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In Search of Serenity: Religious Struggle Among Patients Hospitalized for Suspected Acute Coronary Syndrome

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Abstract

Hospitalization for a sudden cardiac event is a frightening experience, one that is often marked by uncertainty about health status, fear of recurrent cardiac problems, and related existential, religious, and spiritual concerns. Religious struggle, reflecting tension and strain regarding religious and spiritual issues, may arise in response to symptoms of acute coronary syndrome (ACS). The present study examined the prevalence and types of religious struggle using the Brief RCOPE, as well as associations between religious struggle, psychological distress, and self-reported sleep habits among 62 patients hospitalized with suspected ACS. Fifty-eight percent of the sample reported some degree of religious struggle. Questioning the power of God was the most frequently endorsed struggle. Those struggling religiously reported significantly more symptoms of anxiety, depression, and sleep disturbance. Non-White participants endorsed greater use of positive religious coping strategies and religious struggle. Results suggest that patients hospitalized for suspected ACS experiencing even low levels of religious struggle might benefit from referral to a hospital chaplain or appropriately trained mental health professional for more detailed religious and spiritual assessment. Practical means of efficiently screening for religious struggle during the often brief hospitalization period for suspected ACS are discussed.

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References

  • Ai, A. L., Pargament, K. I., Appel, H. B., & Kronfol, Z. (2010a). Depression following open-heart surgery: A path model involving interleukin-6, spiritual struggle, and hope under preoperative distress. Journal of Clinical Psychology, 66(10), 1057–1075. doi:10.1002/jclp.20716.

    Article  PubMed  Google Scholar 

  • Ai, A. L., Pargament, K., Kronfol, Z., Tice, T. N., & Appel, H. (2010b). Pathways to postoperative hostility in cardiac patients: Mediation of coping, spiritual struggle and interleukin-6. Journal of Health Psychology, 15(2), 186–195. doi:10.1177/1359105309345556.

    Article  PubMed  Google Scholar 

  • Ai, A. L., Park, C. L., Huang, B., Rodgers, W., & Tice, T. N. (2007). Psychosocial mediation of religious coping styles: A study of short-term psychological distress following cardiac surgery. Personality and Social Psychology Bulletin, 33(6), 867–882. doi:10.1177/0146167207301008.

    Article  PubMed  Google Scholar 

  • Ai, A. L., Park, C. L., & Shearer, M. (2008). Spiritual and religious involvement relate to end-of-life decision-making in patients undergoing coronary bypass graft surgery. International Journal of Psychiatry in Medicine, 38(1), 113–132. doi:10.2190/PM.38.1.k.

    Article  PubMed  Google Scholar 

  • Ai, A. L., Seymour, E. M., Tice, T. N., Kronfol, Z., & Bolling, S. F. (2009). Spiritual struggle related to plasma interleukin-6 prior to cardiac surgery. Psychology of Religion and Spirituality, 1(2), 112–128. doi:10.1037/a0015775.

    Article  Google Scholar 

  • Alcoholics Anonymous World Services. (2001, June). Alcoholics anonymous. Chapter 5: How it works. Retrieved October 2012 from http://www.aa.org/bigbookonline/en_bigbook_chapt5.pdf.

  • Ano, G. G., & Vasconcelles, E. B. (2005). Religious coping and psychological adjustment to stress: A meta-analysis. Journal of Clinical Psychology, 61(4), 461–480. doi:10.1002/jclp.20049.

    Article  PubMed  Google Scholar 

  • Arbab-Zadeh, A., Nakano, M., Virmani, R., & Fuster, V. (2012). Acute coronary events. Circulation, 125(9), 1147–1156. doi:10.1161/CIRCULATIONAHA.111.047431.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bastien, C. H., Vallie’res, A., & Morin, C. M. (2000). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297–307. doi:10.1016/S1389-9457(00)00065-4.

    Article  Google Scholar 

  • Chaves, M. (2011). Religious trends in America. Social Work & Christianity, 38(2), 119–132.

    Google Scholar 

  • Exline, J. J., & Rose, E. (2005). Religious and spiritual struggles. In R. F. Paloutzian & C. L. Park (Eds.), Handbook of the psychology of religion (pp. 315–330). New York, NY: Guilford Press.

    Google Scholar 

  • Ferrer, J. N. (2009). The plurality of religions and the spirit of pluralism: A participatory vision of the future of religion. International Journal of Transpersonal Studies, 28(1), 139–151. Retrieved from http://www.transpersonalstudies.org/.

    Google Scholar 

  • Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R., & Davis, J. A. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34(2), 179–196. doi:10.2190/UCJ9-DP4M-9C0X-835M.

    Article  PubMed  Google Scholar 

  • Fitchett, G., & Risk, J. L. (2009). Screening for spiritual struggle. Journal of Pastoral Care & Counseling, 63(1–2). Retrieved from http://journals.sfu.ca/jpcp/index.php/jpcp/index.

  • Fitchett, G., Rybarczyk, B. D., DeMarco, G. A., & Nicholas, J. J. (1999). The role of religion in medical rehabilitation outcomes: A longitudinal study. Rehabilitation Psychology, 44(4), 333–353. doi:10.1037/0090-5550.44.4.333.

    Article  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. doi:10.1016/0022-3956(75)90026-6.

    Article  CAS  PubMed  Google Scholar 

  • Hall, D. E., Meador, K. G., & Koenig, H. G. (2008). Measuring religiousness in health research: Review and critique. Journal of Religion and Health, 47(2), 134–163. doi:10.1007/s10943-008-9165-2.

    Article  PubMed  Google Scholar 

  • Hampton, M. C., Halkitis, P. N., & Mattis, J. S. (2010). Coping, drug use, and religiosity/spirituality in relation to HIV serostatus among gay and bisexual men. AIDS Education and Prevention, 22(5), 417–429. doi:10.1521/aeap.2010.22.5.417.

    Article  PubMed  Google Scholar 

  • Johns, M. W. (1994). Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep: Journal of Sleep Research & Sleep Medicine, 17(8), 703–710. Retrieved from http://www.journalsleep.org/.

    Google Scholar 

  • Koenig, H. G., George, L. K., & Titus, P. (2004). Religion, spirituality, and health in medically ill hospitalized older patients. Journal of the American Geriatrics Society, 52(4), 554–562. doi:10.1111/j.1532-5415.2004.52161.x.

    Article  PubMed  Google Scholar 

  • Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). New York, NY: Oxford University Press.

    Google Scholar 

  • Lavery, M. E., & O’Hea, E. L. (2010). Religious/spiritual coping and adjustment in individuals with cancer: Unanswered questions, important trends, and future directions. Mental Health, Religion & Culture, 13(1), 55–65. doi:10.1080/13674670903131850.

    Article  Google Scholar 

  • Levin, J. S., Chatters, L. M., & Taylor, R. J. (1995). Religious effects on health status and life satisfaction among black Americans. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 50B(3), S154–S163. doi:10.1093/geronb/50B.3.S154.

    Article  Google Scholar 

  • Mason, S. J., Deane, F. P., Kelly, P. J., & Crowe, T. P. (2009). Do spirituality and religiosity help in the management of cravings in substance abuse treatment?. Substance Use and Misuse, 44(13), 1926–1940. doi:10.3109/10826080802486723.

    Article  PubMed  Google Scholar 

  • McConnell, K. M., Pargament, K. I., Ellison, C. G., & Flannelly, K. J. (2006). Examining the links between spiritual struggles and symptoms of psychopathology in a national sample. Journal of Clinical Psychology, 62(12), 1469–1484. doi:10.1002/jclp.20325.

    Article  PubMed  Google Scholar 

  • Miller, J. F., McConnell, T. R., & Klinger, T. A. (2007). Religiosity and spirituality: Influence on quality of life and perceived patient self-efficacy among cardiac patients and their spouses. Journal of Religion and Health, 46(2), 299–313. doi:10.1007/s10943-006-9070-5.

    Article  Google Scholar 

  • Moorey, S., Greer, S., Watson, M., & Gorman, C. (1991). The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer. The British Journal of Psychiatry, 158, 255–259. doi:10.1192/bjp.158.2.255.

    Article  CAS  PubMed  Google Scholar 

  • National Opinion Research Center. (1998). General social survey. Retrieved April/5, 2002 from http://webapp.iepsr.umich.edu/GSS/.

  • Oman, D., & Thoresen, C. E. (2005). Do religion and spirituality influence health? In R. F. Paloutzian & C. L. Park (Eds.), Handbook of the psychology of religion and spirituality (pp. 435–459). New York, NY: Guilford Press.

    Google Scholar 

  • Oxman, T. E., Freeman, D. H., & Manheimer, E. D. (1995). Lack of social participation or religious strength and comfort as risk factors for death after cardiac surgery in the elderly. Psychosomatic Medicine, 57(1), 5–15. Retrieved from http://www.psychosomaticmedicine.org/.

  • Pargament, K. I. (1996). Religious methods of coping: Resources for the conservation and transformation of significance. In E. P. Shafranske (Ed.), Religion and the clinical practice of psychology (pp. 215–239). Washington, DC: American Psychological Association. doi:10.1037/10199-008.

  • Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. New York, NY: Guilford Press.

    Google Scholar 

  • Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56(4), 519–543. doi:10.1002/(SICI)1097-4679(200004)56:4<519:AID-JCLP6>3.3.CO;2-T.

    Article  CAS  PubMed  Google Scholar 

  • Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001a). Religious struggle as a predictor of mortality among medically ill elderly patients: A 2-year longitudinal study. Archives of Internal Medicine, 161(15), 1881–1885. doi:10.1001/archinte.161.15.1881.

    Article  CAS  PubMed  Google Scholar 

  • Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2004). Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study. Journal of Health Psychology, 9(6), 713–730. doi:10.1177/1359105304045366.

    Article  PubMed  Google Scholar 

  • Pargament, K. I., Magyar, G. M., Benore, E., & Mahoney, A. (2005a). Sacrilege: A study of sacred loss and desecration and their implications for health and well-being in a community sample. Journal for the Scientific Study of Religion, 44(1), 59–78. doi:10.1111/j.1468-5906.2005.00265.x.

    Article  Google Scholar 

  • Pargament, K. I., Murray-Swank, N., Magyar, G. M., & Ano, G. G. (2005b). Spiritual struggle: A phenomenon of interest to psychology and religion. In W. R. Miller & H. D. Delaney (Eds.), Judeo-Christian perspectives on psychology: Human nature, motivation, and change (pp. 245–268). Washington, DC: American Psychological Association. doi:10.1037/10859-013.

  • Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37(4), 710–724. doi:10.2307/1388152.

    Article  Google Scholar 

  • Pargament, K. I., Tarakeshwar, N., Ellison, C. G., & Wulff, K. M. (2001b). Religious coping among the religious: The relationships between religious coping and well-being in a national sample of Presbyterian clergy, elders, and members. Journal for the Scientific Study of Religion, 40(3), 497–513. doi:10.1111/0021-8294.00073.

    Article  Google Scholar 

  • Pargament, K. I., Zinnbauer, B. J., Scott, A. B., Butter, E. M., Zerowin, J., & Stanik, P. (2003). Red flags and religious coping: Identifying some religious warning signs among people in crisis. Journal of Clinical Psychology, 59(12), 1335–1348. doi:10.1002/jclp.10225.

    Article  Google Scholar 

  • Park, C. L., Malone, M. R., Suresh, D. P., Bliss, D., & Rosen, R. I. (2008). Coping, meaning in life, and quality of life in congestive heart failure patients. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 17(1), 21–26. doi:10.1007/s11136-007-9279-0.

    Article  Google Scholar 

  • Park, C. L., Wortmann, J. H., & Edmondson, D. (2011). Religious struggle as a predictor of subsequent mental and physical well-being in advanced heart failure patients. Journal of Behavioral Medicine, 34(6), 426–436. doi:10.1007/s10865-011-9315-y.

    Article  PubMed  Google Scholar 

  • Raiya, H. A., Pargament, K. I., Mahoney, A., & Stein, C. (2008). A psychological measure of Islamic religiousness: Development and evidence for reliability and validity. International Journal for the Psychology of Religion, 18(4), 291–315. doi:10.1080/10508610802229270.

    Article  Google Scholar 

  • Rosmarin, D. H., Pargament, K. I., & Flannelly, K. J. (2009). Do spiritual struggles predict poorer physical/mental health among Jews? International Journal for the Psychology of Religion, 19(4), 244–258. doi:10.1080/10508610903143503.

    Article  Google Scholar 

  • Soenke, M., Landau, M. J., & Greenberg, J. (2013). Sacred armor: Religion’s role as a buffer against the anxieties of life and the fear of death. In K. Pargament, J. Exline & J. Jones, (Eds.), APA handbook of psychology, religion, and spirituality (pp. 105–122): Context, theory, and research (pp. 105–122). Washington DC: American Psychological Association.

  • Thompson, E. H. J., Killgore, L., & Connors, H. (2009). ‘Heart trouble’ and religious involvement among older white men and women. Journal of Religion and Health, 48(3), 317–331. doi:10.1007/s10943-008-9202-1.

    Article  PubMed  Google Scholar 

  • Trevino, K. M., Archambault, E., Schuster, J., Richardson, P., & Moye, J. (2012). Religious coping and psychological distress in military veteran cancer survivors. Journal of Religion and Health, 51(1), 87–98. doi:10.1007/s10943-011-9526-0.

    Article  PubMed  Google Scholar 

  • Trost, J. C., & Lange, R. A. (2011). Treatment of acute coronary syndrome: Part 1: Non-ST-segment acute coronary syndrome. Critical Care Medicine, 39(10), 2346–2353. doi:10.1097/CCM.0b013e31821e855f.

    Article  PubMed  Google Scholar 

  • Violani, C., Lucidi, F., Robusto, E., Devoto, A., Zucconi, M., & Strambi, L. F. (2003). The assessment of daytime sleep propensity: A comparison between the Epworth Sleepiness Scale and a newly developed resistance to sleepiness scale. Clinical Neurophysiology, 114(6), 1027–1033. doi:10.1016/S1388-2457(03)00061-0.

    Article  CAS  PubMed  Google Scholar 

  • Weaver, A. J., Pargament, K. I., Flannelly, K. J., & Oppenheimer, J. E. (2006). Trends in the scientific study of religion, spirituality, and health: 1965–2000. Journal of Religion and Health, 45(2), 208–214. doi:10.1007/s10943-006-9011-3.

    Article  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. doi:10.1111/j.1600-0447.1983.tb09716.x.

    Article  CAS  PubMed  Google Scholar 

  • Zwingmann, C., Wirtz, M., Müller, C., Körber, J., & Murken, S. (2006). Positive and negative religious coping in German breast cancer patients. Journal of Behavioral Medicine, 29(6), 533–547. doi:10.1007/s10865-006-9074-3.

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported through the Johns Hopkins University Center for Mind Body Research with funding from the National Institute of Health’s National Center for Complementary and Alternative Medicine (R24AT004641). The authors thank Kellie Hirt for her assistance in participant recruitment and data management.

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  1. Iain Tucker Brown

    Present address: Department of Humanities, Social Sciences, and Language & Letters, Northern New Mexico College, Paseo de Oñate, Española, NM, USA

Authors and Affiliations

  1. Department of Pastoral Counseling, Loyola University Maryland, 8890 McGaw Rd, Suite 380, Columbia, MD, 21045, USA

    Gina Magyar-Russell, Iain Tucker Brown & Inna R. Edara

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Gina Magyar-Russell & Michael T. Smith

  3. Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Joseph E. Marine & Roy C. Ziegelstein

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  1. Gina Magyar-Russell
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Correspondence to Gina Magyar-Russell.

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Magyar-Russell, G., Brown, I.T., Edara, I.R. et al. In Search of Serenity: Religious Struggle Among Patients Hospitalized for Suspected Acute Coronary Syndrome. J Relig Health 53, 562–578 (2014). https://doi.org/10.1007/s10943-013-9713-2

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