The influences of faith on illness representations and coping procedures of mental and cognitive health among aging Arab refugees: a qualitative study

Lana Bridi; Dahlia A Kaki; Behnan Albahsahli; Dania Abu Baker; Xara Khan; Raghad Aljenabi; Nissma Bencheikh; Melody K Schiaffino; Alison A Moore; Tala Al-Rousan

doi:10.3389/fpsyt.2023.1083367

The influences of faith on illness representations and coping procedures of mental and cognitive health among aging Arab refugees: a qualitative study

Front Psychiatry. 2023 May 8:14:1083367. doi: 10.3389/fpsyt.2023.1083367. eCollection 2023.

Authors

Lana Bridi¹, Dahlia A Kaki^{2

3}, Behnan Albahsahli³, Dania Abu Baker^{3

4}, Xara Khan^{3

5}, Raghad Aljenabi⁵, Nissma Bencheikh¹, Melody K Schiaffino^{6

7}, Alison A Moore¹, Tala Al-Rousan³

Affiliations

¹ School of Medicine, University of California, San Diego, San Diego, CA, United States.
² School of Medicine, University of California, San Francisco, San Francisco, CA, United States.
³ Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States.
⁴ School of Social Work, San Diego State University, San Diego, CA, United States.
⁵ School of Social Sciences, University of California, San Diego, San Diego, CA, United States.
⁶ School of Public Health, San Diego State University, San Diego, CA, United States.
⁷ Center for Health Equity, Education, and Research, UCSD Moores Cancer Center, San Diego, CA, United States.

Abstract

Introduction: Refugees experience higher rates of mental illness such as depression and post-traumatic stress disorder (PTSD) which are documented risk factors for dementia. Faith and spiritual practices have been shown to play a significant role in patients' understanding and coping with illness, however, this field of study among refugee populations remains lacking. This study aims to address this literature gap by examining the role of faith on mental health and cognitive health among Arab refugees resettled in Arab and Western countries.

Materials and methods: A total of 61 Arab refugees were recruited through ethnic community-based organizations in San Diego, California, United States (N = 29) and Amman, Jordan (N = 32). Participants were interviewed through in-depth, semi-structured interviews or focus groups. Interviews and focus groups were transcribed, translated, and coded using inductive thematic analysis and organized based on Leventhal's Self-Regulation Model.

Results: Faith and spiritual practices significantly impact participants' illness perceptions and coping procedures regardless of resettlement country or gender. Several themes emerged: (1) participants believe in the interdependent relationship between mental and cognitive health. (2) There is a self-awareness of the impact of the refugee experience and trauma on participants' mental health problems, leading to a belief of increased personal risk for developing dementia. (3) Spiritual fatalism (belief that events are predetermined by God, fate, or destiny) greatly informs these perceptions of mental and cognitive health. (4) Participants acknowledge that practicing faith improves their mental and cognitive health, and many read scripture to prevent dementia. (5) Finally, spiritual gratitude and trust are important coping procedures that build resilience among participants.

Conclusions: Faith and spirituality play an important role in shaping Arab refugees' illness representations and coping procedures of mental and cognitive health. Holistic public health and clinical interventions tailored to the spiritual needs of aging refugees and incorporating religion in prevention strategies are increasingly needed to improve the brain health and wellbeing of refugees.

Keywords: Alzheimer's; Christianity; Islam; Self-Regulation Model; dementia; religion; spirituality.

Grants and funding

K01 AG068592/AG/NIA NIH HHS/United States