Religion & Healthy Aging

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A STUDY OF THE IMPACT
OF SPIRITUALITY, RELIGION
AND
FUNCTIONAL HEALTH
OF THE ELDERLY

A Dissertation
Presented to the Faculty of the
School of Health Administration
Kennedy-Western University

In Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy in Health Administration

by
Kendall Brune
St. Louis, Missouri

Table of Contents
Chapter 1 – Introduction……………………………….1 Introduction………………………………… 1
Statement of the Problem………………… 2
Purpose of the Study……………………… 3
Importance of the Study……………………4
Scope of the Study………………………… 6
Rationale of the Study………………………9
Overview of the Study……………………..11
Definition of Terms………………………..141
Chapter 2 – Review of Related Literature…………..13
History of Religious Studies-Health Care…15
Demographic Trends in Health Care………16
Science & Religion…………………………...23
Review-Religion in Medical School ………..26
The Relaxation Response: Harvard.……26
Aging as a Spiritual Journey: Loyola……27
Faith- life-promoting: Emory……………..30
Physician & Religion: St. Louis…………31
International Center for the Integration of
Health and Spirituality………………… ….34
Centers for Disease Control………………35
Joint Commission on Accreditation of Healthcare
Organizations (JCAHO)
………………………………………………..37
A Review of:
Patient Satisfaction…………….…………..41
Spiritual Directives………………………....42

ii

Health Outcomes……………….………….38
Spiritual & Emotional Needs……….……..40
Clinical Cohorts from Benjamins…………44
Clinical Cohorts from Daaleman………….45
Patients Desire for Religion……………….47
Clergy Issues in Healthcare………………53
Ethical Issues in Healthcare ………….….56
Summaries &Conclusions.………………..57
Chapter 3 – Methodology…………………………….59 Approach of the Benjamins’ Study……….61
Benjamins’ Conceptual Framework………61
Benjamins’ Study Mechanisms……………61
Benjamins’ Control Mechanisms………….62
Benjamins’ Social Resources …………….63
The Database of the Study………………..66
Variables in the Benjamins Study………...71
The Approach of the Daaleman Study…..75
Daaleman’s Conceptual Framework……..76
Daaleman’s Study Variables………………77
Daaleman’s Well Being Questionnaire…..79
Summary…………………………………….86
Chapter 4……………………………………………….87 Demographics and Statistics…………….89
The Data Analysis for Daaleman………..92
The Data Analysis for Daaleman………..94
Data Charts………………………………..96
Chapter 5………………………………………………108 Theory on Aging………………………….109

iii

Recommendations/Action Items………..112
Spiritual Care & Assessment………….121
Role of the Physician……….………….121
Conclusion: National Impact of Studies…132
Final Comment………………………….136
Bibliography…………………………………………….I Tables and Charts……………………………………..XVIII Chart 1: Faith Support Flowchart………………XVIII
Table 1: Relative Risk of Dying, Strawbridge…XXI
Table 2: Life Expectancy & Religious Activity…XXI
Table 3: JCAHO RI.1.13 Care @ End of Life….XX
Table 4: JCAHO Reading Referrals to Patients.XXII
Table 5: Benjamins Statistical Results………….XXIII
Table 6: Daaleman – Demographics……………XXV
Table 7: Spirituality Index of Well Being……….XXVII

Appendices……………………………………………..XXVIII A: Joint Commission Regulations…………XXVII
B: SF – 12v1 Survey Description…………..LIII
C: SES Descriptive Charts ………………..LXIII
D: Health Retirement and Survey Data….LXVI
E: JCAHO Spiritual Assessment Tool……CXXII
F: Geriatric Depression Scale…………….CXXVI
G: Spirituality Survey – 12-item Scale……CXXII

iv

Abstract of Dissertation
A STUDY OF THE IMPACT OF SPIRITUALITY, RELIGION
AND
FUNCTIONAL HEALTH OF THE ELDERLY
By
KENDALL BRUNE
Kennedy-Western University
THE PROBLEM
Religion is a source of comfort to some and a conflict to
others. A study done by Gallop at Princeton claimed a vast
majority of Americans (94%) claim to believe in God. Koenig’s study found among older Americans, 98% believe in God, and
pray. Maungans, et al. found physicians tend to ignore
religious issues in the care of their patients (Maugans, 1991. pp.210-13). However, this trend is changing. As reported by
Koenig...
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