Religion, Spirituality, and Health Status in Geriatric Outpatients Essay

Daaleman, Perrera and Studenski wished to re-examine the effect of religiosity and spirituality on perceptions of older persons, operationalized as geriatric outpatients. The authors proceeded from two conceptual constructs.   The first is that self-reported health status is central to aging research.   The old know whereof they speak.   Self-ratings are valid because they correlate well with health status over time and, consequently, health service utilization.   The second construct is that, no matter how morally they lived as young adults, those in late middle age come to embrace religion and spirituality with more fervor. Prior research had scrutinized the relationship between religion and health perceptions.   Some results were inconclusive, an outcome that the authors attributed to failure to control for such covariates as spirituality. Definitions vary, the authors acknowledged, but they proposed defining â€Å"religiosity† as principally revolving on organized faith while â€Å"spirituality† has more to do with giving humans â€Å"meaning, purpose, or power either from within or from a transcendent source.†Ã‚   In turn, the dependent variable was measured by a single-item global health from the Years of Healthy Life (YOHL) scale, a self-assessment of general health (would you say your health in general is †¦) and a 5-item Likert response from excellent to poor. Fieldwork consisted of including a 5-item measure of religiosity15 and a 12-item spirituality instrument in a 36-month health service utilization, health status, and functional status study among 492 outpatients of a VA and HMO network, all residents of the Kansas City metropolitan area. The authors were remiss in not formally articulating their hypotheses for the study though one gleans that the alternative hypothesis could have stated, â€Å"Structured religion, a deep sense of spirituality, mental status and mobility, and personal and demographic variables materially influence measures of health status and physical functioning.† In the end, the data was subjected to univariate and multivariate best-fit statistics.   The key findings: Table 2. Predictors of Self-Reported Good Health          Status (N = 277)                Factor* Unadjusted OR (95% CL    Adjusted OR (95% CI)       Age 0.94 (0.89–0.99)†        Male 0.72 (0.41–1.25)†¡       White race 2.79 (1.51–5.17) § 3.32 (1.33–8.30) ¶ Grade school 0.1 (0.02–0.49) ¶       Some high school 0.28 (0.06–1.44)†¡       High school graduate 0.24 (0.05–1.14)†¡       Technical/business school 0.29 (0.06–1.43)†¡       Some college 0.31 (0.06–1.49)†¡       Not depressed (GDS) 32.4 (4.03–261) §       Physical functioning(SF36-PFI) 1.04 (1.03–1.05) § 1.03 (1.01–1.04) § Quality of life (EuroQol) 1.69 (1.41–2.01)†  1.36 (1.09–1.70)†  Religiosity (NORC) 0.93 (0.85–1.02)†¡       Spirituality (SIWB) 1.15 (1.10–1.21) § 1.09 (1.02–1.16)†  OR = odds ratio; CI = confi dence interval; GDS = Geriatric Depression Scale; SF36-PFI = Physical Functioning Index from SF-36; NORC = National Opinion Research Center; SIWB = Spirituality Index of Well-Being.          *Referent factors: age-1 year younger; female, nonwhite; college graduate; GDS score of 0-9; PFI-index of 1 less; EuroQol-score of 0.1 less; SIWB-score of 1 less. †  P = .01.                †¡ P = NS.                 § P