Religious Struggle as a Predictor of Mortality Among Medically Ill Elderly Patients

Kenneth I. Pargäment · Harold George Koenig · Nalini Tarakeshwar · June Hahn

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Religion, Spirituality, and Psychology Palliative Care and End-of-Life Issues Religion and Society Interactions

Abstract

BACKGROUND: Although church attendance has been associated with a reduced risk of mortality, no study has examined the impact of religious struggle with an illness on mortality. OBJECTIVE: To investigate longitudinally the relationship between religious struggle with an illness and mortality. METHODS: A longitudinal cohort study from 1996 to 1997 was conducted to assess positive religious coping and religious struggle, and demographic, physical health, and mental health measures at baseline as control variables. Mortality during the 2-year period was the main outcome measure. Participants were 596 patients aged 55 years or older on the medical inpatient services of Duke University Medical Center or the Durham Veterans Affairs Medical Center, Durham, NC. RESULTS: After controlling for the demographic, physical health, and mental health variables, higher religious struggle scores at baseline were predictive of greater risk of mortality (risk ratio [RR] for death, 1.06; 95% confidence interval [CI], 1.01-1.11; chi(2) = 5.89; P =.02). Two spiritual discontent items and 1 demonic reappraisal item from the religious coping measure were predictive of increased risk for mortality: "Wondered whether God had abandoned me" (RR for death, 1.28; 95% CI, 1.07-1.50; chi(2) = 5.22; P =.02), "Questioned God's love for me" (RR for death, 1.22; 95% CI, 1.02-1.43; chi(2) = 3.69; P =.05), and "Decided the devil made this happen" (RR for death, 1.19; 95% CI, 1.05-1.33; chi(2) = 5.84; P =.02). CONCLUSIONS: Certain forms of religiousness may increase the risk of death. Elderly ill men and women who experience a religious struggle with their illness appear to be at increased risk of death, even after controlling for baseline health, mental health status, and demographic factors.

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References

1998The Psychology of Religion and Coping: Theory Research Practice 1998Patterns of Positive and Negative Religious Coping with Major Life Stressors 2000The many methods of religious coping: Development and initial validation of the RCOPE 1982Stages of Faith: The Psychology of Human Development and the Quest for Meaning 2000Religious involvement and mortality: A meta-analytic review.1983Stages of Faith: The Psychology of Human Development and the Quest for Meaning 1999Religious involvement and U.S. adult mortality

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2004Religious Coping Methods as Predictors of Psychological, Physical and Spiritual Outcomes among Medically Ill Elderly Patients: A Two-year Longitudinal Study 2006Religiousness and mental health: a review 2014The Religious and Spiritual Struggles Scale: Development and initial validation.2002TARGET ARTICLE: The Bitter and the Sweet: An Evaluation of the Costs and Benefits of Religiousness 2012Religious and spiritual struggles.2004Religion, Spirituality, and Medicine: Research Findings and Implications for Clinical Practice

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