49ABSTRACT BACKGROUND Religion and spirituality remain important social and psychological factors in the lives of older adults, and there is continued interest in examining the effects of religion and spirituality on health status. The purpose of this study was to examine the interaction of religion and spirituality with self-reported health status in a community-dwelling geriatric population.
METHODSWe performed a cross-sectional analysis of 277 geriatric outpatients participating in a cohort study in the Kansas City area. Patients underwent a home assessment of multiple health status and functional indicators by trained research assistants. A previously validated 5-item measure of religiosity and 12-item spirituality instrument were embedded during the fi nal data collection. Univariate and multivariate analyses were performed to determine the relationship between each factor and self-reported health status.
RESULTSIn univariate analyses, physical functioning (P <.01), quality of life (P <.01), race (P <.01), depression (P <.01), age (P = .01), and spirituality (P <.01) were all associated with self-reported health status, but religiosity was not (P = .12). In a model adjusted for all covariates, however, spirituality remained independently associated with self-appraised good health (P = .01).CONCLUSIONS Geriatric outpatients who report greater spirituality, but not greater religiosity, are more likely to appraise their health as good. Spirituality may be an important explanatory factor of subjective health status in older adults.
INTRODUCTIONT here is continued interest in examining the interaction of religion and spirituality with health-related outcomes.1 Although health status has been one outcome of interest, a research review found an inconsistent relationship between measures of religiosity and subjective health status, limited by a failure to control for known covariates of health status.2 It is possible that functional status is predictive of both religious service attendance and health status, which suggests one potential confounding factor.3 In addition, although multiple studies have examined the association between religion and self-reported health, 2 none have explored the relationship among religion, spirituality, and health status.Religion and spirituality are important social and psychological factors in the lives of older adults, 4 and the examination of self-reported health status is a key component of aging research. Global measures of self-rated health are independent predictors of mortality, even after adjusting for other such covariates as social and demographic factors and health behaviors. 5 In elderly persons self-ratings of health are strongly associated with changes in functional status over time, and those who report poor health are at increased risk for declines in their physical functioning.6 Health status, despite variations in how it is measured, has also repeatedly been shown to be the best predictor of health service utilization. In studies that examine health-related outcom...