David L. Klemmack

Religiosity and mental health in southern, community-dwelling older adults

This study considers potential interaction effects of three measures of religiosity, organized (OR), non-organized (NOR), and intrinsic religiosity (IR), on depression and general mental health, controlling for socio-demographic characteristics and mobility. In-home interviews were conducted among a stratified random sample of Medicare beneficiaries from five central Alabama counties (the University of Alabama at Birmingham Study of Aging). Those who were high on all three dimensions of religiosity reported having fewer symptoms of depression and better mental health than did those who were low on all three dimensions of religiosity. Subjects who scored high on OR reported lower levels of depression (F (1, 981) = 3.97, p<0.05). Neither IR nor NOR had salutary effects on the measure of depression nor on the general measure of mental health. The interpretation of the relationships of religiosity with the Geriatric Depression Scale (GDS) and the general mental health (Mental Component Score of the SF-12; MCS) measures was complicated by the presence of three way interactions (F (1, 981) = 9.02, p<0.01 and F (1, 981) = 5.46, p<0.05, for GDS and MCS respectively). The presence of interaction effects between the different dimensions of religiosity and mental health affirms the importance of remaining sensitive to the multidimensional nature of religiousness and its relationships with measures of mental health.

Secondary Traumatic Stress and Oncology Social Work: Protecting Compassion from Fatigue and Compromising the Worker's Worldview

Abstract Secondary traumatic stress (STS) represents a disorder that has the same symptoms as post traumatic stress disorder, but results from vicariously experiencing trauma through association with those directly encountering the traumatic event(s). This exploratory study examined STS in 21 oncology social workers who were members of the Association of Oncology Social Workers. The results of this study revealed that oncology social workers experienced compassion fatigue and burnout and that these variables were inversely related to compassion satisfaction. Other relationships between emotional involvement, ability to separate work from home, level of licensure, personal loss, and empathetic responsiveness were also examined.

Religiousness and Longitudinal Trajectories in Elders' Functional Status

The purpose of this study was to examine the effects of religiousness on the trajectories of difficulties with activities of daily living (ADLs) and instrumental ADLs (IADLs) in community-dwelling older adults over a three-year period. Seven waves of data from the University of Alabama at Birmingham Study of Aging were analyzed using a hierarchical linear modeling method. The study was based on the 784 participants who completed interviews every six months between December 1999 and February 2004. Frequent religious service attendance was associated with fewer ADL difficulties and IADL difficulties at baseline. Furthermore, religious service attendance predicted slower increases for frequent churchgoers and steeper increases for less frequent churchgoers in IADL difficulties, controlling for variables related to demographics and resources. Religious service attendance was independently associated with ADL and IADL difficulties cross-sectionally. However, significant protective effects of religious service attendance were identified longitudinally only for the IADL trajectory.

Predicting the trajectories of depressive symptoms among southern community-dwelling older adults: The role of religiosity

Background: This study examined the effects of religiosity on the trajectories of depressive symptoms in a sample of community-dwelling older adults over a four-year period in a Southern state in the US. Methods: Data from the University of Alabama at Birmingham (UAB) Study of Aging were analyzed using a hierarchical linear modeling (HLM) method. This study involved 1000 participants aged 65 and above (M age = 75 at baseline, SD = 5.97) and data were collected annually from 1999 to 2003. The Geriatric Depression Scale measured depressive symptoms; the Duke University Religion Index measured religious service attendance, prayer, and intrinsic religiosity; and control variables included sociodemographics, health, and social and economic factors. Results: The HLM analysis indicated a curvilinear trajectory of depressive symptoms over time. At baseline, participants who attended religious services more frequently tended to report fewer depressive symptoms. Participants with the highest levels of intrinsic religiosity at baseline experienced a steady decline in the number of depressive symptoms over the four-year period, while those with lower levels of intrinsic religiosity experienced a short-term decline followed by an increase in the number of depressive symptoms. Implications: In addition to facilitating access to health, social support and financial resources for older adults, service professionals might consider culturally appropriate, patient-centered interventions that boost the salutary effects of intrinsic religiosity on depressive symptoms.

A Cluster Analysis Typology of Religiousness/Spirituality Among Older Adults

This study used cluster analysis to identify sets of individuals similar to one another across multiple measures of religiousness and then ascertained if these groups differed by sociodemographic characteristics, health risk behaviors, physical health and functional status, and mental health. The authors identified six clusters using data from 1,000 community-dwelling older adults in a k-means cluster analysis of a modified version of the Duke University Religion Index. Participants in the strongly religious, moderately religious, and minimally religious clusters had the highest scores on the health, functional status, and mental health variables. The privately practicing moderate attender and the privately practicing nonattender groups were similar to each other and generally had poorer health, functional status, and mental health. The typology illustrates the importance of simultaneously considering multiple measures of religiousness and the complexity of the relationships among religiousness, sociodemographic characteristics, and health and well-being.

Religiosity, Smoking, Exercise, and Obesity Among Southern, Community-Dwelling Older Adults

This study examined associations between organizational (OR), nonorganizational (NOR), and intrinsic religiosity (IR) and measures of cigarette smoking, exercise, and obesity among older adults, controlling for measures of sociodemographic characteristics and comorbidity. In-home interviews were conducted among a stratified, random sample of Medicare beneficiaries from five central Alabama counties (the University of Alabama at Birmingham Study of Aging). Balanced numbers of African American and White, female and male, and rural and urban participants were recruited for the study. OR and NOR were negatively related to lifetime cigarette smoking and OR was positively related to leisure-time physical activity, even when controlling for sociodemographic characteristics and comorbidity. No measure of religiosity was related to the likelihood of being obese, and IR did not predict smoking or exercise. The authors suggest that faith-based communities may be important resources for delivering health promotion programs for older adults.

Death anxiety and religiosity among lithuanian health and social service professionals

This study examined the applicability of the Multidimensional Fear of Death Scale (MFODS; J.W.Hoetler, 1979a) in Lithuania, a culture where death anxiety has not been studied previously. It also ascertained the relationship between death anxiety and a multidimensional measure of religiosity. Confirmatory factor analysis indicated that MFODS structure fit the Lithuanian data reasonably well, particularly if factors were allowed to be correlated. Lithuanian participants who expressed higher levels of intrinsic religiosity also expressed less fear of the unknown, but no other independent, linear relationships existed among the various dimensions of religiosity and death anxiety.

Transportation Difficulty of Black and White Rural Older Adults

This study explores self-reported transportation difficulty among rural older adults, using data from the University of Alabama at Birmingham Study of Aging for community-dwelling participants (255 Black and 259 White) residing in rural areas. The authors examine the relationship of predisposing characteristics, enabling resources, and measures of need for care with self-reports of transportation difficulty. Blacks report having more transportation difficulty than Whites (24.7% vs. 11.6%; p < .05). When the authors introduce other variables, race differences disappear, but there is a race-by-income interaction with transportation difficulty. Whites with lower incomes are more likely to have transportation difficulty than Whites with higher incomes. When data from Blacks and Whites are analyzed separately, income is the only variable associated with transportation difficulty among Whites. Among Blacks, income is not related to transportation difficulty but several variables other than income (age, gender, marital status, Mini Mental State Exam scores, and depression) are.

Norms for employed daughters' and sons' behavior toward frail older parents

This study examined whether norms that concerning assisting frail older parents were different for daughters than for sons when the adult children are members of dual-earner couples. Data were gathered by telephone interviews from a probability sample of 315 adults residing in western Alabama. Of the 18 statements presented, statistically significant differences between the expectations for daughters and sons occurred in only three cases (help with housework, meal preparation, and yard work), suggesting substantial support for norms of equalitarianism. Further, there were few differences between the expectations held by females and by males for daughters and sons. Generally, the results suggested strong support for behaviors that facilitate the independent living of both adult children and their frail older parents.

Widowhood, religiousness and self-assessed well-being among older adults

ABSTRACT Background: The well-being of older, widowed persons is of concern to aging practitioners, including those in faith-based organizations. Some have suggested that engaging in religious/spiritual activities may mitigate the negative effects of widowhood for older adults. This cross-sectional study examined predictors of self-assessed well-being of widowed and married elders. The aim of this study was to determine whether participation in religious/spiritual activities mediated the relationship between marital status and well-being after controls were instituted. Method: This study is a secondary analysis of data collected for the National Opinion Research Centers 1998 General Social Survey. Analyses are based on 150 married and 120 widowed persons aged 60 or older. We regressed married/widowed status, demographic characteristics, self-reported health, and four measures of religious/spiritual activity on a fouritem index of self-assessed well-being. Results: Widowed elders reported lower levels of well-being than married elders, even after we controlled for sociodemographic characteristics, self-perceived health, and measures of religious/spiritual activity. Socioeconomic status (SES) and self-perceived health had positive relationships with well-being, and frequency of prayer had a negative relationship with well-being. Conclusion: Congregations wishing to improve well-being among widowed and married elders should consider focusing on ministries to improve financial well-being and health and advocacy for programs that benefit low income elders. Church-based programs targeting widowed elders should focus on positive religious coping and prayer.