TY - JOUR
T1 - Impact of spiritual symptoms and their interactions on health services and life satisfaction
AU - Katerndahl, David A.
N1 - Funding Information:
Funding support : This study was supported by the Texas Academy of Family Physicians Foundation.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2008
Y1 - 2008
N2 - PURPOSE: Recent work suggests that the biopsychosocial model should be expanded to include the spiritual dimension as well. The purpose of this study was to assess the independent effects of spiritual symptoms and their interactions with biopsychosocial symptoms on health care utilization, extreme use of services, and life satisfaction among primary care patients. METHODS: Three hundred fifty-three adult waiting room patients at 2 primary care clinics completed the Biopsychosociospiritual Inventory (BioPSSI) as well as measures of life satisfaction and health care use. Hierarchical logistic regression analysis was performed with each outcome to determine whether adding spiritual symptoms and their interaction terms better accounted for outcomes than demographics, functional status, and chronic medical problems alone. RESULTS: Spiritual symptoms (alone or in interaction) were associated with 7 of the 10 outcomes and were particularly important to extreme use of health care services and life satisfaction. Among best-fit models, spiritual symptoms alone were significantly associated with any mental health use (β = 0.694, P ≤.05), fair-poor health status (β = 0.837, P ≤.05), and life lacking meaning (β = 1.214, P ≤.001). CONCLUSIONS: This study has shown the relevance of spiritual symptoms and their interactions to understanding health outcomes. Extreme utilization outcomes were related to the number of chronic problems, as well as to the social-spiritual interaction. Satisfaction outcomes were associated with physical and spiritual symptoms. These findings may have important implications for providing comprehensive, outcome-based care, as well as for modeling of research findings.
AB - PURPOSE: Recent work suggests that the biopsychosocial model should be expanded to include the spiritual dimension as well. The purpose of this study was to assess the independent effects of spiritual symptoms and their interactions with biopsychosocial symptoms on health care utilization, extreme use of services, and life satisfaction among primary care patients. METHODS: Three hundred fifty-three adult waiting room patients at 2 primary care clinics completed the Biopsychosociospiritual Inventory (BioPSSI) as well as measures of life satisfaction and health care use. Hierarchical logistic regression analysis was performed with each outcome to determine whether adding spiritual symptoms and their interaction terms better accounted for outcomes than demographics, functional status, and chronic medical problems alone. RESULTS: Spiritual symptoms (alone or in interaction) were associated with 7 of the 10 outcomes and were particularly important to extreme use of health care services and life satisfaction. Among best-fit models, spiritual symptoms alone were significantly associated with any mental health use (β = 0.694, P ≤.05), fair-poor health status (β = 0.837, P ≤.05), and life lacking meaning (β = 1.214, P ≤.001). CONCLUSIONS: This study has shown the relevance of spiritual symptoms and their interactions to understanding health outcomes. Extreme utilization outcomes were related to the number of chronic problems, as well as to the social-spiritual interaction. Satisfaction outcomes were associated with physical and spiritual symptoms. These findings may have important implications for providing comprehensive, outcome-based care, as well as for modeling of research findings.
KW - Delivery of health care
KW - Health care delivery
KW - Health status
KW - Mental health
KW - Quality of life
KW - Spirituality
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U2 - 10.1370/afm.886
DO - 10.1370/afm.886
M3 - Article
C2 - 18779545
AN - SCOPUS:54349127576
VL - 6
SP - 412
EP - 420
JO - Annals of Family Medicine
JF - Annals of Family Medicine
SN - 1544-1709
IS - 5
ER -