Religiousness-Health Links in CHF: Roles of Mediators and Age

宗教和精神变量作为健康的决定因素近年来受到了大量的研究关注，并且越来越多的证据表明宗教/精神（R/S）对健康产生了各种复杂的影响。然而，大多数研究都研究了“参加服务”的变量;对R/S的其他方面对身体健康的影响知之甚少。此外，虽然R/S似乎在高度紧张的情况下发挥其最强的作用，但对慢性或晚期疾病患者的R/S因素和健康知之甚少。这项两次纵向研究检查了R/S的几个维度，作为充血性心力衰竭（CHF）老年人6个月内健康状况的预测因子，CHF是一种慢性、进行性和使人衰弱的疾病。此外，虽然已经提出了一些途径作为调解人，很少有被测试。本研究探讨了社会支持、健康行为、生活意义、积极情感和希望对健康的潜在中介影响。最后，虽然很多研究都研究了宗教和灵性对老年人健康的影响，但很少有人研究R/S是否随着年龄的增长与健康有更强的联系。本研究探讨了年龄的宗教/精神健康联系的调节剂的影响。本研究的主要目的是更好地了解R/S对健康的功能，并扩大我们对年龄在这些关系中的影响的理解。这项研究涉及以下具体目标：（1）审查宗教/精神层面的影响（除了“出勤”之外）对健康和适应慢性疾病CHF生活的各个方面施加影响，（2）测试R/S与健康之间的潜在影响途径，包括社会支持、健康行为、生活意义、积极情感和希望，对健康和适应的各个方面，（3）确定年龄对R/S-健康联系的潜在调节作用。这条研究路线可能会导致干预措施，利用R/S对那些宗教或精神的人最有帮助的方面，并为那些没有宗教或精神的人确定可能被利用的替代类型的意义

DESCRIPTION (provided by applicant): Religious and spiritual variables as determinants of health have received a great deal of research attention in recent years, and evidence is accumulating that religiousness/spirituality (R/S) exerts varied and complex influences on health. However, most research has examined the variable of "attendance at services"; much less is known about the influence of other aspects of R/S on physical health. Further, although R/S appears to exert its strongest effects in highly stressful situations, little is known about R/S factors and health in those living with chronic or terminal illness. This two-occasion longitudinal study examines several dimensions of R/S as predictors of health over a 6 month period in older individuals living with congestive heart failure (CHF), a chronic, progressive, and debilitating disease. Further, although a number of pathways have been proposed as mediators, few have been tested. The proposed study examines the potential mediating influences of social support, health behaviors, life meaning, positive affect, and hope on health. Finally, while much research has examined effects of religiousness and spirituality on the health of older individuals, very little has examined whether R/S is more strongly linked to health as people age. This study examines the influence of age as a moderator of the religiousness/spirituality-health link. The primary goals of this study are to better understand the functions of R/S on health and to expand our understanding of the influences of age in these relationships. This study addresses the following specific aims: (1) Examine the influences that dimensions of religion/spirituality (in addition to "attendance") exert on various aspects of health and adaptation to living with a chronic illness, CHF, (2) Test potential pathways of influence between R/S and health, including social support, health behaviors, life meaning, positive affect, and hope, on various aspects of health and adaptation, and (3) Determine the potential moderating effect of age on the R/S-health links. This line of research may lead to interventions that capitalize on the most helpful aspects of R/S for those who are religious or spiritual, and, for those who are not, to identify alternative types of meaning that might be drawn upon