Andrea D Clements 1, Beth A Bailey 2, Heather Wright 2, & Anna V Ermakova 1 1 East Tennessee State...
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Andrea D Clements 1 , Beth A Bailey 2 , Heather Wright 2 , & Anna V Ermakova 1 1 East Tennessee State University, 2 James H. Quillen College of Medicine Contact: Andrea D Clements, PhD Department of Psychology East Tennessee State University Johnson City, Tennessee 37614 [email protected] Presented at the 3 rd Annual Conference of the Society for Spirituality, Theology, and Health, Durham, NC Funding for this research was Provided by the Tennessee Governor’s Office on Children’s Care Coordination. Implications The positive relationships between PR and health correlates in this sample support the further investigation of religiosity as a predictor of pregnancy health. Exploration of the mechanism by which religiosity affects health is warranted, and the time-limited event of pregnancy and birth is an ideal event for study; however, experimentally studying something so personal as religiosity is controversial and difficult. Introduction In the current study, we investigated the means by which pregnant women in rural Southern Appalachia report dealing with stress. Of primary interest was the health of women and their neonates for whom Prayer/Religiosity (PR) was the primary prenatal stress coping strategy. To date, no published studies have explored the link between PR as a prenatal stress coping method and pregnancy/birth health, so there was little to inform predictions. However, we do know that positive coping techniques have been associated with positive health behaviors, while negative techniques predict negative behaviors. Smoking, alcohol and drug use, inadequate prenatal care, inappropriate weight gain, and exposure to certain diseases and environmental toxins are known to pose risk for fetuses. Several other factors are known to be specifically correlated with PTB including pre-pregnancy health, pregnancy history, marital status, inter- pregnancy interval, (Goldenberg et al., 2008), and age (Anderson, Smiley, Flick, & Lewis, 2000). We explored the degree to which PR predicted several of these known risk factors. Abstract During intake, a rural sample of 1312 women admitted for low- risk singleton birth was asked the open-ended question, “How do you deal with stress?” Responses were categorized into 18 Method Sample Delivery charts were reviewed for 1334 cases, representing all singleton deliveries from 1/1/06 through 12/31/08 at a rural Appalachian hospital. Women admitted in the final stages of labor were not asked the primary question of interest in this study (n = 22), bringing the final sample size for this report to 1312 (ages 12 to 42 yrs). High-risk births were transferred to a nearby teaching hospital, thus the sample was of low-obstetric-risk. Data were collected via individual chart review by research project staff using a two page study- designed data collection form. Results We found that several variables that have been found to be predictive of pregnancy health were related to reporting prayer/religiosity (PR) as the primary means of dealing with stress. PR women were more likely to be married, to have attended or graduated from college, and to breastfeed than women who did not report PR for dealing with stress. The PR women (M = 30.73 yrs) were also significantly older than the non PR women (M = 24.36 yrs). Alternatively, women who reported PR for dealing with stress were far less likely to have positive screens for alcohol, tobacco, or other drug use, all known prenatal risk factors. Prayer/Religiosity as Primary Stress Coping Strategy Predicts Health-Related Pregnancy and Birth Factors in a Rural Appalachian Sample Conclusion Findings were largely consistent with expectations because religiosity measured in various ways has been shown to be predictive of positive health outcomes. Although only one outcome (infant’s length of hospital stay) was significantly related to PR, several known correlates of health were as well. We believe that, because women were asked an open-ended question about how they deal with stress, the PR group truly uses PR coping because there was no risk of endorsing PR due to suggestion. There is the possibility that some women who use PR did not report its use, but those who did report it (n = 22) most likely use that method of coping. In this sample, the women endorsing PR for stress coping were also older and more likely to be married, both factors that are predictive of health, however, neither was significantly related to the outcome variables in this sample. Because of the correlational nature of this study, we cannot pinpoint the religion– health mechanism, but several possibilities exist. Religious women may be more likely to avoid substance use due to personal conviction or pressure from a religious social system, PR may serve as a stress buffer, or older, more educated women may be both healthier and more religious. stress coping strategies, including Prayer/Religiosity (n = 22). Demographically, women endorsing prayer/religiosity (PR) were older (p < .001), more educated (p = .007), more likely to be married (p = .004), and had more children (p = .001) than non PR women. PR women were significantly less likely to have positive screens for alcohol use (p = .028), tobacco use (p = .002), or have a positive prenatal drug screen (p = .045), and far more likely to breastfeed (p = .006) compared to Non PR women, all factors predictive of pregnancy and birth health. PR women did not differ from others in presence of complications, but they did have infants who were hospitalized fewer days at birth (p = .038). Procedure All women were asked the following open- ended question by the intake nurse when they arrived for delivery: “How do you deal with stress?” No response choices were offered and responses were recorded verbatim. For the first 300 exactly what was written in the chart was recorded, with qualitative methodology used to combine responses into 18 distinct and meaningful categories. These categories allowed for classification of all responses from the first 300 cases, and were then used to record responses dichotomously for the next 200 cases. At the end of those 200 cases it was clear that the categories included all possible responses seen, and were subsequently used as designed for the remainder of the data collection. Health-related information was gathered Table 1.H ealth-related Variables by Prayer/R eligion as Prim ary PrenatalStress C oping M ethod U se Prayer/R eligion To D eal w ith Stress D o N otU se Prayer/R eligion To D eal w ith Stress 2 p Predictive ofH ealth Married 77.3% 46.2% 8.37 .004 College 54.5% 25.5% 22.67 <.0001 Breastfeeding 71.4% 43.6% 10.30 .006 Predictive ofR isk Tobacco U se 13.6% 46.2% 9.25 .002 Alcohol Use 0.0% 1.6% 7.15 .028 Positive D rug Screen 15.4% 0.0% 4.00 .045 PR only significantly predicted one outcome of interest, infant’s length of hospital stay. No other complications were predicted by PR. Table 2.C om parison ofW om en W hose Prim ary Prenatal Stress C oping M echanism is Prayerto A llO therW om en in the Sam ple t df p M other’s Age atBirth -5.48 1306 <.0001 Length ofM other’s H ospital Stay 1.66 1309 .097 Length ofInfant’s H ospital Stay 2.08 1304 .038 Infant’s G estational Age .224 1308 .82 Infant’s Birth W eight -.864 1308 .387
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Transcript of Andrea D Clements 1, Beth A Bailey 2, Heather Wright 2, & Anna V Ermakova 1 1 East Tennessee State...
Andrea D Clements1, Beth A Bailey2, Heather Wright2, & Anna V Ermakova1
1East Tennessee State University, 2James H. Quillen College of Medicine
Contact: Andrea D Clements, PhDDepartment of PsychologyEast Tennessee State UniversityJohnson City, Tennessee [email protected]
Presented at the 3rd Annual Conference of the Society for Spirituality, Theology, and Health, Durham, NCFunding for this research was Provided by the Tennessee Governor’s Office on Children’s Care Coordination.
ImplicationsThe positive relationships between PR and health correlates in this sample support the further investigation of religiosity as a predictor of pregnancy health. Exploration of the mechanism by which religiosity affects health is warranted, and the time-limited event of pregnancy and birth is an ideal event for study; however, experimentally studying something so personal as religiosity is controversial and difficult.
IntroductionIn the current study, we investigated the means by which pregnant women in rural Southern Appalachia report dealing with stress. Of primary interest was the health of women and their neonates for whom Prayer/Religiosity (PR) was the primary prenatal stress coping strategy. To date, no published studies have explored the link between PR as a prenatal stress coping method and pregnancy/birth health, so there was little to inform predictions. However, we do know that positive coping techniques have been associated with positive health behaviors, while negative techniques predict negative behaviors.
Smoking, alcohol and drug use, inadequate prenatal care, inappropriate weight gain, and exposure to certain diseases and environmental toxins are known to pose risk for fetuses. Several other factors are known to be specifically correlated with PTB including pre-pregnancy health, pregnancy history, marital status, inter-pregnancy interval, (Goldenberg et al., 2008), and age (Anderson, Smiley, Flick, & Lewis, 2000). We explored the degree to which PR predicted several of these known risk factors.
AbstractDuring intake, a rural sample of 1312 women admitted for low-risk singleton birth was asked the open-ended question, “How do you deal with stress?” Responses were categorized into 18
MethodSample
Delivery charts were reviewed for 1334 cases, representing all singleton deliveries from 1/1/06 through 12/31/08 at a rural Appalachian hospital. Women admitted in the final stages of labor were not asked the primary question of interest in this study (n = 22), bringing the final sample size for this report to 1312 (ages 12 to 42 yrs). High-risk births were transferred to a nearby teaching hospital, thus the sample was of low-obstetric-risk. Data were collected via individual chart review by research project staff using a two page study-designed data collection form.
ResultsWe found that several variables that have been found to be predictive of pregnancy health were related to reporting prayer/religiosity (PR) as the primary means of dealing with stress. PR women were more likely to be married, to have attended or graduated from college, and to breastfeed than women who did not report PR for dealing with stress. The PR women (M = 30.73 yrs) were also significantly older than the non PR women (M = 24.36 yrs).
Alternatively, women who reported PR for dealing with stress were far less likely to have positive screens for alcohol, tobacco, or other drug use, all known prenatal risk factors.
Prayer/Religiosity as Primary Stress Coping Strategy Predicts Health-Related Pregnancy and Birth Factors in
a Rural Appalachian Sample
ConclusionFindings were largely consistent with expectations because religiosity measured in various ways has been shown to be predictive of positive health outcomes. Although only one outcome (infant’s length of hospital stay) was significantly related to PR, several known correlates of health were as well. We believe that, because women were asked an open-ended question about how they deal with stress, the PR group truly uses PR coping because there was no risk of endorsing PR due to suggestion. There is the possibility that some women who use PR did not report its use, but those who did report it (n = 22) most likely use that method of coping.
In this sample, the women endorsing PR for stress coping were also older and more likely to be married, both factors that are predictive of health, however, neither was significantly related to the outcome variables in this sample.
Because of the correlational nature of this study, we cannot pinpoint the religion–health mechanism, but several possibilities exist. Religious women may be more likely to avoid substance use due to personal conviction or pressure from a religious social system, PR may serve as a stress buffer, or older, more educated women may be both healthier and more religious.
stress coping strategies, including Prayer/Religiosity (n = 22). Demographically, women endorsing prayer/religiosity (PR) were older (p < .001), more educated (p = .007), more likely to be married (p = .004), and had more children (p = .001) than non PR women. PR women were significantly less likely to have positive screens for alcohol use (p = .028), tobacco use (p = .002), or have a positive prenatal drug screen (p = .045), and far more likely to breastfeed (p = .006) compared to Non PR women, all factors predictive of pregnancy and birth health. PR women did not differ from others in presence of complications, but they did have infants who were hospitalized fewer days at birth (p = .038).
Procedure
All women were asked the following open-ended question by the intake nurse when they arrived for delivery:
“How do you deal with stress?”
No response choices were offered and responses were recorded verbatim. For the first 300 exactly what was written in the chart was recorded, with qualitative methodology used to combine responses into 18 distinct and meaningful categories. These categories allowed for classification of all responses from the first 300 cases, and were then used to record responses dichotomously for the next 200 cases. At the end of those 200 cases it was clear that the categories included all possible responses seen, and were subsequently used as designed for the remainder of the data collection.
Health-related information was gathered from self-report surveys and from medical charts.
Table 1. Health-related Variables by Prayer/Religion as Primary Prenatal Stress Coping Method
Use Prayer/Religion
To Deal with Stress
Do Not Use Prayer/Religion
To Deal with Stress
2 p
Predictive of Health
Married 77.3% 46.2% 8.37 .004
College 54.5% 25.5% 22.67 <.0001
Breastfeeding 71.4% 43.6% 10.30 .006
Predictive of Risk
Tobacco Use 13.6% 46.2% 9.25 .002
Alcohol Use 0.0% 1.6% 7.15 .028
Positive Drug Screen
15.4% 0.0% 4.00 .045
PR only significantly predicted one outcome of interest, infant’s length of hospital stay. No other complications were predicted by PR.
Table 2. Comparison of Women Whose Primary Prenatal Stress Coping Mechanism is Prayer to All Other Women in the Sample
t df p
Mother’s Age at Birth -5.48 1306 <.0001
Length of Mother’s Hospital Stay
1.66 1309 .097
Length of Infant’s Hospital Stay
2.08 1304 .038
Infant’s Gestational Age .224 1308 .82
Infant’s Birth Weight -.864 1308 .387
