Transcript The Correlation Between Medical Diagnoses and Prescription


Previous research indicates that higher
levels of spiritual
involvement are related to improved physical
health. The purpose of this study was to determine the
correlation between spiritual belief and physical health and also
between spiritual belief and use of chronic prescription
medications. Spiritual health was determined by using the
Spiritual Involvement and Belief Scale. Physical health was
measured by calculating the number of medical diagnoses
listed in the electronic medical record of the patient. A similar
method was used to determine the number of chronic
medications in use. A total of 100 participants were surveyed
and, after controlling for age, the results showed no reliable
correlation between spirituality and health, when health was
measured in terms of diagnoses and medications documented.
While this data differs from previous studies, it is conceivable that
replication of this same study with a larger and more diverse
population might reveal more significant correlations.
“The body is a unit; the person is a unit of
body, mind, and spirit”
 Spiritual treatments for illness well
documented reliability

› 12-Step programs for addictions

US polls:
› belief in God is consistently recorded as 95%
› one in three Americans regards themselves as
spiritual, though not religious
› Seventy-seven percent of people believe that
their spiritual needs should be addressed by their
physician

purpose of this study was to evaluate
self-reported spirituality and compare it
to physical health

Physical health was measured in terms of
diagnoses and medications
 after
controlling for age, the
higher the level of reported
spirituality, the lower the
number of medical diagnoses
and the fewer chronic
medications will be utilized

A single Family Practice office was the
site of the study. Approval from practice
owners was obtained.
 All patients over 18 years of age were
asked to complete a survey voluntarily
 Consent was obtained from each
patient
 Completed surveys were collected
 Study lasted for a period of two weeks

Journal of Family
Practice in 1998, the
validity and reliability
of the SIBS instrument
were evaluated by
several measures.
Instrument reliability
and validity were
found to be “very
good, with high
internal consistency
and strong test-retest
reliability
Scoring instructions:
 For positively worded items (items where answers
indicating agreement seem more spiritual):
 These items have been marked with the letter “P” and
shaded for ease of use.
 Strongly agree = 5; Agree = 4; Neutral = 3; Disagree = 2;
Strongly disagree = 1.
 For negatively worded items, where agreement would
seem less spiritual:
 Strongly agree = 1; Agree = 2; Neutral = 3; Disagree = 4;
Strongly disagree = 5.
 For items 24 - 26:
 Highest frequency category = 5; Next highest category =
4; Middle frequency = 3; Next to lowest frequency = 2;
Lowest frequency = 1


100 surveys collected.
› 96 were utilized for the study
› Surveys were scored by hand and recorded

Using the patient identifiers, the
practice’s electronic medical record
was accessed and the patient charts
retrieved. Age was verified with date of
birth and gender was recorded for each
patient

List of active diagnoses was counted
and number recorded
› Exclusions: trauma/traumatic pathology

List of active medications was counted
and recorded
› Inclusions: rx medication, vitamins, herbal
supplements

Patient identifiers were removed

Pearson’s Correlation performed:
› Age vs. SIBS score
› SIBS score vs. # diagnoses
› SIBS score vs. # medications

Data broken down into age groups
› 18-29yo, 30-39yo, 40-49yo, 50-59yo, 60-69yo,
70+ yo
› Analysis performed for each age group
Table 1.
Males
Females
All
Total # of people
35 (36.5%)
61 (63.5%)
96 (100%)
Average Age
53.3
46.3
48.8
Average Spirituality Score
91.22
94.8
93.5 (26-130 possible)
Average # medical diagnoses
5.1
6.3
5.9
Average # medications
5.5
5.6
5.57
Table 2.
Age group
N
Avg. age
Avg. # diagnoses
Avg. # medications
Avg. score
ALL
96
48.88
5.9
5.57
93.5
18-29
13
25.85
3
2.8
81
30-39
18
35.39
4.7
3.7
86
40-49
18
44.83
5.8
5.7
100
50-59
23
54.09
6.6
6.1
96.2
60-69
15
64.73
8.6
8.5
96.5
70+
9
77.44
6.5
6.3
106.6
group
Score
Age
#meds
#dx
All
Score
Pearson Correlation
1
.408**
.081
.086
Age 18-29
Score
Pearson Correlation
1
.279
.207
.402
Age 30-39
Score
Pearson Correlation
1
.247
-.407
-.361
Age 40-49
Score
Pearson Correlation
1
-.172
.191
.209
Age 50-59
Score
Pearson Correlation
1
-.221
.325
-.385
Age 60-69
Score
Pearson Correlation
1
.051
.051
-.069
Age 70+
Score
Pearson Correlation
1
-.248
-.392
.486
**. Correlation is significant at the 0.01 level (2-tailed).
The only significant relationship was a
positive correlation between overall
score and age.
 participants ages 30-39 and ages 50-59
followed the hypothesized pattern

› Negative linear correlation between
 SIBS score vs. # diagnoses
 SIBS score vs. # medications

Participants ages 18-29 and ages 40-49
demonstrated a pattern opposite of
what was expected
› Positive linear correlations between
 SIBS score vs. # diagnoses
 SIBS score vs. # medications

Participants ages 60-69 showed no
correlations between any data elements

Participants aged 70 and older showed
a negative correlation between SIBS
score and # of diagnoses but a positive
correlation between SIBS score and # of
medications
Directionality was not studied
 As a person ages, they are more likely to
have higher levels of self-reported
spirituallity

› ?variable of generation vs. aging process

Small sample size (96)
› Even smaller samples sizes when broken
down into age groups
Population socioeconomic status not
representative of entire population
 Practice physicians may auto-select
patients with greater spiritual
involvement and belief
 More spiritual patients may have chosen
to participate more often

Patients receiving healthcare at the
moment of survey completion may not
represent general population
 Race/ethnicity not considered
 Researchers not blind


EMR- great improvement over paper
charts but not infallible secondary to user
error
› Medications listed but not renewed within
appropriate intervals
› Medications given but no documented
supporting diagnosis
› All active diagnoses and medications were
recorded for purpose of study
Studies have consistently shown
spirituality to play a role in an individual’s
life and often has a significant effect on
a person’s physical health
 This study attempted to define the
relationship between the spiritual and
physical health of a person. The data did
not support any direct relationship in one
direction or another, but the study did
have multiple limitations.




Despite the large number of limitations within
this study and the lack of supporting evidence,
there is promise for future studies.
A similar study conducted in several different
practices within a geographical location might
yield a larger and more diverse sample
population and lend itself to more significant
findings.
It would be interesting to study patients using
the SIBS to evaluate spirituality over time in
concurrence with overall health in order to
determine the directional relationship between
the two.
Andrew Harbison, DO, preceptor
 Julie Thomas, DO, OGME-I


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
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
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
Wilson Bill, et al. The Big Book of Alcoholics Anonymous. Alcoholics Anonymous World
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
Hatch R, Burg MA, Naberhaus DS, Helmich LK. The Spiritual Involvement and Beliefs
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
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