Sunday, November 4, 2007

This presentation is part of : Palliative Care Nursing Research with Older Adults
Spirituality in Coping with Chronic Disease among Puerto Rican Women
Jean W. Lange, RN, PhD, School of Nursing, Fairfield University, Fairfield, CT, USA

Background: Palliative care encompasses the management of disease-related disabilities as well end-of-life care. Among the rapidly growing Hispanic population, Puerto Ricans report the highest incidence of disability, most often linked to chronic disease. Prevalence of disabling diseases such as cardiovascular disease, diabetes, and renal dysfunction among Puerto Rican women poses challenges for coping with the associated functional losses. Spirituality, an integral part of Puerto Rican culture, reportedly enables feelings of emotional well-being among those with chronic illness (Morales et al., 2002). Purpose: To explore the spiritual experience of Puerto Rican women in coping with chronic disease. Methods: A qualitative design using phenomenological methods (Colaizzi, 1979) guided this study. Interviews with 12 Puerto Rican women aged 55 or older, diagnosed with a chronic illness for at least five years 5 years, and reporting at least one activity limitation (Katz, 1970; activity Lawton, 1969) were audiotaped and transcribed. Measures to enhance credibility and dependability included achieving saturation plus one; bracketing researcher preconceptions; reaching inter-rater agreement of 80% or higher regarding the identification of significant statements, categories, and themes; documenting the decision trail from formulated meanings to theme clusters promote auditability; and seeking participant validation to authenticate themes. Findings: Preliminary findings suggest three themes: dedication to God; relinquishing control to a higher being; and faith as source of inner security and peace. Implications: The findings suggest that spirituality is an integral part of coping among Puerto Rican women with chronic disease. Nurses may facilitate more effective coping by recognizing the prominent role spirituality can have in helping patients deal with illness. Further research regarding the phenomenon of spirituality in diverse groups, such as in Puerto Rican men or other Hispanic subgroups is needed. The potential for spirituality to positively impact coping with disease and disability warrants greater attention in nursing curricula.