Modeling the effects of spirituality/religion on patients' perceptions of living with HIV/AIDS.
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.
Szaflarski
Magdalena
M
Institute for the Study of Health, University of Cincinnati, Cincinnati, OH 45267-0840, USA. magdalena.szaflarski@uc.edu
Ritchey
P Neal
PN
Leonard
Anthony C
AC
Mrus
Joseph M
JM
Peterman
Amy H
AH
Ellison
Christopher G
CG
McCullough
Michael E
ME
Tsevat
Joel
J
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