Devon M. Berry

Methodological pitfalls in the study of religiosity and spirituality.

The number of studies demonstrating a relationship between religiosity and spirituality and physical and psychological health have increased rapidly during the past decade. There are significant disputes in the literature regarding the methodological quality of research in this area. Despite nursing scholars’ interest in this area, no thorough review of the methodological critiques is available. The purpose of this study is to review areas of methodological difficulty in the study of religiosity and spirituality by identifying contemporary methodological critiques, critically evaluating the critiques and the underlying issues, and making suggestions for methodological advancement in the field. Three main areas of methodological critique exist: construct measurement, study design, and data analysis. Research in this area should aim for conceptual clarity, deliberate design, and appropriate analysis. Considerations of these critiques are instructive for nursing research done in the area of religiosity and spirituality.

The relationship between depression and emerging adulthood: theory generation.

Depression during the transition from late adolescence to young adulthood is a major mental health concern. Developmental theories addressing this transition, also called emerging adulthood, are few, and fewer yet are theories addressing mental health or psychopathology during this period. This article establishes the legitimacy of emerging adulthood as a unique developmental period and attempts to generate directions for theory development by merging theories of depression and development at the point of emerging adulthood. This article concludes with a theoretical discussion and application of this process in research and practice.

Measuring Religiosity/Spirituality in Diverse Religious Groups: A Consideration of Methods

Minority religious groups continue to grow in the United States, and traditional religious groups are becoming more diverse. The purpose of this paper is to detail the methodology of the measure adaptation and psychometric phase of an ongoing study that is designed to describe the relationship between R/S, emotional extremes, and risk behaviors in Christian, Jewish, and Muslim high school students as they transition to college. Unique challenges associated with measurement, recruitment, and research team dynamics were encountered. These challenges and possible solutions are discussed in the context of conducting research that focuses on religious minority groups.

Spirituality and Uncertainty at the End of Life

PURPOSE/OBJECTIVES To examine the theoretical congruency between uncertainty and spirituality at the end of life (EOL). DATA SOURCES Relevant empirical and theoretical articles using the key words spirituality, uncertainty, terminal illness, and similar derivatives were drawn from the databases of CINAHL®, MEDLINE®, PsycINFO, and SocINDEX. DATA SYNTHESIS Spirituality and uncertainty were compared for theoretical congruency based on five general categories: prevalence, temporality, interpretation, quality, and directionality. The categories were drawn from the uncertainty literature and looked at the ability of spirituality and uncertainty to contribute to or detract from health. CONCLUSIONS This article presents an innovative way of viewing how spirituality is experienced at the EOL. The likelihood that uncertainty and spirituality can coexist as a simultaneous and even blended construct that influences the EOL is supported and warrants additional exploration. IMPLICATIONS FOR NURSING Health professionals must recognize the prevalence of spiritual uncertainty in the lives of their patients and understand the need to frequently assess for spiritual uncertainty. Specific recommendations are provided to guide professionals in addressing spiritual uncertainty with patients.

Risk, religiosity, and emerging adulthood: description of Christian, Jewish, and Muslim university students at entering the freshman year

American students transitioning to university are at an increased risk for behaviours such as binge drinking, depression and suicidality. Despite the proliferation of prevention and intervention programs, rates remain high. Although religiosity is known to confer a protective effect in this population, it remains largely untapped as a resource because, among other reasons, it is poorly understood, poses ethical challenges, and exposes areas of distrust between the religious and medical establishments. This report describes the findings of a survey that examined possible factors explaining the relationship between religiosity, risky behaviours and emotional extremes in students as they transitioned into their first year of university. This study accounted for the religious diversity of the US by surveying Christian, Jewish, Muslim and religiously unaffiliated students. Findings indicated that religiosity was consistently and negatively correlated to risky behaviours across all faith groups. Interestingly, unique patterns in levels of religiosity emerged among the various faith groups. Similarly, patterns of engagement in risky behaviours demonstrated variation among religious groups. Our findings add to the body of evidence that suggests university-based professionals take into consideration student religiosity when creating prevention intervention programs for students.

Factors Affecting Community Participation in the CDTI Program in Morogoro, Tanzania

BACKGROUND Up to 4 million people in Tanzania are at risk for the parasitic disease onchocerciasis. A treatment program, Community-Directed Treatment with Ivermectin (CDTI), has made significant gains in prevention and treatment. Understanding factors affecting participation could help boost treatment coverage and sustain gains made in controlling onchocerciasis in endemic areas. PURPOSE To explore community-perceived factors related to participation in and sustainability of the CDTI program in southwest Tanzania. METHODS Multilevel triangulation design using surveys, focus group discussions (FGDs), and semistructured interviews to collect data in two villages in the Morogoro Rural District of Tanzania. In total, 456 villagers participated in the survey and 42 in FDGs. Five community-directed distributors (CDDs) and three community health workers were interviewed. FINDINGS High levels of awareness of onchocerciasis (90%) and methods of prevention and treatment (95%) were reported. Over 75% of participants knew how ivermectin was distributed and 74% have taken the drug. Over 90% of villagers knew that distribution of the drug was for treatment and prevention. Only 43% knew the cause of onchocerciasis. Through FGDs, villagers reported barriers to participation, including lack of comprehensive understanding of the disease, fears of medication, distrust of the method determining dose, lack of health education materials, insufficient CDD-resident communication, and inflexible drug distribution mechanisms. CONCLUSIONS Sustaining programs without supporting growth of CDDs and reinforcing education of communities could lead to a decrease in treatment and an increase in the public health threat. This research uncovered a need for more effective community education and sensitization. CLINICAL RELEVANCE Understanding barriers to participation in community-based programs can assist public health and community health nurses and key stakeholders including Ministries of Health and local and regional health systems in the development of education and support materials to enhance health literacy and encourage program participation.

Clustering Countries to Evaluate Health Outcomes Globally

Clustering countries based on health outcomes is a useful technique for assessing global health disparities. However, data on country-specific indicators of health outcomes are inconsistent across databases from different sources, such as World Bank, WHO, and UNICEF. The new database on under-five child mortality from the Institute for Health Metrics and Evaluation advances information about child mortality by showing both country-level estimates and confidence intervals. We used the new database for child mortality and WHO data for HALE from 160 countries to identify country clusters through model-based clustering techniques. The four clusters in 2000 and six in 2003, within levels of uncertainty, showed nonlinear distributions of health outcomes globally, indicating that no single trajectory for progression is evident. We propose the use of country clusters in further study of societal conditions that contribute to health outcomes and changes over time.

Caritas and job environment: a replication of Persky et al.

Abstract The purpose of this study was to replicate and expand on Persky, Nelson, Watson, and Bent (2008) study of characteristics related to nurses who were effective in Watson’s Caritas framework. Previous research suggests that poorer work environments are associated with higher levels of caring. This surprising finding warrants further investigation. Registered nurses were recruited from a mid-sized community-based hospital in the Midwest portion of the United States of America (N = 20). Each completed the health environment survey (HES). Ten patients that had received primary care from the nurse completed the caring factors survey (CFS). Two hundred nurse/patient dyads were used to determine the relationship between the CFS and HES. Six of the 13 HES scales were positively associated with CFS scores. As nurses’ positive perceptions of the work environment increased, patients’ perceptions of caring increased. Our findings contrast Persky et al.’s. Further research is needed examining factors influencing the relationship between job environment and patient perceptions of caring.