Relationships among spirituality, religious practices, personality factors, and health for five different faith traditions

Spiritual Fitness, Spiritual Readiness, and Depressive Symptoms in Reserve Officers' Training Corps Cadets

CONTEXT

Over the past decade, the United States military has taken an interest in addressing soldiers' spiritual fitness and readiness to help improve their mental health and resiliency. Similar efforts have not been applied within the Reserve Officers' Training Corps (ROTC) population despite the mental health challenges these college students experience.

OBJECTIVE

To examine spiritual readiness, spiritual fitness, and depressive symptoms in ROTC cadets.

DESIGN

Cross-sectional study.

SETTING

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS

We recruited ROTC cadets from 1 large southeastern university (n = 91 of 315, 28.9% response rate). The ROTC cadets (age = 21 ± 3 years; men = 68, 74.7%; women = 22, 24.2%; missing = 1, 1.1%) were mainly classified as juniors (n = 30, 33.0%) and in Army ROTC (ROTC branch: Army = 69, Air Force = 20, Navy = 2).

MAIN OUTCOME MEASURE(S)

The survey contained 3 validated instruments used to assess spiritual fitness (the Spiritual Fitness Inventory [SFI]), spiritual readiness (Spiritual Wellbeing Scale [SWBS]), and mental health via depressive symptoms (Patient Health Questionnaire [PHQ-9]). Results were analyzed using descriptive statistics and nonparametric Mann-Whitney U tests to compare belief in God or gods with the dependent measures. A Pearson correlation was calculated to assess the relationship between the SWBS score and PHQ-9 data.

RESULTS

In total, 85.7% (n = 78/91) of ROTC cadets stated that they believed in God or gods. Overall, the cadets were considered to have average spiritual fitness (mean = 75.04 ± 14.89) and moderate spiritual well-being (mean = 90.46 ± 18.09). The average PHQ-9 score was 4.22 ± 5.25. Individuals who believed in God or gods had higher spiritual readiness (believer = 94.44 ± 16.10, nonbeliever = 67.00 ± 9.35; P ≤ .01). No statistically significant differences were noted for symptoms of depression (believer = 3.38 ± 4.90, nonbeliever = 6.60 ± 6.90; P = .143) or spiritual fitness (believer = 76.12 ± 14.78, nonbeliever = 64.40 ± 12.68; P = .054) in ROTC cadets based on belief status.

CONCLUSIONS

Overall, the ROTC cadets had moderate to average spiritual fitness and readiness, with typical depressive symptoms scores. Spiritual readiness was different for those who believed in God or gods, and existential well-being was significantly correlated with depressive symptoms.

Global coronavirus vaccination campaign: The role of religious workers in vaccine distribution, public mobilization and the eradication of nationalism

BACKGROUND

Throughout history, the world has faced numerous health challenges and outbreaks, but through the dedication of medical professionals, solutions have been found. Despite this, the emergence of the coronavirus (COVID-19) has presented a new and dangerous threat. Nevertheless, with unwavering commitment, health experts have triumphantly discovered a remedy.

OBJECTIVES

The study aimed to examine how religious workers worldwide could contribute positively to ensuring the fair distribution of COVID-19 vaccines, addressing vaccine hesitancy, encouraging people to get vaccinated, and preventing vaccine nationalism.

METHOD

Our study employed a refined qualitative content analysis methodology to categorize factual information and pave the way for subsequent policymakers. We meticulously curetted the most trustworthy secondary data sources and utilized them to analyze the study.

RESULTS

The content analysis reveals that religious workers played an active role in the global coronavirus vaccination drive by working towards better vaccine distribution, encouraging people to get vaccinated and countering hesitation and nationalism.

CONCLUSION

In light of the discoveries, it would be prudent for policymakers to engage religious workers in advancing the cause of public health, regardless of whether the health matters are localized, national, or global in scale. This strategy has the potential to be both alluring and convincing.

Personality, Religiosity and Satisfaction with Life in Young Muslim and Christian Women in Pakistan

This study investigated the relationship between personality traits, religiosity and satisfaction with life in young Muslim and Christian women. The current research involved a convenience sample (N = 200; Mage = 21.26) that was drawn from Kinnaird College for Women University Lahore, and Youhanabad Town Lahore, Pakistan. The Big Five Inventory, Centrality of Religiosity Scale, and the Satisfaction with Life Scale were administered. Results of correlation analysis demonstrated a significant positive relationship between 'conscientiousness' and 'religious ideology' among Muslim women, whereas 'openness' and 'agreeableness' were strongly associated with all the dimensions of religiosity in Christian women. Findings of hierarchical linear regression analyses indicated that extraversion and agreeableness significantly predicted life satisfaction among Muslim and Christian participants respectively. Religiosity did not contribute to life satisfaction among both groups. Results of independent sample t-test showed that Christian women reported significantly higher degrees of extraversion and life satisfaction as compared to Muslim women who in contrast reported significantly higher level of agreeableness, neuroticism, and public religious practice. The findings are discussed in the context of gender, religion, culture and mental health.

Spiritual support of transgender individuals: a literature review

Spiritual support has been a staple of healthcare before hospitals in western civilizations were established by communities of faith. Research has demonstrated that wellbeing is associated with balanced care for the body, mind, and spirit. Healthcare disparities are being identified as disproportionally impacting transgender and gender nonconforming (TGNC) individuals. The root cause of this disparity is being studied as are medical and wellbeing interventions, including the benefit of spiritual support. This author's objective was two-fold. First, to identify opportunities for extending spiritual support to TGNC individuals in healthcare by chaplains. Secondly, to identify evidence of current spiritual support advocacy initiatives and interventions for TGNC patients in healthcare by chaplains.

Relationship between Neuroticism, Spiritual Well-Being, and Subjective Well-Being in Korean University Students

Previous studies on mental health and quality of life have revealed that religiosity/spirituality was positively associated with indicators of well-being and personality factors. However, limited research has examined the relationship between spiritual well-being, the subfactors of the personality factor Neuroticism (i.e., anxiety, hostility, depression, self-consciousness, impulsiveness, and vulnerability), and subjective well-being in a non-Western sample. The present findings revealed that the five subfactors of neuroticism did not have an equally negative or positive effect on spiritual and subjective well-being among Korean undergraduate University students. Regarding its subdimensions, vulnerability was strongly associated with spiritual well-being, while depression was closely linked to subjective well-being. Moreover, we found that spiritual well-being exerted significant effects on subjective well-being above personality factors. The significance of the findings and directions for further research have been discussed.

Nursing care based on the Support-Based Spiritual Care Model increases hope among women with breast cancer in Iran

PURPOSE

Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer.

METHODS

In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups.

RESULTS

The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05).

CONCLUSION

According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer.

CLINICAL IMPLICATIONS

Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model.

Examining Cultural, Ethnic, and Religious Differences with the Brief Multidimensional Measure of Religiousness and Spirituality in the U.S. and India

The Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) is regularly used to measure spirituality and religiosity in U.S. Christian populations, although it has not been used for making comparisons with non-Western groups. This study compared BMMRS results for 109 individuals (60 in the U.S. and 49 in India) with traumatic brain injury (TBI) from different cultures (U.S., India), ethnic groups (African American, Caucasian, South Asian), and religions (Christian, Hindu, Muslim). In general, the results indicated that U.S. African Americans and Christians reported being the most spiritual, South Asians and Hindus the least. Groups differed significantly in self-reported spiritual experiences, but less in frequency of religious activities. Results suggest using caution when applying Western-based measures of religion and spirituality in non-Western, non-Christian populations.

Forgiveness and Health Outcomes in Cancer Survivorship: A Scoping Review

BACKGROUND

Religious and spiritual beliefs including forgiveness are an important aspect of cancer survivorship; however, the relationship between forgiveness and health is not well understood.

OBJECTIVE

The aim of this study was to conduct a scoping review that examines and maps the current research regarding relationships between forgiveness and health outcomes in individuals with cancer.

METHODS

We searched 5 electronic databases using key search terms related to forgiveness and cancer. Using a scoping review framework, we synthesized the existing literature regarding forgiveness and health among individuals with cancer and examined forgiveness as a process for coping with cancer.

RESULTS

We located 277 articles for review; 24 met inclusion criteria. Forgiveness in interpersonal relationships emerged more often as forgiveness coping than other types of forgiveness. Most studies reported a positive association between forgiveness and mental health. Fewer studies were available regarding relationships between forgiveness and physical health, and findings were mixed.

CONCLUSIONS

Forgiveness in interpersonal relationships is a spiritual concern for individuals with cancer. Addressing forgiveness needs may promote mental health in cancer survivors. More empirical evidence is needed to understand the role of forgiveness in physical health in individuals with cancer.

IMPLICATIONS FOR PRACTICE

Acknowledging forgiveness beliefs is a psychosocial-spiritual intervention that nurses can provide to support mental health in individuals with cancer. The potential role of forgiveness in physical health for individuals with cancer requires further study.

Meanings and Interpretations of Spirituality in Nursing and Health

Numerous spirituality models and tools have been developed in health education and research, but a gap still exists around the conceptual clarity and articulation of spirituality among nurses and healthcare providers. Nurses and healthcare providers still find it difficult to interpret and apply the concepts of spirituality in their practice settings. This paper provides a concept analysis of spirituality using the Walker and Avant method of conceptual analysis. Several databases including conceptual and empirical literature from various disciplines have been used. The defining attributes of spirituality included spirituality and religion as a separable or mutual construct, spirituality as a personal construct, wholeness and integration, meaning making and purpose, sense of connectedness and relationship, transcendence, inner source of power, energy, and strength. Major antecedents of spirituality found were faith, personal values, and belief systems, and life adversities. Consequences of spirituality included personal/spiritual growth and wellbeing, resilience, and religiousness. Spirituality is a unique and personal human experience, an individualised journey characterised by multiple experiential accounts such as meaning making, purpose, connectedness, wholeness and integration, energy, and transcendence. Spiritual experiences are often difficult to examine and measure using scientific tools and empirical language. Healthcare providers need to fully understand and apply spirituality and spiritual care aspects to provide holistic person-centred care.

The Relationship Between Spiritual Life and Quality of Life in People with Intellectual Disability and/or Low-Functioning Autism Spectrum Disorders

Spirituality seems to represent a relevant domain in the person-centred care planning and outcome assessment for persons with intellectual disability and low-functioning autism spectrum disorder. Despite this, the impact of spirituality on subjective well-being and quality of life (QoL) has been scarcely investigated. The aim of the present study was to map the international scientific literature in order to identify the reasons of such misconsideration and the key points for future research and practice implementation. The relationship between spirituality and QoL depends on a complexity of factors, ranging from QoL theoretical models to services' organisation. Personal attitude, family members, health and social-care personnel, training, faith and life communities, and even different religions seem to deserve an in-depth analysis.

The Effect of Hajj Trip on Mental Health: A Longitudinal Study

Hajj is a spiritual journey and religious ritual which is performed every year. Here, we evaluate the psychological effect of the Hajj. Using General Health Questionnaire (GHQ) questionnaire with 28 questions, the mental health of the pilgrims was assessed before and after the journey. A total of 154 people were questioned, 72 pilgrims (47%) were male. The mean GHQ score of participants before the journey was 50.1 and after the journey was 49.5 (P = 0.248). The results of analysis of variance and generalized estimating equation indicated that the GHQ scores had no significant difference before and after the journey.

Christianity and Schizophrenia Redux: An Empirical Study

This paper explores the relationship among schizophrenia, spirituality, and Christian religiosity. We interviewed 120 patients with schizophrenia and 120 control individuals (74.2 % of individuals with self-reported Christian religions). Patients with schizophrenia showed increases in positive spirituality and decreases in positive congregational support, as measured by the Brief Multidimensional Measure of Religiousness/Spirituality. There was no significant difference in Christian religiosity. Higher positive spirituality was predicted by more severe self-disorder, perceptual disorder, and positive clinical symptoms. Schizophrenia patients with religious delusions did not exhibit enhanced Christian beliefs and rituals. These results do not confirm the hypothesis of general hyper-religiosity in schizophrenia.

Later-life satisfaction with adult children's achievements: does parents' personality matter?

The happy personality model proposes that individuals with happy personality traits are more satisfied with the events of their lives than those who are not. Based on this proposition, this study examined whether parents' personality - as measured by the Big Five typology - would predict satisfaction with the achievements of adult children. Participants include 465 community elders from Ekiti State, comprising 294 mothers with mean age 74.18 ± 9.42. Both univariate and multivariate statistics were used in data analyses. Results indicated that mothers' extraversion and conscientiousness respectively predicted satisfaction with children's achievements in relationships and spirituality. Conversely, mothers' neuroticism predicted dissatisfaction in education, occupation, finances and health achievements. Fathers' agreeableness and openness traits respectively predicted satisfaction in education and occupation. These results provide support for the happy personality model by demonstrating that extraversion, agreeableness, and conscientiousness predict satisfaction with life events, while neuroticism predicts dissatisfaction.

Factors promoting Iranian older adults' spirituality: a qualitative content analysis

Background

Spirituality plays an important role during old age, but reveals itself as a confounding mental health concept, which needs to be defined when providing spiritual care. The purpose of this study was to explore factors promoting Iranian older adults’ spirituality.

Method

In a qualitative content analysis approach, we searched for the factors promoting spirituality among a selection of Iranian older adults. Totally, 22 people aged above 60 years old were interviewed using open-ended questions. The recorded interviews were then transcribed, and a coding process was applied based on a qualitative, conventional content analysis.

Results

Three key factors were found to promote the spirituality among the older adults: 1) insight in personal belief, 2) spiritual socialization, and 3) peace of mind. Traditional dimensions, the cultural surroundings, and participants’ religious beliefs were apparent in each of the categories.

Conclusion

Society’s role in making the seniors spiritual role models was very important; moreover the hereafter life on religious grounds seemed to be another important factor in reaching for high levels of spiritual and mystical perfection. Educational interventions based on the elders’ needs for spiritual empowering by health care professionals especially with regards to their spiritual based social interactions and reaching peace of mind, will comprise a major part of wellness approaches.

Religiousness, Spirituality, and Salivary Cortisol in Breast Cancer Survivorship: A Pilot Study

BACKGROUND

Psychoneuroimmunological theory suggests a physiological relationship exists between stress, psychosocial-behavioral factors, and neuroendocrine-immune outcomes; however, evidence has been limited.

OBJECTIVE

The primary aim of this pilot study was to determine feasibility and acceptability of a salivary cortisol self-collection protocol with a mail-back option for breast cancer survivors. A secondary aim was to examine relationships between religiousness/spirituality (R/S), perceptions of health, and diurnal salivary cortisol (DSC) as a proxy measure for neuroendocrine activity.

METHODS

This was an observational, cross-sectional study. Participants completed measures of R/S, perceptions of health, demographics, and DSC.

RESULTS

The sample was composed of female breast cancer survivors (n = 41). Self-collection of DSC using a mail-back option was feasible; validity of mailed salivary cortisol biospecimens was established. Positive spiritual beliefs were the only R/S variable associated with the peak cortisol awakening response (rs = 0.34, P = .03). Poorer physical health was inversely associated with positive spiritual experiences and private religious practices. Poorer mental health was inversely associated with spiritual coping and negative spiritual experiences.

CONCLUSIONS

Feasibility, validity, and acceptability of self-collected SDC biospecimens with an optional mail-back protocol (at moderate temperatures) were demonstrated. Positive spiritual beliefs were associated with neuroendocrine-mediated peak cortisol awakening response activity; however, additional research is recommended.

IMPLICATIONS FOR PRACTICE

Objective measures of DSC sampling that include enough collection time points to assess DSC parameters would increase the rigor of future DSC measurement. Breast cancer survivors may benefit from nursing care that includes spiritual assessment and therapeutic conversations that support positive spiritual beliefs.

Does Religion Predict Health-Promoting Behaviors in Community-Dwelling Elderly People?

As the aging phenomenon gains importance in many societies, regular health-promoting activities by the elderlies become more crucial for disability reduction and their health promotion. Religious viewpoints and perspectives can have an influence on the individuals' assessment of life events. Recent studies show a correlation between religiosity and mental health. However, there is limited number of studies on the relationship between religiosity and health behaviors, especially in elderly. The purpose of this research is to evaluate religion's predictive power in health-improving behaviors of the elderly. This cross-sectional study was conducted on 316 community-dwelling elderly with the mean age of 67.9 ± 6.6 years, who were functionally independent without cognitive or mental impairments. Health-promoting lifestyle profile 2 assessment (HPLP2) and Alport questionnaires were used to assess health behaviors and religious orientation, respectively. Data analysis was performed by independent T test and multiple linear regression models with SPSS version 23. An internal religious orientation was found in 71 elderly; this accounts for 22.5% of the study population. Based on the health behavior scoring 154 individuals, 48.8% of the study population obtained a score of higher or equal to 139. These individuals were placed on third quartile and higher. Among the health behavior components, "the health responsibility" was the only component related to religious orientation [internal 25.1 ± 6.6 (P < 0.001, r = 0.78) vs. external 22.6 ± 6.5 (P > 0.05, r = 0.22)]. Based on the multiple linear regression models, no significant relationship was found between total health behavior score and religious orientation. However, a significant relationship existed between the participants' health behaviors and some of their profile. The results indicate that despite good health behaviors in nearly half of the elderlies, no significant relationship was found between health behavior and religious orientation. The results suggest possible impact of other religion-related concepts including private religious behaviors, devotion, spiritual transcendence, religious adaptation, and religious traditions and experiences on the health behaviors. These concepts require further study for better understanding of their impact.

Perception of Spirituality and Spiritual Care among Muslim Nurses in Indonesia

This cross-sectional study was conducted to examine 256 Muslim nurses' perception of spirituality and spiritual care in Indonesia. The Spirituality and Spiritual Care Rating Scale (SSCRS) was translated and culturally adapted. Moderately high degrees in five domains and total SSCRS were found. Specialty, education level, clinical seniority, having spiritual training, and previous spiritual caring experience could impact on the SSCRS. Most nurses have cared for patients with spiritual needs, but denied having any formal training in providing spiritual care. Providing adequate curriculum and on-job training to equip nurses' knowledge and competence of spiritual care is urgent in Muslim healthcare environment.

Spiritual Factors Predict State and Trait Anxiety

This research study was designed to examine the effect of spiritual well-being and spirituality on state and trait anxiety. Two hundred and thirty-eight adults in the USA were surveyed using the State-Trait Anxiety Inventory, Duke University Religion Index, Spiritual Well-Being Scale, and Participant Questionnaire. Results indicate that spiritual well-being can predict 39.1 % of an adult's state anxiety and 37.9 % of trait anxiety. Furthermore, frequency of religious attendance, frequency of private religious activity, and intrinsic religiosity can predict 6.2 % of an adult's state anxiety and 8.6 % of trait anxiety. Recommendations for researchers and implications for clinicians are discussed.

Validation of Brief Multidimensional Spirituality/Religiousness Inventory (BMMRS) in Italian Adult Participants and in Participants with Medical Diseases

This study aimed at assessing the reliability and construct validity of Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) on Italian sample.

SAMPLE

353 Italian participants: 58.9% affected by different diseases and 41.1% healthy subjects. The results of descriptive statistics of internal consistency reliabilities (Chronbach's coefficient) of the BMMRS revealed a remarkable consistency and reliability of different scales DSE, SpC, SC, CSC, VB, SPY-WELL and a good Inter-Class Correlations ≥70 maintaining a good stability of the measures over the time. BMMRS is a useful inventory for the evaluation of the principal spiritual dimensions.

Spirituality in Arab Muslim Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Approach

BACKGROUND

A cancer diagnosis and treatment can be a stressful, life-altering experience that can pose a threat to life and raise existential challenges. Spirituality may influence the process of coping with the stress of the cancer experience. Studies of the role of spirituality for Muslim cancer patients and survivors are limited.

OBJECTIVE

The aim of this study was to understand the role of spirituality in the cancer experience among Arab Muslim hematopoietic stem cell transplant (HSCT) survivors.

METHODS

In this qualitative, descriptive study, 63 HSCT survivors (mean, 20.2 months) responded to 2 open-ended, self-report questions on the role of spirituality in their HSCT experience. Thematic analysis was used to identify themes related to spirituality.

RESULTS

Three dimensions that helped patients cope with their experiences were identified: sickness viewed in light of belief in God, use of religious/spiritual resources, and support from family and community. Two general themes described changes in their faith as a result of having the HSCT procedure: strengthening of faith in God and greater reliance on religious/spiritual activities.

CONCLUSION

Spirituality was important to the Arab Muslim survivors in coping with cancer and HSCT treatment. Muslim cancer survivors are often deeply connected to their religion.

IMPLICATIONS FOR PRACTICE

Healthcare providers in the United States and other Western countries need to be aware of the unique religious and spiritual needs of Muslim cancer survivors in order to provide them with culturally sensitive care. More research on the spiritual needs of Muslim cancer patients and survivors residing in Western countries is needed.

Effect of Religiosity on Voice

The aim of this study was to examine the relationship between religiosity and phonatory behavior. A total of 186 participants participated in a survey that included four sections: demographic data, extent of religiosity, history of dysphonia, phonatory behavior and laryngeal manipulation, in addition to the Voice Handicap Index (VHI-10). There was no significant association between the prevalence of phonatory symptoms and any of the religiosity questions. There was no significant association between phonatory behavior, history of laryngeal manipulation and any of the religiosity questions. There was also no significant association between the score of the Voice Handicap Index and any of the five religiosity questions. There is no association between religiosity and prevalence of phonatory disturbances, phonotraumatic behavior and/or history of laryngeal manipulation.

Do spirituality and religiousness differ with regard to personality and recovery from depression? A follow-up study

BACKGROUND

The studies show that both spirituality and religiousness are protective for mental health. Personality is related with course and outcome of depression, as well as spirituality and religiousness, and their relations toward to recovery from depression are underresearched. This study followed influence of spirituality and religiousness on course and outcome of depression in patients with depressive episode, controlled for personality dimensions.

METHODS

The patients were assessed with self-report measures of depression (Beck Depression Inventory), spirituality (WHO-Quality of Life-Spiritual, Religious, Personal Beliefs), religiousness (Duke University Religion Index) and personality (Temperament and Character Inventory). Ninety nine patients finished a year long follow up.

RESULTS

Higher spirituality influenced recovery of depression in patients with depressive episode, but religiousness did not show to be significant predictor of recovery for depression. Dimension harm avoidance was significant predictor of improvement of depression in all points of measurement.

LIMITATIONS

Some limitations of this research are small sample size, usage of the self-report measures of depression in follow-up period, and the predominantly Catholic affiliation of the participants that can impact the generalizability of our data to other denominations.

CONCLUSION

Spirituality and dimension harm avoidance are significant predictors of recovery from depression during a year long follow up.

A Model of Spirituality for Ageing Muslims

Spirituality's influence on general well-being and its association with healthy ageing has been studied extensively. However, a different perspective has to be brought in when dealing with spirituality issues of ageing Muslims. Central to this perspective is the intertwining of religion and spirituality in Islam. This article will contribute to the understanding of the nature of Islamic spirituality and its immense importance in the life of a practicing ageing Muslim. Consequently, it will help care providers to include appropriate spiritual care in the care repertoire of a Muslim care recipient. It is assumed that the framework for a model of spirituality based on Islamic religious beliefs would help contextualise the relationship between spirituality and ageing Muslims. Not only challenges, but also the opportunities that old age provides for charting the spiritual journey have underpinned this model.

A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship

Objective This is a review of spiritually based interventions (eg, mindfulness-based stress reduction) that utilized psychoneuroimmunological (PNI) outcome measures in breast cancer survivors. Specifically, this review sought to examine the evidence regarding relationships between spiritually based interventions, psychosocial-spiritual outcomes, and biomarker outcomes in breast cancer survivors. Methods A systematic search of 9 online databases was conducted for articles of original research, peer-reviewed, randomized and nonrandomized control trials from 2005-2015. Data were extracted in order to answer selected questions regarding relationships between psychosocial-spiritual and physiological measures utilized in spiritually based interventions. Implications for future spiritually based interventions in breast cancer survivorship are discussed. Results Twenty-two articles were reviewed. Cortisol was the most common PNI biomarker outcome studied. Compared with control groups, intervention groups demonstrated positive mental health outcomes and improved or stable neuroendocrine-immune profiles, although limitations exist. Design methods have improved with regard to increased use of comparison groups compared with previous reviews. There are few spiritually based interventions that specifically measure religious or spiritual constructs. Similarly, there are few existing studies that utilize standardized religious or spiritual measures with PNI outcome measures. Findings suggest that a body of knowledge now exists in support of interventions with mindfulness-breathing-stretching components; furthermore, these interventions appear to offer potential improvement or stabilization of neuroendocrine-immune activity in breast cancer survivors compared to control groups. Conclusion From a PNI perspective, future spiritually based interventions should include standardized measures of religiousness and spirituality in order to understand relationships between and among religiousness, spirituality, and neuroendocrine-immune outcomes. Future research should now focus on determining the minimum dose and duration needed to improve or stabilize neuroendocrine-immune function, as well as diverse setting needs, including home-based practice for survivors who are too ill to travel to group sessions or lack economic resources.

Spirituality and Its Relationship with Personality in Depressed People: Preliminary Findings

The relationship between spirituality and personality in patients with depression is complex and not much explored. The aim of our study is to examine the interconnection between the spiritual quality of life (QoL) and Cloninger's psychobiological model of personality in patients with depression. The sample consisted of 85 consecutive outpatients treated for depression. The measurements used were: Beck Depression Inventory, WHO-Quality of Life-Spiritual, Religious, Personal Beliefs, and Temperament and Character Inventory. The results have shown that higher harm avoidance, lower self-directedness and lower cooperativeness are personality dimensions associated with depression. The spiritual QoL has showed to play a significant role in depression, just as it has proved to be a unique predictor of lower depressive symptoms, adjusted for personality dimensions. The spiritual QoL itself is predicted by personality dimensions, self-directedness and self-transcendence implying that spirituality is a broader construct than the character dimension. Our findings may contribute to a more comprehensive understanding of depression, spirituality and personality.

Development and Initial Validation of a Spiritual Support Subscale for the MOS Social Support Survey

While spirituality and religious practices are important in coping with illness or other crises, there are few ways of assessing support that people receive from members of their spiritual communities. The goal of this study was to validate a new spiritual support subscale for the Medical Outcomes Study Social Support Scale (MOS-SSS). Questions for the subscale were formed based on responses of 135 breast cancer survivors who were interviewed about their cancer experience. Exploratory factor analysis resulted in four specific factors for the MOS-SSS: emotional/informational, tangible, affectionate, and spiritual support. The new spiritual support subscale has adequate reliability and validity and may be useful in assessing an area of support that is not always addressed.

Spirituality, gender, and drug use among students from one University in Barbados

The research aimed to clarify the relationships between spirituality, gender, and drug use among undergraduate students of one university in Barbados. A quota sample of 250 students was required from the Faculty of Social Sciences as the study was part of a larger multi-centric study involving students from the Faculty of Social Sciences from seven other participating countries in Latin America and the Caribbean. Significant negative relationships were found between a student's level of spirituality and their licit and illicit drug use over the past 12 and three months. Males and females also differed significantly in terms of illicit drug use (past 12 and three months). However no gender differences were found as it related to licit drug use. Moreover, females possessed significantly higher levels of spirituality than their male counterparts. Further qualitative research should be conducted among this age group within the Barbadian context to better explain these findings.

Dimensions of religiousness and spirituality as predictors of well-being in advanced chronic heart failure patients

We examined relationships between seven dimensions of religion/spirituality (RS) (forgiveness, daily spiritual experiences, belief in afterlife, religious identity, religious support, public practices, and positive RS coping) and three dimensions of well-being (physical, mental, and existential) in a sample of 111 patients with advanced chronic heart failure. Participants completed questionnaires at baseline and 3 months later. Results showed that fairly high levels of RS were reported on all seven dimensions. Furthermore, RS dimensions were differentially related to well-being. No aspect of RS was related to physical well-being, and only a few aspects were related to mental well-being. Forgiveness was related to less subsequent depression, while belief in afterlife was related to poorer mental health. All aspects of RS were related to at least one aspect of existential well-being. In particularly, daily spiritual experiences were linked with higher existential well-being and predicted less subsequent spiritual strain. These results are consistent with the view that in advanced disease, RS may not affect physical well-being but may have potent influences on other aspects of well-being, particularly existential aspects.

Schizophrenia--time to commit to policy change

Care and outcomes for people with schizophrenia have improved in recent years, but further progress is needed to help more individuals achieve an independent and fulfilled life. This report sets out the current need, informs policy makers and all relevant stakeholders who influence care quality, and supports their commitment to creating a better future. The authors recommend the following policy actions, based on research evidence, stakeholder consultation, and examples of best practice worldwide. (1) Provide an evidence-based, integrated care package for people with schizophrenia that addresses their mental and physical health needs. (2) Provide support for people with schizophrenia to enter and to remain in their community, and develop mechanisms to help guide them through the complex benefit and employment systems. (3) Provide concrete support, information, and educational programs to families and carers on how to enhance care for an individual living with schizophrenia in a manner that entails minimal disruption to their lives. (4) All stakeholders, including organizations that support people living with schizophrenia, should be consulted to regularly revise, update, and improve policy on the management of schizophrenia. (5) Provide support, which is proportionate to the impact of the disease, for research and development of new treatments. (6) Establish adequately funded, ongoing, and regular awareness-raising campaigns that form an integral part of routine plans of action. Implementation of the above recommendations will require engagement by every stakeholder, but with commitment from all, change can be achieved.

Perception of mental health in Pakistani nomads: an interpretative phenomenological analyses

The study was conducted to explore the mental health issues of Pakistani nomads and to uncover their concept, ideation, and perception about mental health and illnesses. It was an exploratory study situated in the qualitative paradigm. The research strategy used was Interpretative Phenomenological Analysis (IPA), as the study was planned to explore the lived experiences of nomads regarding mental health and coping strategies and how they interpret those experiences. For data collection, focus group discussions (FGDs) were conducted. Seven participants were included in the FGDs, and two FGDs were conducted composed of both genders. The responses were recorded, and data were transcribed and analysed using IPA. Data verification procedures of peer review, which help to clarify researcher bias and rich thick description, were used. The major themes were lack of resources and myriad unfulfilled needs, specifically the basic needs (food, shelter, and drinking and bathing water). Moreover, a strong desire to fulfil the secondary needs of enjoyment and having luxuries was also reflected. A list of recommendations was forwarded for policy making of this marginalized community and to create awareness regarding mental health.

Religious faith in coping with terminal cancer: what is the nursing experience?

This qualitative study describes nurses' reports on the role played by religious faith in the care of patients with terminal cancer. Using Gadamer's philosophical hermeneutics and C. Roy's adaptation model as a base, in-depth interviews were carried out with 23 nurses who had cared for patients with terminal cancer for at least 6 months. Three main themes emerged when a Gadamerian-based hermeneutic research method was applied: faith facilitates the coping process in cases of terminal cancer, faith hinders the coping process in cases of terminal cancer and terminal illness impacts faith. The lack of univocal results indicates that the role of faith in coping with death is essentially practical, individualised and changeable. The nurse-patient relationship can help to determine the spiritual needs of cancer patients at the end of life. This source of knowledge held by the nurse, together with the rest of the multidisciplinary team, can help to improve end-of-life care.

Evaluation of a salutogenetic concept for inpatient psychosomatic treatment

The increase of psychosomatic disorders due to cultural changes requires enhanced therapeutic models. This study investigated a salutogenetic treatment concept for inpatient psychosomatic treatment, based on data from more than 11000 patients of a psychosomatic clinic in Germany. The clinic aims at supporting patients' health improvement by fostering values such as humanity, community, and mindfulness. Most of patients found these values realized in the clinical environment. Self-assessment questionnaires addressing physical and mental health as well as symptom ratings were available for analysis of pre-post-treatment effects and long-term stability using one-year follow-up data, as well as for a comparison with other clinics. With respect to different diagnoses, symptoms improved in self-ratings with average effect sizes between 0.60 and 0.98. About 80% of positive changes could be sustained as determined in a 1-year follow-up survey. Patients with a lower concordance with the values of the clinic showed less health improvement. Compared to 14 other German psychosomatic clinics, the investigated treatment concept resulted in slightly higher decrease in symptoms (e.g., depression scale) and a higher self-rated mental and physical improvement in health. The data suggest that a successfully implemented salutogenetic clinical treatment concept not only has positive influence on treatment effects but also provides long-term stability.