SPIRITUALITY AS A MEDIATOR OF STRESS IN A UNIVERSITY STRESS MANAGEMENT COURSE

The relationship between spiritual health and perceived stress was studied using a nonequivalent control group design with a Treatment Group (n = 60) and a Comparison Group (n = 55). Participants from a southwestern University were enrolled in two upper-division Stress Management courses: a spirituality-enhanced curricula (Treatment) or a traditional curricula (Comparison). The Spirituality Assessment Scale and the Lifestyle Appraisal Questionnaire (part II) tested the research hypotheses. Pearson’s r-test revealed high levels of spiritual health significantly correlated with low levels of perceived stress (r = –.355, p < .01). While participants in the Treatment group exhibited no significant difference in perceived stress scores at post-test from those in the Comparison group, participants in both groups demonstrated significantly lower perceived stress scores from preto post-test (t = 4.396, df = 39, p < .01; t = 3.467, df = 44, p < .01). Findings suggest that a traditional stress management curriculum may be equally effective in reducing levels of stress as one aimed at fostering spiritual health. INTRODUCTION In 1958, the World Health Organization (WHO) redefined health as “a state of complete mental physical, mental, and social well-being, not merely the absence 237 2004, Baywood Publishing Co., Inc. of disease or infirmity,”—a movement that initiated a paradigm shift in the traditional Western medical model of health. This movement, sometimes referred to as the holistic health movement, offered a concept of positive wellness to replace and exceed the existing notion of health. No longer was the mere absence of physical illness symptoms deemed as defining a suitable state of health. Rather, the goal was to achieve optimal levels of well-being in all dimensions of health— the physical, the mental or emotional, and the social. One facet of health that is noticeably absent from the WHO definition of health is spiritual health. Nonetheless, this has not prevented researchers and clinicians from including it in their own definitions of health. In the 1970s, spirituality assumed the central role of the holistic health movement. This movement emerged from the initiative of church leaders; however, it was quickly adopted and supported by professionals in the health and medical fields and was further facilitated by Osman and Russell’s (1979) call to accept the spiritual component as an integral aspect of well-being. However, little is known as to the role spirituality plays in mediating other aspects of health. BACKGROUND A central tenet of the spiritual health movement is the belief that spiritual health plays a critical role in the individual’s active pursuit of their personal healing process. As a result, various health and wellness models have been developed that not only include spiritual health as a component of wellness, but also position it as a fundamental element contributing to all other areas of health. Such models include the Holistic Wellness Model, the Spirit-Focused Conceptual Model of Nursing, the Wheel of Wellness and Prevention Model, and the “Cube” Model of Health (Chandler, Holden, & Kolander, 1992; Eberst, 1984; Swanson, 1995; Sweeney & Witmer, 1991). The movement had become so strong by the early 1980s, that a survey found that a majority of health educators claimed to believe in a spiritual dimension of health (Banks, 1980; Banks, Poehler, & Russell, 1984). Yet, despite such an enthusiastic reception by members of the health and medical fields, to date relatively little has been done to determine the actual impact of spiritual well-being upon overall health status. A recent study conducted by Adams, Bezner, Drabbs, Zambarano, and Steinhardt (2000) examined the relationship between spirituality and perceived wellness among college students and found the indices of life purpose, optimism, and sense of coherence positively correlated to perceived overall wellness. What remains unanswered is the impact of spiritual health upon indices of wellness. One area of health generally perceived to be benefited by spiritual health is mental health—specifically with regard to stress (Aldridge, 1993; Koenig, 1993; Simon, 1989). Based on results of various surveys and studies conducted all over the world, WHO has now labeled stress a global epidemic (Seaward, 1997). 238 / McGEE, NAGEL AND MOORE