title: Modeling the effects of spirituality/religion on patients' perceptions of living with HIV/AIDS.
abstract: BACKGROUND
  Spirituality/religion is an important factor in health and illness, but more work is needed to determine its link to quality of life in patients with HIV/AIDS.
  
  
  OBJECTIVE
  To estimate the direct and indirect effects of spirituality/religion on patients' perceptions of living with HIV/AIDS.
  
  
  METHODS
  In 2002 and 2003, as part of a multicenter longitudinal study of patients with HIV/AIDS, we collected extensive demographic, clinical, and behavioral data from chart review and patient interviews. We used logistic regression and path analysis combining logistic and ordinary least squares regression.
  
  
  METHODS
  Four hundred and fifty outpatients with HIV/AIDS from 4 sites in 3 cities.
  
  
  METHODS
  The dependent variable was whether patients felt that life had improved since being diagnosed with HIV/AIDS. Spirituality/religion was assessed by using the Duke Religion Index, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded, and Brief RCOPE measures. Mediating factors included social support, self-esteem, healthy beliefs, and health status/health concerns.
  
  
  RESULTS
  Approximately one-third of the patients felt that their life was better now than it was before being diagnosed with HIV/AIDS. A 1-SD increase in spirituality/religion was associated with a 68.50% increase in odds of feeling that life has improved--29.97% due to a direct effect, and 38.54% due to indirect effects through healthy beliefs (29.15%) and health status/health concerns (9.39%). Healthy beliefs had the largest effect on feeling that life had improved; a 1-SD increase in healthy beliefs resulted in a 109.75% improvement in feeling that life changed.
  
  
  CONCLUSIONS
  In patients with HIV/AIDS, the level of spirituality/religion is associated, both directly and indirectly, with feeling that life is better now than previously. Future research should validate our new conceptual model using other samples and longitudinal studies. Clinical education interventions should focus on raising awareness among clinicians about the importance of spirituality/religion in HIV/AIDS.
authors.affiliation: Institute for the Study of Health, University of Cincinnati, Cincinnati, OH 45267-0840, USA. magdalena.szaflarski@uc.edu
authors.forename: Magdalena
authors.initials: M
authors.lastname: Szaflarski
authors.forename: P Neal
authors.initials: PN
authors.lastname: Ritchey
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Leonard
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mrus
authors.forename: Amy H
authors.initials: AH
authors.lastname: Peterman
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Ellison
authors.forename: Michael E
authors.initials: ME
authors.lastname: McCullough
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D015999:Multivariate Analysis; D012069:Religion and Psychology; D012649:Self Concept; D012938:Social Perception; D012944:Social Support; D014481:United States / Q000453:epidemiology