Understanding the Roles of Religiosity and Religious Coping on Latino Caregivers' Psychological Well-Being

Background:

By 2050, the older Latino population will reach 17.5 million and constitute 20% of U.S. seniors; correspondingly, the Alzheimer’s disease rate among Latinos is projected to increase 1.3 million. Consequently, there is growing interest in delivering culturally sensitive health care services to this population.  Although a significant body of research exists exploring how personal resources may moderate the impact of caregiving stressors on caregiver well-being, there is relatively little research on the roles of religiosity and religious coping on caregiver mental health.  This knowledge gap is significant given evidence suggests that Latinos more often use religion and spirituality as a coping mechanism than Anglos.  In this study, we therefore tested hypotheses about association of religiosity and religious coping on the experience of depression and anxiety among Latino Alzheimer’s caregivers.

Methods:

The data are from in-person interviews conducted in Spanish with 67 Latino family members caring for a loved one with Alzheimer’s disease in the Boston area.  Trained bilingual interviewers conducted the interviews in the participants’ homes.   The participants were predominately Latino daughters and wives whose cultural identities were primarily Dominican or Puerto Rican. Approximately three-quarters had spent their childhood living outside the U.S. mainland and currently spoke only Spanish in their households. Our core independent measures, religiosity and religious coping, were measured by the Duke University Religion Index (DUREL) and Pargament’s Brief Religious Coping Methods (Brief RCOPE).  The DUREL consists of five items that examine three dimensions of religiosity: organizational religiosity (i.e. public practice of religious rituals); non-organizational religiosity (i.e. private practice of religious rites); and intrinsic religiosity (i.e. internalized religion). The Brief RCOPE has two three-item subscales: (1) positive coping (e.g. thinking of oneself as part of a larger spiritual force; working with God as a partner; looking to God for strength, support, and guidance); and (2) negative coping (e.g. feeling that God is punishing and/or abandoning one; trying to work through the situation without God).  Our two dependent measures, depression and anxiety, were measured with the 20-item CES-D Depression Scale and the 20-item State Anxiety Inventory-State Scale (STAI-S).   Using hierarchical regression analysis, we tested our hypotheses and explored the contribution of religiosity and religious coping on the two mental health outcomes, controlling for caregiver and recipient demographic and health variables.

Findings:

Regression analyses revealed that, after controlling for caregiver and care recipient demographic and health variables, negative religious coping methods predicted both greater levels of depression and anxiety. No significant association was found however between religiosity and the two mental health measures of depression and anxiety.

Implications:

This study supports emerging research findings that Latino caregivers may use their religion as a way of coping with stress and coming to terms with their circumstances.   Importantly, it distinguishes between forms of religious coping and suggests that forms of negative religious coping may be harmful to one’s psychological well-being.    From a practice perspective, it is important to note that few health care programs currently address the spiritual and religious concerns of ethnic minority groups, including Latinos.