Spiritual well-being plays role in life satisfaction for US patients: Study

Patients in racial minority groups found to be more dissatisfied with their lives

Patricia Inácio, PhD avatar

by Patricia Inácio, PhD |

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More than 30% of people with systemic sclerosis (SSc) are dissatisfied with their lives, and higher levels of dissatisfaction are reported by racial minority groups, a U.S.-based study has found.

The spiritual well-being of patients was the strongest contributor to life satisfaction scores. These scores were found to be significantly lower for Black, Asian, American Indian, and Alaska Native patients.

“Spiritual well-being is particularly important in understanding life satisfaction in people with systemic sclerosis,” researchers wrote, adding that this should prompt further research to “assess and examine spiritual well-being and its impact on life satisfaction in a larger and more diverse systemic sclerosis sample.”

The study, “Factors associated with life satisfaction in systemic sclerosis: Examining the moderating roles of social support and spiritual well-being,” was published in the Journal of Scleroderma and Related Disorders.

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Life satisfaction often reflects mental health status

SSc, also known as scleroderma, is a chronic autoimmune condition that causes inflammation and fibrosis (scarring) of the skin, but it can also affect internal organs. Symptoms can include joint pain, fatigue, and gastrointestinal problems — all of which increase functional limitations and affect quality of life.

Life satisfaction, a parameter that reflects how people evaluate their lives as a whole, is one of the tools for assessing quality of life. Life satisfaction often reflects mental health status and has been associated with mortality risk.

However, few studies have addressed life satisfaction of SSc patients. Prior research has indicated that social support is important to help people with SSc cope with disease-related challenges, and that spiritual well-being has a positive impact on their perception of well-being.

To understand the effects of spiritual well-being, integrated with social support and functional limitations, a team of researchers in the U.S. analyzed data from the University of California Los Angeles Scleroderma Quality of Life Study.

SSc patients, 18 and older, completed questionnaires about their demographics, symptoms of depression, functional limitations, social support, and spiritual well-being.

Functional limitations, social support, and especially spiritual well-being are all associated with subjective well-being in people with SSc.

Life satisfaction measured based on level of agreement to 5 statements

Overall life satisfaction was measured using the Satisfaction with Life Scale, which evaluates patient ratings for five statements, each scored from one (strongly disagree) to seven (strongly agree). They are: “In most ways, my life is close to my ideal;” “the conditions of my life are excellent;” “I am satisfied with my life;” “so far I have gotten the important things I want in life;” and “if I could live my life over, I would change almost nothing.”

Overall, a score of five indicates extreme dissatisfaction, while a score of 35 indicates extreme satisfaction.

In total, data from 206 SSc participants (mean age 51 years, 84% women, 52% with limited cutaneous SSc) were analyzed. Most patients were at the early stages of the disease, within five years of their diagnosis.

The overall mean life satisfaction score was 22.9, with 79 participants (38%) classified as dissatisfied, and 127 patients (62%) as satisfied.

Significantly lower satisfaction scores were found in patients who were unmarried (mean score of 20 vs. 23.5 for married patients) and had symptoms of depression (15.9 vs. 25.2 for those who were not depressed).

Life satisfaction differed significantly based on race, with racial minorities — including Black patients (mean 18.2) and Asian patients (20.6), as well as American Indian, Alaska Native, and others (17.8) — scoring lower than white patients (mean score 23).

Significantly lower life satisfaction was also linked to having a SSc diagnosis for more than 10 years (20.1) compared with five years (23.4) or from 5 to 10 years (20.8).

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Spiritual well-being strongly contributes to life satisfaction scores

A statistical analysis showed that 12% of the variation in life satisfaction scores was explained by demographics (such as age, race, education level, and marital status). The combination of SSc features and symptoms of depression explained a further 29% of the variation. Functional limitations, social support, and spiritual well-being accounted for another 16%.

Social support and spiritual well-being showed a positive correlation with life satisfaction, whereas functional limitations were negatively correlated. Spiritual well-being was measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, which includes measures on meaning in life, peacefulness, and a sense of strength and comfort from one’s faith.

In this analysis, spiritual well-being turned out to be the strongest contributor to life satisfaction scores.

Overall, these findings “suggest that functional limitations, social support, and especially spiritual well-being are all associated with subjective well-being in people with SSc,” the researchers wrote. “Besides regular assessment of functional limitations, future research examining how social support and spiritual well-being relate to life satisfaction over time is warranted.”