The role of religiosity and spirituality in coping with sickle cell disease clinical severity

Religiosity and spirituality often play a role in managing chronic diseases. Sickle cell disease (SCD) is a genetic chronic disease associated with lifelong complications, but there is limited analysis of the potential impact of religiosity and spirituality on SCD. This study aims to analyze the association between constructs of religiosity and spirituality with health outcomes (disease severity, depression, and pain) in an SCD population (n = 275).

Data from the INSIGHTS Study (NCT02156102) were used for this analysis. The relationships between religious/spirituality measures (religious attendance, self-reported spirituality, religious saliency, coping, and support) and SCD outcomes (disease severity, depression, and pain scores) were analyzed through bivariate correlations and multivariable models. Models adjusted for different dimensions of religiosity and spirituality separately (Model 1) and all measures simultaneously (Model 2).

In the bivariate analyses, we found a positive association between disease severity and spirituality (P < .05) and an inverse relationship between positive religious coping and depression (P = .01). In Model 1, which adjusted for individual measures separately, there was an association between SCD severity and spirituality (β = 0.07, P < .001) as well as with religious attendance (β = 0.02, P < .01). However, in the models that simultaneously adjusted for all the measures (Model 2), religious attendance was no longer associated with SCD severity (β = 0.006, P > .05), while the association with spirituality remained significant (β = 0.05, P < .05).

The observed associations between spirituality and disease severity among patients with SCD suggest that individuals with severe disease may beneficially use spirituality to cope with complications. Future research should rigorously evaluate this hypothesis.