Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease

Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention

Inflammatory bowel disease (IBD) is treated with medications to induce and maintain remission. However, many people with IBD do not take their prescribed treatment. Identifying factors associated with IBD medication adherence is crucial for supporting effective disease management and maintaining remission. Quantitative and qualitative studies researching IBD medication adherence between 2011 and 2023 were reviewed. In total, 36,589 participants were included in 79 studies. The associated non-adherence factors were contradictory across studies, with rates notably higher (72-79%) when measured via medication refill. Non-adherence was lower in high-quality studies using self-report measures (10.7-28.7%). The frequent modifiable non-adherence risks were a poor understanding of treatment or disease, medication accessibility and an individual's organisation and planning. Clinical variables relating to non-adherence were the treatment type, drug regime and disease activity. Depression, negative treatment beliefs/mood and anxiety increased the non-adherence likelihood. The non-modifiable factors of limited finance, younger age and female sex were also risks. Side effects were the main reason cited for IBD non-adherence in interviews. A large, contradictory set of literature exists regarding the factors underpinning IBD non-adherence, influenced by the adherence measures used. Simpler medication regimes and improved accessibility would help to improve adherence. IBD education could enhance patient knowledge and beliefs. Reminders and cues might minimise forgetting medication. Modifying risks through an adherence support intervention could improve outcomes.

Burden of Common Mental Disorders in Ulcerative Colitis and Irritable Bowel Syndrome Patients: An Analysis of Risk Factors

Background: Common mental disorders are an underdiagnosed comorbidity, which can significantly worsen the prognosis of the main disease and decrease the quality of life. We aimed to investigate the prevalence of depression and anxiety in a cohort of irritable bowel syndrome with diarrhea (IBS-D) and ulcerative colitis (UC) patients and to evaluate the risk factors for their occurrence. Materials and Methods: A total of 112 patients were evaluated. Multivariable analysis was used to determine associations between patient factors and common mental disorders, evaluated with PHQ-9 and GAD-7 questionnaires. Results: We found a significantly higher prevalence of moderate and severe anxiety among patients with IBS-D, when compared with the UC group (p < 0.01). Linear regression analysis revealed an inverse association between anti-TNF-alpha monoclonal antibodies treatment and a higher PHQ-9 score (p = 0.02). Multivariate analysis revealed that, in patients with UC, the presence of children has been associated with a higher GAD-7 score (p = 0.01), both individually and in combination with a higher duration of the disease. (p < 0.01). For IBS-D, a combination of active employment status and religious belief, active employment status and higher educational level, as well as religious belief and the presence of children correlated with higher GAD-7 scores (p = 0.03, p = 0.03 and p = 0.02, respectively). Conclusions: Infliximab used in the treatment for UC improved the parameters of depression. Patients with UC who have university education and a longer duration of the disease are at increased risk of developing depression and anxiety, especially if they have children in care. Regarding IBS-D patients who have an active work status, religious beliefs and caregivers are at increased risk of developing anxiety.

Is religiosity/spirituality in patients with Crohn's disease important to their quality of life?

The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes.

METHODS

Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index - Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire - Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques.

RESULTS

The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes.

CONCLUSIONS

The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients' lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.

The Relationship between Distress Tolerance and Spiritual Well-Being towards ARV Therapy Adherence in People Living with HIV/AIDS

A crucial factor in the success of treatment for patients with Human Immunodeficiency Virus (HIV) is adherence to antiretroviral (ARV) therapy among People Living with HIV/AIDS (PLWHA). Adherence issues remain a persisting problem with multifaceted causes. There are many studies on variables related to ARV therapy adherence, but no study has been found on spiritual well-being and distress tolerance in ARV therapy adherence. This study aims to determine the relationship between distress tolerance and spiritual well-being on adherence to ARV therapy in PLWHA. This research used a quantitative approach with a cross-sectional design. The sample collection process followed a consecutive sampling technique, with data gathered from 129 participants at the South Lampung Regional General Hospital located in Indonesia. Data collection was conducted using three questionnaires administered by the interviewer, which assessed distress tolerance using the Miller-Smith Rating Scale For Stress Tolerance (MSRS-ST), evaluated spiritual Well-Being using the Spiritual Well-Being Scale (SWBS), and gauged ARV therapy adherence using the Medication Adherence Rating Scale (MARS). Data analysis using a simple logistic regression with a 95% confidence interval (CI) showed a significant relationship between distress tolerance (p-value 0.002) and spiritual well-being (p-value 0.036) towards ARV therapy adherence in PLWHA. The results of multiple logistic regression yielded distress tolerance as the most dominant and influential variable in this research. Distress tolerance and spiritual well-being impact adherence to ARV therapy in PLWHA. Suggestions for healthcare services should consider these factors to decrease the risk of non-adherence to therapy and inadvertently heighten mortality risk.

«Digesting Crohn's Disease»: The Journey of Young Adults since Diagnosis

Crohn's disease affects 2.5 million people in Europe (more than 100,000 people in France) and often occurs between the ages of 15 and 30, a period marked by self-construction. However, few studies have focused on the experience of the diagnosis during this sensitive developmental stage. This study aimed to qualitatively explore the experience of Crohn's disease in young adults since their diagnosis. Fifteen young adults (18-35 years) diagnosed with Crohn's disease participated in a semi-directive interview. Narrative data were subjected to a thematic analysis, and thirty percent of the interviews were double-coded. The results revealed an evolution of four main themes since diagnosis: (1) course of care, (2) illness perceptions, (3) disease management and (4) self-perception. For most participants, the onset of the disease was difficult, marked by severe symptoms requiring hospitalization, numerous medical examinations and sometimes several consultations before diagnosis. This journey was more difficult when it was associated with negative relations with the medical staff, who were sometimes perceived as unsupportive. Thus, some people described this diagnostic period as an "ordeal", while others experienced it as a "relief" from their suffering. The announcement of the diagnosis was often a "shock", an "upheaval" or a "downfall", followed by phases of denial associated with a desire to maintain a "normal life" and not to be defined by the disease. Despite a difficult start, most participants grew from their experience with CD, with a sense of a personal development that was made possible by self-regulation processes that enabled them to draw on their own experience and resources to adjust to their illness. By highlighting positive possibilities for evolution, this study suggests the importance of supporting the psychological resources of young adults by proposing, at an early stage, psychological support or therapies focused on acceptance and engagement.

Effect of a religious coping intervention of rational emotive behavior therapy on mental health of adult learners with type II diabetes

BACKGROUND

Some previous studies have highlighted the high rate of mental health problems associated with type II diabetes (T2DM). The primary purpose of this study was to investigate the effect of a religious coping intervention of rational emotive behavior therapy (REBT) on the mental health of adult learners with T2DM.

METHODS

This study utilized a randomized controlled trial to select 146 adult learners with T2DM and mental health-related problems. The treatment group was made up of 73 adult learners, while the control group was also made up of 73 adult learners. The experimental group received 8 sessions of a religious coping intervention of REBT, while the control group received usual care. Data were collected using the patient health questionnaire, Warwick-Edinburgh mental well-being scale, and Kessler psychological distress scale. Repeated ANOVA and univariate analysis of covariance were used for data analyses.

RESULTS

The religious coping intervention of REBT substantially enhanced the mental health of adult learners with T2DM as measured by Warwick-Edinburgh mental well-being scale (P < .000) and patient health questionnaire (P < .000). The religious coping intervention of REBT significantly alleviated the psychological distress of adult learners with T2DM as measured by Kessler psychological distress scale (P < .000).

CONCLUSION

In this study, it has been demonstrated that a religious coping intervention of REBT effectively improves the mental health of adult learners with T2DM. The study concludes that the religious coping intervention of REBT is a practical alternative medicine approach to enhancing the mental health of adult learners with T2DM.

Religious/spiritual coping, symptoms of depression, stress, and anxiety in caregivers of children and adolescents with type 1 diabetes

BACKGROUND

It was verified the level of religiosity and spirituality, and symptoms of depression, stress, and anxiety of caregivers of children and adolescents with type 1 diabetes, and its interference in glycaemic control.

METHODS

Socio-economic and demographic data were collected from caregivers of 59 children and adolescents with type 1 diabetes and obtained dosages of fasting glucose (FG); postprandial glycaemia (PPG); fructosamine (FRUTO); and HbA1c, as well as the glycaemic variability-∆HbA1c. Levels of religiosity were obtained by the DUREL scale; the use of religious/spiritual coping was verified by the SRCOPE-Brief scale. Symptoms of depression, anxiety, and stress were analysed by the DASS-21 scale. The correlations between the variables were analysed by the Pearson coefficient, with significance at 5% level.

RESULTS

Inverse correlations were observed between caregivers' schooling with PPG (r = -0.30; P = 0.002) and FRUTO (r = -0.34; P = 0.008) and between family income and FRUTO (r = -0.37; P = 0.004). Direct, moderate correlations were observed between negative religious/spiritual coping (NSRCOPE) with symptoms of depression (r = 0.588; P < 0.0001), stress (r = 0.500; P < 0.0001), and anxiety (r = 0.551; P < 0.0001).

CONCLUSION

The direct association between NSRCOPE with symptoms of depression, stress, and anxiety was the highlighted item in the present study emphasizing the need for greater attention to the emotional health of informal caregivers of children and adolescents with DM1. It is necessary to reflect on the religious/spiritual support especially for the main caregiver of children and adolescents with DM1.

The Effect of Religious Coping on the Satisfaction with Life Among Turkish Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) with life-threatening features due to uncomfortable symptoms such as dyspnea decreases satisfaction with life. This study aims to determine the effect of religious coping methods on satisfaction with life in patients with COPD in Turkey. This descriptive and cross-sectional study was conducted with patients who had COPD for at least a year (n = 149). The positive religious coping levels of the patients were high while their negative religious coping levels were low and their levels of satisfaction with life were below average. A positive correlation was found between the positive religious coping levels and satisfaction with life of the patients (p < 0.05). The patients' age, general health levels, economic status, state of meeting their daily needs and usage of positive religious coping were the factors that significantly affected their levels of satisfaction with life, and these factors explained 38% of the total variance in the patients' satisfaction with life. It is important to evaluate religious coping in increasing the satisfaction with life of COPD patients who receive treatment in health institutions.

Relationship between perceived threat of COVID-19 and burnout among frontline nurses: A mediation analysis

BACKGROUND

Burnout of nurses during the Coronavirus of 2019 pandemic can end up extremely expensive for societies. It is found that positive religious coping (PRC) and a secure God attachment are effective for shielding against the adverse consequences of being exposed to stressful situations.

METHODS

This research explores the relationships among God attachment, religious coping, and burnout among nurses who are confronted with COVID-19 as a perceived threat through a model based on the combination of attachment theory and the Job Demands-Resources model. Analysis was done using SMART-PLS.

RESULTS

The results reveal that perceived threat of COVID-19 (PTC) positively correlates with burnout among nurses and that secure attachment to God and PRC can buffer this relationship, while insecure attachment to God, including anxious and avoidant attachment, along with negative religious coping positively mediates the relationship between PTC and burnout.

CONCLUSION

Finally, this study suggests managerial implications of these findings for healthcare organizations and a recommendation for helping out staff to help them manage such threats and their attachment to God.

Investigating Pre-Competition-Related Discrete Emotions and Unaccustomed Religious Coping among Elite Student-Athletes: Implications for Reflexive Practice

Given that elite athletes experience a wide range of different emotions (e.g., anxiety, anger, dejection, excitement) toward upcoming sporting environments, it is surprising that researchers have given limited attention to the linkages between varied emotional experiences and diverse coping (unaccustomed) among athletes from diverse backgrounds. This study investigated the impact of religious coping, as opposed to conventional psychological skills, to ascertain whether these coping options influence elite student-athletes’ emotional reactions across gender, competitive status, and religion. Using a descriptive cross-sectional survey design, self-reported discrete emotions and religious coping were measured with the Sport Emotion Questionnaire (SEQ) and Brief-Religious Coping Scale (Brief RCOPE) after 300 selected athletes were conveniently chosen. A factorial multivariate analysis of covariance (MANCOVA) after controlling for age revealed no significant interactions for between-subject factors (gender, status, religion) across all the discrete emotions and religious coping dimensions. However, significant main effects were realized for competitive status and religion on only anger, anxiety, dejection, and negative religious coping. A follow-up multiple regression analysis identified religion as the most significant predictor of anger, anxiety, and dejection, whereas competitive status was the most associated variable for negative religious coping. Current findings suggest that athletes’ unpleasant or negative emotions were linked to negative religious coping, a maladaptive coping mechanism that may hinder attaining optimal emotional state prior to competition. Therefore, these athletes need purposeful strategies (e.g., positive religious coping, motivational strategies) that may improve weakened beliefs based on their struggles before competition. The development of appropriate psychological intervention framework that maintains respect for athletes’ religious identities for improved psychological well-being is also warranted.

Psychometric Properties of the Brief Religious Coping Scale (Brief-RCOPE) in Chilean Adults Exposed to Stressful Events

Among the different ways of coping with stress, religious coping has shown particularly the promising results; nonetheless, there are few validated instruments to assess it in non-English language. This article presents the psychometric properties of the Brief Religious Coping Scale (Brief-RCOPE) in Chilean adults exposed to stressful events. The scale shows a reliability, test-retest stability, and confirmatory factor analysis support structural validity. The scale also shows concurrent validity with another measure of religious coping. Finally, confirming predictive criterion validity, negative religious coping predicts posttraumatic stress symptoms 6 months after, but not posttraumatic growth. Positive religious coping was associated with posttraumatic growth enhancement. This study shows Brief-RCOPE as a valid and reliable instrument for measuring religious coping in this population.

Treating anxiety and depression in inflammatory bowel disease: a systematic review

OBJECTIVE

Inflammatory Bowel Disease (IBD) is associated with higher rates of clinically significant anxiety and depression than in healthy populations. Psychosocial interventions targeting anxiety and depression in IBD have variable efficacy and disparate treatment approaches, making treatment recommendations difficult. The current study aimed to identify effective treatment components across psychosocial treatment approaches for anxiety and depression in IBD.

DESIGN

A systematic review of psychosocial treatments for anxiety and depression in IBD was conducted. Based on the Distillation and Matching Model, treatments were coded and data aggregated by intervention components, or practice elements (PE), to elucidate replicable clinical techniques.

MAIN OUTCOME

The percentage of studies utilizing a given PE was the primary outcome.

MEASURES

Among all included studies, as well as among those finding favorable, significant effects on anxiety or depression, the percentage utilizing each PE and number of PEs utilized was determined.

RESULTS

The most utilized PEs among included interventions were relaxation, IBD psychoeducation, cognitive restructuring, distraction, and social skills. Examining only interventions with favorable differences on specified outcomes (HRQoL, Anxiety, Depression, and/or Coping) indicated that relaxation, education, cognitive restructuring, and mindfulness were most utilized.

CONCLUSION

Implications for clinical practice are discussed, including the development and dissemination of treatment recommendations.

Influence of Religiousness and Spirituality on Remission Rate, Mental Health, and Quality of Life of Patients With Active Crohn's Disease: A Longitudinal 2-Year Follow-up Study

BACKGROUND AND AIMS

Studies on inflammatory bowel disease [IBD] have shown that religiousness and spirituality [R/S] were associated with better mental health and quality of life [QOL]. However, longitudinal studies assessing the impact of R/S on long-term clinical outcomes of Crohn's disease [CD] are scarce. The aim of this study was to assess the influence of R/S on the course of CD after a 2-year follow-up and to determine whether these R/S beliefs were associated with mental health and QOL.

METHODS

A longitudinal 2-year follow-up study was conducted at a referral centre for IBD, including patients with moderately to severely active CD. Clinical data, disease activity [Harvey-Bradshaw Index], QOL [Inflammatory Bowel Disease Questionnaire-IBDQ], depression and anxiety [Hospital Anxiety and Depression Scale-HADS], and R/S [Duke Religion Index-DUREL, Spirituality Self-Rating Scale-SSRS, and Spiritual/Religious Coping-SRCOPE scale] were assessed at baseline and at the end of the 2-year follow-up. Linear and logistic regression models were employed.

RESULTS

A total of 90 patients [88.2%] were followed up for 2 years. On logistic regression, baseline levels of spirituality (odds ratio [OR] = 1.309; 95% confidence interval [CI]= 1.104-1.552, p = 0.002) and intrinsic religiousness [OR = 1.682; 95% CI = 1.221-2.317, p = 0.001] were predictors of remission at 2 years. On linear regression, the different dimensions of R/S did not significantly predict IBDQ or anxiety and depression scores after 2 years.

CONCLUSIONS

R/S predicted remission of CD patients after a 2-year follow-up. However, these beliefs failed to predict mental health or QOL. Health professionals who treat CD should be aware of the religious and spiritual beliefs of their patients, given these beliefs may impact on the disease course.

Exploring Culture, Religiosity and Spirituality Influence on Antihypertensive Medication Adherence Among Specialised Population: A Qualitative Ethnographic Approach

BACKGROUND

Hypertension is one of the major risk factors of stroke and leading risk factors for global death. Inadequate control of blood pressure due to medication non-adherence remains a challenge and identifying the underlying causes will provide useful information to formulate suitable interventions.

PURPOSE

This study aimed to explore the roles of culture, religiosity, and spirituality on adherence to anti-hypertensive medications.

METHODOLOGY

A semi-structured qualitative interview was used to explore promoters and barriers to medication adherence among hypertensive individuals residing in urban and rural areas of Perak State, West Malaysia. Study participants were individuals who are able to comprehend either in Malay or English, above 18 years old and on antihypertensive medications. Interview transcriptions from 23 participants were coded inductively and analyzed thematically. Codes generated were verified by three co-investigators who were not involved in transcribing process. The codes were matched with quotations and categorized using three levels of themes named as organizing, classifying and general themes.

RESULTS

Cultural aspects categorized as societal and communication norms were related to non-adherence. The societal norms related to ignorance, belief in testimony and anything "natural is safe" affected medication adherence negatively. Communication norms manifested as superficiality, indirectness and non-confrontational were also linked to medication non-adherence. Internal and organizational religiosity was linked to increased motivation to take medication. In contrast, religious misconception about healing and treatment contributed towards medication non-adherence. The role of spirituality remains unclear and seemed to be understood as related to religiosity.

CONCLUSION

Culture and religiosity (C/R) are highly regarded in many societies and shaped people's health belief and behaviour. Identifying the elements and mechanism through which C/R impacted adherence would be useful to provide essential information for linking adherence assessment to the interventions that specifically address causes of medication non-adherence.

Application of the common sense model in inflammatory bowel disease: A systematic review

BACKGROUND AND AIMS

The aim of this paper was to undertake a systematic review of the research utilizing the Common Sense Model (CSM) involving IBD cohorts to explain the psychosocial processes, including illness perceptions and coping styles, that underpin patient reported outcomes (PROs) - psychological distress (PD) and quality of life (QoL).

METHODS

Adult studies were identified through systematic searches of 8 bibliographic databases run in August 2020 including Medline, Embase, and PsychINFO. No language or year limits were applied.

RESULTS

Of 848 records identified, 516 were selected with seven studies evaluating the CSM mediating pathways for final review (n = 918 adult participants). Consistent with the CSM, illness perceptions were associated with PD and QoL in six and five studies respectively. Illness perceptions acted as mediators, at least partially, on the relationship between IBD disease activity and PD and/or QoL in all seven studies. Coping styles, predominantly maladaptive-based coping styles, were found to act as mediators between illness perceptions and PD and/or QoL in five studies. Perceived stress was identified in one study as an additional psychosocial process that partially explained the positive influence of illness perceptions on PD, and a negative impact on QoL. Five studies were classified as high quality and two as moderate.

CONCLUSIONS

The CSM can be utilised in IBD cohorts to evaluate key psychosocial processes that influence PROs. Future research should explore additional psychosocial processes within the CSM and evaluate the efficacy of targeting CSM processes to promote psychological well-being and QoL in IBD cohorts.

The Impact of Spirituality and Religiosity on Mental Health and Quality of Life of Patients with Active Crohn's Disease

We aim to investigate the association among religious/spiritual coping (RSC), quality of life (QOL), and mental health in patients with active Crohn's disease (CD). This cross-sectional study included 102 patients with active CD. Religious and spiritual beliefs were common among patients, being positive RSC higher than negative RSC. Negative coping was associated with mood disorders (depressive or anxiety symptoms) through the Hospital Anxiety and Depression Scale (β = 0.260, p < 0.01) but not with QOL (Inflammatory Bowel Disease Questionnaire) (β = - 0.105, p = NS) after adjustments. Positive coping and other religious/spiritual beliefs and behaviors were not associated with either QOL or mental health. This study suggests that a negative RSC is associated with worse mental health outcomes. This may detrimentally impact adaptations to deal with CD in the active phase, although patients generally tend to use more common positive strategies. These findings may increase the awareness of health professionals while dealing with spiritual beliefs in patients with CD.

"A Temple of God": A Qualitative Analysis of the connection Between Spiritual/Religious Beliefs and Health Among Mormons

In the last decades, studies have increasingly shown an association between religious/spiritual beliefs (R/S) and several health outcomes. In this context, Mormons provide an intriguing case for such investigation because Mormonism stands out for its commitment to the "Word of Wisdom" with several restrictions and recommendations. Despite the consolidated wide array of evidence, showing that the relationship between "Word of Wisdom" and health may usually have a protective effect in North-American studies, little is know about this community in other countries and, to our knowledge, no health studies have ever been carried out in European and Spanish Mormons. The present qualitative study aims to fill this gap, exploring the discourses, opinions, and attitudes of the members of the Church of Jesus Christ of Latter-day Saints about the recommendations of the Health Law and the "Word of Wisdom" on their health. In the analysis, six themes appeared during the coding process and were converted in the following categories: Theme 1 Body as a Temple, Theme 2 Promises of blessing, Theme 3 Healthy lifestyle, Theme 4 Stigma, Theme 5 Damage to the family, and Theme 6 Spiritual Performance. We found that fulfilling the "Law of Wisdom" may lead Mormons to take care of their health, and to have a network of support from church leaders, who may act as health promoters. Religiosity tends to insert values and behaviours that seem to benefit individual's health and protect their families, such as the non-use of substances and the preservation of a "healthy body" (i.e. "body as a temple"). However, some stigma and isolation may appear in contact with other groups due to these restrictions and limitations.

Assessment of religious coping in patients with COPD

Objective:

To compare religious coping (RC) in patients with COPD and healthy individuals, as well as to determine whether RC is associated with demographic characteristics, quality of life, depression, and disease severity in the patients with COPD.

Methods:

This was a cross-sectional study conducted between 2014 and 2016, involving outpatients with moderate to severe COPD seen at one of two hospitals in Fortaleza, Brazil, as well as gender- and age-matched healthy controls. The Brief RCOPE scale assessed RC in all of the participants. We also evaluated the COPD group patients regarding symptoms, quality of life, and depression, as well as submitting them to spirometry and a six-minute walk test.

Results:

A total of 100 patients were evaluated. The mean age was 67.3 ± 6.8 years, and 54% were men. In the COPD group, the mean positive RC score was significantly higher than was the mean negative RC score (27.17 ± 1.60 vs. 8.21 ± 2.12; p = 0.001). The mean positive RC score was significantly higher in women than in men (27.5 ± 1.1 vs. 26.8 ± 2.8; p = 0.02). Negative RC scores were significantly higher in the COPD group than in the control group (p = 0.01). Negative RC showed an inverse association with six-minute walk distance (6MWD; r = −0.3; p < 0.05) and a direct association with depressive symptoms (r = 0.2; p < 0.03). Positive RC correlated with none of the variables studied. Multiple regression analysis showed that negative RC was associated with 6MWD (coefficient = −0.009; 95% CI: −0.01 to −0.003). 6MWD explained the variance in negative RC in a linear fashion.

Conclusions:

Patients with COPD employ negative RC more often than do healthy individuals. Exercise capacity and depressive symptoms are associated with negative RC.

Psychological Characteristics of Inflammatory Bowel Disease Patients: A Comparison Between Active and Nonactive Patients

BACKGROUND AND AIMS

The role of new psychological factors such as psychopathological patterns and defense mechanisms in the care of inflammatory bowel disease (IBD) has been poorly investigated. We aimed to assess the psychological characteristics and defense mechanisms of IBD patients.

METHODS

This was a single-center, observational, cross-sectional study. Consecutive adult IBD patients were enrolled and stratified according to disease activity. Sociodemographic and clinical data were collected, and validated questionnaires (Symptom Checklist-90-R [SCL-90-R]) for psychological distress, Defense Mechanism Inventory (DMI) for psychological defense mechanisms, and Inflammatory Bowel Disease Questionnaire (IBDQ) for quality of life (QoL) were administered.

RESULTS

Two hundred one patients were enrolled: 101 in remission and 100 with active disease. The mean score for IBDQ was below the cutoff level (156.8 ± 37.8), with a significantly greater impairment of QoL in subjects with flares (136.5 vs 177.5, P < 0.001). Lower scores were associated with female gender. No patients had psychological scores above the cutoff for normality. Statistically higher SCL-90-R scores were found in active patients for obsessive-compulsive disorder (P = 0.026), depression (P = 0.013), anxiety (P = 0.013), phobic anxiety (P = 0.002), psychoticism (P = 0.007), global severity index (GSI) (P = 0.005) and positive symptom total (PST) (P = 0.001). A significantly increased probability of higher global indexes was associated with Crohn's disease and disease flares. None of the defensive Defense Mechanism Inventory (DMI) styles resulted above the cutoff in our cohort.

CONCLUSIONS

Further data are needed to demonstrate the potential key role of psychological intervention in the therapeutic strategies utilized for IBD patients, and the identification of specific psychological patterns based on the patients profile is necessary to optimize psychological intervention.

Influence of Religious and Spiritual Elements on Adherence to Pharmacological Treatment

The objective of this study is to know the influence of religious/spiritual elements on the adherence to pharmacological therapy. The descriptors used for this literature review were "medicine, medication, drug, or treatment," "adherence to treatment," and "religion or spirituality or faith or prayer" in different databases (CINAHL, PsycINFO, PubMed). Finally, 23 articles were selected. Articles available in full text, published between 2010 and 2017, in English or Spanish were included. The results showed that some studies relate positively the R/S and therapeutic adherence, but others determine an opposite or even mixed effect, mainly addressing pathologies such as HIV and other chronic diseases. The influence of religiosity/spirituality on therapeutic adherence requires that health professionals acquire sensitivity and competence to address these issues with their patients.

Determinants of quality of life among Malaysian cancer patients: a cross-sectional study

BACKGROUND

Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia.

METHODS

A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models.

RESULT

A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p < 0.05). However, among socio-demographics only age, race, religion, working status were significantly associated with QOL. Based on the multivariate regression analysis, the main predictors of QOL among cancer patients in Malaysia were age, self-esteem as positive predictors, and Indian race, nausea, fatigue, hair loss, bleeding as negative predictors.

CONCLUSION

The findings of this study provide a scientific basis to develop a comprehensive program for improving quality of life of cancer patients in Malaysia.

Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses-Part II

BACKGROUND

There has been burgeoning interest in quality of life (QoL) in inflammatory bowel disease (IBD) in recent decades, with hundreds of studies each year now assessing this outcome. This paper is part 2 of a systematic review evaluating 5 key QoL comparisons within IBD states and relative to others without IBD. Part 1 examined QoL comparing IBD and a healthy/general population and other medically ill groups. Part 2, presented here, examines within-disease comparisons of active/inactive disease, Ulcerative colitis (UC) / Crohn's disease (CD), and change in QoL over time. Outcomes using generic versus IBD-specific QoL measures were also examined.

METHODS

Adult and pediatric studies were identified through systematic searches of 7 databases from the 1940s (where available) to October 2015.

RESULTS

Of 6173 abstracts identified, 466 were selected for final review based on controlled design and validated measurement, of which 83 unique studies (75 adult, 8 pediatric) addressed the within-disease comparisons. The pooled mean QoL scores were significantly lower in active versus inactive IBD (n = 26) and for those with CD versus UC (n = 37), consistent across IBD-specific and generic QoL measures, for almost all comparisons. There was significant improvement in QoL over time (n = 37). Study quality was generally low to moderate. The most common measures of QoL were the disease-specific Inflammatory Bowel Disease Questionnaire and generic 36-Item Short Form Survey (SF-36) (adults) and the IBD-specific IMPACT (children).

CONCLUSIONS

For adults in particular, there was strong confirmation that QoL is poorer during active disease and may be poorer for those with CD. The finding that QoL can improve over time may be encouraging for individuals with this chronic disease.

THE ROLE OF PSYCHOLOGICAL WELL-BEING IN BOOSTING IMMUNE RESPONSE: AN OPTIMAL EFFORT FOR TACKLING INFECTION

Background:

Many attempts have been made to improve human body resistance towards infection. These attempts were exemplified by promotion of hygiene and the use of antiseptic ingredients, pharmaceutical compounds, and vaccines. To prove an aspect which intentionally less explored was attempt to boosting the host immune responses by creating a psychological balance, which was important aspect of psychological well-being.

Material and Method:

These article reviews searched and compiled using database Google Scholar, from 1995 to latest. Search keywords were: immune response, psychological well-being, psychological ill-being.

Results:

Based on literature our findings showed that psychological well-being was proven could increase human body immune response. The evidenced were by improvements of several indicators in saliva, blood and plasma. In other way, psychological ill-being was associated with decreased immune responses. Numerous studies compiled and discussed in review also suggested that improving immune response through psychological well-being could increase living comfort.

Conclusion:

The psychological well-being could improve the human body immune responses, enhance resistance towards diseases (including infectious diseases), and create a spiritually and physically more prosperous life.

Effects of religiosity and religious coping on medication adherence and quality of life among people with epilepsy

The epidemiologic information demonstrates the importance of caring people with epilepsy (PWE). Indeed, the impaired quality of life (QoL) and medication nonadherence rate among PWE have been reported. However, religiosity and religious coping could be potential factors for clinicians to foster appropriate intervention on epileptic care. This study investigated two models to further understand the relationships between religiosity, religious coping (including positive and negative coping), medication adherence, and QoL in an Iranian sample with epilepsy. Eligible PWE (n=760) completed the religiosity scale (Duke University Religion Index; DUREL) at baseline; the religious coping scale (Brief Religious Coping Scale; Brief RCOPE) one month later; the medication adherence scale (Medication Adherence Report Scale; MARS-5) two months later; and the QoL scale (Quality of Life in Epilepsy; QOLIE-31) twelve months later. Their antiepileptic drug serum level was measured during the period they completed the MARS. Through structural equation modeling (SEM), we found that religiosity directly correlated with negative religious coping and medication adherence, and indirectly correlated with medication adherence through negative religious coping. Both positive and negative religious coping directly correlated with medication adherence and QoL. Therefore, religiosity and religious coping may be determinants of medication adherence and QoL in PWE; health professionals may consider asking PWE if religion is important to them and how they use it to cope with their epilepsy.

Medication non-adherence in adult patients affected by inflammatory bowel disease: a critical review and update of the determining factors, consequences and possible interventions

Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations. In particular, we reviewed the literature focusing on the definition and detection of non-adherence, on its extent and on the possible non-modifiable and modifiable factors involved (patient-centred, therapy-related, disease-related and physician-related). Furthermore, we analysed the interventional studies performed so far. The literature review was conducted through PubMed addressing medication non-adherence in IBD, using the keywords 'adherence' and related terms and 'IBD, ulcerative colitis or Crohn's disease'. Expert commentary: Adherence to therapy for IBD is a complex yet fundamental issue that cannot be solved by addressing a single aspect only. Future studies should focus on patient-tailored and multidimensional interventions.

The Greek-Orthodox version of the Brief Religious Coping (B-RCOPE) instrument: psychometric properties in three samples and associations with mental disorders, suicidality, illness perceptions, and quality of life

BACKGROUND

The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated.

METHODS

The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N = 74) or specialty clinics (N = 302) and 127 people without LTCs. Diagnosis of mental disorders was established by the MINI. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), illness perceptions (B-IPQ), and health-related quality of life (WHOQOL-BREF) were also investigated.

RESULTS

The Greek version of B-RCOPE showed a coherent two-dimensional factor structure with remarkable stability across the three samples corresponding to the positive (PRC) and negative (NRC) religious coping dimensions. Cronbach's alphas were 0.91-0.96 and 0.77-0.92 for the PRC and NRC dimensions, respectively. Furthermore, NRC was associated with poorer mental health, greater depressive symptom severity and suicidality, and impaired HRQoL. In patients with LTCs, PRC correlated with lower perceived illness timeline, while NRC was associated with greater perceived illness consequences, lower perceived treatment control, greater illness concern, and lower illness comprehensibility.

CONCLUSIONS

These findings indicate that the Greek-Orthodox B-RCOPE version may reliably assess religious coping. In addition, negative religious coping (i.e., religious struggle) is associated with adverse illness perceptions, and thus may detrimentally impact adaptation to medical illness. These findings deserve replication in prospective studies.