{"title":"信仰作为医学:土耳其成年人精神和糖尿病自我管理的12个月纵向研究。","authors":"Ahmet Özbay","doi":"10.1007/s10943-025-02407-2","DOIUrl":null,"url":null,"abstract":"<p><p>Type 2 diabetes requires sustained lifestyle modifications that can be psychologically challenging. Spirituality may serve as an important coping resource, yet longitudinal evidence remains limited in Muslim populations where spiritual beliefs are deeply integrated into daily life and health practices. To examine longitudinal relationships between spirituality, religious coping, and diabetes self-management behaviors, quality of life, and glycemic control among Turkish adults with type 2 diabetes over 12 months, and to test theoretical pathways through which spirituality influences health outcomes. A prospective study of 240 Turkish adults with type 2 diabetes from endocrinology clinics in Istanbul and Bursa (January 2023-June 2024). Participants completed validated questionnaires measuring spirituality (FACIT-Sp), religious coping (Brief RCOPE), diabetes self-care activities (SDSCA), quality of life (DQOL), and diabetes distress at baseline, 6 months, and 12 months. HbA1c levels were obtained at each time point. Linear mixed-effects models examined relationships between spirituality variables and outcomes, with mediation analysis testing positive religious coping as a mediating mechanism. Of 240 participants enrolled, 218 (90.8%) completed 12-month follow-up. Mean age was 53.4 years (SD = 9.6), 52.1% were female, and mean diabetes duration was 7.2 years. Higher baseline spirituality was significantly associated with better trajectories across all outcomes: self-care behaviors (β = 0.28, SE = 0.07, p < 0.001), quality of life (β = - 0.23, SE = 0.08, p = 0.008), and glycemic control (β = - 0.19, SE = 0.09, p = 0.021). Positive religious coping partially mediated the relationship between spirituality and self-care behaviors (indirect effect: β = 0.15, 95% CI 0.08-0.24, representing 35.7% of total effect). Participants in the highest spirituality tertile showed significantly greater HbA1c improvements compared to the lowest tertile (- 0.8% vs - 0.3%, p = 0.012). Age moderated these relationships, with stronger effects among older participants. Spirituality represents a valuable resource for diabetes self-management among Turkish adults, with positive religious coping serving as a key mediating mechanism. Healthcare providers should consider spiritual assessment as part of comprehensive diabetes care. The findings support developing culturally adapted, spiritually-informed diabetes interventions that integrate Islamic perspectives with evidence-based medical care.</p>","PeriodicalId":48054,"journal":{"name":"Journal of Religion & Health","volume":" ","pages":"3955-3977"},"PeriodicalIF":2.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Faith as Medicine: A 12-Month Longitudinal Study of Spirituality and Diabetes Self-Management in Turkish Adults.\",\"authors\":\"Ahmet Özbay\",\"doi\":\"10.1007/s10943-025-02407-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Type 2 diabetes requires sustained lifestyle modifications that can be psychologically challenging. Spirituality may serve as an important coping resource, yet longitudinal evidence remains limited in Muslim populations where spiritual beliefs are deeply integrated into daily life and health practices. To examine longitudinal relationships between spirituality, religious coping, and diabetes self-management behaviors, quality of life, and glycemic control among Turkish adults with type 2 diabetes over 12 months, and to test theoretical pathways through which spirituality influences health outcomes. A prospective study of 240 Turkish adults with type 2 diabetes from endocrinology clinics in Istanbul and Bursa (January 2023-June 2024). Participants completed validated questionnaires measuring spirituality (FACIT-Sp), religious coping (Brief RCOPE), diabetes self-care activities (SDSCA), quality of life (DQOL), and diabetes distress at baseline, 6 months, and 12 months. HbA1c levels were obtained at each time point. Linear mixed-effects models examined relationships between spirituality variables and outcomes, with mediation analysis testing positive religious coping as a mediating mechanism. Of 240 participants enrolled, 218 (90.8%) completed 12-month follow-up. Mean age was 53.4 years (SD = 9.6), 52.1% were female, and mean diabetes duration was 7.2 years. Higher baseline spirituality was significantly associated with better trajectories across all outcomes: self-care behaviors (β = 0.28, SE = 0.07, p < 0.001), quality of life (β = - 0.23, SE = 0.08, p = 0.008), and glycemic control (β = - 0.19, SE = 0.09, p = 0.021). Positive religious coping partially mediated the relationship between spirituality and self-care behaviors (indirect effect: β = 0.15, 95% CI 0.08-0.24, representing 35.7% of total effect). Participants in the highest spirituality tertile showed significantly greater HbA1c improvements compared to the lowest tertile (- 0.8% vs - 0.3%, p = 0.012). Age moderated these relationships, with stronger effects among older participants. Spirituality represents a valuable resource for diabetes self-management among Turkish adults, with positive religious coping serving as a key mediating mechanism. Healthcare providers should consider spiritual assessment as part of comprehensive diabetes care. The findings support developing culturally adapted, spiritually-informed diabetes interventions that integrate Islamic perspectives with evidence-based medical care.</p>\",\"PeriodicalId\":48054,\"journal\":{\"name\":\"Journal of Religion & Health\",\"volume\":\" \",\"pages\":\"3955-3977\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Religion & Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10943-025-02407-2\",\"RegionNum\":1,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Religion & Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10943-025-02407-2","RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
2型糖尿病需要持续的生活方式改变,这在心理上是具有挑战性的。灵性可能是一种重要的应对资源,但在灵性信仰深深融入日常生活和健康实践的穆斯林人群中,纵向证据仍然有限。研究土耳其2型糖尿病成人患者12个月以上的灵性、宗教应对、糖尿病自我管理行为、生活质量和血糖控制之间的纵向关系,并测试灵性影响健康结果的理论途径。2023年1月至2024年6月,对伊斯坦布尔和布尔萨内分泌科诊所240名土耳其2型糖尿病成年人进行前瞻性研究。参与者在基线、6个月和12个月完成了有效的问卷调查,测量灵性(FACIT-Sp)、宗教应对(Brief RCOPE)、糖尿病自我护理活动(SDSCA)、生活质量(DQOL)和糖尿病困扰。获取各时间点的HbA1c水平。线性混合效应模型检验了灵性变量与结果之间的关系,中介分析检验了积极的宗教应对作为中介机制。在240名参与者中,218名(90.8%)完成了12个月的随访。平均年龄53.4岁(SD = 9.6),女性占52.1%,平均糖尿病病程7.2年。在所有结果中,更高的基线灵性与更好的轨迹显着相关:自我保健行为(β = 0.28, SE = 0.07, p
Faith as Medicine: A 12-Month Longitudinal Study of Spirituality and Diabetes Self-Management in Turkish Adults.
Type 2 diabetes requires sustained lifestyle modifications that can be psychologically challenging. Spirituality may serve as an important coping resource, yet longitudinal evidence remains limited in Muslim populations where spiritual beliefs are deeply integrated into daily life and health practices. To examine longitudinal relationships between spirituality, religious coping, and diabetes self-management behaviors, quality of life, and glycemic control among Turkish adults with type 2 diabetes over 12 months, and to test theoretical pathways through which spirituality influences health outcomes. A prospective study of 240 Turkish adults with type 2 diabetes from endocrinology clinics in Istanbul and Bursa (January 2023-June 2024). Participants completed validated questionnaires measuring spirituality (FACIT-Sp), religious coping (Brief RCOPE), diabetes self-care activities (SDSCA), quality of life (DQOL), and diabetes distress at baseline, 6 months, and 12 months. HbA1c levels were obtained at each time point. Linear mixed-effects models examined relationships between spirituality variables and outcomes, with mediation analysis testing positive religious coping as a mediating mechanism. Of 240 participants enrolled, 218 (90.8%) completed 12-month follow-up. Mean age was 53.4 years (SD = 9.6), 52.1% were female, and mean diabetes duration was 7.2 years. Higher baseline spirituality was significantly associated with better trajectories across all outcomes: self-care behaviors (β = 0.28, SE = 0.07, p < 0.001), quality of life (β = - 0.23, SE = 0.08, p = 0.008), and glycemic control (β = - 0.19, SE = 0.09, p = 0.021). Positive religious coping partially mediated the relationship between spirituality and self-care behaviors (indirect effect: β = 0.15, 95% CI 0.08-0.24, representing 35.7% of total effect). Participants in the highest spirituality tertile showed significantly greater HbA1c improvements compared to the lowest tertile (- 0.8% vs - 0.3%, p = 0.012). Age moderated these relationships, with stronger effects among older participants. Spirituality represents a valuable resource for diabetes self-management among Turkish adults, with positive religious coping serving as a key mediating mechanism. Healthcare providers should consider spiritual assessment as part of comprehensive diabetes care. The findings support developing culturally adapted, spiritually-informed diabetes interventions that integrate Islamic perspectives with evidence-based medical care.
期刊介绍:
Journal of Religion and Health is an international publication concerned with the creative partnership of psychology and religion/sprituality and the relationship between religion/spirituality and both mental and physical health. This multidisciplinary and interdisciplinary journal publishes peer-reviewed original contributions from scholars and professionals of all religious faiths. Articles may be clinical, statistical, theoretical, impressionistic, or anecdotal. Founded in 1961 by the Blanton-Peale Institute, which joins the perspectives of psychology and religion, Journal of Religion and Health explores the most contemporary modes of religious thought with particular emphasis on their relevance to current medical and psychological research.