Spirituality, Coping, and Resilience Among Rural Residents Living with Chronic Kidney Disease
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Spirituality, Coping, and Resilience Among Rural Residents Living with Chronic Kidney Disease Tony V. Pham1 · Cherry M. Beasley2 · Jane P. Gagliardi1,3 · Harold G. Koenig1,5 · John W. Stanifer4
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Spirituality, an established resource within rural America, serves as an important coping mechanism for crises of chronic illness. We examined the effects of spirituality on chronic kidney disease (CKD) maintenance in the rural community of Robeson County, North Carolina. We conducted nine focus group discussions and 16 interviews involving 80 diverse key informants impacted by CKD. As disenfranchised patients, they locally engaged in spirituality which mobilized personal and social resources and elicited support from a transcendent authority. Our participants developed a heuristic and aesthetic understanding of disease, built resilience and self-care skills, and improved overall coping and survival. Keywords Spirituality · Renal insufficiency · Chronic · Rural health · Mental health · Mind–body relations
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1094 3-019-00892-w) contains supplementary material, which is available to authorized users. * Tony V. Pham [email protected] 1
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27701, USA
2
Department of Nursing, University of North Carolina, Pembroke, Pembroke, NC, USA
3
Division of General Internal Medicine, Department of Medicine, Duke Health, Durham, NC, USA
4
Munson Nephrology, Munson Healthcare, Traverse City, MI, USA
5
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Vol.:(0123456789)
Journal of Religion and Health
Introduction In the USA, chronic kidney disease (CKD) affects more than 30 million adults, with ethnic and racial minorities experiencing disproportionately greater burdens. This includes a two- to fourfold increased risk of CKD and poor CKD outcomes, including end-stage kidney disease (Hsu et al. 2003; McClellan et al. 2006; Saran et al. 2016). People living in rural communities are particularly negatively impacted by CKD, yet little focus has been given to factors affecting these people and their CKD maintenance. Rural residents are more likely to be under-resourced and experience additional barriers to achieving optimal health, including limited social support, lower health literacy, higher reports of distrust of the medical establishment, and structural challenges related to living in rural settings (Brems et al. 2006; Douthit et al. 2015; Elnicki et al. 1995; Jackson et al. 2007; Marrone 2007). Collectively, these barriers can lead to feelings of existential distress because of disharmony of mind, body, and spirit (Soeken and Carson 1987). Spirituality, an established resource within rural America and ethnic minorities, serves as an important coping mechanism for dealing with crises that often occur with chron
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