. 2021 Oct 21;19:246. doi: 10.1186/s12955-021-01878-7

Table 3.

Synthesis of the studies distributed according to similar instruments measuring S/R and QoL

Author/year /study design/country	Objectives	Methods	Results	Conclusions
Chai et al. (2012) [41] Observational cross-sectional New Zealand	To verify whether domestic and international students, with different ethnicities, adopt S/R coping strategies and how these affects QoL	679 college students Female (495), Male (184) Average age = 22.59 years old	WHOQOL-SRPB; WHOQOL-bref	Europeans x Asians: SRPB = 24.79 and 26.85 Coping with stressors F(1.433) = 30.81, higher among Asian students S/R predicts psychological domains among Asian students (β = *0.22)	↑ SRPB»► ↑ ability to cope with stress; ↑ SRPB»► ↑ psychological domains, social relationships, especially among Asian students when compared to European students
Hsu et al. (2009) [37] Observational cross-sectional New Zealand	To verify whether S/R is related with QoL and with coping mechanisms among domestic and international students	382 college students Gender not reported Average age = 23.78 years old	WHOQOL-SRPB; WHOQOL- bref	Domestic x international students: SRPB = 24.01 and 26.92* Correlations SRPB x psychological domain = 0.36 and 0.32 SRPB x social relation domains = 0.13 and *0.23	↑ SRPB»► ↑ psychological domain in both groups; ↑ social relationships among internationals ↑ SRPB»► ↑ social relationships among international students
Krageloh et al. [30] (2015) Observational cross-sectional New Zealand	To verify the effect of S/R and personal beliefs on the QoL of student affiliated with a religion or not	275 medical students Female (156), Male (118) Average age = 22.86 years old	WHOQOL-SRPB; WHOQOL- bref	General mean of the WHOOL-SRPB facets: *14.35 (religious), 10.82 (non-religious)	↑ SRPB»► ↑ General QoL ↑ hope, optimism, and meaning of life»► ↑ psychological domain for all students
Deb and Strodl [29] (2018) Observational cross-sectional India	To verify association between S/R and QoL among graduate Indian students	475 graduate students Female (234), Male (241) Average age = 22.13	SAI: DUREL, EWBS, NRCOPE, MHLC; WHOQOL-bref	Most significant correlations: NRCOPE x psychological domain = 0.60 NRCOPE x QV = 0.60 Most significant regressions: All S/R measures with psychological domains (F = 35.10) and Environment (F = 25.04)	↑ E/R»► ↑ psychological and environmental domains ↑ E/R»► ↑ Total QoL, emphasis on the hope and high self-control facets
Felicilda-Reynaldo et al. (2019) [42] Observational cross-sectional USA	To verify the predictive role of S/R on the QoL of nursing students from four countries	659 nursing students Female (112), Male (547) Average age = 21.14 years old	DUREL, SCS; WHOQOL- bref	Linear regression S/R x QoL: Organizational and non-organizational religiosity x physical domain (β = 0.98 and β = 0,99), physical domain (β = 0.98 and β = 0.99). Non religious coping x psychological domain (β = *0.98)	↑ Organizational and on non-organizational S/R»► ↑ physical domain and environment ↑ Non-organizational S/R»► ↑ psychological domain; ↑ Non-religious coping»►↑ QoL in the 4 domains
Lau et al. (2015) [43] Longitudinal observational China	To verify the causal model in the relationship between spirituality and QoL during three years among college students	1160 college students Female (787), Male (373) Average age = 20.9 years old	STS; WHOQOL-bref	Direct effects between the 1^st and 3^rd assessment of the STS in WHOQOL-brief (β = *0.130). The inverse did not occur (β = 0.098)	Spirituality predicted QoL but not vice-versa, regardless of affiliation or gender
Pillay et al. (2016) [28] Observational cross-sectional South Africa	To assess the role of spirituality in the relationship with depressive symptoms and QoL among medical students	230 medical students 166) Average age = 21 years old	SIBS; WHOQOL-bref	r de person SIBS x WHOQOL-brief = 0.294 SIBS x depression symptoms = − 0.143	↓ S/R»► ↑ depressive symptoms ↑ S/R»► ↑ QoL
Casu et al. (2018) [38] Observational cross-sectional Brazil	To verify how spirituality (S) is associated with stress and QoL among infertile couples	152 couples (n = 304) Average age = 36.67 years old	FACIT-sp; WHOQOL-bref	Total effect of spirituality on QoL, B = * 0.55	↑ S was positively associated with ↑ individual QoL ↑ S ↓ stress among infertile couples
DadkhahtehranI et al. (2018) [39] Observational cross-sectional Iran	To assess the association between religious coping and QoL among infertile individuals and their spouses	200 couples (n = 400) Average age = 30.71 years old	Brief RCOPE scale; SF-36	Positive religious coping among the wives x QoL (β = 0.51), negative coping x QoL (β = − 1.31). Positive coping among the husbands x QoL (β = *0.80)	Personal beliefs positively influence QoL, but only individually among the wives; this effect was not found among their partners
Gonçalves et al. (2018) [40] Observational cross-sectional Brazil	To investigate the relationship between S/R and mental health and QoL in a riverside community	129 individuals Female (59), Male (70) Average age = 36.6 years old	SSRS, DUREL; SF-12	Linear regression S x anxiety (β = * − 0.236) and depression (β = * − 0.398). Non-organizational religiosity x anxiety (β = * − 0.250), x depression (β = * − 0.351). Intrinsic religiousness x depression (β = * − 0.315)	↑ S»► ↓ anxiety and depression symptoms; ↑ non-organizational R and intrinsic R»► ↓ anxiety and depression; S/R measures were not associated with QoL

Author/year /study design/country

Objectives

Methods

Results

Conclusions

Sample

S/R and QoL instruments

Chai et al. (2012) [41]

Observational cross-sectional

New Zealand

To verify whether domestic and international students, with different ethnicities, adopt S/R coping strategies and how these affects QoL

679 college students

Female (495), Male (184)

Average age = 22.59 years old

WHOQOL-SRPB;

WHOQOL-bref

Europeans x Asians:

SRPB = 24.79 and *26.85

Coping with stressors F(1.433) = *30.81, higher among Asian students

S/R predicts psychological domains among Asian students (β = *0.22)

↑ SRPB»► ↑ ability to cope with stress;

↑ SRPB»► ↑ psychological domains, social relationships, especially among Asian students when compared to European students

Hsu et al. (2009) [37]

Observational cross-sectional

New Zealand

To verify whether S/R is related with QoL and with coping mechanisms among domestic and international students

382 college students

Gender not reported

Average age = 23.78 years old

WHOQOL-SRPB;

WHOQOL- bref

Domestic x international students:

SRPB = 24.01 and 26.92*

Correlations SRPB x psychological domain = *0.36 and *0.32

SRPB x social relation domains = 0.13 and *0.23

↑ SRPB»► ↑ psychological domain in both groups; ↑ social relationships among internationals

↑ SRPB»► ↑ social relationships among international students

Krageloh et al. [30] (2015)

Observational cross-sectional

New Zealand

To verify the effect of S/R and personal beliefs on the QoL of student affiliated with a religion or not

275 medical students

Female (156), Male (118)

Average age = 22.86 years old

WHOQOL-SRPB;

WHOQOL- bref

General mean of the WHOOL-SRPB facets:

*14.35 (religious), 10.82 (non-religious)

↑ SRPB»► ↑ General QoL

↑ hope, optimism, and meaning of life»► ↑ psychological domain for all students

Deb and Strodl [29] (2018)

Observational cross-sectional

India

To verify association between S/R and QoL among graduate Indian students

475 graduate students

Female (234), Male (241)

Average age = 22.13

SAI: DUREL, EWBS, NRCOPE, MHLC;

WHOQOL-bref

Most significant correlations:

NRCOPE x psychological domain = *0.60

NRCOPE x QV = *0.60

Most significant regressions:

All S/R measures with psychological domains (F = *35.10) and Environment (F = *25.04)

↑ E/R»► ↑ psychological and environmental domains

↑ E/R»► ↑ Total QoL, emphasis on the hope and high self-control facets

Felicilda-Reynaldo et al. (2019) [42]

Observational cross-sectional

USA

To verify the predictive role of S/R on the QoL of nursing students from four countries

659 nursing students

Female (112), Male (547)

Average age = 21.14 years old

DUREL, SCS;

WHOQOL- bref

Linear regression S/R x QoL:

Organizational and non-organizational religiosity x physical domain (β = *0.98 and β = *0,99), physical domain (β = *0.98 and β = *0.99). Non religious coping x psychological domain (β = *0.98)

↑ Organizational and on non-organizational S/R»► ↑ physical domain and environment

↑ Non-organizational S/R»► ↑ psychological domain;

↑ Non-religious coping»►↑ QoL in the 4 domains

Lau et al. (2015) [43]

Longitudinal observational

China

To verify the causal model in the relationship between spirituality and QoL during three years among college students

1160 college students

Female (787), Male (373)

Average age = 20.9 years old

STS;

WHOQOL-bref

Direct effects between the 1^st and 3^rd assessment of the STS in WHOQOL-brief (β = *0.130). The inverse did not occur (β = 0.098)

Spirituality predicted QoL but not vice-versa, regardless of affiliation or gender

Pillay et al. (2016) [28]

Observational cross-sectional

South Africa

To assess the role of spirituality in the relationship with depressive symptoms and QoL among medical students

230 medical students

166)

Average age = 21 years old

SIBS;

WHOQOL-bref

r de person SIBS x WHOQOL-brief = *0.294

SIBS x depression symptoms = * − 0.143

↓ S/R»► ↑ depressive symptoms

↑ S/R»► ↑ QoL

Casu et al. (2018) [38]

Observational cross-sectional

Brazil

To verify how spirituality (S) is associated with stress and QoL among infertile couples

152 couples (n = 304)

Average age = 36.67 years old

FACIT-sp;

WHOQOL-bref

Total effect of spirituality on QoL, B = * 0.55

↑ S was positively associated with ↑ individual QoL

↑ S ↓ stress among infertile couples

DadkhahtehranI et al. (2018) [39]

Observational cross-sectional

Iran

To assess the association between religious coping and QoL among infertile individuals and their spouses

200 couples (n = 400)

Average age = 30.71 years old

Brief RCOPE scale;

SF-36

Positive religious coping among the wives x QoL (β = *0.51), negative coping x QoL (β = * − 1.31). Positive coping among the husbands x QoL (β = *0.80)

Personal beliefs positively influence QoL, but only individually among the wives; this effect was not found among their partners

Gonçalves et al. (2018) [40]

Observational cross-sectional

Brazil

To investigate the relationship between S/R and mental health and QoL in a riverside community

129 individuals

Female (59), Male (70)

Average age = 36.6 years old

SSRS, DUREL;

SF-12

Linear regression S x anxiety (β = * − 0.236) and depression (β = * − 0.398). Non-organizational religiosity x anxiety (β = * − 0.250), x depression (β = * − 0.351). Intrinsic religiousness x depression (β = * − 0.315)

↑ S»► ↓ anxiety and depression symptoms;

↑ non-organizational R and intrinsic R»► ↓ anxiety and depression;

S/R measures were not associated with QoL

DUREL (Duke University Religious Index), EWBS (Existential Well-Being Scale), FACIT-Sp (The Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale), MHLC (Multidimensional Health Locus of Control Scale), NRCOPE (Negative Religious Cope), RCOPE (Religious Coping Strategies), SAI (Spiritual Attitude Inventory) SIBS (Spiritual Involvement and Beliefs Scale), SSRS (Spirituality Self Rating Scale), STS (Spiritual Transcendence Scale), SCS (Spiritual Coping Strategy Scale), SWBQ-G (Spiritual Well-Being Questionnaire Germany), SWBS (Spiritual Well-Being Scale) WHOQOL-SRPB (World Health Organization Quality of Life—Spirituality, Religiousness and Personal Beliefs)

(*): considered significant (p < 0.05 or < 0.01)

(↑): Increase, (↓): decrease, (»►): resulted/produced/meant