Does religious activity improve health outcomes? A critical review of the recent literature

Knowledge and perceptions of religious leaders toward HIV prevention among young people in a resource-limited setting: A qualitative study

Background

Currently, 410,000 new HIV infections among youth occur worldwide, which is a significant public health issue. Members of the clergy can be trustworthy allies in the reduction of HIV infections among the youth. However, little is known regarding their knowledge as well as the perceptions they hold towards HIV prevention among young people. Thus, we explored the knowledge and perceptions of religious leaders regarding HIV prevention among young people (15-24 years) in Lira district.

Methods

This was a cross-sectional qualitative study conducted among 20 religious leaders in March 2021 in Lira district. Religious leaders were sampled purposively and recruited from modern religions (beliefs influenced by Christianity or Islam) in Lira district. Guides for key informant interviews were utilized to gather information. Each interview was audio recorded, transcribed, and entered into NVivo version 12 software, and the data was then ready for analysis. The main themes were determined using thematic analysis.

Results

Although a few individuals had some misconceptions, the majority of participants had good knowledge about the transmission and prevention of HIV. Participants knew awareness creation, abstinence, and faithfulness in marriage as HIV prevention strategies and held positive perceptions. Perceived barriers to HIV prevention involvement were lack of knowledge and training, and inadequate resources whereas motivating factors were; being respected, and trusted, and having easy access to young people.

Conclusion

In conclusion, religious leaders show limited HIV prevention knowledge due to religious beliefs, but understand the importance of measures like abstinence. Despite challenges, their involvement is crucial. Addressing knowledge gaps and providing support is vital. Future efforts should emphasize both behavioral measures and interventions like condom use, Post Exposure Prophylaxis, and Pre-Exposure Prophylaxis.

Development and Validation of the Nursing Care and Religious Diversity Scale (NCRDS)

(1) Background: In response to the impact of religious intervention on health outcomes and the importance of documenting how nurses experience the spiritual need of 392 hospitalized patients, it is vital to provide the nursing profession with instruments to evaluate these spiritual aspects. This study describes the development and validation of the Nursing Care and Religious Diversity Scale (NCRDS); (2) Methods: A two-step design was used for NCRDS translation and psychometric validation. The tool design was developed in the first step, while the psychometric characteristics were tested in the second step. An inductive study was conducted to test the validity and reliability of the NCRDS tool. The overall sample consisted of 317 nurses; (3) Results: The final instrument comprised 25 items in five dimensions. The construct validity indicated five dimensions. The face and content validity were adequate. Test-retest reliability displayed good stability, and internal consistency (Cronbach's α) was acceptable (0.83); (4) Conclusions: Initial testing of the NCRDS suggested that it is a valid and reliable instrument to evaluate individuals in religious diversity, with five dimensions for evaluating the meaning of spirituality and individual belief, the religious healthcare environment, educational adequacy, spiritual and religious needs, and religious plurality.

Implementation of an Evidence-Based, Tai Ji Quan Fall Prevention Program in Rural West Virginia Churches: A RE-AIM Evaluation

This study implemented a 16-week Tai Ji Quan: Moving for Better Balance® intervention for older adults in churches in hard-to-reach, medically underserved, rural communities, and evaluated the process using the RE-AIM Framework. Community-dwelling adults, aged 55 years, or older, were eligible. Data (N = 237) were collected at baseline, 16 weeks, and 32 weeks on falls efficacy, depression, physical/mental health-related quality of life, aerobic activity, gait speed, mobility, balance, and leg strength. Generalized/linear mixed models determined if outcomes improved. Eighteen churches sponsored 16 classes. Church adoption was 94%, instructor adoption was 86%, reach was 90%, and fidelity was good/fair. All outcomes improved except physical health-related quality of life and gait speed. Thirty-six percent of participants, 28% of churches, and 37% of instructors continued Tai Ji Quan: Moving for Better Balance at 32 weeks. Compared with two prior RE-AIM evaluations, adoption and reach rates, improvements in outcomes, and satisfaction were comparable; attendance, program completion, and continuation rates were lower.

Regional Brain Volume Changes in Catholic Nuns: A Cross-Sectional Study Using Deep Learning-Based Brain MRI Segmentation

OBJECTIVE

Religious behaviors are considered as complex brain-based phenomena that may be associated with structural brain change. To identify the pattern of regional brain volume change in nuns, we investigated structural alterations in the brains of nuns using a fast processing automated segmentation method based on deep learning algorithms.

METHODS

We retrospectively reviewed the medical records of the catholic sisters between the ages of 31 and 80 who are members of the charity of St. Vincent de Paul of Korea. A total of 193 asymptomatic subjects (86 nuns and 107 control subjects) received comprehensive health screening and underwent brain MRI scans. We compared cortical and sub-cortical volume between groups across multiple locations using our in-house U-Net++ deep learning-based automatic segmentation tool.

RESULTS

Compared to the control group, the nun group displayed increased gray matter volume in the right lingual cortex, left isthmus-cingulate, posterior-cingulate, rostral-middle-frontal, superior-frontal, supramarginal, temporal-pole cortices, and bilateral pars-triangularis cortices after correction for multiple comparisons. On the other hand, the nun group showed reduced gray matter volume in the temporal and parietal regions relative to healthy controls.

CONCLUSION

Our study suggests that spiritual practice may affect brain structure, especially in several frontal regions involved in a higher level of insight function.

Does hospitalisation impact the successful ageing of community-dwelling older adults?: A propensity score matching analysis using the Korean national survey data

OBJECTIVES

For community-dwelling older adults with hospitalisation experience, it is necessary to be strategic when promoting successful ageing. This study aimed to investigate whether components of successful ageing (i.e., diseases and complications, functions and engagement with life) differ according to hospitalisation experience in community-dwelling older adults.

METHODS

A secondary data analysis with the Korean national survey was performed. Using propensity score matching, 1812 older adults with hospitalisation experience were matched to 1812 older adults without hospitalisation experience. Sampling weight of the survey was considered for all statistical analyses.

RESULTS

The hospitalisation experienced group had more chronic illnesses, malnourishment, impairment in physical function, and depressive symptoms, and less activity in terms of working and social activities. There were no differences in cognitive function or religious activities.

CONCLUSIONS

Older adults with hospitalisation experience were less likely to experience successful ageing. To facilitate successful ageing of community-dwelling older adults with hospitalisation experience, nursing interventions for effective transitional care to encourage the use of community resources and participation in social activities are needed.

Introduce a New Intervention Model Based on Islamic Lifestyle for Decreasing the Risk of Cardiovascular Disease in People at Risk: A Comparative Study

The main purpose of the present study was designing and assessing the common lifestyle and Islamic lifestyle interventions and comparison of them. Sample of the study was thirty-nine subjects participated in a healthy lifestyle program. The Islamic group were received the Islamic healthy lifestyle program. In comparison with common, in the Islamic group the CVD risk was significantly lower; the psychological well-being was increased significantly; the psychological distress was decreased significantly; and the spiritual well-being was increased significantly. The most powerful element of Islamic lifestyle was to strengthen the spirituality that can positively affect the life.

Osteopathic Principles: The Inspiration of Every Science Is Its Change

The Educational Council on Osteopathic Principles (ECOP) annually renews and reviews the fundamental osteopathic principles that Dr. Still left behind for osteopathic medicine (OM). These tenets represent a guide and rationale for the osteopathic manual approach. The non-profit research organization, Foundation of Osteopathic Research and Clinical Endorsement (FORCE), which was founded in 2013 under the auspices of different international professionals, wishes to propose changes to these principles based on scientific knowledge, which did not exist in the nineteenth century, as well as all the information discovered subsequently. The proposal is not a constraint, but a further stimulus to improve the vision of OM. We believe, in fact, that a principle or a point of view never ceases to evolve: the inspiration of every science is its change.

Stakeholder views of the practical and cultural barriers to epilepsy care in Uganda

OBJECTIVE

Epilepsy is one of the most prevalent, treatable neurological diseases globally. In sub-Saharan Africa, people with epilepsy (PWE) frequently seek treatment from traditional or pastoral healers, who are more accessible than biomedical care providers. This often contributes to the substantial time delay in obtaining adequate biomedical care for these patients. In Uganda, the few biomedical providers who can treat epilepsy cannot meet the great need for epilepsy care. Additionally, patients are often hesitant to seek biomedical care, often preferring the easily accessible and trusted sociocultural treatment options. This study sought to elucidate the barriers to biomedical care for PWE as well as identify potential solutions to overcome these barriers from various stakeholder perspectives.

METHODS

This study used qualitative research methods. Semistructured interviews and focus group discussions were conducted with four major stakeholder groups: PWE or family members of PWE, neurologists and psychiatrists, traditional healers, and pastoral healers. All interviews and focus group discussions that were in English were audio recorded and transcribed verbatim. Those that were not in English were translated live and audio recorded. A translator later translated the non-English portion of audio recording to ensure proper interpretation. Two independent coders coded the dataset and conducted an inter-rater reliability (IRR) assessment to ensure reliable coding of the data. Thematic analysis was then performed to discern themes from the data and compare nuances between each of the study design groups.

RESULTS

Participants discussed several different causes of epilepsy ranging from spiritual to biological causes, often incorporating elements of both. Commonly endorsed spiritual causes of epilepsy included witchcraft and ancestral spirits. Commonly endorsed biological causes included genetics, fever, malaria, and brain injury. For patients and families, beliefs about the cause of epilepsy often played a role in whom they chose to seek treatment from. Three major barriers to biomedical care were discussed: practical barriers, medical infrastructure barriers, and barriers related to stigma. Practical barriers related to issues such as transportation, cost of medical care, and distance to the nearest healthcare facility. Under medical infrastructure, drug stock-outs and lack of access to antiepileptic drugs (AEDs) were the most consistent problems stated among patients. Stigma was heavily discussed and brought up by nearly every participant. Additionally, three significant solutions to improving epilepsy care in Uganda were highlighted by participants: collaboration among treatment providers, community sensitization efforts to address stigma, and building medical infrastructure. Within building infrastructure, all participant types, except traditional healers, proposed the development of an epilepsy clinic designed to specifically treat epilepsy.

CONCLUSIONS

Based on these findings, there are four critical interventions that should be considered for improving epilepsy care in Uganda: the creation of dedicated epilepsy clinics, infrastructure strengthening to address medication stock-outs, community outreach programs for sensitization, and collaboration between biomedical providers and traditional healers. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".

Religion and Psychiatry in the Age of Neuroscience

In recent decades, an evolving conversation among religion, psychiatry, and neuroscience has been taking place, transforming how we conceptualize religion and how that conceptualization affects its relation to psychiatry. In this article, we review several dimensions of the dialogue, beginning with its history and the phenomenology of religious experience. We then turn to neuroscientific studies to see how they explain religious experience, and we follow that with two related areas: the benefits of religious beliefs and practices, and the evolutionary foundation of those benefits. A final section addresses neuroscientific and evolutionary accounts of the transcendent, that is, what these fields make of the claim that religious experience connects to a transcendent reality. We conclude with a brief summary, along with the unresolved questions we have encountered.

Spirituality as a sociocultural determinant of health in the context of medical curriculum: A call for action

Background: This study aimed to investigate the state of spirituality in the general medicine curricula in Iran. Methods: Reference books for general medicine were reviewed and data were analyzed according to the qualitative content analysis method. Results: After reviewing references, it was found that only 35 paragraphs of the educational reference pages dealt with this subject. Related topics to spirituality had 2 major themes: (a) spirituality and care (assessment, treatment, palliative care, and bereavement); (b) spirituality and professionalism (considering culture and medical ethics). Conclusion: This study showed that despite the importance of the subject and much evidence on spirituality and medicine, medical references have limitations. The authors suggested some strategies to develop a specific course and integrate all educational references with the objectives of the general medical education course in Iran.

A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery

BACKGROUND

This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients.

METHODS

Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups' depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software.

RESULTS

The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group.

CONCLUSION

The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.

The Role of Religious Behavior in Health Self-Management: A Community-Based Participatory Research Study

Prevalence of chronic disease, mental health problems, and risk behaviors in San Bernardino (SB) County reflect some of the worst health outcomes in the State of California and the United States. Using the Integrated Theory of Health Behavior Change (ITHBC) as the theoretical framework, this community-based participatory research (CBPR) study aimed to determine how religious self-regulation skills and ability, and religious behaviors, jointly affect health promotion behaviors among socio-economically challenged residents of southwest SB County, California. A convenience sample of adult residents (N = 261) completed a series of inventories to measure the relationship between modified ITHBC constructs of religious self-regulation skills, religious self-management behaviors, and health outcomes. Structural Equation Modeling (SEM) analysis was conducted to validate the strong positive effect of religious self-regulation skills and ability on how frequently individuals engage in both organized and non-organized religious activities. Results also indicated a significant positive impact of religious behaviors towards healthy eating behaviors. However, without the engagement in religious activities, high religious self-regulation skills and ability inhibited the likelihood of healthy food intake. This faith-related theoretical model provides an avenue for faith-based organizations’ capacity for contributing to community health promotion.

Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.

Do differences in religious affiliation explain high levels of excess mortality in the UK?

BACKGROUND

High levels of mortality not explained by differences in socioeconomic status (SES) have been observed for Scotland and its largest city, Glasgow, compared with elsewhere in the UK. Previous cross-sectional research highlighted potentially relevant differences in social capital, including religious social capital (the benefits of social participation in organised religion). The aim of this study was to use longitudinal data to assess whether religious affiliation (as measured in UK censuses) attenuated the high levels of Scottish excess mortality.

METHODS

The study used the Scottish Longitudinal Study (SLS) and the ONS Longitudinal Study of England and Wales. Risk of all-cause mortality (2001-2010) was compared between residents aged 35 and 74 years of Scotland and England and Wales, and between Glasgow and Liverpool/Manchester, using Poisson regression. Models adjusted for age, gender, SES and religious affiliation. Similar country-based analyses were undertaken for suicide.

RESULTS

After adjustment for age, gender and SES, all-cause mortality was 9% higher in Scotland than in England and Wales, and 27% higher in Glasgow than in Liverpool or Manchester. Religious affiliation was notably lower across Scotland; but, its inclusion in the models did not attenuate the level of Scottish excess all-cause mortality, and only marginally lowered the differences in risk of suicide.

CONCLUSIONS

Differences in religious affiliation do not explain the higher mortality rates in Scotland compared with the rest of the UK. However, it is possible that other aspects of religion such as religiosity or religious participation which were not assessed here may still be important.

Role of psychosocial reserve capacity in anxiety and depression in patients with systemic lupus erythematosus

AIM

To examine the relationship between reserve capacity measures and anxiety/depression among patients with systemic lupus erythematosus (SLE) from Southern California (SoCal), United States and Manila, Philippines.

METHODS

A total of 235 participants with SLE completed self-reported scales to assess anxiety/depression and psychosocial reserve capacity measures (self-esteem, optimism, personal mastery/coping skills, social support), socioeconomic status (SES) data, and Mexican SLE Disease Activity Index. Statistical analyses included independent sample t-tests, Chi-square, and point-biserial and Pearson correlations.

RESULTS

Overall, participants from Manila reported lower SES than SoCal participants. Over half of Manila and SoCal participants (69% and 59.1%, respectively) reported high anxiety scores. SoCal participants had higher depression scores than Filipinos (66%, 27%, respectively, P < 0.001) despite appearing to be more resilient by exhibiting higher scores for all reserve capacity measures (P < 0.001). Participants with low self-esteem scores from both groups had higher anxiety and depression scores. SoCal participants who reported lower optimism, lower personal mastery and lower social support were more anxious and depressed, while Filipinos low on these three variables reported less depressive symptoms.

CONCLUSION

Reduced psychosocial reserve capacity in individuals leads to vulnerabilities that may ultimately result in greater disease burden and psychological distress. Low self-esteem, optimism, coping and social support were associated with depression and low self-esteem was associated with anxiety for both groups. Despite the Filipino cohort's lower reserve capacity and SES, Filipino patients exhibited less depression than their SoCal counterparts, suggesting that other factors may protect them from experiencing depression.

Effect of Prayer on Intensity of Migraine Headache: A Randomized Clinical Trial

BACKGROUND AND AIM

Migraine is a common form of headache that affects patients quality of life negatively. In addition to pharmacologic treatment, there are a variety of nonpharmacologic treatments for migraine headache. In present study, we examined the effect of prayer on intensity of migraine pain.

METHODS

In a prospective, randomized, controlled trial from October 2013 to June 2014, this study has been conducted in Kerman, Iran. We randomly assigned 92 patients in 2 groups to receive either 40 mg of propranolol twice a day for 2 month (group "A") or 40 mg of propranolol twice a day for 2 months with prayer (group "B"). At the beginning of study and 3 months after intervention, patients' pain was measured using the visual analogue scale.

RESULTS

At the beginning of study and before intervention, the mean score of pain in patients in groups A and B were 5.7 ± 1.6 and 6.5 ± 1.9, respectively. According to results of independent t test, mean score of pain intensity at the beginning of study were similar between patients in 2 groups (P > .05). Three month after intervention, mean score of pain intensity decreased in patients in both groups. At this time, the mean scores of pain intensity were 5.4 ± 1.1 and 4.2 ± 2.3 in patients in groups A and B, respectively. This difference between groups was statistically significant (P < .001).

CONCLUSIONS

The present study revealed that prayer can be used as a nonpharmacologic pain coping strategy in addition to pharmacologic intervention for this group of patients.

Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013-2014

BACKGROUND

Translating evidence-based, community-delivered, fall-prevention exercise programs into new settings is a public health priority.

COMMUNITY CONTEXT

Older adults (aged ≥65 y) are at high risk for falls. We conducted a community engagement project in West Virginia to evaluate the adoption of a tai chi exercise program, Tai Ji Quan: Moving for Better Balance, by rural faith-based organizations (FBOs) and exercise instructors by recruiting 20 FBOs and 20 or more exercise instructors and by obtaining input from key stakeholders (representatives of FBOs, community representatives, exercise instructors) regarding potential barriers and facilitators to program adoption.

METHODS

We used both multistage, purposeful random sampling and snowball sampling to recruit FBOs and exercise instructors in 7 West Virginia counties. Two forums were held with stakeholders to identify barriers and facilitators to program adoption. We calculated separate adoption rates for organizations and exercise instructors.

OUTCOME

It took up to 3 months to recruit each FBO with an adoption rate of 94%. We made 289 telephone calls, sent 193 emails and 215 letters, distributed brochures and flyers to 69 FBOs, held 118 meetings, and made 20 trips over a period of 31 days (8,933 miles traveled). Nineteen of 22 trained exercise instructors started classes, an instructor adoption rate of 86%. Key issues regarding adoption were the age requirement for participants, trust, education, and competing priorities.

INTERPRETATION

Although we had recruitment challenges, our adoption rates were similar to or higher than those reported in other studies, and the objectives of the community engagement project were met. Clustering the FBOs and having them located closer geographically to our location may have reduced our resource use, and using a recruitment coordinator from the local community may have enabled us to gain the trust of congregants and clergy support.

The Ethics of Ironic Science in Its Search for Spoof

The goal of most scientific research published in peer-review journals is to discover and report the truth. However, the research record includes tongue-in-cheek papers written in the conventional form and style of a research paper. Although these papers were intended to be taken ironically, bibliographic database searches show that many have been subsequently cited as valid research, some in prestigious journals. We attempt to understand why so many readers cited such ironic science seriously. We draw from the literature on error propagation in research publication for ways categorize citations. We adopt the concept of irony from the fields of literary and rhetorical criticism to detect, characterize, and analyze the interpretations in the more than 60 published research papers that cite an instance of ironic science. We find a variety of interpretations: some citing authors interpret the research as valid and accept it, some contradict or reject it, and some acknowledge its ironic nature. We conclude that publishing ironic science in a research journal can lead to the same troubles posed by retracted research, and we recommend relevant changes to publication guidelines.

Spirituality and Health Education: A National Survey of Academic Leaders UK

Whole person care is deemed important within UK medical practice and is therefore fundamental in education. However, spirituality is an aspect of this often neglected. Confusion and discomfort exists regarding how care relating to issues of spirituality and health (S&H) should be delivered. Different interpretations have even led to disciplinary action with professionals seeking to address these needs [ http://www.telegraph.co.uk/health/healthnews/4409168/Nurse-suspended-for-offering-to-prayfor-patients-recovery.html ]. Previous research shows 45% of patients want spiritual needs to be addressed within their care (Jackson and Summerton 2008). Two-thirds of healthcare professionals want to do this. However, lack of knowledge is a significant barrier (Moynihan 2008). Little is known regarding how Medical schools address S&H, only one limited study exists in the literature (Koenig et al. in Int J Psychiat Med 40: 391-8, 2010). Thirty-two UK educational institutions were surveyed. The chosen survey was compiled by Koenig and Meador (Spirituality and Health in Education and Researc. Duke University, Durham, 2008). Fifty-nine academics were contacted across UK medical schools, and the response rate was 57.6%. Statistical analysis was performed using SPSS 16.0. 5.6% institutions provide required and dedicated S&H teaching, 63.4% provided it as an integrated component. Nearly 40% felt staff were not adequately trained to teach S&H but welcomed opportunities for training. S&H is given value in undergraduate education but with little evidence of formal teaching. Institutions feel that this area is addressed within other topic delivery, although previous studies have shown integrating S&H with PBL leads to poor clinical performance (Musick et al. in Acad Psychiatry 27(2):67-73, 2003). Seminars or lectures are students' preferred methods of learning (Guck and Kavan in Med Teach 28(8):702-707, 2006). Further consideration should be given towards S&H delivery and training for practice.

Mortality differences and inequalities within and between 'protected characteristics' groups, in a Scottish Cohort 1991-2009

BACKGROUND

Little is known about the interaction between socio-economic status and 'protected characteristics' in Scotland. This study aimed to examine whether differences in mortality were moderated by interactions with social class or deprivation. The practical value was to pinpoint population groups for priority action on health inequality reduction and health improvement rather than a sole focus on the most deprived socioeconomic groups.

METHODS

We used data from the Scottish Longitudinal Study which captures a 5.3 % sample of Scotland and links the censuses of 1991, 2001 and 2011. Hazard ratios for mortality were estimated for those protected characteristics with sufficient deaths using Cox proportional hazards models and through the calculation of European age-standardised mortality rates. Inequality was measured by calculating the Relative Index of Inequality (RII).

RESULTS

The Asian population had a polarised distribution across deprivation deciles and was more likely to be in social class I and II. Those reporting disablement were more likely to live in deprived areas, as were those raised Roman Catholic, whilst those raised as Church of Scotland or as 'other Christian' were less likely to. Those aged 35-54 years were the least likely to live in deprived areas and were most likely to be in social class I and II. Males had higher mortality than females, and disabled people had higher mortality than non-disabled people, across all deprivation deciles and social classes. Asian males and females had generally lower mortality hazards than majority ethnic ('White') males and females although the estimates for Asian males and females were imprecise in some social classes and deprivation deciles. Males and females who reported their raised religion as Roman Catholic or reported 'No religion' had generally higher mortality than other groups, although the estimates for 'Other religion' and 'Other Christian' were less precise.Using both the area deprivation and social class distributions for the whole population, relative mortality inequalities were usually greater amongst those who did not report being disabled, Asians and females aged 35-44 years, males by age, and people aged <75 years. The RIIs for the raised religious groups were generally similar or too imprecise to comment on differences.

CONCLUSIONS

Mortality in Scotland is higher in the majority population, disabled people, males, those reporting being raised as Roman Catholics or with 'no religion' and lower in Asians, females and other religious groups. Relative inequalities in mortality were lower in disabled than nondisabled people, the majority population, females, and greatest in young adults. From the perspective of intersectionality theory, our results clearly demonstrate the importance of representing multiple identities in research on health inequalities.

Negative effects of diabetes-related distress on health-related quality of life: an evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia

BACKGROUND

Patients with type 2 diabetes mellitus (T2D) often experienced change in life, altered self-esteem and increased feelings of uncertainty about the future that challenge their present existence and their perception of quality of life (QoL). There was a dearth of data on the association between diabetes-related distress (DRD) and health-related quality of life (HRQoL). This study examined the determinants of HRQoL, in particular the association between DRD and HRQoL by taking into account the socio-demographic-clinical variables, including depressive symptoms (DS) in adult patients with T2D.

METHODS

This cross-sectional study was conducted in 2012-2013 in three public health clinics in Malaysia. The World Health Organization Quality of Life-Brief (WHOQOL-BREF), 17-items Diabetes Distress Scale (DDS-17), and 9-items Patient Health Questionnaire (PHQ-9) were used to measure HRQoL, DRD and DS, respectively. The aim of this research was to examine the association between the socio-demographic-clinical variables and HRQoL as well as each of the WHOQOL-BREF domain score using multivariable regression analyses.

RESULTS

The response rate was 93.1% (700/752). The mean (SD) for age was 56.9 (10.18). The majority of the patients were female (52.8%), Malay (53.1%) and married (79.1%). About 60% of the patients had good overall HRQoL. The mean (SD) for Overall QoL, Physical QoL, Psychological QoL, Social Relationship QoL and Environmental QoL were 61.7 (9.86), 56.7 (10.64), 57.9 (11.73), 66.8 (15.01) and 65.3 (13.02), respectively. The mean (SD) for the total DDS-17 score was 37.1 (15.98), with 19.6% (136/694) had moderate distress. DDS-17 had a negative association with HRQoL but religiosity had a positive influence on HRQoL (B ranged between 3.07 and 4.76). Women, especially younger Malays, who had diabetes for a shorter period of time experienced better HRQoL. However, patients who were not married, had dyslipidaemia, higher levels of total cholesterol and higher PHQ-9 scores had lower HRQoL. Macrovascular complications showed the largest negative effect on the overall HRQoL (adjusted B = -4.98, 95% CI -8.56 to -1.40).

CONCLUSION

The majority of primary care adult with T2D had good overall HRQoL. Furthermore, the independent determinants for HRQoL had also concurred with many past studies. In addition, the researchers found that DRD had negative effects on HRQoL, but religiosity had positive influence on HRQoL. Appropriate support such as primary care is needed for adult patients with T2D to improve their life and their HRQoL.

TRIAL REGISTRATION

NMRR-12-1167-14158.

Religion, Poverty, and Politics: Their Impact on Women's Reproductive Health Outcomes

OBJECTIVE

This study sought to explore the relationship(s) between U.S. states of selected social determinants of health (SDH) and three women's reproductive health outcomes including abortion, teen births, and infant mortality rates (IMR).

DESIGN AND SAMPLE

The data from multiple population surveys were used to establish on a state-by-state basis, the interactions between selected SDH (religion, voting patterns, child poverty, and GINI) and their policy effects on three women's reproductive health outcomes (abortion, teen births, and IMRs) using publicly available national databases.

MEASURES

Child poverty rates and the GINI coefficient were analyzed. Religiosity information was obtained from the Pew Forum's surveys. Voting results were collected from the 2008 congressional and presidential races and were used as proxy measures for conservative- versus liberal-leaning policies and policy makers.

RESULTS

Using multiple regression analysis, higher IMRs were associated with higher religiosity scores. Lower abortion rates were associated with voting conservatively and higher income inequality. Higher teen birth rates were associated with higher child poverty rates and voting conservatively.

CONCLUSIONS

This study shows that selected SDH may have substantial impacts on women's reproductive health outcomes at the state level. Significant inequalities exist between liberal and conservative states that affect women's health outcomes.

The Santa Clara Strength of Religious Faith Questionnaire (SCSORF): a validation study on Iranian Muslim patients undergoing dialysis

The Santa Clara Strength of Religious Faith Questionnaire (SCSORF) is an often used and validated scale that is uncommonly utilized in culturally diverse populations. The purpose of this research investigation was to adapt the SCSORF for use among Iranian Muslim patients undergoing dialysis and to examine the reliability and validity of the scale among this population. A total of 428 patients (228 females, 200 males, M age = 52.2 years, SD = 10) were selected from five dialysis center in Tehran and Qazvin, Iran. A comprehensive forward-backward translation system was used for cross-cultural translation. Patients completed a baseline questionnaire obtaining demographic and clinical information as well as the SCSORF, the Age Universal Religious Orientation Scale (AUROS), the religious life inventory (RLI), and the Duke University religion index (DUREL). 2 weeks later, patients were asked to complete the SCSORF once again. Reliability of the SCSORF was examined using internal consistency and test-rest reliability. Convergent validity and factor structure using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were also examined. Cronbach's α for the single construct of the SCSORF was 0.89 with adequate test-retest reliability measured over a 2 week period. SCSORF scores were significantly correlated with AUROS, RLI and the DUREL. The EFA generated a single factor solution for the SCSORF while these results were confirmed by the CFA in an independent sample. Findings demonstrated that the SCSORF has favorable reliability, convergent validity, and divergent validity among Iranian Muslim patients undergoing dialysis and is recommended for use by clinicians (e.g., nephrologists) to measure strength of religious faith among patients.

Active aging for individuals with Parkinson's disease: definitions, literature review, and models

Active aging has been emerged to optimize different aspects of health opportunities during the aging process in order to enhance quality of life. Yet, most of the efforts are on normal aging and less attention has been paid for the elderly suffering from a chronic illness such as Parkinson's disease (PD). The aim of this review was to investigate how the concept of "active aging" fit for the elderly with PD and to propose a new model for them using the recent improvements in caring models and management approaches. For this purpose, biomedical databases have been assessed using relevant keywords to find out appropriate articles. Movement problems of PD affect physical activity, psychiatric symptoms lessen social communication, and cognitive impairment could worsen mental well-being in elderly with PD, all of which could lead to earlier retirement and poorer quality of life compared with healthy elderly. Based on the multisystematic nature of PD, a new "Active Aging Model for Parkinson's Disease" is proposed consisting of self-care, multidisciplinary and interdisciplinary care, palliative care, patient-centered care, and personalized care. These strategies could potentially help the individuals with PD to have a better management approach for their condition towards the concept of active aging.

Acceptance of disability and its predictors among stroke patients in Taiwan

BACKGROUND

Modern medicine has increased the survival rate for stroke patients; however, the patient's psychosocial adaptation after stroke onset may be related to the clinical outcomes. This study aimed to investigate patients' acceptance of disability (AOD) and its predictors in stroke patients.

METHODS

This cross-sectional study used a purposive sampling method to recruit 175 stroke patients from a hospital in southern Taiwan. A structured questionnaire gathered data on respondent demographics and disease characteristics, and included the Chinese version of the AOD Scale-Revised. Factors associated with AOD were examined by a multiple linear regression analysis.

RESULTS

The mean AOD score was 71.72, which indicated a lower level of disease acceptance (range, 32-128). Our findings showed that patients who reported no religious beliefs, shorter disease duration, recurrent stroke episodes, and poorer physical functioning also reported lower levels of disability acceptance. These factors accounted for 38.2% of the variance in AOD among participants.

CONCLUSIONS

The findings are beneficial to healthcare providers by identifying those stroke patients with predisposition of having lower disability acceptance, which could then facilitate the provision of appropriate rehabilitation interventions within six months after the diagnosis of stroke to support their adaptation process.

Prevalence and correlates of depression among chronic kidney disease patients in Taiwan

Background

Chronic kidney disease (CKD) is a progressive disease that causes a permanent impairment of renal function and premature mortality. The associated prognosis may result in serious psychological distress to the affected individual. However, there are limited data on the psychological correlates, and in particular depression, in Chinese CKD patients. This study aimed to examine the prevalence of depression, as well as the influence of other psychosocial factors on depression, among Taiwanese CKD patients.

Methods

We used a cross-sectional research design to recruit 270 CKD patients who were not undergoing dialysis treatment at a hospital in southern Taiwan during 2011. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the Taiwanese Depression Questionnaire. Factors associated with depression were examined by a multiple logistic regression analysis.

Results

The crude and age-standardized prevalence of depression were 22.6% and 20.6%, respectively. Those who had sleep disturbances, reported having no religious beliefs, followed no regular exercise regimen, and were diagnosed with stage III or above CKD demonstrated a significantly higher risk of depression.

Conclusion

Our findings are beneficial to healthcare providers, as they identify both the prevalence of depression and several of its correlates. By identifying CKD patients with a higher risk of depression, healthcare providers may be better able to ensure the provision of appropriate rehabilitation to this population.

The lived spiritual experiences of patients transitioning through major outpatient surgery

Dramatic changes in outpatient surgery have occurred in recent years, but the basic care needs of surgical patients remain constant. Most outpatients face the same spiritual and coping issues that inpatients do, but outpatient surgery requires that patients cope with the surgery at an accelerated pace. This phenomenological study describes the meanings of the lived spiritual experiences of patients transitioning through major outpatient surgery. Analysis of interviews with participants resulted in four distinct themes: a point in time, holy other, vulnerability in the OR, and appraisals of uncertainty. Ways that health care providers can provide holistic case include developing an understanding of the patient's overall experience, understanding the patient's goals, and supporting the patient's own coping mechanisms and resources. Additional research should be conducted to explore interventions related to patients' spiritual well-being in outpatient settings.

Quality of life of orthopedists in Mato Grosso do Sul

OBJECTIVE

Evaluate QOL and its implications for health care providers specialized in orthopedics.

METHODS

In this quantitative, descriptive, cross-sectional study two questionnaires, World Health Organization Quality of Life (WHOQOL-100) and sociodemographic, were sent to 117 orthopedic surgeons, with 29 doctor's response. Statistical analysis was performed using three different tests: Analysis of Variance (ANOVA), Student t-test, and Pearson's linear correlation. The tests were applied with a reliability of 95%.

RESULTS

Twenty-nine orthopedic surgeons responded to the questionnaire. The studied variables regarding domains were age and employment duration, which have a positive relationship with the environment and social relationships domains; income, which positively influences the level of independence and environment domains; and workload, which negatively influences the psychological domain.

CONCLUSION

Orthopedic physicians had high scores in the WHOQOL-100 domains and, in their perception, good quality of life had higher scores compared to other professions.

Religion and smoking: a review of recent literature

Tobacco smoking and exposure to secondhand smoke are a major threat to human health worldwide. The effort to prevent tobacco use should be regarded as an important public health strategy. Given the significance of religion and spirituality in the daily life of more than 90% of the world's population, the relationship of religion and smoking should be seen as a critical research area. Religions are many and varied, but most value human well-being highly and so do not approve of tobacco use, even though they do not prohibit it entirely. In recent years, researchers have shown more interest in the subject of religion and health, including drug and tobacco use. Differences of focus and methodology notwithstanding, most studies have ascertained a deterrent role for religion as regards tobacco use, and several mechanisms have been proposed to explain the negative relationship between religion or spirituality and smoking. Many of the studies, however, suffer from shortcomings that need to be acknowledged and addressed, such as using nonstandard data-gathering tools, lack of a unified definition of religion or spirituality, and paucity of research in non-Christian and developing countries. Finally, the cross-sectional nature of many of the studies makes the meaningful interpretation of findings difficult.

Health promotion in megachurches: an untapped resource with megareach?

INTRODUCTION. In the United States, megachurches (churches with 2,000+ attendance) represent a community institution with extensive reach within the population. Despite this potential for reach, the current health promotion practices of megachurches are unknown. This study aimed to document current health promotion activities and resources for health promotion in megachurches.

METHOD

Staff at megachurches were recruited to take an online survey of health promotion programs, health promotion-related beliefs, barriers, and existing resources.

RESULTS

Respondents (n = 110 churches) indicated that churches were primarily Baptist (23.6%) or nondenominational (21.1%), had 2,500 to 4,999 congregation members (44.5%), primarily White congregation members (83.5%), and 31 to 60 employees (45.4%). Churches reported 4.73 ± 2.54 activities/year, most commonly reporting clubs or teams related to physical activity (74.5%), hands-on classes (65.5%), and educational activities (59.1%). Most churches (39.1%) reported their primary faith leader was minimally involved in health-related activities. The most common barrier was competition for time/space with other church activities (46.2%). Churches reported several employee health-related policies. Respondents reported a budget of $0 to $499/year for health-related programs (44.4%).

CONCLUSION

These findings provide insight regarding the current status of health promotion in megachurches. These large churches are a potential health promotion partner for researchers and practitioners for developing culturally tailored interventions.

To pray or not to pray: a question of ethics

There is a widespread belief that nurses have a duty to provide spiritual care. However, many feel there is still a need for debate surrounding the ethical use of prayer in both nursing research and practice. By using critical reflections and evidence-based literature, this paper develops a discourse on the ethics of prayer as a spiritual intervention in nursing and health care practice. Several key ethical issues are highlighted. In regards to research, lack of informed consent is a major concern in both research and nursing practice. Key ethical issues in practice include questions around intention and authority, e.g. despite the religious beliefs of the nurse, intentions to proselytize must be avoided to protect patient autonomy and avoid abuse of the nurse's authority. Furthermore, prayer has unknown side effects and implications. This paper concludes that, in practice, nurses must reconcile their personal, spiritual beliefs with their professional duties, and while this may be a delicate balance, it is not yet appropriate to encourage or dissuade a patient from their beliefs until appropriate research evidence is produced.

A Family History Intervention

This article describes the effect of individualized counseling using family history data and objective cardiovascular risk factors on intent to change and actual exercise behavior in a diverse sample of working adults. Using a longitudinal, quasi-Bxperimental, crossover design, objective data (blood lipids, glucose, blood pressure, and body mass index) and subjective data (awareness of heart disease risk, depression, spirituality, and knowledge of family history) were collected from 91 (mostly female and with a mean age of 45 years) primary and secondary teachers in a southwestern city. The Transtheoretical Model of Change guided the study and measured intent to exercise. Objective risks in this sample mirrored national indices of risk for obesity and abnormal lipids. Although some participants increased their exercise, no significant differences were found between the groups in exercise behavior at 6 and 12 months. Using knowledge of family history to raise awareness and encourage lifestyle changes related to cardiovascular risk warrants further study.

Religion in trauma care: grand narratives and sacred rituals

This article outlines major religious practices observed in the UK and discusses how associated spiritual and religious custom and rites should be honoured by emergency practitioners. The article does not intend to be an all encompassing text on religion but to heighten awareness among emergency practitioners about various spiritual and religious considerations affecting patients and families under their care during critical and sometimes life-changing events in their life.

[Religious intervention and recovery from drug addiction]

OBJECTIVE

To analyze the role of emerging religious interventions in the recovery from drug addiction.

METHODOLOGICAL PROCEDURES

An exploratory qualitative study carried out in the city of Sao Paulo, Southeastern Brazil, in 2004 and 2005. In-depth interviews were held with 85 former drug users who had turned to non-medical religious resources for the treatment of their drug addiction and who were free from drugs for at least six months. The religious groups included in the analysis were Catholics, Evangelicals and Spiritualists. The interviews contained questions relating to sociodemographic data, the religiosity of the interviewee, his or her history of drug consumption, medical treatment for drug addiction, religious treatment and prevention of drug consumption through religion.

ANALYSIS OF RESULTS

There were differences between the religious groups in the way that the drug addict was supported. The group that most used religion as an exclusive form of treatment was the Evangelicals, who rejected the intervention of a doctor andr any kind of pharmacological treatment. The Spiritualists most turned to therapeutic support for alcohol dependence, as well as conventional treatment, on account of their greater purchasing power. Catholics generally relied exclusively on religious therapy, but were less likely to reject the possibility of medical treatment. The importance given to prayer as an anxiolytic method was common in the three treatments. Confessions and pardons--in the forms of (faith) conversions and penitence for Evangelicals and Catholics respectively--served to help to rebuild people's lives and restore their self-esteem.

CONCLUSIONS

According to the interviewees, what helped them to maintain their abstinence from drugs was more than just religious faith. Other factors included the support, positive pressure and welcoming offered by the group, and the offer to rebuild their lives with the unconditional support of religious leaders.

Religious treatments for drug addiction: an exploratory study in Brazil

The main objective of the present work is to understand the processes used in emerging Catholic and Protestant religious interventions for recovery from drug dependence, from the vantage point of individuals subjected to them. A qualitative method and an intentional sample selected by criteria were adopted for this investigation, which was conducted in São Paulo, Brazil. An in-depth semi-structured interview was conducted with 57 predominantly male former drug users who fit the criteria: they had been submitted to non-medical religious treatments to treat dependence and were abstinent for at least 6 months. Crisis was found to be the main reason leading interviewees to seek treatment; this includes, losing family, losing employment, and experiencing severe humiliation. Evangelicals most used religious resources exclusively as treatment, showing strong aversion to the role of doctors and to any type of pharmacological treatment. A common feature of Catholic and Protestant groups is the importance ascribed to praying and talking to God, described by subjects as strongly anxiolytic, and a means to control drug craving. Confession and forgiveness, through faith conversion or penitences, respectively, appeal strongly to the restructuring of life and increase of self-esteem. Religious interventions were considered effective by the individuals who underwent them and were seen as attractive for the humane, respectful treatment they delivered. The key aspects of this type of treatment are social support provided by the receiving group, equal treatment, and instant, judgment-free acceptance. The success of these actions, then, is not only due to some "supernatural" aspect, as might be assumed, but also more to the unconditional dedication of human beings to their peers. Given the difficulty in treating drug dependence, religious interventions could be used as a complementary treatment for conventional therapies.