Spirituality and the Illness Experience: Perspectives of African American Older Adults

Abstract

Background: Disparities in hospice and palliative care (PC) for African Americans have been linked to mistrust toward the healthcare system, racial inequalities, and cultural preferences. Spirituality has been identified as important to African Americans in general. Less is known about the influence of spirituality on African American illness experiences. Objective: The goal of this study was to understand older African Americans’ perspectives on how spirituality influences chronic illness experiences to inform the development of a culturally tailored PC intervention. Methods: In partnership with 5 churches in the Denver metropolitan area, we conducted focus groups with African American older adults (n = 50) with chronic health conditions and their family caregivers. Transcripts were analyzed using a deductive approach. The theoretical framework for this study draws on psychology of religion research. Results: Themes referenced participants’ spiritual orienting systems, spiritual coping strategies, and spiritual coping styles. Psycho-spiritual struggles, social struggles, and sources of social support were also identified. Findings suggest African Americans’ spirituality influences chronic illness experiences. Participants relied on their spirituality and church community to help them cope with illness. In addition, social struggles impacted the illness experience. Social struggles included mistrust toward the healthcare system and not being connected to adequate resources. Participants expressed a need to advocate for themselves and family members to receive better healthcare. Churches were referred to as a trusted space for health resources, as well as spiritual and social support.

Are cultural or psychosocial factors associated with patient‐reported outcomes at the conclusion of kidney transplant evaluation?

“…It is important to note that medical mistrust and religiosity were also associated with lower physical QOL in our sample. Our findings confirm work in kidney disease and other clinical populations demonstrating associations between medical mistrust and religiosity, engagement with the healthcare system, and health outcomes 49–51 . Given these complex findings, we believe that more research on the relationship between culturally‐related factors and QOL is warranted.…”

“…Our findings confirm work in kidney disease and other clinical populations demonstrating associations between medical mistrust and religiosity, engagement with the healthcare system, and health outcomes. [49][50][51] Given these complex findings, we believe that more research on the relationship between culturally-related factors and QOL is warranted. Additionally, we recommend that healthcare organizations take measures to reduce healthcare discrimination, racial and socio-economic exclusion, and decrease mistrust in medical institutions.…”

Espiritualidad en adultos mayores y sus beneficios en salud: una revisión narrativa

“…Respecto a la espiritualidad y bienestar biofísico, los participantes de un estudio notaron que a través de la espiritualidad pudieron sobrellevar sus enfermedades y verlas como procesos de curación 24 , en otro estudio la espiritualidad guarda relación con la autoestima y está a su vez influencia de manera positiva el bienestar físico y psicológico 25 , también se menciona que la espiritualidad constituye ser una estrategia de ayuda para los adultos mayores que les permite enfrentarse a los desafíos propios del proceso de envejecimiento en relación a las enfermedades, malestares y sufrimientos que pudieran experimentar 26 y finalmente se encuentra la relación importante entre religiosidad y capacidad funcional en los adultos mayores donde el afrontar la discapacidad y un deterioro funcional retardado se destacaron 27 . Por otra parte, en cuanto al interés de los pacientes en relación a la espiritualidad se muestra que a pesar de que el cuidado espiritual ha tendido a ser desconocido la mayoría de los pacientes adultos mayores poseen interés en abordar los temas relacionados con este tema 28 .…”

“I Am Grateful for Every Day I Live”

“…In fact, pain is accepted as a test for one’s belief in Islam, and it is stated that the reward of patience (to endure pain) will be heaven 23 . In studies conducted with Christian participants, religious practices such as going to church, praying, and being grateful to God were identified as contributing to feeling more optimistic and hopeful and to shifting their focus from the disease 16,25,26 . Studies conducted with patients with cancer of different religious beliefs and cultures revealed that belief and commitment to God was an integral part of coping with the disease process 9,12,18,26 .…”

“…According to the World Health Organization, the spiritual and religious aspects of a patient’s life are an integral component of holistic patient care 9 . Spirituality is defined as “the aspect of humanity that refers to the way individuals seek and express meaning and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.” 13 In the literature, several studies examine the role and effects of spirituality and religion in coping with the cancer experience 8,10,12,14–20 . These studies revealed that there was a positive correlation between spirituality and quality of life in cancer patients during the disease process, 8,10,14,15,17 and they emphasize that women with cancer who have a low level of spirituality have high levels of anxiety, depression, 7,14,17,21 and death anxiety 2 .…”