Integrative medicine, spirituality improves outcomes in urban adolescents with asthma

A new study by researchers at the University of Cincinnati (UC) shows that urban adolescents with asthma may experience worse outcomes when not using spiritual coping and often use complementary and alternative medicine, or integrative medicine, like prayer or relaxation, to manage symptoms.

These findings, being presented at the National Conference in Pediatric Psychology in San Antonio April14-16, could help physicians and other providers gain insight into additional ways to help pediatric populations self-manage chronic illnesses.

The study, led by Sian Cotton, PhD, assistant professor in the department of family and community medicine, looked at urban adolescents dealing with asthma and uncovered the ways that they were both coping with their illness as well as ways coping methods affected their mental and physical health outcomes.

One set of analyses examined ways these adolescents used complementary and alternative medicine strategies for symptom management; the other set of analyses looked at spiritual struggles in adolescents with asthma to see whether they contributed to health-related quality of life.

"Few studies have examined the role of spiritual struggles in children, and none have examined the relationship between spiritual struggles, secular coping and their outcomes; we wanted to see if spiritual struggles contribute uniquely to a patient's quality of life, beyond demographic variables," says Cotton.

"Similarly, prior studies have shown that 50 to 80 percent of adolescents with asthma have used complementary and alternative medicine and feel that these actions are successful in treating symptoms. We wanted to understand more about which sorts of patients might benefit from being approached on this subject by a physician."

The analyses involved 151 adolescents with asthma between the ages of 11 and 19 at a children's hospital in the Midwest who were given questionnaires assessing spiritual coping, secular coping, complementary alternative medicine use and other psychosocial, clinical and demographic variables.

In the spiritual struggles analyses, outcome variables included anxiety and depressive symptoms as well as quality of life. Researchers then determined the association between spiritual struggles and health outcomes after accounting for age, gender, ethnicity and asthma severity.

Those who were male African-Americans, experiencing more spiritual struggles and using more negative secular coping methods, had poorer quality of life.

In addition, researchers found that non-African-Americans, adolescents who struggled spiritually and adolescents with more severe disease had increased anxiety symptoms. Also, non-African-Americans and females had increased depressive symptoms.

"As hypothesized, religious or spiritual coping and secular coping predicted similar amounts of variance in these outcomes, similar to previous findings in adult populations, suggesting that spiritual coping is an important element to consider when caring for adolescents with asthma," Cotton says.