Introduction

Aging should always be seen as a natural and normal process experienced by human beings ¹ and is both a social and demographic reality throughout the world ². Currently, life expectancy has increased and the fertility rate has decreased, which has triggered a rapid increase in the elderly population, more than in any other age group ³; in addition, the World Health Organization mentions that the number of elderly will increase from 12 to 22% by the year 2050 ⁴, of which 65% will live in middle and low-income countries ⁵.

The increase in life expectancy provides great opportunities for the elderly, for their families and for society ⁶, that is mainly determined by a healthy aging of the individual; thus, it is conducive to an active person and continue contributing to society, and above all, in those additional years of life the individual could undertake new personal activities ^6,7,8. However, the use of those opportunities is determined by their physical condition, given that if the elderly are in good health and have a favorable environment, they will be able to carry out beneficial activities, but if they do not have a good quality of life, their contributions to society will be negative ^5,6,9.

This change of demographic and epidemiological transition has a great influence on indigenous peoples or communities, since it changes the ways of observing and caring for the elderly; likewise, the quality of life of the elderly has been modified ¹⁰. In Mexico, the 2015 Intercensal Survey documented that there are more than 60 indigenous communities, representing 12,025,947 indigenous people who live according to their cultural beliefs, history, and traditions, of whom 1,247,673 ¹¹ are 60 years of age or older. The indigenous peoples with the largest number of elderly people are the Nahuatl, Maya, Zapotec, Mixtec, Otomi and Totonac ^10,12.

Indigenous communities are socially classified as living in areas of poverty and marginalization ¹³. Indigenous populations have their own habits and customs, i.e., they have cultural aspects that differentiate them from other population groups; this regulates the way they see, understand and interact with the world. That is, it is the way they act, dress, eat, and celebrate festivities, among other things, which has a direct impact on the context of health and disease ^14,15.

It is documented that the quality of life of the elderly is a complex ^16,17, multidimensional ¹⁸ and subjective ¹⁹ term, and is directly determined by the physical and social environments where they evolve, such as the homes and communities to which they belong; in addition, it is also determined by the personal characteristics of the individual, such as family, gender and ethnicity, unfortunately this gives rise to social inequities ^14,20. At present, quality of life will be expressed through the interpretation of well-being and the operation of each individual ¹⁹.

The WHO defines quality of life as "the perception that individuals have of their place in life, in the context of their culture and value system, and regard to their goals, expectations, rules and concerns". This perception is influenced by the individual's physical health, psychological state, level of independence, social relationships and their relationship with the environment ^20,21.

This research performed at an indigenous community in the northeast portion of the state of Guanajuato, Mexico, is a first approach to this topic, since there is not enough scientific evidence to indicate whether there is a relationship between religious beliefs and the quality of life of the elderly. This could be a basis for future research on these variables, and in the future, nursing interventions focused on determinants of health in these indigenous peoples could be developed. The objective of this research was to determine the relationship between religious beliefs and the quality of life of the elderly in an indigenous community.

Methodology

It is a quantitative and correlational study with cross-sectional design, which was conducted in an indigenous community in the northeast portion of the state of Guanajuato, Mexico, during the months of January to June 2019. The sample was calculated using the EPI INFO software, with a reliability of 95% and an expected frequency of 60%, with a total population of 57 adults over 60 years of age in the community, resulting in a sample of 49 randomly selected participants. Eligibility criteria were: older adults of both sexes, living in the community, who were aware of their religious beliefs and were active practitioners of these beliefs. The variables studied were quality of life and religious beliefs, which were studied using a data instrument containing socio-demographic data, the WHOQOL-BREF instrument composed of four dimensions, that is, physical health, psychological health, social relationships and the environment ²², and the SBI-15R Belief System Inventory composed of two factors, namely, religious conviction and religious social support ²³. Informed consent was obtained from the participants, respecting the Regulations of the General Health Law on Health Research in Mexico ²⁴, and was submitted for approval by the Ethics and Research Committee of the School of Nursing of the University with registration number 2019/ELEUAC/004.

Descriptive statistics were used for socio-demographic variables, such as mean and standard deviation for numerical variables; frequency (f) and percentage (%) for categorical variables. Pearson's correlation coefficient was used to determine the relationship between the variables, establishing a significance level of p<0.05.

Results

The mean age of the participants was 73.3 years, SD = 7.7, 63% were female, 96% were Catholics, 49% had no formal education, 61% were married and 80% suffered from chronic diseases.

To the question, “Do you get the support you need from others?” 38.8% responded “a little”, followed by “moderate” with 30.6% and only 2% responded “totally”. To the question, “How would you rate your quality of life?” 44.9% responded “fair”, followed by “average” with 38.8% and 2% responded “very good” (Table 1).

Regarding the mean of the quality of life dimensions, the results were 22.3±3.3 for physical health, 18.9±2.7 for psychological health, 10.2±1.6 for social relationships and 25.3±3.2 for the environment. 55% of the elderly obtained a high level of quality of life, with an average of 81.3±8.8.

For the religious conviction factor a mean of 26.4±3.9 was obtained and for the religious social support factor a mean of 11.1±3.3 was obtained. 59% of the participants scored a high level of religious belief, with a mean of 37.4±6.6. The relationship between the two variables was statistically significant with a Pearson correlation coefficient of 0.379 with p=.007, therefore, the level of religious beliefs moderately modifies the quality of life of older adults in an indigenous community, i.e., the higher the level of religious beliefs, the better the quality of life.

Discussion

The objective of this study was to determine the relationship between religious beliefs and the quality of life of the elderly in an indigenous community. It was found that the indigenous community perceives that they should maintain their beliefs, practices and habits to preserve their health, as mentioned by the UN ²⁵ and CEPAL ²⁶; this contrasts with the results obtained, which indicate that most of the elderly had chronic diseases, which is in accordance with Macín, et al., who reported a high rate of obesity, diabetes and metabolic syndrome ²⁷. Regarding quality of life, it was found that more than half of the respondents reported a high level, which is in agreement with several authors who mention that most of the respondents reported a normal quality of life ^28,29,30.

Regarding the factors of the Belief System Inventory, the highest average corresponded to conviction of religious beliefs with 26.4 and the lowest average corresponded to religious social support with 11.1, which is consistent with the study of Parodi, et al., which reported similar results of 22.1 and 11.3 respectively, and a total average of 33.4 ³¹, which is lower than the 37.4 average obtained in this study. Quality of life depends on personal, social and cultural factors ³²; therefore, the nursing professional should analyze quality of life from a multidimensional approach to act in all spheres that may affect the quality of life of the elderly in situations of vulnerability.

The limitation of this study was that the participants belonged to only one community; therefore, it would be worthwhile to carry out the study in another community to compare the results. Additionally, it would be feasible to study the same variables with a qualitative approach, since religious beliefs and quality of life are very subjective, and addressing them from another approach would help the nursing personnel to provide individualized care to each of the members using a holistic approach.

Conclusions

This study revealed that the population of elderly thought of themselves as having a high quality of life and high (more conscious) religious beliefs, although some of them were illiterate and suffered from chronic diseases. This provides us with a better understanding of how the religious or cultural beliefs of an indigenous people are related to the quality of life of their elderly. The data obtained indicate that there is a statistically significant and direct relationship between quality of life and religious beliefs; this gives us the opportunity to continue investigating this topic in depth in this specific group, especially when individuals sometimes are not considered as integral persons who give value to everything around them, and this has repercussions on their quality of life and, therefore, on their health. Therefore, nursing personnel should consider the religious and cultural beliefs of the individuals when performing their professional practice in this type of population, to provide a better healthcare.

Conflicts of interests

The authors declare that there is no conflict of interest.

Financing

The authors declare that there was no funding of any kind.