Abstract
Objective: To examine the prevalence of religious beliefs and practices in hospitalized patients with congestive heart failure (CHF) or chronic pulmonary disease (CPD), and determine relationships with physical and mental health. Methods: Subjects were a consecutive sample of 196 patients age 55 or over admitted to Duke University Medical Center with a diagnosis of CHF or CPD. Patients underwent a 60–90 minute interview and physical exam to assess physical health, social support, mental health, religious activities and attitudes (attendance, prayer and scripture study, intrinsic religiosity). Results: Religious practices were widespread; 98% had a religious affiliation; 48% reported attending religious services weekly or more; 70% reported praying or reading religious scriptures at least daily; and over 85% consistently indicated intrinsic religious beliefs and attitudes. Religious activities and attitudes were inversely related to measures of physical illness severity and functional disability, and were less common among patients with prior psychiatric problems, hospitalizations for depression, drinking problems, and those currently taking psychotropic drugs. Religious activities (especially religious attendance) were associated with greater social support, but were only weakly related to less depression. Conclusions: Religious beliefs and activities are common among patients with CHF and CPD, are associated with less severe illness and functional disability, fewer prior psychiatric problems, and less psychotropic drug use. Treatment implications are discussed.
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Murray C. Global Burden of Disease. Cambridge, MA: Harvard University Press, 1996.
American Heart Association. 2001 Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association, 2000.
HFSA guidelines for management of patients with HF caused by LV systolic dysfunction: Pharmacological approaches. J Cardiac Failure 1998; 5:357-382.
Cohn JN, Rector TS. Prognosis of congestive heart failure and predictors of mortality. Am J Cardiol 1988; 62:25A-30A.
Schocken DD, Arrieta MI, Leaverton PE, Ross EA. Prevalence and mortality rate of congestive heart failure in the United States. J Am College Cardiol 1992; 20:301-306.
Gooding J, Jette AM. Hospital readmissions among the elderly. J Am Geriatr Soc 1985; 33:595-601.
Vinson JM, Rich MW, Spery JC, Shah AS, McNamara T. Early readmission of elderly patients with congestive heart failure. J Am Geriatr Soc 1990; 38:1290-1295.
National Center for Health Statistics. Raw Data from the National Health Interview Survey, U.S., 1998 (Analysis by the American Lung Association Best Practices Division, Using SPSS an SUDAAN software).
Center for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 1995. DHHS Pub. No. (PHS) 96-1232. Hyattsville, MD, May 1996
Koenig HG. Depression in elderly patients with congestive heart failure. Gen Hosp Psychiatry 1998; 20:29-43.
Freedland KE, Carney RM, Rich MW, Caracciolo A, Krotenberg JA, Smith LJ, Sperry J. Depression in elderly patients with congestive heart failure. J Geriatr Psychiatry 1991; 24 (1):59-71.
Agle DP, Baum GL, Chester EH, Wendt M. Multidiscipline treatment of chronic pulmonary insufficiency: psychologic aspects of rehabilitation. Psychosom Med 1973; 35:41-49.
McSweeney AJ, Grant I, Heaton RK, Adams KM, Timms RM. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med 1982; 142:473-478.
Finnegan DL, Suler JR. Psychological factors associated with maintenance of improved health behaviors in postcoronary patients. J Psychol 1985; 119:87-94.
Hackett TP, Rosenbaum JF, Tesa GE. Emotional, psychiatric disorders, and the heart. In Braunwald E (ed): Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, WB Saunders, 1988; 1883-1900.
Perlman LV, Ferguson S, Bergum K, Isenberg EL, Hammarsten JF. Precipitation of congestive heart failure: Social and emotional factors. Ann Intern Med 1971; 75:1-7.
Shenkman B. Factors contributing to attrition rates in a pulmonary rehabilitation program. Heart & Lung 14:53-58.
Pressman, P., Lyons, J.S., Larson, D.B., & Strain, J.J. Religious belief, depression, and ambulation status in elderly women with broken hips. Am J Psychiatry 1990; 147:758-759.
Koenig, H.G., Cohen, H.J., Blazer, D.G., Pieper, C., & Meador, K.G., Shelp, F., Goli, V., & DiPasquale, R. Religious coping and depression in elderly hospitalized medically ill men. Am J Psychiatry 1992; 149:1693-1700.
Harris, R.C., Dew, M.A., Lee, A., Amaya, M., Buches, L., Reetz, D., & Coleman, G. The role of religion in heart transplant recipients' health and well-being. J Religion & Health 1995; 34(1):17-32.
Saudia, T.L., Kinney, M.R., Brown, K.C., & Young-Ward, L. Health locus of control and helpfulness of prayer. Heart & Lung 1991; 20:60-65.
Koenig HG. Religious beliefs and practices of hospitalized medically ill older adults. Int'l J Geriatr Psychiatry 1998; 13:213-224.
Koenig HG, McCullough M, Larson D. Handbook of Religion and Health. New York, NY: Oxford University Press, 2001.
Hoge DR. A validated intrinsic religious motivation scale. J for Sci Study of Religion 1972; 11:369-376.
Koenig HG, Smiley M, Gonzales J. Religion, Health, and Aging. Westport, CT: Greenwood Press, 1988.
Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB. A brief self-administered questionnaire to determine functional capacity (The Duke Activity Status Index). Am J Cardiology 1989; 64:651-654.
Goldman L, Hashimoto B, Cook F, Loscalzo. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: Advantages of a new specific activity scale. Circulation 1981; 64:1227-1234.
Guyatt GH, Nogradi S. Halcrow S, Singer J, Sullivan MJJ, Fallen EL. Development and testing of a new measure of health status for clinical trials in heart failure. J Gen Intern Med 1989; 42:101-107.
Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987; 42:773-778.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 1987; 40:373-383.
Linn B, Linn M, Gurel L. Cumulative Illness Rating Scale. J Am Geriatr Soc 1968;16:622-626.
American Society of Anesthesiologists: New classification of physical status. Anesthesiology 1963; 24:191-198.
Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 9th ed. Boston, Mass: Litttle, Brown & Co, 1994:243-256.
Conwell Y, Forbes NT, Cox C, Caine ED. Validation of a measure of physical illness burden at autopsy: The Cumulative Illness Rating Scale. J Am Geriatr Soc 1993; 41:38-41.
Koenig HG, Westlund RE, George LK, Hughes DC, Hybels C. Abbreviating the Duke Social Support Index for use in chronically ill older adults.< Psychosomatics 1993; 34:61-69.
Landerman R, George L, Campbell R, Blazer D. Alternative models of the stress buffering hypothesis. Am J Comm Psychol 1989; 17:625-642.
Robbins, L, Helzer, J., Croughan, J. National Institute of Mental Health Diagnostic Interview Schedule: History, characteristics, validity. Arch Gen Psychiatry 1981; 38:381-389.
DSM-IV. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association, 1994, pp. 327, 720-721.
Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc & Clin Psychol 1967; 6:278-296.
Idler, E.L., & Kasl, S.V. Religion among disabled and nondisabled elderly persons, II: Attendance at religious services as a predictor of the course of disability. J Gerontology 1997; 52B:S306-S316.
Idler, E.L. Religion, health, and nonphysical senses of self. Social Forces 1995; 74:683-704.
Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K.E., Pbert, L., Lenderking, W.R., & Santorelli, S.F. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 1992; 149, 936-943.
Koenig, H.G., Ford, S., George, L.K., Blazer, D.G., & Meador, K.G. Religion and anxiety disorder: An examination and comparison of associations in young, middle-aged, and elderly adults. J Anxiety Disorders 1993; 7:321-342.
Haley, K.C., Koenig, H.G., Burchett, BM. Relationship between private religious activity and physical functioning in older adults. J Religion & Health 2001 (in press).
Idler, E.L. Religious involvement and the health of the elderly: some hypotheses and an initial test. Social Forces 1987; 66:226-238.
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Smith, J.H., & van Tilburg, W. Religiosity as a protective or prognostic factor of depression in later life; results from the community survey in the Netherlands. Acta Psychiatrica Scandinavia 1997; 96:199-205.
Koenig, H.G., Hays, J.C., George, L.K., & Blazer, D.G., Larson, DB, & Landerman, L.R. (1997). Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms. Am J Geriatr Psychiatry 1997; 5:131-143.
Koenig, H.G., George, L.K., & Peterson, B.L. Religiosity and remission from depression in medically ill older patients. Am J Psychiatry 1998; 155:536-542.
Rabins, P.V., Fitting, M.D., Eastham, J., & Zabora, J. Emotional adaptation over time in care-givers for chronically ill elderly people. Age and Ageing 1990; 19:185-190.
Ehman, J, Ott B, Short, T, Ciampa R, Hansen-Flaschen, J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med 1999; 159:1803-1806.
Sloan RP, Bagiella E, VandeCreek L, Hover M. Should physicians prescribe religious activities? NEJM 2000; 342:1913-1916.
Lo B, Quill T, Tulsky J. Discussing palliative care with patients. Ann Intern Med 1999; 130:744-749.
Princeton Religion Research Center. Religion in America. Princeton, NJ: the Gallup poll, 1996.
Koenig HG, Pargament KI, Nielsen J. Religious coping and health outcomes in medically ill hospitalized older adults. J Nerv & Ment Dis 1998; 186:513-521.
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Koenig, H.G. Religion, Congestive Heart Failure, and Chronic Pulmonary Disease. Journal of Religion and Health 41, 263–278 (2002). https://doi.org/10.1023/A:1020241004572
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DOI: https://doi.org/10.1023/A:1020241004572