Enfrentamento religioso-espiritual em pacientes com doença pulmonar obstrutiva crônica: estudo comparativo com cardiopatas e indivíduos saudáveis

Abstract

BACKGROUND: COPD patients have impairments in several aspects of their lives such as daily life activities, social relationships, sexual activity, leisure and professional life. Religiosity and spirituality are coping strategies that can be useful as outcome predictors in physical and mental health for chronic illness such as copd, although its shortage in scientific literature. AIMS: This transversal multicentric study aimed to assess spirituality as well as religiosity through two validated scales: The Duke Religious Index (DUREL) and Brief R-cope Scale in stable COPD outpatients in two hospitals located in Fortaleza-Ceará from February 2014 to February 2016. METHODS: 100 patients enrolled the study. They were assessed to general health, respiratory functional tests, health related quality of life, religiousity and spirituality. RESULTS AND DISCUSSION: Mean age was 67,3±6,8 years, 54% were male, mean FEV1 was 45,49±12,60, 77% were catholic, 68% were literate, 67% were married/stable union. CAT mean result was 18,6±8,2. PHQ-9 mean score was 9,03±5,83. Mean physical summary score was 39,25±15,28. Mean mental summary score was 51,28±11,83. Six-minute walk distance was 368,5±76,12 meters. Concerning organizational religiosity, 65% of the sample went to church/temple at least once a week. 99% of the patients used to perform home-based religious activities such as prayers, Reading, meditation and religous tv/radio broadcast shows. 100% of the sampled believed God’s presence in their lives (intrinsic religiosity). Regarding religious/spiritual coping (CRE) assessed through brazilian version of the Brief R-cope scale, mean CRE(+) score was 27,17±1,6 and CRE(-) score was 8,21±2,12. COPD patients use more positive strategy to tackle the disease (p = 0.01). Women tend to use more positive aspect of the CRE than men (p = 0.02). By correlating the spirituality with the sample data we observe that CRE negative strategy correlated with disease severity as assessed by 6MWT (r = -0.3 p <0.05). we also found a direct relationship between CRE (-) with psychological struggle, as measured by PHQ-9 (r = 0.2 p <0.03). This was a cross-sectional study no cause and effect relationship was estabilished. Patients were derived from tertiary care institutions, it is not possible to generalize findings for primary care patients. CONCLUSIONS: No gender difference in religiosity was found. Negative religious coping was less common in the sample, although it has had significant implications for outcomes such as severity of the disease and psychological distress. Those who attended religious institution at least once a week have better quality of life and use less negative aspects of religious/spiritual coping (CRE)