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Salud mental

Print version ISSN 0185-3325

Salud Ment vol.30 n.1 México Jan./Feb. 2007

 

Artículos originales

Medidas de afrontamiento religioso y espiritualidad en adultos mayores mexicanos

Armando Rivera-Ledesma* 

María Montero-López Lena* 

* Facultad de Psicología, División de Estudios de Posgrado, Universidad Nacional Autónoma de México, Ciudad Universitaria. E-mail: monterol@servidor.unam.mx; armandoriveral@aol.com


Resumen:

La vida espiritual parece jugar un importante papel en el afrontamiento del estrés y el mantenimiento de la salud en la adultez mayor. Se ha documentado que cuando la espiritualidad forma parte de la personalidad, tiende a expresarse en las estrategias de afrontamiento religioso con un impacto positivo en la salud al ser éstas utilizadas eficientemente contra el estrés. Se han destacado dos aproximaciones generales al estudio del afrontamiento religioso: a) las formas específicas de afrontamiento (como el perdón, la purificación y la confesión, etc.) y b) los patrones de afrontamiento, como el afrontamiento religioso positivo y el afrontamiento religioso negativo; el primero, asociado a mejores parámetros de salud que el segundo. Pargament y cols., han incluido estos patrones de afrontamiento en la Escala de patrones positivos y negativos de métodos de afrontamiento religioso (Brief-RCOPE).

La presente investigación evaluó la validez y confiabilidad de la escala de afrontamiento religioso (Brief-RCOPE) propuesta por Pargament y cols. en dos muestras de adultos mayores residentes de la Ciudad de México elegidas por disponibilidad en dos clínicas de salud. Adicionalmente, a fin de ampliar nuestro conocimiento sobre las características del afrontamiento religioso y la vida espiritual de los adultos mayores mexicanos, este trabajo exploró la existencia de diferencias significativas en dichas variables en función del sexo, edad, nivel educativo, religión, situación marital y laboral. La investigación incluyó: 1. información socio-demográfica; 2. la Escala de patrones positivos y negativos de métodos de afrontamiento religioso, Brief-RCOPE con dos sub-escalas (afrontamiento religioso positivo y afrontamiento religioso negativo), 3. la sub-escala de afrontamiento religioso ante la soledad, ARS, del Inventario multifásico de soledad, IMSOL y 4. la sub-escala de relación con Dios de la Escala de bienestar espiritual, EBE.

Los resultados permitieron concluir que los instrumentos utilizados poseen una adecuada consistencia interna calculada mediante el alfa de Cronbach; con excepción de la sub-escala de afrontamiento religioso negativo que podría requerir mayor investigación. El Brief-RCOPE Positivo obtuvo una adecuada validez convergente al compararlo con la Escala de Afrontamiento religioso ante la soledad, y la sub-escala de relación con Dios. Contrariamente y de manera consistente con los resultados de los autores, el Brief- RCOPE Negativo no se asoció significativamente con las otras escalas, pero obtuvo una asociación conservadora con una medida compuesta por dos reactivos de la sub-escala de relación con Dios del EBE, que parece evaluar específicamente la insatisfacción en la relación con Dios.

El análisis factorial de componentes principales con rotación varimax permitió conformar la estructura de la sub-escala de afrontamiento religioso positivo, la escala de Afrontamiento religioso ante la soledad, y la sub-escala de relación con Dios del EBE que arrojó dos componentes que parecen medir respectivamente una relación satisfactoria, y una relación insatisfactoria con Dios. El análisis de la existencia de diferencias significativas en la variables sociodemográficas arroja hallazgos concordantes con los de otras investigaciones realizadas en México, aportando evidencia empírica sobre la manera en que viven los adultos mayores mexicanos su vida espiritual.

Palabras clave: Afrontamiento religioso; espiritualidad; adultos mayores; soledad

Summary:

Spiritual life seems to play an important role in coping with stress in older adults. Spiritual life has been documented to have a positive effect on the sense of personal wellbeing in seniors and it has been inversely related to depression, to low levels of loneliness and psychopathology measured by MMPI-2. It has been documented that, when spirituality forms part of the subject’s personality it tends to be expressed in his/her religious coping strategies and to have a positive impact on his/her health when these strategies are effectively used against stress during hospitalization and illness and against losses common in older age that are associated with depression.

Two general approaches to the study of religious coping have been emphasized: a) the specific ways of coping, in which religious coping is a multidimensional phenomenon, which may include forgiveness, purification and confession, spiritual support, etc.; b) the study of coping patterns. The second approach includes religious coping methods and the patterns of interrelation they involve. Pargament et al. have distinguished between positive religious coping and negative religious coping; the former leads the individual towards productive and efficient spiritual coping associated with better health indicators than the negative coping strategy. According to the authors above mentioned, positive religious coping includes methods such as benevolent religious appraisal, collaborative religious coping and seeking spiritual support, seeking the support of clergy and church members, religious help and religious forgiveness. Negative religious coping includes methods such as punishing religious reappraisal, demonic religious appraisal, the reappraisal of the power of God, spiritual discontent, self directed religious coping, and interpersonal religious discontent. Pargament et al. have included these coping patterns in the Scale of Positive and Negative Patterns of Religious Coping Methods (Brief-RCOPE).

Our research was aimed at identifying the validity and reliability of the religious coping scale (Brief-RCOPE) proposed by Pargament et al. in two samples of older adults living in Mexico City and selected according to availability in two health clinics. Additionally, with the objective of gaining greater knowledge of the characteristics of religious coping and the spiritual life of older Mexican adults, our research explored the possible existence of significant differences in the above mentioned variables regarding sex, age, education and religious denomination, marital and employment status. The subjects answered a questionnaire containing 37 questions with dichotomic multiple choice answers (likert type) which included: 1) demographic information; 2) the Positive and Negative Methods of Religious Coping Scale, Brief- RCOPE, with two subscales (positive religious coping and negative religious coping); 3) the subscale of Religious Coping when Confronting Loneliness, ARS, from the Loneliness Multiphase Inventory, IMSOL; and 4) the subscale of the Relationship with God from the Spiritual Wellbeing Scale, EBE.

The results obtained allowed us to conclude that the tools that were used have adequate internal consistency which we obtained by calculating Cronbach’s alpha coefficient; however, the negative religious coping subscale gave conservative results that may indicate the need for further investigation. A significant association between the positive Brief-RCOPE, Religious Coping when confronted with loneliness and the subscale of Relationship with God was found, which supports the convergent validity of the first subscale.

On the contrary, and in a way consistent with the results of the authors negative Brief-RCOPE was not significantly associated with the other scales, but had a conservative association with regard to a measurement consisting of two items in the Relationship with God subscale. These items seem to specifically evaluate the dissatisfaction of the individual in his/her relationship with God.

We calculated the factorial structure of the tools through the analysis of major components with varimax rotation of eigenvalues greater than 1: For Brief-RCOPE it was only possible to confirm a well defined structure representing 49.5% of the variance explained with an internal consistency of α=.82 and which corresponded to positive religious coping. The Scale of Religious Coping when confronted with loneliness maintained a solid structure based on only one component which explained the 70.2% variance, according to the expectations of the author, with an internal consistency of α=.91. The EBE subscale of the Relationship with God presented two clearly defined components, which explained the 59.3% variance. The first component seems to evaluate a satisfactory relationship with God, whereas the second one seems to indicate an unsatisfactory one.

In analyzing the socio-demographic variables, we found that the tendency to cope with feelings of loneliness through greater closeness with God was more frequent among women ( X=18.46) than among men ( X=16.47; t=2.04, p=.04). On the other hand, Religious Coping, when confronted with loneliness, seems so show a relationship that changes with the number of years of schooling: the higher the educational level, the less this coping strategy was used (elementary school, =18.66; middle school, X=17.71; high school, X=17.55; college, X=14.61; F=3.252, p=.024). Meanwhile, those subjects who were in a relationship (either married or living with their partner) tended to resort to religious coping to a lesser extent (Positive Brief-RCOPE, =19.29, ARS, X=16.72), than single people (single, widowed, separated or divorced) did (Positive Brief-RCOPE, =21.44, t=2.203, p=.030; ARS, =18.85, t=2.249, p=.026.) Finally, we compared the largest religious groups -Catholics and Christians- and we found that the latter turn more frequently to religious coping when confronted with loneliness ( X=20.45) than Catholics do ( X=17.30; t=2.667, p=.017). On the other hand, traditional christian denominations relate to God more frequently ( X=40.27) than Catholics do ( X=37.35; t=2.345, p=.032).

Results reported here significantly attest to the psychometric qualities of the tools utilized. However, the negative coping subscale appears to call for further research. The IMSOL Religious Coping subscale proved to have the best psychometric properties, as regards internal consistency, validity and factorial structure for its use in research protocols dealing with older Mexican adults. Although EBE’s Relationship with God subscale resulted in two clearly defined components instead of one, it was also shown to have psychometric qualities that make it useful for research.

The analysis of the significant differences that exist in sociodemographic variables shows findings that are consistent with other research carried out in the Mexican context. The results obtained give empirical evidence on the way older Mexican adults live their spiritual life. Although the results described herein cannot be generalized, since they are not based on a random sample they contribute data that is consistent with other research.

Key words: Religious coping; spirituality; older adults; loneliness

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