RESUMO
Religion and spirituality (R/S) serve as coping mechanisms for circumstances that threaten people's psychological well-being. However, using R/S inappropriately to deal with difficulties and problems in daily life may include the practice of Spiritual Bypass (SB). SB refers to avoiding addressing emotional problems and trauma, rather than healing and learning from them. On the other hand, coping strategies may be determined by the cultural context. This study aims to describe the presence of SB in individuals who may have experienced stressful situations and to understand the influence of culture on SB by comparing SB in two culturally different groups. The sample consists of a total of 435 people, 262 of Honduran nationality and 173 of Spanish nationality. Both groups are approximately equivalent in age and gender. The degree of SB, stressful events, perception of social support and spiritual well-being are examined, respectively, through the Spiritual Bypass Scale, and specific items and subscales from the Social Readjustment Rating Scale, Multidimensional Scale of Perceived Social Support, and the Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing. The results showed a higher spiritual well-being and use of SB in the Honduran sample as compared to the Spanish sample, but similar social support and stressful events. Furthermore, some of the factors predicting SB were different between the two samples. While age and a greater number of R/S practices were important in both samples, for the Honduran sample the variables that best explained SB were being a Christian, having greater social support, fewer stressful events, and greater attendance at church or temple. For the Spanish sample, however, the variable that best explained SB was studying R/S texts. Therefore, SB must be understood within the culture in which it develops, since in different cultural contexts it appears to relate to differing factors. Thus, SB becomes a possible functional or dysfunctional coping strategy depending on the social context.
RESUMO
BACKGROUND: Despite established links between reduced nocturnal blood pressure (BP) dipping and cardiovascular disease, BP dipping research in Hispanics is limited. PURPOSE: This study investigated socioeconomic status (SES) as a predictor of BP dipping and the contributions of psychosocial factors to this relationship. Analyses were conducted for the overall sample and separately for higher and lower acculturated women. METHODS: Mexican-American women (N = 291; 40-65 years) reported demographics and completed psychosocial assessments and 36-h ambulatory BP monitoring. RESULTS: Lower SES related to reduced BP dipping in the overall sample and in more US-acculturated women (r's = .17-.30, p's < .05), but not in less-acculturated women (r's = .07, p's > .10). An indirect effect model from SES to BP dipping via psychosocial resources/risk fits well across samples. CONCLUSIONS: In Mexican-American women, the nature of SES gradients in BP dipping and the roles of psychosocial resources/risk differ by acculturation level.
Assuntos
Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , Americanos Mexicanos , Adulto , Idoso , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Classe Social , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Lower socioeconomic status (SES) is associated with poorer health, possibly through activation of the sympathetic nervous system. PURPOSE: This study aimed to examine the association between SES and catecholamine levels, and variations by acculturation. METHODS: Three hundred one Mexican-American women underwent examination with a 12-h urine collection. Analyses tested associations of SES, acculturation (language and nativity), and their interaction with norepinephrine (NOREPI) and epinephrine (EPI). RESULTS: No main effects for SES or the acculturation indicators emerged. Fully adjusted models revealed a significant SES by language interaction for NOREPI (p< .01) and EPI (p< .05), and a SES by nativity interaction approached significance for NOREPI (p= .05). Simple slope analyses revealed that higher SES related to lower catecholamine levels in Spanish-speaking women, and higher NOREPI in English-speaking women. Although nonsignificant, similar patterns were observed for nativity. CONCLUSIONS: Associations between SES and catecholamines may vary by acculturation, and cultural factors should be considered when examining SES health effects in Hispanics.
Assuntos
Aculturação , Catecolaminas/urina , Americanos Mexicanos/etnologia , Classe Social , Adulto , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , MulheresRESUMO
OBJECTIVE: Inflammation may represent a biological mechanism underlying associations of socioeconomic status (SES) with cardiovascular disease. We examined relationships of individual and neighborhood SES with inflammatory markers in Mexican American women and evaluated contributions of obesity and related heath behaviors to these associations. METHODS: Two hundred eighty-four Mexican American women (mean age = 49.74 years) were recruited from socioeconomically diverse South San Diego communities. Women completed measures of sociodemographic characteristics and health behaviors, and underwent a physical examination with fasting blood draw for assay of plasma C-reactive protein (CRP), interleukin 6 (IL-6), and soluble intercellular adhesion molecule 1 (sICAM-1). Neighborhood SES was extracted from the US Census Bureau 2000 database. RESULTS: In multilevel models, a 1-standard deviation higher individual or neighborhood SES related to a 27.35% and 23.56% lower CRP level (p values < .01), a 7.04% and 5.32% lower sICAM-1 level (p values < .05), and a 10.46% (p < .05) and 2.40% lower IL-6 level (not significant), respectively. Controlling for individual SES, a 1-standard deviation higher neighborhood SES related to a 18.05% lower CRP level (p = .07). Differences in body mass index, waist circumference, and dietary fat consumption contributed significantly to SES-inflammation associations. CONCLUSIONS: The findings support a link between SES and inflammatory markers in Mexican American women and implicate obesity and dietary fat in these associations. Additional effects of neighborhood SES were not statistically significant; however, these findings should be viewed tentatively due to the small sample size to evaluate contextual effects. Trial Registration ClinicalTrials.gov identifier: NCT00387166.
Assuntos
Inflamação/etnologia , Americanos Mexicanos/estatística & dados numéricos , Obesidade/etnologia , Características de Residência/estatística & dados numéricos , Classe Social , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , California/epidemiologia , Doenças Cardiovasculares/epidemiologia , Gorduras na Dieta , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Inflamação/sangue , Molécula 1 de Adesão Intercelular/sangue , Interleucina-6/sangue , Modelos Lineares , Pessoa de Meia-Idade , Análise Multinível , Fatores de Risco , Fatores Socioeconômicos , Circunferência da CinturaRESUMO
Despite the effectiveness of cancer screening procedures, its utilization among Latinas remains low. Guided, in part, by the Behavioral Model for Vulnerable Populations, this study examined the associations between predisposing, enabling, and need factors with self-reported breast, cervical, and colorectal cancer screening adherence. Participants were 319 Mexican-American women, from a range of socioeconomic backgrounds, living near the United States-Mexico border. Women were adherent with breast cancer (BC) screening (≥42 years) if they had received at least one mammogram within the last 2 years, with cervical cancer (CC) screening (≥40 years) if they had received at least one Pap exam in the last 3 years, and with colorectal cancer (CRC) screening (≥52 years) if they had undergone one or more of the following: Fecal Occult Blood Test within the last year, or sigmoidoscopy in the last 5 years, or colonoscopy within the last 10 years. BC and CC screenings were higher in the current sample compared to national and state figures: 82% with mammography and 86% adherent with Pap exam screening. However, only 43% were adherent with CRC screening recommendations. Characteristics associated with mammography adherence included CC adherence and usual source of care. BC adherence was associated to CC adherence. Characteristics associated with CRC adherence included BC adherence, being premenopausal, and insurance coverage. A key correlate of cancer screening adherence was adherence to other preventive services. Results underscore the need for continued efforts to ensure that Latinas of all SES levels obtain regular and timely cancer screenings.
Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Americanos Mexicanos/psicologia , Sangue Oculto , Cooperação do Paciente/etnologia , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/etnologia , Estudos Transversais , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Mamografia/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Sigmoidoscopia/estatística & dados numéricos , Fatores Socioeconômicos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/etnologia , Esfregaço Vaginal/estatística & dados numéricosRESUMO
OBJECTIVES: The current study examined the contributions of psychosocial factors to the association between socioeconomic status (SES) and metabolic syndrome (MetSyn) risk, in a randomly selected community cohort of 304 middle-aged (40-65 years old) Mexican-American women, a population at elevated cardiometabolic risk. METHODS: Participants underwent a clinical exam and measures of demographic factors and psychosocial resource (i.e., personal and social resources) and risk (i.e., negative emotions and cognitions) variables. Confirmatory factor analysis (CFA) and structural equation models (SEMs) were performed in the total sample and in more- and less-U.S.-acculturated women (defined by language preference) separately. RESULTS: CFAs revealed single latent constructs for SES (i.e., income, education) and psychosocial resources/risk. Three-factor solution was identified, with blood pressure (systolic diastolic), lipids (high-density lipoprotein cholesterol triglycerides), and metabolic variables (glucose waist circumference) forming separate factors. SEMs showed that an indirect effects model with SES relating to MetSyn factors through psychosocial resources/risk provided a reasonable descriptive and statistical fit in the full and more-acculturated sample (root mean square error of approximation [RMSEA] and standardized root-mean-square residual < .08); fit in the less-acculturated sample was marginal according to RMSEA = .09. A significant mediated path from low SES to higher waist circumference/fasting glucose via lower psychosocial resources/higher psychosocial risk was identified in the overall and more-acculturated samples (p < .05). CONCLUSIONS: In this cohort of healthy, middle-aged Mexican-American women, contributions of psychosocial factors to SES-MetSyn associations were limited to the core underlying metabolic mechanisms, and to more-U.S.-acculturated women.
Assuntos
Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/etnologia , Síndrome Metabólica/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Classe Social , Adulto , Idoso , Pressão Sanguínea , Doenças Cardiovasculares/psicologia , HDL-Colesterol , Estudos de Coortes , Escolaridade , Feminino , Humanos , Renda , Lipídeos/sangue , Síndrome Metabólica/psicologia , Pessoa de Meia-Idade , Risco , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura , MulheresRESUMO
BACKGROUND: Little research has examined how chronic stress in different domains relates to allostatic load (AL). PURPOSE: We examined the relationship between multiple chronic stressors with AL, and evaluated lifestyle factors as possible mediating factors. METHODS: Three hundred one middle-aged Mexican-American women underwent a physical exam and completed measures of lifestyle factors and chronic stress in eight domains. A composite of 12 neuroendocrine, metabolic, cardiovascular, and inflammatory markers represented AL. RESULTS: Chronic work, financial, and caregiving domains related to higher AL scores after adjusting for covariates and other stressors. Lifestyle factors made little contribution to the association between stressors and AL. CONCLUSIONS: Chronic work, financial, and caregiving stressors are associated with physiological dysregulation in Mexican-American women. This study is among the first to examine multiple domains of chronic stress in relation to AL, in a population that has been understudied in research concerning stress and health.