyze its external validity.MethodsReliability and factor analysis of the 8-item 'Brief Multidimensional Life Satisfaction Scale' (BMLSS) were performed according to standard procedures. The test sample contained 979 individuals (mean age 54 ± 11 years). Forty-two percent had cancer, 22% chronic pain conditions, 10% depressive disorders, 6% other chronic diseases, and 20% were healthy.ResultsReliability analysis of the 8-item pool revealed a good internal consistency coefficient (Cronbach's alpha = .869), and a single-factor structure which explains 53% of variance. The BMLSS sum scores significantly differed with respect to the underlying disease, family status, duration of disease, and age. The highest scores were found in healthy individuals, and the lowest in patients with chronic pain conditions and depressive disorders. In cancer patients, the BMLSS correlated negatively with Depression/Anxiety (HADS), Fatigue (CFS-D), and positively with SF-12's mental health and to a weaker content also with physical health. Stepwise regression analyses revealed that life satisfaction can be predicted best by (the absence of) depression, but also by Conscious Living (AKU), which is an active cognitive-behavioral style in terms of adaptive coping.ConclusionsThe evaluation of the BMLSS revealed that the instrument has good psychometric properties and can be regarded as a brief, reliable and valid measure of LS in patients with chronic diseases. The instrument can be an important additive to existing health-related quality of life questionnaires, since it captures dimensions that contribute to quality of life but are not health related.

Mission:The Permanente Journal is published for physicians, practitioners, and nurses to create and to deliver superior health care through the principles and benefits of Permanente Medicine.Permanente Medicine is preventive, innovative, evidence-based, population care practiced by a multispecialty group, using an electronic health and medical record, and focused on patient relationships and outcomes.

Aim: We intended to clarify which strategies to control their diseases were utilized by patients with chronic diseases and whether they are convinced that spirituality/religiosity (SpR) may offer some beneficial effects. Patients and Methods: We investigated elderly German insurants and outpatients with chronic diseases with the SpREUK and AKU questionnaires. Results: Patients with chronic diseases relied on adaptive coping styles which refer to both external help (Trust in Medical Help, Search for Alternative Help, Trust in God’s Help) and internal powers/ virtues (Conscious and Healthy Living, Perspectives and Positive Attitudes). Reappraisal (Illness as Chance) was strongly connected with Trust in God’s Help, which was of relevance particularly for female cancer patients. Compared to patients with other chronic diseases, cancer patients were significantly more in Search for Meaningful Support, had Trust in Higher Source and a Positive Interpretation of Disease. Women with breast cancer had significantly higher interest in Search for Meaningful Support and Positive Interpretation than patients with prostate cancer. The SpR attitudes and convictions were significantly influenced by gender, SpR self-categorization, and educational level. Conclusion: Particularly women with breast cancer refer to SpR issues and existential practices in order to better cope with their illness. In medical context, however, these needs are often neither recognized nor addressed.

For several reasons one may suggest a connection between spirituality and religiosity (SpR) and the usage of CAM. It is suggested that patients with severe diseases which use CAM have more active coping strategies and a higher religious involvement than patients which do not use these treatments. We thus investigated basic attitudes of 313 patients with chronic diseases attending a CAM outpatient clinic towards SpR and their adjustment to their illness, and relevant adaptive coping strategies. All test instruments were extensively (re)validated before usage, particularly the AKU questionnaire which measures adaptive coping styles. The main important strategies were "Search for information and medical help" and "Positive arrangement of life," while "Religious support" and "Positive interpretation of illness" were less important. Among those with an interest in SpR, "Support of life through SpR" was highly relevant. "Search for alternative ways of healing" did not correlate with any of the SpR scales, but strongly with "Search for information and medical help" and "Positive arrangement of life." We conclude that interest in CAM is not a unique pattern of SpR, but of an adaptive and active coping. Nevertheless, we confirm SpR is of high importance in patients with life-threatening diseases such as cancer.