Religiousness and spirituality in fibromyalgia and chronic pain patients

The Power of Spiritual Well-Being: Its Relationship with Pain Intensity, Pain Management, and Pain Catastrophizing in Individuals with Chronic Pain

BACKGROUND

Chronic pain negatively affects human life. Chronic pain is multidimensional. Therefore, a multidimensional approach that focuses on the biologic, psychological, sociologic, and spiritual needs of patients is required in pain management.

AIM

This study was conducted to determine the relationship of spiritual well-being with the level of pain catastrophizing, pain intensity, and pain management in individuals with chronic pain.

METHODS

The snowball sampling method was used in the research and the data were collected by individuals with ankylosing spondylitis and rheumatoid arthritis who had chronic pain via an online survey form. The study was completed between March and May 2023 with the participation of 399 people. The data of the study were collected using the Descriptive Characteristics Questionnaire, Pain Catastrophizing Scale, Three-Factor Spiritual Well-Being Scale, and Numerical Rating Scale.

RESULTS

There was a negative, high-level correlation between the spiritual well-being and the Pain Catastrophizing Scale and its subscales. At the same time, there was a negative, weak level correlation between the levels of spiritual well-being and the pain intensity. Spiritual Well-Being Scale scores differ according to the method used in pain management. Spiritual well-being and pain intensity explain 68% of the total variance in pain catastrophizing.

CONCLUSIONS

The results of this research show that there may be a relationship between increased spirituality and reduced perceptions of pain in this population.

The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study

Introduction

Low back pain and neck pain are among the most commonly reported forms of chronic pain worldwide, and are associated with significant distress, disability and impairment in quality of life. Though these categories of pain can be analyzed and treated from a biomedical perspective, there is evidence that they are both related to psychological variables such as depression and anxiety. The experience of pain can be significantly influenced by cultural values. For example, cultural beliefs and attitudes can influence the meaning attached to the experience of pain, the responses of others to a sufferer's pain, and the likelihood of seeking medical care for particular symptoms. Likewise, religious beliefs and practices can influence the both experience of pain and the responses to it. These factors have also been associated with variations in the severity of depression and anxiety.

Methods

In the current study, data on the estimated national prevalence of both low back pain and neck pain, obtained from the 2019 Global Burden of Disease Study (GBD 2019), is analyzed in relation to cross-national variations in cultural values, as measured using Hofstede's model (n =115 countries) and in religious belief and practice, based on the most recent Pew Research Center survey (n = 105 countries). To address possible confounding factors, these analyses were adjusted for variables known to be associated with chronic low back or neck pain, namely smoking, alcohol use, obesity, anxiety, depression and insufficient physical activity.

Results

It was found that the cultural dimensions of Power Distance and Collectivism were inversely correlated with the prevalence of chronic low back pain, and Uncertainty Avoidance was inversely correlated with the prevalence of chronic neck pain, even after adjustment for potential confounders. Measures of religious affiliation and practice were negatively correlated with the prevalence of both conditions, but these associations were not significant after adjusting for cultural values and confounders.

Discussion

These results highlight the existence of meaningful cross-cultural variations in the occurrence of common forms of chronic musculoskeletal pain. Psychological and social factors that could account for these variations are reviewed, along with their implications for the holistic management of patients with these disorders.

The Relationship between Alexithymia, Psychological Well-Being and Religious Coping in Fibromyalgia Patients in Turkey

This study aimed to investigate the relationship between alexithymia, psychological well-being, and religious coping in fibromyalgia patients. This study was planned as a descriptive and cross-sectional research design. The sample consisted of 175 fibromyalgia patients. Data were collected using the Toronto Alexithymia Scale-20, the Psychological Well-being Scale, and the Religious Coping Scale. Data were analyzed by Pearson's correlation test and Multiple Linear Regression analysis. A negative correlation was found between alexithymia and negative religious coping (r = - 0.377, p = 0.000). A positive correlation was found between psychological well-being and negative religious coping (r = 0.364, p = 0.000). The alexithymia was predicted by psychological well-being level (β = - 0.629), positive (β = 0.170) and negative (β = - 0.216) religious coping levels (p < 0.05). Negative and positive religious coping strategies can affect psychological well-being and expressive thinking in patients with FMS.

Relation between Coping with Pain & Spiritual Wellbeing in Chronic Pain Living Individuals

The aim of this study was to investigate the relationship between coping with pain in individuals with chronic pain and their levels of spiritual wellbeing. The research was conducted as a cross-sectional study. It was conducted with 148 participants who were experiencing chronic pain. Data were collected using Sociodemographic Questionnaire, Pain Coping Questionnaire (PCQ) and Spiritual Well-Being Scale (SWBS). Data were analyzed using Kolmogorov-Smirnov/Shapiro-Wilk's test, skewness, kurtosis, Cronbach's α, mean, standard deviation, mean rank and binary logistic regression analysis. According to the data obtained, it was concluded that participants' levels of spiritual wellbeing were high, and spiritual wellbeing could be used as an effective mechanism for coping with pain. It is therefore recommended that training sessions and information meetings be organized to create awareness in health care and social work professionals and in those living with chronic pain and their families.

Relevance of Religiosity for Coping Strategies and Disability in Patients with Fibromyalgia Syndrome

Coping strategies are essential for the outcome of chronic pain. This study evaluated religiosity in a cohort of patients with fibromyalgia syndrome (FMS), its effect on pain and other symptoms, on coping and FMS-related disability. A total of 102 FMS patients were recruited who filled in questionnaires, a subgroup of 42 patients participated in a face-to-face interview, and data were evaluated by correlation and regression analyses. Few patients were traditionally religious, but the majority believed in a higher existence and described their spirituality as "transcendence conviction". The coping strategy "praying-hoping" and the ASP dimension "religious orientation" (r = 0.5, P < 0.05) showed a significant relationship independent of the grade of religiosity (P < 0.05). A high grade of belief in a higher existence was negatively associated with the choice of ignoring as coping strategy (r = - 0.4, P < 0.05). Mood and affect-related variables had the highest impact on disability (b = 0.5, P < 0.05). In this cohort, the grade of religiosity played a role in the choice of coping strategies, but had no effects on health and mood outcome.

Impact of spiritual care on the spiritual and mental health and quality of life of patients with advanced cancer

BACKGROUND

Cancer is a growing threat to human health. Due to the double torment of cancer and cancer treatment, patients with advanced cancer generally have a low quality of life. At present, there is a lack of systematic spiritual care plans for patients with advanced cancer as well as systematic guidance plans on the specific clinical application of spiritual care for advanced cancer patients. We hypothesized that our care plan would be effective in improving the spiritual and mental health and quality of life of patients with advanced cancer.

AIM

To construct a spiritual care plan suitable for Chinese patients with advanced cancer through literature analysis.

METHODS

From February to December 2018, through purpose sampling, we selected 100 advanced cancer patients from the Oncology Department and Hospice Ward of a tertiary hospital in Liaoning Province who met the study standards. Patients were randomly divided into experimental and control groups, with 50 cases in each group. The control group received the current routine care, while the experimental group received the advanced cancer spiritual care intervention in addition to routine care.

RESULTS

After the intervention, the overall spiritual health score for the experimental group was higher than that of the control group (4.68 ± 1.36 vs 3.63 ± 1.71). The difference between the groups was statistically significant (P < 0.05). The proportion of anxiety-free patients in the experimental group was 95.45%, which was significantly higher than the 60.98% in the control group. Moreover, the proportion of non-depressed patients in the experimental group was 97.73%, which was significantly higher than the 85.37% in the control group (P < 0.05). The overall quality of life score for the experimental group was significantly higher than that of the control group (5.36 ± 1.16 vs 4.39 ± 1.36, P < 0.05).

CONCLUSION

Our spiritual care plan for patients with advanced cancer could improve their spiritual health and quality of life and reduce negative mental health symptoms.

Spirituality Needs in Chronic Pain Patients: A Cross-Sectional Study in a General Hospital in Malaysia

Evidence-based practices that rely upon pain relieving medications and interventional strategies for symptom alleviation in chronic pain survivors have shown modest benefits. The recent emphasis of spiritual care as a new dimension of treatment strategy incorporated within the biopsychosocial model has inspired new hopes to mediate mental and physical health for illness coping. This study aimed to explore the factors associated with spirituality needs among chronic pain patients in a general hospital in Malaysia. An analytical cross-sectional study was conducted among 117 chronic pain patients in a general hospital in Malaysia. Clinical features and assessments were evaluated by an experienced pain physician and retrieved from patient medical records. An interviewer-administered questionnaire that consisted of items on socio-demographics, the validated 19-items spiritual needs questionnaire and the visual analog scale was utilized. Multivariate linear regression analysis was conducted to identify the factors associated with spiritual needs in chronic pain patients. Patients had higher actively giving score as compared to other spirituality need domains. Central neuropathic pain (β = 1.691, p = 0.040) predicted existential. Renal problems (β = 5.061, p = 0.019) highly predicted religiosity; followed by head pain (β = 3.774, p = 0.036), central neuropathic pain (β = 2.730, p = 0.022), heart problems (β = 1.935, p = 0.041), income (β = 0.001, p = 0.003), living arrangement (β = - 3.045, p = 0.022), face (β = - 3.223, p = 0.005) and abdominal (β = - 4.745, p = 0.0001) pains. Predictors of inner peace include renal problems (β = 3.752, p = 0.021), shoulder pain (β = 1.436, p = 0.038) and pain duration (β = - 0.012, p = 0.027). Predictors of actively giving were renal problems (β = 3.803, p = 0.001), central neuropathic pain (β = 1.448, p = 0.017), heart problems (β = 1.004, p = 0.042), income (β = 0.001, p = 0.0001), age (β = - 0.046, p = 0.004) and abdominal pain (β = - 2.617, p = 0.0001). Chronic pain patients had higher actively giving score compared to other spirituality needs. Their spirituality needs were significantly influenced by pain type, duration and site, co-existing medical conditions and socio-demographics.

Spirituality in pain medicine: A randomized experiment of pain perception, heart rate and religious spiritual well-being by using a single session meditation methodology

The aim of this study is to investigate different effects on pain perception among randomly assigned volunteers practicing meditation compared to a relaxation condition. The study examines whether participants of the experimental conditions (meditation versus relaxation) differ in the change of pain perception and heart rate measurement and in religious and spiritual well-being after an intervention. Method: 147 volunteers (long-term practitioners and novices) were randomly assigned to the experimental conditions with a headphone guided 20-minute single session intervention. The change in their pre- and post-intervention pain perception was measured using Quantitative Sensory Testing and Cold Pressor Testing (CPTest), their stress-level was compared by monitoring heart rate, and their religious and spiritual well-being by using the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSB48). Additionally, dimensions of the Brief Symptom Inventory (BSI) measured the psychological resilience of the participants; pain and stress experience, and the state of relaxation and spirituality experience were assessed. Five persons were excluded due to failure in measuring the heart rate and 29 participants had to be excluded because of high values on the BSI. Results: The meditation group showed an increase in their pain tolerance on the CPTest and a decrease in their pain intensity for heat after the experimental condition, in contrast to the relaxation group. Futhermore, the meditation group showed a higher level of religious spiritual well-being (MI-RSB48 Total score) as well as in the sub-dimensions General Religiosity, Forgiveness, and Connectedness after the experimental condition, compared to the relaxation group. Our data is consistent with the hypothesis that meditation increases pain tolerance and reduces pain intensity, however, further work is required to determine whether meditation contains similar implications for pain patients.

Chronische Schmerzpatientinnen und -patienten sprechen über ihre Spiritualität

Innerhalb des vom schweizerischen Nationalen Forschungsprogramms 74 „Gesundheitsversorgung“ geförderten Projekts „Die spirituelle Dimension in der Schmerzbehandlung“ wurden 37 narrative Interviews von chronischen Schmerzpatientinnen und -patienten aus dem deutschen Projekt „krankheitserfahrungen.de“ untersucht. Im Rahmen einer Sekundäranalyse wurden diese inhaltsanalytisch und sprachlich feinanalytisch im Hinblick auf spirituelle Bezüge analysiert. Aus den vollständig transkribierten Interviews ergaben sich 21 Passagen aus 14 Interviews, in denen Schmerzpatientinnen und -patienten über spirituelle Aspekte sprachen. Drei Erzählkategorien wurden herausgearbeitet: (1) die Aushandlung, ob und wie über Spiritualität gesprochen wird, (2) Spiritualität als Ressource und (3) Schmerz als Herausforderung für die Spiritualität. Die Frage nach der Aushandlung spiegelt die Schwierigkeit der Patientinnen und Patienten wider, in klinisch-therapeutischen Kontexten spirituelle Aspekte zu thematisieren. Die Ergebnisse der Analyse weisen auf die Herausforderung hin, Patientinnen und Patienten im klinischen Setting auf ihre spirituellen Ressourcen und Bedürfnisse anzusprechen.

Cancer-Induced Bone Pain Management Through Buddhist Beliefs

Dealing with physical pain represents a huge public health expenditure, especially for cancer-induced bone pain, one of the most difficult health issues, which impairs appetite, sleep, and mobility, negatively impacting quality of life and evoking mental problems. Although some literature has reported positive correlation between religion and pain management, there is a dearth of research examining the effectiveness of Buddhism on this topic. This study investigates the usefulness of Buddhist beliefs in managing cancer-induced bone pain through a case example. It illustrates how an advanced cancer patient, with the assistance of a counsellor, perceived pain and coped with it and pain-induced mental problems via Buddhist teachings and practices, including the four noble truths, the law of dependent origination, and karma. It offers alternative perspectives for helping professionals (such as physicians, nurses, counsellors, social workers, hospice and palliative service providers, and pain management practitioners) who are keen to equip themselves with a wider worldview and life view to better serve their clients.

Meditation awareness training for the treatment of fibromyalgia syndrome: A randomized controlled trial

OBJECTIVES

The purpose of this study was to conduct the first randomized controlled trial (RCT) to evaluate the effectiveness of a second-generation mindfulness-based intervention (SG-MBI) for treating fibromyalgia syndrome (FMS). Compared to first-generation mindfulness-based interventions, SG-MBIs are more acknowledging of the spiritual aspect of mindfulness.

DESIGN

A RCT employing intent-to-treat analysis.

METHODS

Adults with FMS received an 8-week SG-MBI known as meditation awareness training (MAT; n = 74) or an active control intervention known as cognitive behaviour theory for groups (n = 74). Assessments were performed at pre-, post-, and 6-month follow-up phases.

RESULTS

Meditation awareness training participants demonstrated significant and sustained improvements over control group participants in FMS symptomatology, pain perception, sleep quality, psychological distress, non-attachment (to self, symptoms, and environment), and civic engagement. A mediation analysis found that (1) civic engagement partially mediated treatment effects for all outcome variables, (2) non-attachment partially mediated treatment effects for psychological distress and sleep quality, and (3) non-attachment almost fully mediated treatment effects for FMS symptomatology and pain perception. Average daily time spent in meditation was found to be a significant predictor of changes in all outcome variables.

CONCLUSIONS

Meditation awareness training may be a suitable treatment for adults with FMS and appears to ameliorate FMS symptomatology and pain perception by reducing attachment to self. Statement of contribution What is already known on this subject? Designing interventions to treat fibromyalgia syndrome (FMS) continues to be a challenge. There is growing interest into the applications of mindfulness-based interventions for treating FMS. Second-generation mindfulness-based interventions (SG-MBIs) are a key new direction in mindfulness research. What does this study add? Meditation awareness training - an SG-MBI - resulted in significant reductions in FMS symptomatology. SG-MBIs recognize the spiritual aspect of mindfulness and may have a role in the treatment of FMS.

Chronic pain care

Objective Experiencing pain not only affects patients' biopsychosocial functioning but also the existential domain. Attention to the existential, in addition to the biopsychosocial domains, might thus be important in chronic pain care. Therefore, we investigated: (a) how satisfied patients were with the attention of their practitioners to the impact of pain on biological, psychological, social, and existential life domains, and (b) how satisfaction with each domain was related to patient functioning. Method Pain patients ( N = 163) were questioned on their satisfaction with the attention of their practitioners to biological, psychological, social, and existential life domains, and on pain intensity, pain disability, life satisfaction, and depressive symptoms. Results Patients reported low satisfaction with the attention of their practitioners to the social and existential domains. Satisfaction with each domain was negatively related with pain intensity, pain disability, and depressive symptoms and positively related with life satisfaction. Only satisfaction with the existential domain was able to predict all functional outcomes above and beyond all other satisfaction variables modeled simultaneously. Conclusions Patients reported not feeling satisfied with the attention to the social and existential life domains. Furthermore, practitioners' attention to the existential domain seems highly important for patient functioning. Openness to existential concerns of pain patients might thus be an important aspect of chronic pain care.

The impact of pain on spiritual well-being in people with a spinal cord injury

STUDY DESIGN

The study uses a cross-sectional, group comparison, questionnaire-based design.

OBJECTIVES

To determine whether spinal cord injury and pain have an impact on spiritual well-being and whether there is an association between spiritual well-being and measures of pain and psychological function.

SETTING

University teaching hospital in Sydney, New South Wales, Australia.

METHODS

Questionnaires evaluating pain, psychological and spiritual well-being were administered to a group of people with a spinal cord injury (n=53) and a group without spinal cord injury (n=37). Spiritual well-being was assessed using the Functional Assessment of Chronic Illness and Therapy - Spirituality Extended Scale (FACIT-Sp-Ex). Pain and psychological function were also assessed using standard, validated measures of pain intensity, pain interference, mood and cognition.

RESULTS

Levels of spiritual well-being in people with a spinal cord injury were significantly lower when compared with people without a spinal cord injury. In addition, there was a moderate but significant negative correlation between spiritual well-being and pain intensity. There was also a strong and significant negative correlation between depression and spiritual well-being and a strong and significant positive correlation between spiritual well-being and both pain self-efficacy and satisfaction with life.

CONCLUSION

Consequences of a spinal cord injury include increased levels of spiritual distress, which is associated, with higher levels of pain and depression and lower levels of pain self-efficacy and satisfaction with life. These findings indicate the importance of addressing spiritual well-being as an important component in the long-term rehabilitation of any person following spinal cord injury.

SPONSORSHIP

This study was supported by grant funding from the Australian and New Zealand College of Anaesthetists, and the National Health and Medical Research Council of Australia.

Spirituality: what is its role in pain medicine?

BACKGROUND

For many years, spirituality has been regarded as an integral aspect of patient care in fields closely allied to pain medicine such as palliative and supportive care. Despite this, it has received relatively little attention within the field of pain medicine itself. Reasons for this may include a lack of understanding of what spirituality means, doubtfulness of its relevance, an uncertainty about how it may be addressed, or a lack of awareness of how addressing spirituality may be of benefit.

METHODS

A review of the literature was conducted to determine the changing conceptual frameworks that have been applied to pain medicine, the emergence of the biopsychospiritual approach and what that means as well as evidence for the benefits of incorporation of this approach for the management of pain.

RESULTS

Although the concept of spirituality is broad, there is now greater consensus on what is meant by this term. Many authors and consensus panels have explored the concept and formulated a conceptual framework and an approach that is inclusive, accessible, relevant, and applicable to people with a wide range of health conditions. In addition, there is accumulating evidence that interventions that address the issue of spirituality have benefits for physical and emotional health.

CONCLUSIONS

Given the firm place that spirituality now holds within other fields and the mounting evidence for its relevance and benefit for people with pain, there is increasing evidence to support the inclusion of spiritual factors as an important component in the assessment and treatment of pain.

Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study

Background

Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon.

Objective

To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon.

Methods

A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM.

Results

A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users.

Conclusion

The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time.

Predicting the Trajectories of Perceived Pain Intensity in Southern Community-Dwelling Older Adults: The Role of Religiousness

This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing (n = 47); (2) consistently unchanging (n = 292); and (3) decreasing (n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group.

Spirituality and Religion in Pain and Pain Management

Pain relief is a management problem for many patients, their families, and the medical professionals caring for them. Although everyone experiences pain to some degree, responses to it vary from one person to another. Recognizing and specifying someone else’s pain is clinically a well know challenge. Research on the biology and neurobiology of pain has given us a relationship between spirituality and pain. There is growing recognition that persistent pain is a complex and multidimensional experience stemming from the interrelations among biological, psychological, social, and spiritual factors. Patients with pain use a number of cognitive and behavioral strategies to cope with their pain, including religious/spiritual factors, such as prayers, and seeking spiritual support to manage their pain. This article provides an overview of the complex phenomenon of pain, with a focus on spiritual and religious issues in pain management.

[Restrictions in participation in women with fibromyalgia syndrome. An explorative pilot study]

BACKGROUND

Patients with fibromyalgia syndrome are often severely restricted in their ability to participate in everyday activities and in social interaction. The aim of this study was to document female patients' subjectively-perceived limitations in participation and to develop material to generate items for a specific participation questionnaire.

MATERIAL AND METHODS

We collected data from 8 groups of women with fibromyalgia syndrome (n=38), and developed a hierarchical system of categories using the patients' statements (ATLAS.ti; Qualitative Data Analysis).

RESULTS

Our final group of categories contains 10 superordinate categories. Women with fibromyalgia syndrome often describe restrictions in their relationships with other people, and the impaired ability to engage in social and leisure activities. They speak of difficulties at the workplace, while doing housework, and complain about a lack of understanding and awareness on the part of the general public.

CONCLUSION

Fibromyalgia syndrome patients admit to be extremely impaired in a variety of social roles. Their statements have enabled us to develop a questionnaire that reflects the range of factors restricting participation from the patient's perspective.

Complementary and alternative medicine use among pediatric patients with leukemia: the case of Lebanon

BACKGROUND

International evidence indicates that caretakers of pediatric leukemia patients are increasingly using complementary and alternative medicine (CAM) therapies. Such a trend has never been substantiated in the Arab world.

OBJECTIVE

Examine the frequency, types, modes, and reasons of CAM use among pediatric leukemia patients in Lebanon.

METHODS

A cross-sectional design was utilized to survey (by phone) the caregivers of all pediatric leukemia patients on the rosters of the 2 largest cancer treatment facilities in Lebanon for years 2005-2009. A total of 125 parents out of 175 (71.4%) completed the questionnaire, which included 3 sections: socio-demographic characteristics, clinical information and CAM use details. Data analysis employed univariate descriptive statistics, t-test, and χ(2)

RESULTS

Overall, 15.2% of respondents reported using one or more CAM therapies for their child (95% confidence interval: 8.9% to 22.0%). The main CAM therapies used included dietary supplements, prayer/spiritual healing, and unconventional cultural practices (ingesting bone ashes). CAM therapies were used for strengthening immunity (42.1%) and improving the chance of cure (21%). Pediatric users of CAM were 2 years older than nonusers and had been diagnosed with leukemia for a longer period of time (4.76 ± 3.24 vs 3.49 ± 2.38, P<.05). The percentage of males among CAM users was higher than that among nonusers (89.5% vs 56.6%, P<.05).

CONCLUSION

Increasing awareness of both caretakers and physicians of pediatric leukemia patients on the effects and risks of CAM therapies is essential should rational, safe, and evidence-based utilization of CAM therapies be achieved.

Exploring the link between religious attitudes and subjective well-being in chronic pain patients

OBJECTIVE

The aim of the present study was to explore the relations between religious attitudes and subjective well-being in a sample of chronic pain (CP) patients and to investigate whether these associations would differ from those obtained with healthy controls.

METHOD

A total of 155 CP patients (72% women) and 166 healthy controls (72% women) completed questionnaires on pain, religious attitudes, and subjective well-being. The religious attitudes focused both on religiosity as such (Inclusion vs Exclusion of Transcendence) as on the cognitive approach of religious contents (Symbolic vs Literal).

RESULTS

Mean-level analyses showed significant differences between the CP and control samples on subjective well-being and Literal Exclusion. Mediation analyses found a direct influence of sample (CP vs control) on subjective well-being as well as an indirect effect via Literal Exclusion. Correlation analyses revealed that Literal Exclusion correlated negatively with well-being in both samples, whereas Literal Inclusion did not. The differential variable between the two samples was the symbolic approach of religion (Symbolic Inclusion and Exclusion), which was significantly associated with higher levels of well-being only in the CP sample.

CONCLUSION

A literal approach toward religion in combination with a rejection of religion (Literal Exclusion) was, in general-both for CP patients as for healthy controls-associated with lower levels of well-being. In CP patients (but not in healthy controls), a symbolic approach toward religion (regardless of Inclusion or Exclusion of religion) was significantly associated with higher levels of subjective well-being.

Reliability and validity of the perspectives of Support From God Scale

BACKGROUND

Existing spiritual support scales for use with cancer survivors focus on the support believed to come from a religious community, clergy, or health care providers.

OBJECTIVE

The objective of this study was to evaluate the reliability and validity of a new measure of spiritual support believed to come from God in older Christian African American cancer survivors.

METHODS

The Perceived Support From God Scale was administered to 317 African American cancer survivors aged 55-89 years. Psychometric evaluation involved identifying underlying factors, conducting item analysis and estimating reliability, and obtaining evidence on the relationship to other variables or the extent to which the Perceived Support From God Scale correlates with religious involvement and depression.

RESULTS

The Perceived Support From God Scale consists of 15 items in two subscales (Support From God and God's Purpose for Me). The two subscales explained 59% of the variance. Cronbach's alpha coefficients were .94 and .86 for the Support From God and God's Purpose for Me subscales, respectively. Test-retest correlations were strong, supporting the temporal stability of the instrument. Pearson's correlations to an existing religious involvement and beliefs scale were moderate to strong. Subscale scores on Support From God were negatively correlated to depression.

DISCUSSION

Initial support for reliability and validity was demonstrated for the Perceived Support From God Scale. The scale captures a facet of spirituality not emphasized in other measures. Further research is needed to evaluate the scale with persons of other racial/ethnic groups and to explore the relationship of spirituality to other outcome measures.