Spirituality and Religiosity as an Approach to Coping for Adolescents Living with Sickle Cell Disease: A Review of the Literature

Purpose: The purpose of this presentation is to provide researchers and clinicians with a review of research on spiritualty and religiosity (S/R) in adolescents with sickle cell disease (SCD). The review is based on a systematic review of quantitative and mixed-methods research published in peer reviewed journals. Adolescents with SCD experience symptoms, treatments, and complications of their condition that may hinder them in their physical, psychosocial, emotional, and academic functioning. Spirituality and religiosity has been shown to improve coping and correlates with positive health outcomes in research conducted with children and adolescents.^2-4  Consideration of S/R will enlighten clinicians on the spiritual elements of adolescents and allow for enhanced individualized care when constructing interventions and evaluating health outcomes.

Methods: Studies were sought that examined S/R among adolescents with SCD. This search yielded one publication. The search was expanded to studies that included children and adults with SCD. This search strategy represented a developmental view in which the S/R experiences of younger and older persons with SCD were anticipated to provide insights into the experiences of adolescents. Thus studies were included in this review if they met the following criteria: (a) examined S/R in adolescents and/or children with SCD; (b) examined S/R among parents of adolescents and/or children with SCD; (c) examined S/R in adults to include older adolescents aged 18-21; (d) were quantitative or qualitative articles; and (e) were published in peer-reviewed journals. The databases searched were Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source Nursing/Academic, ProQuest Health Module, PsycINFO, Medline, PubMed, and the American Theological Library Association (ATLA).  The search strategy used in this review included the following string of terms: “sickle cell disease” + “spirit*” (for spiritual or spirituality) + “adolescen*” (for adolescent, adolescents, or adolescence) or “x….” The alternate term included the following:  “children,” “religio*” (for religion, religious, or religiosity), “health,” “pediatric,” and “coping.”  A total of 85 articles were retrieved. Eleven articles met the inclusion criteria and were included in this review.

Results: Eleven studies addressed S/R and SCD; one reported on S/R in children with SCD, three included adolescents and children with SCD, one included only adolescents with SCD, and six included adults 18 years and older. In reviewing the studies, four themes emerged including S/R as sources for coping strategies, S/R coping strategies and pain management, S/R coping strategies and health care utilization; and S/R coping strategies and quality of life. ^2,3  

Conclusions: Spirituality and religiosity are meaningful concepts for adolescents with sickle cell disease and promote healthy outcomes. Research studies to further investigate the impact of S/R for adolescents are essential to understanding the concept from a developmental perspective. Further exploring the association of S/R coping strategies with pain management, health care utilization, and quality of life will offer direction for future interventions that improve overall health and wellbeing.