UC Research on Complementary Medicine Replicated at UAB

UC’s Sian Cotton, PhD, has spent much of her research career studying how religion and spirituality, when used alongside traditional therapies, can help people cope with a number of illnesses.

Now, her work is being replicated in additional studies at other institutions to validate and build upon data that supports the use of complementary medicine in the care of children and adolescents with chronic illness.

In February 2012, Cotton and colleagues published a study in the journal Pediatric Blood & Cancer, further detailing work that showed children with sickle cell disease reported using religion to cope with their illness.

"Nineteen children participated in an interview and in an art drawing exercise, focused on the use of general coping and religious coping,” says Cotton, associate professor in the department of family and community medicine who is also affiliated with Cincinnati Children’s Hospital Medical Center and is the director of the new UC Center for Integrative Health and Wellness.

She said the semi-structured interviews were coded, organized and analyzed using qualitative software.

Findings showed that children used religion to gain control, make meaning of their condition and find comfort.

"Most children reported praying to get well, to keep them from getting sick and to get out of the hospital,” she says. "They described a functional God who made them take their medicine or took them to the hospital and an emotional God who made them happy and comforted them when they were sad or scared.”

"These results show that health care providers should be aware of the importance of religion to many children and integrate religion, as appropriate, into discussions about coping with sickle cell disease.”

After publishing these results, she was contacted by University of Alabama Birmingham researcher Avi Madan-Swain, PhD, associate professor in the department of pediatrics at the University of Alabama at Birmingham and director of the Hope and Cope Program within the Alabama Center for Childhood Cancer and Blood Disorders at Children’s Hospital of Alabama, and doctoral student Nina Reynolds, who were interested in replicating the study with children and adolescents being treated for cancer.

"Aggressive medical treatment protocols and illness-related disruptions on social and emotional development put children diagnosed with cancer at risk for psychological adjustment difficulties,” says Madan-Swain. "The use of cognitive coping strategies has been well documented to address these issues. However, more recently, there has been growing recognition that spiritual beliefs represent a unique set of cognitions that are important to understand.  

"A review of the literature revealed Dr. Cotton’s seminal work with spiritual coping in children diagnosed with sickle cell disease.  Subsequently, Nina Reynolds, doctoral student in the UAB-Medical Psychology program, and I consulted with Dr. Cotton and her research team and are using the same study design to examine spiritual coping in children aged 8 to18 at diagnosis and one-year post diagnosis with cancer.”

She adds that the team will also be examining spiritual coping in parents.  

The study, which just began enrollment, will most likely take a year, says Madan-Swain.   

"It will be interesting to see what similarities and differences exist between youth diagnosed with cancer and those with sickle cell disease,” she says. "We also plan on examining whether caregiver spiritual coping is related to their emotional health.”    

"While children and adolescents with sickle cell disease have specific issues that are unique to that group, these studies are helping to create a systematic approach to better understanding spirituality and religious coping in other pediatric populations,” Cotton says. "There truly are few studies looking at religious or spiritual coping in chronic illness. With collaborations and partnerships like this one with Dr. Madan-Swain and Ms. Reynolds, we are making steps to address patients’ needs in a holistic way and improve both their experiences and outcomes.”