Coping (enfrentamento) religioso/espiritual

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Abstract

CONTEXTO: O coping religioso/espiritual (CRE), pouco estudado no Brasil, está associado à saúde e à qualidade de vida (QV). OBJETIVO: Apresentar revisão de literatura sobre CRE, enfocando sua base teórica, avaliação e aplicação na prática clínica. MÉTODO: Pesquisa nas bases de dados Medline, PsycINFO, Scielo e Bireme/BVS entre 1979 e 2006. RESULTADOS: O CRE é o uso da religião, espiritualidade ou fé para lidar com o estresse. Estratégias de CRE, conforme conseqüências que trazem para quem as utiliza, podem ser classificadas como positivas ou negativas, estando geralmente associadas, respectivamente, a melhores ou piores resultados de saúde física/mental e QV. Evidências apontam que as pessoas utilizam CRE especialmente em situações de crise e, também, mais CRE positivo que negativo. Existem cinco estilos de CRE: autodireção, colaboração, delegação, súplica e renúncia. CONCLUSÕES: Instrumentos como RCOPE e Escala CRE podem ajudar na avaliação espiritual do paciente, na pesquisa e no planejamento de intervenções psicoespirituais enfocando o processo de CRE. Estas podem ser efetivas, ajudando os pacientes a mais bem utilizar um importante recurso disponível, com significativo impacto na saúde e na QV populacional, e reduzindos custos de intervenção em termos de saúde pública. Assim, o estudo do CRE mereceria ser incluído na formação dos profissionais da saúde.

Translated abstract

BACKGROUND: Spiritual/religious coping (SRC), little studied in Brazil, is associated to health and quality of life (QoL). OBJECTIVES: To present a literature review about spiritual/religious coping, focusing its theoretical background, assessment and clinical applications. METHODS: Research on Medline, PsycINFO, Scielo and Bireme/BVS databases between 1979-2006. RESULTS: The SRC is the use of religion, spirituality or faith to cope with stress. SRC methods, depending on the consequences that bring to those who use them, can be classified into positive or negative, generally associated to better or worse physical/mental health and QoL outcomes, respectively. Evidences show that people use SRC especially in crisis situations, and also, they use more positive than negative SRC. There are five SRC styles: self-directing, collaborative, deferring, pleading and surrender. CONCLUSIONS: Instruments as RCOPE and SRCOPE Scale can be helpful to patient’s spiritual evaluation, to researches and for planning psychospiritual interventions focused on the SRC process. Those can be effective in helping patients to better use an important available resource, with high impact on population’s health and QoL, and potential to reduce public health costs. So, SRC studies would deserve to be included in health professionals graduate courses.

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The many methods of religious coping: development and initial validation of the RCOPE.

Kenneth I. Pargament, Harold G. Koenig, Lisa Perez (2000)

The purpose of this study was to develop and validate a new theoretically based measure that would assess the full range of religious coping methods, including potentially helpful and harmful religious expressions. The RCOPE was tested on a large sample of college students who were coping with a significant negative life event. Factor analysis of the RCOPE in the college sample yielded factors largely consistent with the conceptualization and construction of the subscales. Confirmatory factor analysis of the RCOPE in a large sample of hospitalized elderly patients was moderately supportive of the initial factor structure. Results of regression analyses showed that religious coping accounted for significant unique variance in measures of adjustment (stress-related growth, religious outcome, physical health, mental health, and emotional distress) after controlling for the effects of demographics and global religious measures (frequency of prayer, church attendance, and religious salience). Better adjustment was related to a number of coping methods, such as benevolent religious reappraisals, religious forgiveness/purification, and seeking religious support. Poorer adjustment was associated with reappraisals of God's powers, spiritual discontent, and punishing God reappraisals. The results suggest that the RCOPE may be useful to researchers and practitioners interested in a comprehensive assessment of religious coping and in a more complete integration of religious and spiritual dimensions in the process of counseling.

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Religion and coping with serious medical illness.

Erik Larson, H Koenig, Peter Larson (2001)

To review and discuss some of the research published in the last several decades that has addressed the role that religion plays in helping patients cope with serious medical illness. Although this is not a systematic review of the literature, it provides a sampling of the studies that have examined the relationship between religious involvement, coping with illness, and health outcomes. This sampling of studies reflects the findings of a much larger systematic review of research (MEDLINE, Current Contents, Psychlit, Soclit, HealthStar, Cancerlit, CINAHL, and others) during the past century that was recently completed by the authors. Epidemiologic studies published in the English-language literature were reviewed and discussed. A number of well-designed cross-sectional and prospective studies have examined the relationship between religious beliefs and activities and adaptation to physical illness in patients with general medical conditions, neurologic disorders, heart disease, renal failure, AIDS, and a host of other physical disorders. This review demonstrates the widespread use of religion in coping with medical illness and provides circumstantial evidence for the possible benefits of this lifestyle factor. When people become physically ill, many rely heavily on religious beliefs and practices to relieve stress, retain a sense of control, and maintain hope and their sense of meaning and purpose in life. Religious involvement appears to enable the sick, particularly those with serious and disabling medical illness, to cope better and experience psychological growth from their negative health experiences, rather than be defeated or overcome by them.