Contribution of spirituality to quality of life in patients with residual schizophrenia

Religiosity and Conversion Therapy is Associated with Psychosocial Health Problems among Sexual Minority Men (SMM) in Nigeria

We investigated the associations between social marginalization, psychosocial health, and religiosity among sexual minority men (SMM) in Nigeria (N = 406). We conducted bivariate and multivariable logistic regression. Factors associated with reporting a history of conversion therapy at a religious institution were: being HIV positive, having depressive symptoms, reporting suicide thoughts, and reporting inability to access medical care. Factors associated with increased odds of agreeing that sex between two men was a sin were: residing in Plateau, being Muslim, and higher levels of internalized homophobia. Our findings support the need for LGBT-affirming religious doctrine, which has implications for the health of LGBT communities.

Quality of Life and Its Associations with Religiosity and Religious Coping among Outpatients with Psychosis in Singapore

This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, p = 0.02) and psychological (β = 0.64, p = 0.01) QOL domains in the regression model. Negative religious coping was related to worse QOL in all four domains: physical (β = −0.44, p = 0.03), psychological (β = −0.76, p < 0.01), social (β = −0.54, p = 0.03), and environment (β = −0.65, p < 0.01). Increased participation in organizational religious activities was positively associated with higher QOL for psychological (β = 2.47, p < 0.01), social relationships (β = 2.66, p = 0.01), and environment (β = 2.09, p = 0.01) domains. Interestingly, those with no religious affiliation were found with higher scores in the QOL domain for social relationships (β = 4.59, p = 0.02). Religious coping plays an important role for the QOL of outpatients with psychosis. Greater awareness of the importance of religion in this population may improve cultural competence in treatment. Individuals with psychosis may benefit from greater community support and collaboration between clinical and religious community-based organizations to improve social integration and QOL.

Predictive Factors of Spiritual Quality of Life during the COVID-19 Pandemic: A Multivariate Analysis

COVID-19 has led to the implementation of various social and sanitary measures, impacting populations' quality of life. Aims: Documenting the spiritual quality of life (SQoL) of university employees and students in Quebec, Canada. A survey of 2,202 employees and students was conducted using health measurement tools, including the short version of the WHOQoL-SRPB. We ran a multiple linear regression to determine which variables promote the SQoL. SQoL was very low (2.92/5). Positive mental health, religion, and age are the main predictors of the SQoL. Some dimensions of spirituality contribute more than others to the respondents' quality of life and health during the COVID-19 pandemic.

Parenting skills of patients with chronic schizophrenia

AIM OF THE STUDY

This study aims to evaluate the parenting skills of patients with schizophrenia as perceived by themselves and their children and compare the same with a matched healthy control group of parents and their children.

MATERIALS AND METHODS

Fifty-one patients with schizophrenia and their 51 children were assessed on the Alabama Parenting Scale. A healthy control group of 51 parents and their children were also assessed for parenting.

RESULTS

The mean age of parents with schizophrenia was 45.23 years. Compared to the parents in the healthy control group, patients with schizophrenia reported deficits in the domains of positive involvement, positive parenting; more often report poor monitoring/supervision, and inconsistent discipline. When the children of patients with schizophrenia and children of healthy parents were compared, children of healthy control parents reported higher positive involvement, positive parenting; and lower corporal punishment and inconsistent discipline. Except for few associations, parenting was not affected by demographic and clinical profile of the patients with schizophrenia.

CONCLUSION

The present study suggests that patients with schizophrenia have deficits in parenting and there is a need to improve the parenting skills of the patients with schizophrenia.

Quality of Life in Schizophrenia: What is Important for Persons with Schizophrenia in India?

BACKGROUND

Quality of life (QOL) is a multidimensional construct and is increasingly recognized as an important outcome measure. Schizophrenia runs a chronic course and is a disabling mental disorder. Assessment of QOL using currently available scales for schizophrenia may not be culturally relevant.

METHODS

In phase one, patients with schizophrenia using psychiatric rehabilitation services, caregivers, and mental health professionals were interviewed qualitatively to identify factors that are important for QOL of patients. In phase two, 40 patients with schizophrenia were recruited consecutively from the outpatient department and asked to rate the importance/relevance of the above items for QOL on a Likert scale.

RESULTS

Themes that emerged were work, family's understanding about illness, stigma, financial issues, social life, social standing, religion and spirituality, medications, physical health, mental health and symptoms, recreation and leisure, and independent living. Work and family's understanding of illness were considered as moderately or very important by all patients in phase two.

CONCLUSIONS

Work is very important for all patients with schizophrenia for their QOL. The themes derived from this study could guide the development of a scale for QOL that is relevant to the Indian context.

Mental Health Disparities, Treatment Engagement, and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness: A Review

Mounting evidence indicates that there are mental health disparities in the United States that disadvantage racial/ethnic minorities in medical and mental health settings. Less is known, however, about how these findings apply to a particularly vulnerable population, individuals with severe mental illness (SMI). The aim of this paper is to (1) provide a critical review of the literature on racial/ethnic disparities in mental health care among individuals with SMI; (2) identify factors which may contribute to the observed disparities; and (3) generate recommendations on how best to address these disparities. Specifically, this article provides an in-depth review of sociocultural factors that may contribute to differences in treatment engagement and rates of attrition from treatment among racial/ethnic minorities with SMI who present at medical and mental health facilities. This review is followed by a discussion of specific strategies that may promote engagement in mental health services and therefore reduce racial/ethnic disparities in SMI.

Coping in residual schizophrenia: Re-analysis of ways of Coping checklist

Background & objectives:

Persons with schizophrenia use various coping strategies to adapt to distressing symptoms as well as to deal with daily stressors. Efforts have been made to explore alternative frameworks of coping using Ways of Coping Checklist (WCC) in persons with schizophrenia. This study aimed to re-analyze (factor analysis) the revised-WCC in Indian patients with residual schizophrenia. The secondary aim of the study was to evaluate the relationship of new framework of coping with psychopathology, disability and quality of life (QOL).

Methods:

Using a cross-sectional design, 103 patients with residual schizophrenia were assessed on WCC. A principal component analysis with varimax rotation was carried out to determine the factor structure of WCC.

Results:

Factor analysis yielded six factors which explained 51.6 per cent of the total variance and had acceptable-to-good internal consistency. Based on the type of items loaded, the six factors were named as follows: active and growth-oriented coping, accepting and fantasizing, reflective and confrontative coping, detachment, seeking social support and negative emotional coping. Patients most often used coping strategy of seeking social support, followed by ‘accepting and fantasizing’ and ‘active and growth-oriented coping’. Correlation analysis showed that those who more often used ‘active and growth-oriented coping’ had less negative symptoms, lower level of disability and higher spiritual and overall QOL.

Interpretation & conclusions:

The factor structure of revised-WCC was different among patients with schizophrenia when compared with individuals without mental illness, living in the community. It was evident that use of certain adaptive coping strategies was associated with better QOL and lower level of psychopathology. Our findings provided a framework of coping in patients with residual schizophrenia and suggested that promotion of certain coping strategies might be useful in improving the QOL and reduction of psychopathology in patients with schizophrenia.

Needs of Patients with Schizophrenia Among an Ethnic Minority Group in Latin America

The aim of the study is to describe the need profile of outpatients with schizophrenia belonging to an Aymara ethnic group in Latin-America and to compare that profile to non-Aymara patients. A sample of 253 patients were evaluated with the Two-Way Communication Checklist (2-COM Checklist) measuring the needs and satisfaction of the patient; Positive and Negative Syndrome scale for Schizophrenia (PANSS) and Attitude to the Drugs (DAI-10). No significant differences were found between Aymara and non-Aymara, either in the total number of needs or in the subscales of satisfaction or in the types of needs. After adjustment for socio-demographic and clinical factors, patients with higher severity (PANSS) had higher number of needs and lower level of satisfaction. Higher score on DAI-10 is related to a higher total number of needs and better satisfaction with medication. Age, sex, ethnicity and employment were also associated with specific needs. The profile of the needs of schizophrenic Aymara patients does not differ from that of non-Aymara patients, and that in both groups it is necessary that the treatment primarily address symptom management and the subjective aspects of quality of life.

Religiosity among patients with schizophrenia: An exploratory study

AIM

This study aimed to compare the religiosity and religious coping of patients with schizophrenia with a healthy control group and to assess the correlation between the level of religiosity and religious coping with residual psychopathology, level of functioning, and quality of life (QOL).

METHODOLOGY

Patients of schizophrenia were assessed on religiousness measure scale, duke religion index (DUREL), brief religious coping scale (RCOPE), positive and negative symptom scale, and World Health Organization QOL-BREF version.

RESULTS

Of the 100 patients of schizophrenia, 99% reported that they believed in God. About 60% of patients attended religious places either once a week or more and 56% of patients indulged in private religious activity at least once a day. Two-third of the participants had high intrinsic religiosity score. The mean score of positive religious coping (PRC) subscale was 14.56 and that for negative religious coping (NRC) subscale was 8.31. No significant difference was noted in the various domains of religious measure scale, DUREL, and PRC between patients with schizophrenia and healthy controls. However, compared to healthy controls, patients more often used NRC. Various aspects of religiosity (except for negative RCOPE score) correlated negatively with residual psychopathology and positively with functioning and QOL.

CONCLUSION

Findings of this study suggest that high proportions of patients with schizophrenia are religious and this is similar to healthy controls in the community. Higher level of religiosity and more frequent use of religious coping are associated with lower level of psychopathology and better QOL.

Quality-of-life and spirituality

Spirituality has been identified as an important dimension of quality-of-life. The objective of this study was to review the literature on quality-of-life and spirituality, their association, and assessment tools. A search was conducted of the keyterms 'quality-of-life' and 'spirituality' in abstract or title in the databases PsycINFO and PubMed/Medline between 1979-2005, complemented by a new search at PUBMED from 2006-2016. Quality-of-life is a new concept, which encompasses and transcends the concept of health, being composed of multiple domains: physical, psychological, environmental, among others. The missing measure in health has been defined as the individual's perception of their position in life in the context of culture and value system in which they live and in relation to their goals, expectations, standards, and concerns. There is consistent evidence of an association between quality-of-life and religiosity/spirituality (R/S), through studies with reasonable methodological rigour, using several variables to assess R/S (e.g. religious affiliation, religious coping, and prayer/spirituality). There are also several valid and reliable instruments to evaluate quality-of-life and spirituality. Further studies are needed, however, especially in Brazil. Such studies will provide empirical data to be used in planning health interventions based on spirituality, seeking a better quality-of-life. In the last 10 years, research is consistently growing about quality-of-life and spirituality in many countries, and also in many areas of health research.

Parental and God Representations Among Individuals with Psychosis: A Grounded Theory Analysis

Religiousness, spirituality, and social support have all been identified as having a positive impact on overall mental health outcomes. The current study describes quantitative and qualitative assessment of parental and God representations among individuals diagnosed with schizophrenia or schizoaffective disorder (N = 46). Six salient themes emerged; participants described the importance of caregiver love and nurturance, need for God, loss of family members, love of God, concrete support provided by parents, and the ability to tolerate ambivalent feelings toward parents. Participants linked their relationships with parents and God to their process of recovery. Implications for clinical practice are discussed.

On the border of deep spirituality and psychosis… A case study

This article is a case study of a 28-year-old patient diagnosed with F23. The report is preceded by an extensive literature review describing the situation of the mentally ill, in which psychiatry intermingles with spirituality and the sacrum.

The aim of the study was to investigate the relationship between religion/spirituality and schizophrenia as well as to draw attention to the complex problem of differential diagnosis of religious and spiritual problems. When is psychiatric treatment enough and when is intervention of a priest really essential?

The authors discuss the problem of mental disorders in connection with religion and spirituality in the clinical context. The article shows that it is very important that the processes of diagnosis and treatment take into account the patients’ individual traits, beliefs, values and spirituality.

The Spiritism as therapy in the health care in the epilepsy

OBJECTIVE

to present a brief history of Spiritism, the vision of epilepsy by Spiritism, and the potential of spirituality and religiosity care as complementary and coadjutants treatments in epilepsy.

METHOD

this is a brief review about the impact of faith, spirituality, and religiosity, particularly the Spiritism philosophy as complementary treatment to neurological disorders (particularly focusing on epilepsy) and mental health. We conduct a review of published articles (about religion/spirituality and epilepsy) in the Pubmed and SciELO databases.

CONCLUSION

the exercise of spirituality and religiosity can be a positive coping strategy to support the traditional therapy of patients with epilepsy and other neurological disorders. However, it is necessary to demystify myths and beliefs about the epilepsy and improve knowledge about this important health dimension among professionals, patients, and caregivers to explore their full treatment and supportive potential.

Filipino Nurses’ Spirituality and Provision of Spiritual Nursing Care

This study was to explore the perceptions of Filipino nurses’ spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses’ Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses’ perception of spirituality were Item 7, “I believe that God loves me and cares for me,” and Item 8, “Prayer is an important part of my life,” with mean scores of 4.87 ( SD = 1.36) and 4.88 ( SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, “I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.),” and Item 25, “I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed,” with mean scores of 3.16 ( SD = 1.54) and 2.92 ( SD = 1.59). Nurse’s spirituality correlated significantly with their understanding of spiritual nursing care ( r = .3376, p ≤ .05) and delivery of spiritual nursing care ( r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care ( r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment.

Effect of Group Positive Psychotherapy on Improvement of Life Satisfaction and The Quality of Life in Infertile Woman

BACKGROUND

Positive psychotherapy is one of the new approaches in psychology which is innovated for treating psychological disorders and enhancing positive emotions. The aim of this study is to investigate the effectiveness of the group positive psychotherapy on elevation of life satisfaction and quality of life in infertile women.

MATERIALS AND METHODS

In a randomized trial study, Beck Depression Inventory II (BDI-II) and clinical interview were used in a pre-test post-test control group design. After analyzing the result of the questionnaire, 36 infertile women who showed signs of mild to moderate depression were randomly placed into two following groups: control (n=18) and intervention (n=18). Before the treatment, the members of both groups answered BDI-II, Satisfaction With Life Scale (SWLS) and 12 item Short Form Health Survey (SF-12). The intervention group received six sessions of group positive psychotherapy, but the treatment of the control group began six weeks after the intervention group.

RESULTS

The results showed that the life satisfaction scores of the intervention group were significantly elevated from 22.66 in pre-test to 26.13 in post-test (P<0.001), while this improvement was not significant in the control group (P=0.405). The difference between life satisfaction scores of the intervention and the control groups was also significant (F=8.92, P=0.006). However, no significant change in the quality of life level of the intervention and control groups was observed (P=0.136).

CONCLUSION

Thus it can be deduced from the findings that this treatment method could be introduced as solution to increase the life satisfaction in infertile women, but not as a treatment for elevating their quality of life (Registration Number: IRCT2013042810063N3).

Religion involvement and quality of life in patients with schizophrenia in Latin America

OBJECTIVE

The aim of the study was to explore the relationship between religion involvement (RI) and quality of life (QoL) in patients with schizophrenia from three countries in Latin America, while considering key confounding factors such as socio-demographic and clinical characteristics.

METHODS

This cross-sectional study was conducted in the public mental health services in La Paz, Bolivia; Arica, Chile; and Tacna, Peru. The data collected included RI, socio-demographic information, clinical characteristics, type of treatment and QoL using the S-QoL 18 questionnaire. A multivariate analysis using multiple linear regressions was performed to determine variables associated with QoL levels.

RESULTS

Two hundred and fifty-three patients with schizophrenia were enrolled in our study. Significant positive associations were found between RI and QoL (the S-QoL 18 index: β = 0.13; p = 0.048; autonomy dimension: β = 0.15; p = 0.027). Other socio-cultural and economic factors were also associated with low QoL level: being a woman, older patient, low education level and being Aymara. Severity of the psychotic symptoms was associated to a lower QoL for all the dimension (β from 0.15 to 0.31), except for the resilience.

CONCLUSION

Our study found that socio-cultural and economic factors including RI were associated with QoL in patients with schizophrenia in Latin America, suggesting that these factors may influence positively health outcome. However, these relationships were moderate in strength, especially in comparison to symptoms severity which remained the most important features associated with QoL.

Measures of spirituality for use in military contexts: a scoping review

Introduction: The purpose of this scoping review is to identify measures of spiritual fitness that can be used in a military context. Methods: Two independent reviewers applied post-hoc inclusion and exclusion criteria for the identification of relevant articles, reviews, and assessments. Each reviewer independently recorded criteria met using a jointly developed form, considering relevant spiritual fitness screening and assessment tools based on clinical experience. When two reviewers were in disagreement, a third blinded reviewer was used to create consensus. Results: 35 assessments with psychometric properties were identified that could be administered by military chaplains, health care professionals, or military personnel (through self-reporting) to evaluate spiritual fitness over time among those in the military service. The assessments were compiled into a table to isolate differing properties of each assessment, including target population, length/time to complete, measurement of affective, behavioural, and cognitive aspects of spiritual fitness, psychometric properties, and example questions. Discussion: There is now an opportunity to further identify and evaluate spiritual fitness screening and assessment tools that will appropriately and effectively determine the spiritual fitness and resilience of individuals serving in the military as well as their families.

Religiosity in young adolescents with auditory vocal hallucinations

The current exploratory study examined the associations between auditory vocal hallucinations (AVH) and delusions and religiosity in young adolescents. 337 children from a population-based case-control study with and without AVH, were assessed after five years at age 12 and 13, on the presence and appraisal of AVH, delusions and religiosity. AVH status (persistent, remittent, incident or control) was examined in relationship to religiosity. Results demonstrated a non-linear association between AVH and religiosity. Moderately religious adolescents were more likely to report AVH than non-religious adolescents (O.R.=2.6). Prospectively, moderately religious adolescents were more likely to have recently developed AVH than non-religious adolescents (O.R.=3.6) and strongly religious adolescents (O.R.=7.9). Of the adolescents reporting voices in this sample (16.3%), more than half reported positive voices. Religious beliefs were often described as supportive, useful or neutral (82%), regardless of the level of religiosity, for both adolescents with and without AVH. Co-occurrence of AVH and delusions, and severity of AVH were not related to religiosity. The present findings suggest there may be a non-linear association between religiosity and hearing voices in young adolescents. A speculative explanation may be that religious practices were adopted in response to AVH as a method of coping.

Comparison of spiritual well-being and coping strategies of patients with generalized anxiety disorder and with minor general medical conditions

The purpose of the present study was to compare the spiritual well-being and coping strategies of patients with generalized anxiety disorder (GAD) and those with general medical conditions (GMC). The sample was comprised of 40 participants with GAD fulfilling the diagnostic criteria of DSM IV-TR and 50 participants with GMC. The descriptive statistics, correlation analysis and independent sample t test were used for data analysis. The results revealed the significant negative correlation of spiritual wellness with GAD symptoms and positive correlation between spiritual wellness, active practical and religious-focused coping strategies. The independent sample t test showed that spiritual wellness of participants with GMC was higher than participants with GAD. Moreover, out of 13 dimensions of spiritual wellness inventory, the scores of participants with minor general medical conditions in the dimensions of conception of divinity, present centeredness, hope, forgiveness, conscientiousness and spiritual freedom remained significantly higher than those with GAD. The participants with GMC used more active practical coping strategies and religious-focused coping strategies than participants with GAD. There was no difference between two groups of participants in using active distracting coping strategies, while avoidance-focused coping strategies were used by participants with GAD more than those with GMC.

The role of religion and spirituality in mental health

PURPOSE OF REVIEW

There has been increased interest in the relationship between religion and spirituality and mental health in recent years. This article reviews recent research into the capacity of religion and spirituality to benefit or harm the mental health of believers. We also examine the implications this may have for assessment and treatment in psychiatric settings.

RECENT FINDINGS

Studies indicate that religion and spirituality can promote mental health through positive religious coping, community and support, and positive beliefs. Research also shows that religion and spirituality can be damaging to mental health by means of negative religious coping, misunderstanding and miscommunication, and negative beliefs. Tools for the assessment of patients' spiritual needs have been studied, and incorporation of spiritual themes into treatment has shown some promise.

SUMMARY

Religion and spirituality have the ability to promote or damage mental health. This potential demands an increased awareness of religious matters by practitioners in the mental health field as well as ongoing attention in psychiatric research.

The effect of service satisfaction and spiritual well-being on the quality of life of patients with schizophrenia

Quality of life (QOL) has been considered an important outcome measure in psychiatric research and determinants of QOL have been widely investigated. We aimed at detecting predictors of QOL at baseline and at testing the longitudinal interrelations of the baseline predictors with QOL scores at a 1-year follow-up in a sample of patients living in Residential Facilities (RFs). Logistic regression models were adopted to evaluate the association between WHOQoL-Bref scores and potential determinants of QOL. In addition, all variables significantly associated with QOL domains in the final logistic regression model were included by using the Structural Equation Modeling (SEM). We included 139 patients with a diagnosis of schizophrenia spectrum. In the final logistic regression model level of activity, social support, age, service satisfaction, spiritual well-being and symptoms' severity were identified as predictors of QOL scores at baseline. Longitudinal analyses carried out by SEM showed that 40% of QOL follow-up variability was explained by QOL at baseline, and significant indirect effects toward QOL at follow-up were found for satisfaction with services and for social support. Rehabilitation plans for people with schizophrenia living in RFs should also consider mediators of change in subjective QOL such as satisfaction with mental health services.

Religion, spirituality, and schizophrenia: a review

Religion and spirituality exert a significant role in the lives of many individuals, including people with schizophrenia. However, the contribution of religion and spirituality to various domains (psychopathology, explanatory models, treatment seeking, treatment adherence, outcome, etc.) has not received much attention. In this article, we review the exiting data with regards to the relationship of religion, spirituality, and various domains in patients with schizophrenia. Available evidence suggests that for some patients, religion instills hope, purpose, and meaning in their lives, whereas for others, it induces spiritual despair. Patients with schizophrenia also exhibit religious delusions and hallucinations. Further, there is some evidence to suggest that religion influences the level of psychopathology. Religion and religious practices also influence social integration, risk of suicide attempts, and substance use. Religion and spirituality also serves as an effective method of coping with the illness. Religion also influences the treatment compliance and outcome in patients with schizophrenia.

Validation of Hindi Translation of SRPB Facets of WHOQOL-SRPB Scale

BACKGROUND

World Health Organization's Quality of Life - Spirituality, Religiousness and Personal Beliefs Scale (WHOQOL SRPB) is a valuable instrument for assessing spirituality and religiousness. The absence of this self-administered instrument in Hindi, which is a major language in India, is an important limitation in using this scale.

AIM

To translate the English version of the SRPB facets of WHOQOL-SRPB scale to Hindi and evaluate its psychometric properties.

MATERIALS AND METHODS

The SRPB facets were translated into Hindi using the World Health Organisation's translation methodology. The translated Hindi version was evaluated for cross-language equivalence, test-retest reliability, internal consistency, and split half reliability.

RESULTS

Hindi version was found to have good cross-language equivalence and test-retest reliability at the level of facets. Twenty-six of the 32 items and 30 of the 32 items had a significant correlation (ρ<0.001) in cross language concordance and test-retest reliability data, respectively. The Cronbach's alpha was 0.93, and the Spearman-Brown Sphericity value was 0.91 for the Hindi version of SRPB.

CONCLUSIONS

The present study shows that cross-language equivalence, internal consistency, split-half reliability, and test-retest reliability of the Hindi version of SRPB (of WHOQOL-SRPB) are excellent. Thus, the Hindi version of WHOQOL-SRPB as translated in this study is a valid instrument.

Spirituality and religion in modern medicine

Man has always yearned for a higher sense of belonging in life. Since ancient ages, human beings have tried to examine and evaluate the relationship between spirituality, religion and medicine. The interface of spirituality, quality of life and mental health is fascinating and sublime. Religion and spirituality play an essential role in the care giving of patients with terminal illnesses and chronic medical conditions. Patient's needs, desires and perspectives on religion and spirituality should be addressed in standard clinical care. Ongoing research in medical education and curriculum design points towards the inclusion of competence, communication and training in spirituality. There are structured and reliable instruments available for assessing the relationship between spirituality, religion and health in research settings. Intervention based scientific studies in the arena of spirituality and modern medicine are needed. Further research should be directed towards making modern medicine more holistic.