Article Figures & Data
Tables
Item Peaceful
A reason for living
Your life has been productive
Peace of mind
Sense of purpose
Able to reach down deep into yourself for comfort
Sense of harmony within yourself
Demographic Number Missing n (%) Sex, female 2 237 (67) Race/ethnicity 3 non-Hispanic white 108 (31) Hispanic 207 (59) Black 22 (6) Other 13 (4) Marital status 3 Married 142 (40) Single 95 (27) Other 113 (32) Employment (full-time) 5 88 (25) Income 59 <$5,000 57 (16) $5,000–$19,999 118 (33) $20,000–$49,999 95 (27) ≥ $50,000 24 (7) Social class 27 II 2 (1) III 61 (17) IV 72 (20) V 191 (54) Age, mean years ±SD 20 42.6 ± 13.5 Chronic medical problems, mean No. ±SD 0 2.1 ± 2.0 Chronic medications, mean No. ±SD 9 2.1 ± 2.5 - Table 3.
Bivariate Biopsychosociospiritual Inventory Differences In Outcomes (Mean Scores)
Outcomes, n Physical Symptoms Psychological Symptoms Social Symptoms Spiritual Symptoms Impaired Functional Status Note: analyses determined by t tests. a P ≤.001. b P ≤.05 by Bonferroni correction. c P ≤.05. d P ≤.005. e P ≤.01. Any utilization Any emergency use No, n = 221 1.02 (0.93)a,b 1.58 (1.30)c 1.61 (1.34) 1.48 (1.35)c 1.48 (1.44)a,b Yes, n = 76 1.53 (1.03) 2.05 (1.39) 1.85 (1.49) 1.90 (1.49) 2.18 (1.56) Any specialist use No, n = 227 0.99 (0.90)a,b 1.56 (1.27)d 1.71 (1.36) 1.51 (1.37)c 1.46 (1.42)a,b Yes, n = 77 1.74 (1.14) 2.18 (1.49) 1.69 (1.51) 1.94 (1.52) 2.40 (1.65) Any mental health use No, n = 265 1.06 (0.93)a,b 1.51 (1.25)a,b 1.56 (1.35)a,b 1.39 (1.29)a,b 1.46 (1.38)a,b Yes, n = 49 1.79 (1.18) 3.07 (1.18) 2.49 (1.37) 3.03 (1.31) 3.10 (1.60) Any hospitalization No, n = 241 1.08 (0.99)c 1.69 (1.32) 1.68 (1.37) 1.59 (1.41) 1.57 (1.50)d Yes, n = 87 1.40 (1.03) 1.79 (1.38) 1.80 (1.44) 1.83 (1.42) 2.20 (1.56) Extreme utilization Frequent primary care use ≤ 4 Visits, n = 260 1.01 (0.91)a,b 1.63 (1.29)a,b 1.66 (1.36) 1.55 (1.40)e 1.51 (1.43)a,b >4 Visits, n = 28 2.10 (1.07) 2.58 (1.65) 2.03 (1.51) 2.29 (1.41) 3.04 (1.53) Frequent ambulatory use ≤ 8 Visits, n = 252 1.02 (0.91)a,b 1.58 (1.29)a,b 1.64 (1.37) 1.50 (1.36)d 1.45 (1.36)a,b >8 Visits, n = 27 1.86 (1.05) 2.70 (1.46) 2.00 (1.51) 2.32 (1.54) 3.35 (1.67) Polypharmacy ≤ 5 Medications, n = 307 1.08 (0.96)a,b 1.67 (1.32)a,b 1.67 (1.38)e 1.61 (1.43)e 1.56 (1.47)a,b >5 Medications, n = 37 2.17 (1.12) 2.75 (1.31) 2.31 (1.24) 2.29 (1.41) 3.09 (1.46) Satisfaction Fair-poor health status No, n = 180 0.74 (0.72)a,b 1.16 (1.08)a,b 1.29 (1.24)a,b 1.05 (1.11)a,b 1.04 (1.21)a,b Yes, n = 159 1.80 (1.08) 2.43 (1.30) 2.23 (1.39) 2.39 (1.41) 2.61 (1.47) Positive quality-of-life No, n = 54 1.92 (1.06)a,b 3.03 (1.22)a,b 2.55 (1.38)a,b 3.10 (1.22)a,b 3.21 (1.45)a,b Yes, n = 228 1.01 (0.89) 1.40 (1.18) 1.52 (1.29) 1.29 (1.23) 1.38 (1.34) Life lacking meaning Never, n = 149 0.90 (0.93)a,b 1.25 (1.24)a,b 1.35 (1.28)a,b 1.02 (1.25)a,b 1.16 (1.32)a,b At least sometimes, n = 183 1.39 (1.02) 2.17 (1.28) 2.04 (1.40) 2.24 (1.34) 2.22 (1.55) Model Any Emergency Use Any Specialist Use Any Mental Health Use Any Hospitalization Note: Adjusted for age, sex, socioeconomic status, race/ethnicity (black), employment (full-time), married. HL P = Hosmer-Lemeshow P value. a P ≤.01. b P ≤.001. c P ≤.005. d P ≤.05. e P ≤.1. Model 1 Number of problems 0.283a 0.271a 0.563b 0.277c R2 (P) .100 (.136) .158 (.009) .268 (.000) .122 (.029) HL P .445 .424 .540 .882 Model 2 Number of problems 0.175 0.174 0.444c 0.218d Impaired functional status 0.372d 0.327d 0.520a 0.175 R2 (P) .148 (.035) .196 (.003) .336 (.000) .134 (.029) HL P .526 .442 .786 .275 Model 3 Number of problems 0.172 0.126 0.498c 0.246d Impaired functional status 0.255 0.226 0.379 0.413d Symptoms Physical 0.364 0.511e −0.333 0.302 Psychological −0.146 −0.045 0.259 −0.804c Social 0.034 −0.364e −0.112 −0.167 Spiritual 0.102 0.032 0.694d 0.210 R2 (P) .164 (.101) .249 (.002) .429 (.000) .232 (.002) HL P .918 .358 .510 .428 Model 4 Number of problems 0.198 0.116 0.508c 0.249d Impaired functional status 0.269 0.124 0.329 0.455d Symptoms Physical 0.412 0.319 0.131 0.598 Psychological −0.106 0.882d 1.310e −1.051a Social 0.332 −1.082a −0.328 0.033 Spiritual 0.586 0.269 0.744 0.359 Symptom Interactions Physical-spiritual 0.000 0.004 0.002 −0.002 Psychological spiritual −0.002 −0.018d −0.006 0.005 Social-spiritual −0.003 0.005e 0.001 −0.002 R2 (P) .183 (.141) .314 (.000) .434 (.000) .252 (.004) HL P .350 .004 .610 .536 Model Frequent Primary Care Use Frequent Ambulatory Use Polypharmacy Note: Adjusted for age, sex, socioeconomic status, race/ethnicity (black), employment (full-time), married. HL P=Hosmer-Lemeshow P value. a P ≤.005. b P ≤.001. c P ≤.05. d P ≤.01. e P ≤.1. Model 1 Number of problems 0.492a 0.647b 0.810b R2 (P) .199 (.109) .299 (.002) .472 (.000) HL P .272 .494 .690 Model 2 Number of problems 0.436c 0.561b 0.769b Impaired functional status 0.342 0.694d 0.394 R2 (P) .227 (.098) .394 (.000) .496 (.000) HL P .912 .853 .982 Model 3 Number of problems 0.456c 0.580a 0.833b Impaired functional status 0.083 0.709c 0.083 Symptoms Physical 1.370c 0.323 0.135 Psychological −0.237 −0.503 0.363 Social −0.021 −0.277 0.389 Spiritual −0.477 0.378 0.003 R2 (P) .327 (.072) .419 (.001) .546 (.000) HL P .784 .717 .994 Model 4 Number of problems 0.457c 0.691a 1.047b Impaired functional status 0.286 0.815c −0.007 Symptoms Physical 2.135e −0.113 −0.338 Psychological 0.038 0.227 0.323 Social 0.917 0.611 1.773c Spiritual 1.780 1.861e 0.860 Symptom interactions Physical-spiritual −0.006 0.002 0.003 Psychological-spiritual −0.008 −0.016 −0.001 Social-spiritual −0.010e −0.007 −0.009c R2 (P) .413 (.045) .475 (.001) .594 (.000) HL P .951 .954 .817 Model Fair-Poor Health Status Positive Quality of Life Life Lacking Meaning Note: Adjusted for age, sex, socioeconomic status, race/ethnicity (black), employment (full-time), married. HL P = Hosmer-Lemeshow P value. a P ≤ .001. b P ≤ .05. c P ≤. .1. d P ≤ .005. e P ≤ .01. Model 1 Number of problems 0.422a −0.676a 0.194b R2 (P) .214 (0.000) .479 (0.000) .103 (0.046) HL P 0.180 0.712 0.929 Model 2 Number of problems 0.215c −0.540a −0.017 Impaired functional status 0.610a −0.601d 0.618a R2 (P) .325 (.000) .545 (.000) .231 (.000) HL P .360 .933 .982 Model 3 Number of problems 0.201 −0.717d 0.005 Impaired functional status 0.061 0.115 0.445b Symptoms Physical 1.149a −1.047b −0.059 Psychological −0.144 0.140 −0.051 Social 0.079 0.096 0.003 Spiritual 0.654d −1.373d 0.567e R2 (P) .503 (.000) .725 (.000) .306( .000) HL P .722 .734 .263 Model 4 Number of problems 0.209 −0.766d 0.041 Impaired functional status 0.085 −0.012 0.464b Symptoms Physical 1.552a −1.849c 0.277 Psychological −0.149 1.902b −0.189 Social 0.075 −1.003 0.407 Spiritual 0.837b −1.090 1.214a Symptom interactions Physical-spiritual −0.003 0.006 −0.003 Psychological-spiritual 0.001 −0.027b 0.002 Social-spiritual 0.000 0.006 −0.004b R2 (P) .511 (.000) .759 (.000) .345 (.000) HL P .725 .690 .642
Additional Files
The Article in Brief
Impact of Spiritual Symptoms and Their Interactions on Health Services and Life Satisfaction
David A. Katerndahl
Background Physical, psychological, and social factors all contribute to health. This study asks whether spiritual factors are related to health as well, looking not only at spiritual symptoms alone, but also at their interaction with physical, psychological, and social symptoms.
What This Study Found Spiritual symptoms (alone or in interaction with other factors) are related to seven of ten measurements of health used in this study. Life satisfaction is associated with both physical and spiritual symptoms.
Implications
- Spiritual symptoms, alone and in interaction with other factors, contribute to our understanding of health.
- This study confirms the complex relationship between spiritual, physical, psychological, and social symptoms of health.
- When attempting to understand why patients with poor quality of life use high levels of medical services, clinicians should inquire about spiritual issues.
