Religiosity,Spirituality,and Death Attitudes in Chronically Ill Older Adults

Abstract

The aim of this study was to examine the association of religiosity and spirituality with fear of death and death acceptance attitudes in chronically ill older adults. In-home interviews were conducted with 257 community-dwelling elders with chronic illness identified through an administrative database of ambulatory care clinics from an academic health center in Kansas City and through primary care practices participating in a practice-based research network in North Carolina. Hierarchical regression models were constructed for predictor variables and the outcomes of fear of death and approach acceptance of death attitudes. Self-efficacy beliefs (b = —.097, p < .001), anxiety (b = .026, p < .01), and physical functioning (b = .015, p < .01) were significantly associated with fear of death attitudes. Self-reported religiosity (b = —.389, p < .001), closeness to God (b = —.595, p < .001), and age (b = —.019, p < .001) contributed significantly to the variance in the final model and were significantly associated with approach acceptance of death attitudes.

Keywords

death attitudes chronic illness religiosity spirituality older adults

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References

Antonovsky, A. 1987. Unraveling the Mystery of Health: How People Manage Stress and Stay Well. San Francisco, CA: Jossey-Bass.

Bandura, A. 1997. Self-Efficacy, the Exercise of Control. New York: Freeman.

Becker, E. 1973. The Denial of Death. New York: Free Press.

Bengston, V.L. , J.B. Cuellar , and P.K. Ragan. 1977. "Stratum Contrast and Similarities Toward Death." Journal of Gerontology 32:78-88.

Breitbart, W. 2002. "Spirituality and Meaning in Supportive Care: Spirituality and Meaning-Centered Group Psychotherapy Interventions in Advanced Cancer ." Support Care Cancer 10:272-80.

Broadhead, W.E. , S.H. Gehlbach , F.V. DeGruy , and B.H. Kaplan. 1988. "The Duke-UNC Functional Social Support Questionnaire." Medical Care 26:709-23.

Callahan, C.M. , F.W. Unverzagt , S.L. Hui , A.J. Perkins , and H.C. Hendrie. 2002. "Six Item Screener to Identify Cognitive Impairment Among Potential Subjects for Clinical Research." Medical Care 40:771-81.

Centers for Disease Control and Prevention. 2003. Chronic Disease Overview. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.

Cicirelli, V.G. 1999. "Personality and Demographic Factors in Older Adults’ Fear of Death." The Gerontologist 39:569-79.

10.

Cicirelli, V.G. 2002. Older Adults’ Views on Death. New York: Springer.

11.

Daaleman, T.P. and B.B. Frey. 2004. "The Spirituality Index of Well-Being: A New Instrument for Health-Related Quality-of-Life Research." Annals of Family Medicine 2:499-503.

12.

Depaola, S.J. , M. Griffin , J.R. Young , and R.A. Neimeyer. 2003. "Death Anxiety and Attitudes Toward the Elderly Among Older Adults: The Role of Gender and Ethnicity." Death Studies 27:335-54.

13.

Dixon, R. and B. Kinlaw. 1983. "Beliefs in the Existence and Nature of Life After Death ." Omega 13:287-92.

14.

Downey, A.M. 1984. "Relationship of Religiosity to Death Anxiety in Middle Age Males." Psychological Reports 54:811-22.

15.

Drolet, J.L. 1990. "Transcending Death During Early Adulthood: Symbolic Immortality, Death Anxiety, and Purpose in Life." Journal of Clinical Psychology 46:148-60.

16.

Erickson, P. , R. Wilson , and I. Shannon. 1995. "Years of Healthy Life. Healthy People 2000 Statistical Notes (No. 7)." DHHS Publication No. (PHS) 95-1237 4-1484 . Hyattsville, MD: U.S. Department of Health and Human Services.

17.

Fillenbaum, G.G. and M.A. Smyder. 1981. "The Development, Validity, and Reliability of the OARS Multidimensional Functional Assessment Questionnaire." Journal of Gerontology 36:428-34.

18.

Folstein, M.R. , S.E. Folstein , and P.R. McHugh . 1975. "‘Mini Mental State’: A Practical Method for Grading the Cognitive State of Patients for the Clinician ." Journal of Psychiatric Research 12:189-98.

19.

Fortner, B.V. and R.A. Neimeyer. 1999. "Death Anxiety in Older Adults: A Quantitative Review ." Death Studies 23:387-411.

20.

Fortner, B.V. , R.A. Neimeyer , and B. Rybarczyk. 2000. "Correlates of Death Anxiety in Older Adults: A Comprehensive Review." Pp. 95-108 in Death Attitudes and the Older Adult, edited by R. A. Neimeyer. Philadelphia: Taylor & Francis .

21.

Frankl, V.F. 1959. Man’s Search for Meaning. Boston : Beacon House.

22.

Frankl, V.F. 1969. The Will to Meaning: Foundations and Applications of Logo-therapy, expanded ed. New York: Penguin.

23.

Frey, B.B. , T.P. Daaleman , and V. Peyton. 2005. "Measuring a Dimension of Spirituality for Health Research." Research on Aging 27:556-77.

24.

Fry, P.S. 2003. "Perceived Self-Efficacy Domains as Predictors of Fear of the Unknown and Fear of Dying Among Older Adults." Psychology and Aging 18:474-86.

25.

Gallup, G. and D.M. Lindsay. 1999. Surveying the Religious Landscape, Trends in U.S. Beliefs . Harrisburg, PA: Morehouse.

26.

Hallberg, I.R. 2004. "Death and Dying From Old People’s Point of View: A Literature Review." Aging Clinical and Experimental Research 16:87-103.

27.

Hoge, D.R. 1972. "A Validated Intrinsic Religious Motivation Scale." Journal for the Scientific Study of Religion 11:369-76.

28.

Jemal, A. , E. Ward , Y. Hao , and M. Thun. 2005. "Trends in the Leading Causes of Death in the United States, 1970-2002." JAMA 294:1255-59.

29.

Kalish, R.A. 1985. Death, Grief, and Caring Relationships. Monterey, CA: Brooks/Cole.

30.

Kastenbaum, R. and R. Aisenberg. 1972. The Psychology of Death. New York: Springer.

31.

Kureshi, A. and A. Husain. 1981. "Death Anxiety in Intraputativeness Among Smokers and Nonsmokers: A Comparative Study." Journal of Psychological Research 25:42-45.

32.

Lethbridge-Cejku, M. and J. Vickerie. 2005. Summary Health Statistics for US Adults: National Health Interview Survey, 2003. Washington, DC: National Center for Health Statistics.

33.

McClain, C.S. , B. Rosenfeld , and W. Breitbart. 2003. "Effect of Spiritual Well-Being on End-of-Life Despair in Terminally Ill Cancer Patients." Lancet 361:1603-07.

34.

Montorio, I. and M. Izal. 1996. "The Geriatric Depression Scale: A Review of its Development and Utility." International Psychogeriatrics 8:103-12.

35.

Morgan, J.D. 1995. "Living Our Dying and Our Grieving: Historical and Cultural Attitudes" Pp. 25-45 in Dying: Facing the Facts, edited by H. Wass and R. A. Neimeyer. Washington, DC: Taylor & Francis.

36.

Mullins, L.C. and M.A. Lopez. 1982. "Death Anxiety Among Nursing Home Residents: A Comparison of the Young-Old and the Old-Old." Death Education 4:237-44.

37.

National Center for Health Statistics. 2003 . Health, United States, 2003. Hyattsville, MD: U.S. Department of Health and Human Services.

38.

Neimeyer, R.A. and M.K. Moore. 1994. "Validity and Reliability of the Multidimensional Fear of Death Scale" Pp. 103-19 in Death Anxiety Handbook: Research, Instrumentation, and Application, edited by R. A. Neimeyer. Washington, DC: Taylor & Francis.

39.

Neimeyer, R.A. and D. vanBrunt. 1995. "Death Anxiety" Pp. 49-88 in Dying: Facing the Facts, edited by H. Wass. Washington, DC: Taylor & Francis.

40.

Roof, W.C. 1993. A Generation of Seekers: The Spiritual Journeys of the Baby Boom Generation. San Francisco, CA: Harper.

41.

Sloane, P.D. , L.F. Callahan , L. Kahwati , and C.M. Mitchell. 2006. "Development of a Practice-Based Patient Cohort for Primary Care Research." Family Medicine 38:50-57.

42.

Stewart, A.L. , R.D. Hays , and J.E. Ware. 1988. "The MOS Short Form General Health Survey ." Medical Care 26:724-25.

43.

Thorson, J.A. and F.C. Powell. 1991. "Constructions of Death Among Those High in Intrinsic Religious Motivation: A Factor Analytic Study." Death Studies 15:131-38.

44.

Tomer, A. 1994. "Death Anxiety in Adult Life: Theoretical Perspectives " Pp. 3-28 in Death Anxiety Handbook: Research, Instrumentation, and Application, edited by R. A. Neimeyer. Washington, DC: Taylor & Francis.

45.

Tomer, A. 2000a. "Attitudes About Life and Death: Toward a Comprehensive Model of Death Anxiety" Pp. 3-22 in Death Attitudes and the Older Adult , edited by A. Tomer. Philadelphia: Brunner-Routledge.

46.

Tomer, A. , ed. 2000b. Death Attitudes and the Older Adult: Theories, Concepts, and Applications. Philadelphia: Brunner-Routledge.

47.

Tomer, A. and G. Eliason. 2000. "Beliefs About Self, Life, and Death: Testing Aspects of a Comprehensive Model of Death Anxiety and Death Attitudes" Pp. 137-53 in Death Attitudes and the Older Adult: Theories, Concepts, and Applications, edited by A. Tomer. Philadelphia : Brunner-Routledge.

48.

Tomer, A. , G. Eliason , and P.T.P. Wong. 2007. Existential and Spiritual Issues in Death Attitudes. Mahwah, NJ: Lawrence Erlbaum.

49.

Ware, J.F. and C.D. Sherbourne. 1992. "The MOS 36-Item Short Form Health Survey (SF-36): I: Conceptual Framework and Item Selection." Medical Care 30:473-83.

50.

Wong, P.T.P. , G.T. Reker , and G. Gesser. 1994. "Death Attitude Profile-Revised: A Multidimensional Measure of Attitudes Toward Death" Pp. 121-48 in Death Anxiety Handbook: Research, Instrumentation, and Application, edited by R. A. Neimeyer. Washington, DC: Taylor & Francis.

51.

Wulff, D.M. 1997. Psychology of Religion, Classic and Contemporary. New York: John Wiley.

52.

Wuthnow, R. 1998. After Heaven: Spirituality in America Since 1950. Berkeley: University of California Press.

53.

Zung, W.W.K. 1971. "A Rating Instrument for Anxiety Disorders." Psychosomatics 7:371-79.