Are spirituality and religiosity resources for patients with chronic pain conditions?

Religiosity and Health Outcomes in a Cohort of Romanian Patients Hospitalized for COVID-19

There is a growing body of evidence for the interrelation between health status and religious beliefs. Our aim was to evaluate the level of religiosity in patients hospitalized for COVID-19 and to assess the link between religiosity and measurable health outcomes. This was an observational, single-center study which included patients with moderate-to-severe forms of COVID-19. A total of 112 patients were enrolled in the study, of whom 77 were highly religious (CRS-15 score ≥ 4) and 35 non-highly religious (CRS-15 score < 4). There was no difference in demographics or prevalence of comorbidities between the two groups. Furthermore, we found no difference between groups in radiological extension of lung lesions, length of hospital stays, or ICU need; however, in-hospital mortality rate was significantly lower in highly religious group (1% vs. 14%, p = 0.005). Serum ferritin level at admission was significantly lower (p = 0.03) and prevalence of post-COVID-19 pulmonary sequelae significantly higher in highly religious group (p = 0.02).

Navigating Complexity: Spiritual Care Discourses Among Swedish Palliative Care Professionals

Through discourse analysis of focus groups, this study investigates how palliative care professionals in Sweden engage with "spiritual care," "religion" and "spirituality." Our results reveal a common assumption that religion is "visible," but at the same time private. Furthermore, we observed a secular and nonreligious positioning, marked by frequent "us versus them" rhetoric, especially in discussions about truth telling. The findings illustrate a view of belonging to a secular society in which a discourse of static understanding of religion dominated, indicating a vague religious literacy. This study indicates a need among healthcare professionals to discern, understand and relate to non-visible forms of religion.

Using a Whole Health Approach to Build Biopsychosocial-Spiritual Personal Health Plans for Veterans with Chronic Pain

Chronic pain affects over 50 million Americans per year and costs society billions of dollars annually. It is widely accepted that the biomedical model is outdated and research on the biopsychosocial model of chronic pain has increased in recent years, concurrent with investigations into self-management of chronic pain. The Veterans Health Administration (VHA) has incorporated both of these approaches into their Whole Health System. This work describes the VHA Whole Health System, reviews the literature on alignment between the Whole Health System's Circle of Health and chronic pain, and explains how the VHA Whole Health model may be used as a method for organizing self-management strategies within a personal health plan in the context of chronic pain. Given the infusion of nurses throughout the healthcare system, nurses are in a unique position to champion this biopsychosocial-spiritual approach to care.

Religious meaning system and life satisfaction: the mediating role of meaning in life among Polish people with multiple sclerosis

Introduction

The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS).

Methods

This cross-sectional study included 600 MS patients recruited from Poland who completed the Satisfaction with Life Scale (SWLS), the Religious Meaning System Questionnaire (RMS) and the Meaning in Life Questionnaire (MLQ). Model 6 of Hayes PROCESS was used to test the hypotheses.

Results

The results of our research indicate that there was a significant indirect effect of religious meaning system on life satisfaction through the presence of meaning in life. The specific indirect effect of religious meaning system on life satisfaction through searching for meaning in life was not significant.

Discussion

The results of our study are relevant because they show that religion as a meaning system is positively related to the presence of meaning in life, which in turn positively predicts life satisfaction. This is particularly important in the case of incurable illness, where finding meaning in life is one of the natural stages of adaptation. By incorporating these findings into mental health practice, professionals can enhance the holistic well-being of people coping with MS and contribute to a more comprehensive and effective approach to mental health care.

Are Prayer-Based Interventions Effective Pain Management Options? A Systematic Review and Meta-analysis of Randomized Controlled Trials

This review examined the effects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large effects emerged for 67% to 69% of between-group comparisons; participants in the prayer condition reported lower pain intensity (0.59 < d < 26.17; 4 studies) and higher pain tolerance (0.70 < d < 1.05; 1 study). Pre- to post-intervention comparisons yielded medium to large effects (0.76 < d < 1.67; 2 studies); pain intensity decreased. Although firm conclusions cannot be made because meta-analysis was based on only two studies, the analysis suggested prayer might reduce pain intensity (SMD = - 2.63, 95% CI [- 3.11, - 2.14], I = 0%). (PROSPERO: CRD42020221733).

Positive religious coping acts through perception of nature and silence in its association with well-being and life satisfaction among Polish Catholics

Previous studies indicate that perceptions of nature and thought-provoking silence can have positive consequences for individual functioning. The purpose of the present study was to assess the relationships between religious coping (assessed with the Brief RCOPE), perceptions of nature and silence (a subscale of the Perception of Change Questionnaire), well-being (the World Health Organization's five-item Well-Being Index) and life satisfaction (the Brief Multidimensional Life Satisfaction Scale). An online questionnaire was completed between 2021-2022 by 1,010 Polish Catholics ages 18 to 73, 61% of whom were women. Structural equation modeling showed that positive religious coping was positively related to well-being (β = 0.08, p = 0.011) and life satisfaction (β = 0.22, p < 0.001). In contrast, negative religious coping was related to reduced well-being (β = -0.07, p = 0.040) and life satisfaction (β = -0.25). In addition, more frequent perceptions of nature and reflective times of silence partially mediated the associations of positive religious coping with well-being (β = 0.04, p = 0.011) and life satisfaction (β = 0.04, p = 0.008). The data might suggest that interventions that help people develop an ability or awareness for nature as an exceptional encounter and may help to strengthen the ways they can utilize their religiosity as a resource and thus contribute to well-being and life satisfaction among Catholics.

Psychometric Properties of a Persian Version of the SpREUK-P Questionnaire: An Instrument for Measuring the Importance and Frequency of Spiritual/Religious Practices in Iranian Patients with Chronic Gastrointestinal Diseases

Attention to spiritual and religious issues is considered an important therapeutic method for patients with chronic disorders. This study aimed to assess the psychometric properties of a Persian version of the SpREUK-P questionnaire for evaluating spiritual and religious opinions among Iranian patients with chronic gastrointestinal diseases. This cross-sectional study was performed on 233 adult patients referring to the gastrointestinal clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, in 2017. The Persian version of the SpREUK-P questionnaire was prepared through the forward-backward translation method. The internal consistency of the questionnaire was evaluated by Cronbach's alpha coefficient. Furthermore, the construct validity of the instrument was assessed via exploratory factor analysis, while convergent and discriminant validity were investigated using Spearman correlation. Cultural adaptation, linguistic equivalency, and content validity of the Persian version of the SpREUK-P questionnaire were approved by a ten-member team of Shiraz University of Medical Sciences. Content validity indices were more than 0.8% across all items. Cronbach's alpha coefficients in terms of importance and practices were 0.81 and 0.71, respectively. Furthermore, the Persian version of the SpREUK-P showed excellent convergent validity and moderate to excellent discriminant validity. The results of exploratory factor analysis showed that all items were loaded properly on their own subscales, except for two items in the practice aspect and one item in the importance aspect. In conclusion, this study showed that the developed Persian SpREUK-P questionnaire is appropriate for assessing spiritual/religious opinions in Iranian patients with chronic diseases.

Changes in intensification of religious involvement during the COVID-19 pandemic in Poland

Introduction

The emergence of the virus Sars-CoV-2, and subsequent COVID-19 pandemic, caused a global threat to public health. In such challenging and worrying situations it can be expected that people will seek comfort in religion. However, before the pandemic there were never such wide world disruptions of religious practice–because of social distancing regulations, religiosity cannot be practiced in the same way as it was before the pandemic.

Methods

Two anonymous online surveys were conducted of adult Poles, one during the second wave (N = 1072; November 2020) and one during the third wave of the pandemic (N = 1080; April 2021). The survey samples of participants reflected the Polish population structure in terms of age, sex, size of place of residence, education, and province.

Results

Participation in institutional religious practices fell threefold to 11.9% during the pandemic, as compared to pre-pandemic times (31.2%). The number of people who did not go to church at all increased from 23.1% to 57.0%. Between the second and third waves, there was a small return to regular practice (from 10.1% to 14.1%). Based on the subjective assessment of the amount of time devoted to prayer, fewer people reporting an increase (10.6%) than a decrease (20.1%) in religious commitment during the pandemic. Logistic regressions showed that an increase in religious commitment can be predicted by older age, more frequent participation in religious practices before the pandemic, and higher life satisfaction. A decrease in religious commitment can be predicted by younger age, less frequent participation in religious practices before the pandemic, and greater number of children in the household.

Conclusion

Our research indicates a deintensification of religious practices during the COVID-19 pandemic in Poland. The pandemic has accelerated process of polarization of Polish religiosity.

Does Religiosity/Spirituality Play a Role in Function, Pain-Related Beliefs, and Coping in Patients with Chronic Pain? A Systematic Review

This systematic review examined the extent to which measures of religiosity/spirituality (R/S): (1) are associated with pain, function, pain-related beliefs (beliefs), coping responses, and catastrophizing in people with chronic pain; and (2) moderate the association between beliefs, coping and catastrophizing, and pain and function. Experimental and observational studies examining at least one of these research questions in adults with chronic pain were eligible. Two reviewers independently performed eligibility screening, data extraction, and quality assessment. Twenty studies were included. Most studies focused on the association between R/S and pain or function. When significant associations emerged, those between R/S and psychological function were weak to strong and positive; those between religious/spiritual well-being and pain and physical dysfunction were negative, but weak. Few studies examined the associations between R/S and beliefs/coping/catastrophizing; none examined the moderation role of R/S. The findings suggest that R/S is associated with pain and psychological function in people with chronic pain, and that viewing oneself as being "spiritual," regardless of religion, may contribute to positive psychological adjustment. More research is needed to determine the reliability of this finding. PROSPERO registry CRD42018088803.

Effect of Spiritual Care Based on the Sound Heart Model on Spiritual Experiences of Hemodialysis Patients

Hemodialysis patients require spiritual care due to their spiritual distress. This study aimed to investigate the effect of spiritual care on spiritual experiences of hemodialysis patients. This randomized controlled trial was conducted in 2017 at hemodialysis departments of Baqiyatallah and Cham ran hospitals in Tehran. The volunteer patients were selected by available sampling according to the inclusion criteria. Participants were randomly assigned to intervention and control groups. Interventions were performed in the educational-supportive nursing system according to the patients' self-care ability. Eight individual counseling sessions, 15-45 min, face-to-face, during dialysis, once a week were implemented for intervention group. Developing the relationship with God, self, people and nature were the main goals of care. Daily spiritual experience questionnaire was completed by patients before and three months after the intervention. There was no significant difference in the spiritual experience score of the intervention (75.20 ± 9.14) and control group (76.63 ± 10.03), before the intervention (P = 0.523). There was a statistically significant difference between the intervention (82.93 ± 5.69) and the control group score (77.24 ± 12.09) three months after the intervention (P < 0.0001). Due to the need for holistic and community-oriented care and the positive effect of this study, the use of the Sound Heart Model is recommended for Muslim patients.

GPs´ Personal Spirituality, Their Attitude and Spiritual Competence: A Cross-Sectional Study in German General Practices

To understand if GPs' spiritual competence, their personal spirituality and attitude towards enquiring about spirituality in practice interrelate, we conducted a cross-sectional survey of 30 German GPs regarding issues of SC. We found correlations between GPs' personal spirituality, their spiritual competence and their attitudes towards SC. The ability to perceive spiritual needs of patients was the competence most strongly related to GPs' attitude towards SC. The competence with the strongest correlation to personal spirituality was Self-awareness and Proactive opening. No correlation was found between affiliation to a spiritual community and GPs' attitude towards SC. The results show that GPs' personal spirituality and spiritual competence are indeed related to addressing spirituality with their patients. To foster SC, training programmes should raise awareness for one's personal spirituality and encourage one to reflect on spiritual competence.

Spiritual Care Competences among Health Care Professionals in Pakistan: Findings from a Cross-Sectional Survey

Introduction: There is a gap in healthcare literature related to the spiritual competence of physicians and nurses practicing in South Asian Muslim communities. To fill that gap, the Spiritual Care Competence Questionnaire (SCCQ) was applied which was developed to address multi-professional spiritual care competences. Materials and Methods: A cross-sectional study among 294 health professionals (61% physicians, 17% nurses, and 22% other professions) in 10 hospitals in Punjab, Pakistan. Results: The highest scoring competences were “Dealing with patients/Communication competences”, while “Team Spirit” scored lowest. There were no gender related differences, but there were effects related to professions. “Team Spirit”, “Dealing with patients/Communication competences”, and “Empowerment competences” scored significantly higher in nurses as compared to physicians and other health care professionals, while there were no significant differences for their “Perception/Documentation competences”. These competences were not relevantly related to the intensity of their prayer/meditation activity. Conclusions: Health care professional from Punjab were preferred to tolerate the pain and the suffering of patients and their relatives rather than to talk about spiritual care issues. Their spiritual care competences were less developed. Thus, there is a clear need for further specific education and training of health professionals.

Can Religiosity and Social Support Explain Effects of Trait Emotional Intelligence on Health-Related Quality of Life: A Cross-Cultural Study

Religion and social support along with trait emotional intelligence (EI) help individuals to reduce stress caused by difficult situations. Their implications may vary across cultures in reference to predicting health-related quality of life (HRQoL). A convenience sample of N = 200 chronic heart failure (CHF) patients was recruited at cardiology centers in Germany (n = 100) and Pakistan (n = 100). Results indicated that trait-EI predicted better mental component of HRQoL in Pakistani and German CHF patients. Friends as social support appeared relevant for German patients only. Qualitative data indicate an internal locus of control in German as compared to Pakistani patients. Strengthening the beneficial role of social support in Pakistani patients is one example of how the current findings may inspire culture-specific treatment to empower patients dealing with the detrimental effects of CHF.

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.

Evaluation of a Spiritual History with Elderly Multi-Morbid Patients in General Practice-A Mixed-Methods Study within the Project HoPES3

Background: The “Holistic Care Program for Elderly Patients to Integrate Spiritual Needs, Social Activity and Self-Care into Disease Management in Primary Care” (HoPES3) examines the implementation of a spiritual history (SH) as part of a multifaceted intervention in German general practices. While the effectiveness of the interventions was evaluated in a cluster-randomized trial, this article investigates the patients’ views concerning the acceptability of the SH and its effects. Methods: A mixed-methods study was conducted in which 133 patients of the intervention group filled in a standardized questionnaire after the intervention. Later, 29 of these patients took part in qualitative semi-standardized interviews. Results: According to the survey, 63% (n = 77) of patients found the SH helpful. In the interviews, however, many indicated that they either kept the conversation brief or declined the offer to talk about spirituality. Contents of longer conversations referred to difficult life events, personal sources of strength, and experiences with religious institutions. Many patients who had a longer conversation about spirituality reported that their relationship with their general practitioner (GP) had improved. Almost all patients recommended integrating a personal conversation of this kind into primary care. Conclusions: The SH seems to be a possible ‘door opener’ for a trusting doctor-patient relationship, which can then be built upon.

Wondering Awe as a Perceptive Aspect of Spirituality and Its Relation to Indicators of Wellbeing: Frequency of Perception and Underlying Triggers

Background: Spirituality is a multidimensional construct which includes religious, existentialistic, and relational issues and has different layers such as faith as the core, related attitudes and conviction, and subsequent behaviors and practices. The perceptive aspects of spirituality such as wondering awe are of relevance for both, religious and non-religious persons. These perceptions were related to perceiving the Sacred in life, mindful awareness of nature, others and self, to compassion, meaning in life, and emotional wellbeing. As awe perceptions are foremost a matter of state, it was the aim (1) to empirically analyze the frequency of wondering awe perceptions (i.e., with respect to gender, age cohorts, religious or non-religious persons) and (2) to qualitatively analyze a range of triggers of awe perceptions.

Methods: Data from 7,928 participants were analyzed with respect to the frequency of Awe/Gratitude perceptions (GrAw-7 scale), while for the second part of the study responses of a heterogeneous group of 82 persons what caused them to perceive moments of wondering awe were analyzed with qualitative content analysis techniques.

Results: Persons who experience Awe/Gratitude to a low extend were the youngest and had lowest wellbeing and lowest meditation/praying engagement, while those with high GrAw-7 scores were the oldest, had the highest wellbeing, and were more often meditating or praying (p<0.001). Gender had a significant effect on these perceptions, too (Cohen’s d=0.32). In the qualitative part, the triggers can be attributed to four main categories, Nature, Persons, Unique Moments, and Aesthetics, Beauty, and Devotion. Some of these triggers and related perceptions might be more a matter of admiration than wondering awe, while other perceptions could have more profound effects and may thus result in changes of a person’s attitudes and behaviors.

Conclusion: Emotionally touching experiences of wondering awe may result in feelings of interconnectedness, prosocial behavior, mindful awareness, and contribute to a person’s meaning in life and wellbeing and can also be a health-relevant resource. These perceptions can be seen as a perceptive aspect of spirituality, which is not exclusively experienced by religious people but also by non-religious persons.

The Spiritual Needs Questionnaire in Research and Clinical Application: a Summary of Findings

To provide spiritual care, an assessment and documentation of patients´ spiritual struggles and/or their spiritual needs is required to initiate appropriate support planning processes. For that purpose, the Spiritual Needs Questionnaire (SpNQ) was developed in 2009 as an easy to apply standardized measure. The tool has so far been translated into numerous languages and is widely used as a valid and reliable instrument to assess a wide range of spiritual needs of patients with chronic diseases, elderly, adolescents, and healthy persons. Its four main factors address Religious needs, Existential needs, Inner Peace needs, and Giving/Generativity needs. Here, the main findings are summarized and discussed.

Including the Spiritual Dimension in Multimodal Pain Therapy. Development and Validation of the Spiritual Distress and Resources Questionnaire (SDRQ)

CONTEXT

Valid instruments for assessing spiritual resources and distress in pain therapy are scarce. The Spiritual Distress and Resources Questionnaire (SDRQ) was developed to fill this gap.

GOALS

The objective of this study was to investigate the SDRQ's psychometric properties.

METHODS

We presented the SDRQ to 219 patients with chronic pain conditions and examined its measurement properties, namely reliability and structural, convergent and discriminant validity. To investigate test-retest reliability, the SDRQ was presented a second time to a subsample of 58 randomly selected participants.

RESULTS

Factor analysis required a grouping of the 22 SDRQ items into four subscales: spiritual distress, spiritual coping, immanence and transcendence, the latter two representing spiritual resources. Cronbach's alpha was high for spiritual distress (0.93), transcendence (0.85), and immanence (0.81) while it was somewhat lower but still satisfactory for spiritual coping (0.70). The construct validity of the SDRQ was shown by correlations with established measures in the field. Higher levels of spiritual distress were associated with signs of more severe illness, such as emotional distress and pain intensity.

CONCLUSION

The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.

The Translation and Psychometric Evaluation of the Persian Version of Brief Multidimensional Life Satisfaction Scale for Iranian Patients with Cancer

Background: Due to the growing prevalence of cancer globally, the disease is considered one of the most important sources of stress, disability, and reduced life satisfaction. Although life satisfaction is supposed to be a relatively stable psychological construct, it may change in response to life events. Life-satisfaction is the assessment of the quality of life according to one’s chosen criteria. Objectives: The purpose of this research is the psychometric evaluation of the Persian version of “Brief Multidimensional Life Satisfaction Scale” (BMLSS) in Iranian patients with cancer. Methods: The present study was a methodological research, during which the BMLSS was translated and the Farsi version was validated for patients with cancer. Results: The fit indices of confirmatory factor analysis confirmed the dual dimension of the BMLSS. Regarding the convergent validity of the BMLSS, the total score of the instrument had a positive and significant relationship with age and the sense of religiosity. Cronbach's alpha and Intraclass Correlation were calculated. Conclusions: The findings indicated that this Persian version has good validity and reliability and can be used as a comprehensive instrument in Iran.

[Religiosity and spirituality as ressources for head neck cancer patients]

OBJECTIVE

 Spiritual Care is a well established part of palliative medicine. Are religiosity / spirituality also ressources of patients during the arly phases of a head neck cancer (HNC) disease?

MATERIAL AND METHODS

 We included 113 HNC patients (27 women, 84 men, 2 divers) to a prospective study using questionnaires focused on actual burden (NRS), spirituality as ressource (SpREUK-15, spiritual needs (SpNQ-20), interpretation of illness (IIQ), and life satisfaction of patients (BMLSS-10, BMLSS-Support, WHO-5). 39 patients were still under therapy, 74 participants were cancer-survivors.

RESULTS

 Only 31/111 (28 %) patients feel themselve as spiritual and/or relgious. 72 % are neither spiritual nor religious. 51/111 see reflexion about their cancer disease as a specific ressource to overcome their actual cancer situation. Spiritual needs are religious in 35/112, existential in 67/112, inner peace in 90/112, and generativity in 84/112 patients. The accepted own religiosity and the actual stadium of disease are highly relevant impact factors on spiritual needs and ressources. HNC patients show a high part of depressive moods (WHO-5) and are (in trend) un-satisfied with their life and support situation.

CONCLUSION

 Up to 90 % of HNC patients have specific spiritual needs which are often hidden. Modern concepts of integrative oncology discover them, and enourage via these ressources the quality of life and the coping of cancer patients.

The Role of Spirituality in Pain, Function, and Coping in Individuals with Chronic Pain

OBJECTIVE

Chronic pain is a multidimensional experience associated with psychosocial (e.g., pain-related beliefs and pain coping responses) and spiritual factors. Spirituality is a universal aspect of the human experience that has been hypothesized to impact pain experience via its effects on pain, physical/psychological function, resilience and pain-related beliefs, and pain coping responses. However, research evaluating the associations between measures of spirituality and measures of pain and function in individuals with chronic pain is limited. This study seeks to address this limitation.

METHODS

Participants were 62 Portuguese adults with chronic musculoskeletal pain. Participants completed measures of spirituality, pain intensity, physical and psychological function, and pain coping responses.

RESULTS

Spirituality as hope and a positive perspective toward life was positively and moderately associated with better psychological function and coping responses of ignoring pain sensations and coping self-statements. Spirituality as a search for meaning and sense of purpose was positively and moderately associated with the coping response of task persistence.

CONCLUSIONS

These findings suggest the possibility that spirituality may be a useful resource for facilitating psychological adjustment, potentially promoting the use of some adaptive pain coping responses.

[Spirituality and health care. The perspective of patients with chronic pain]

Hintergrund

Chronischer Schmerz betrifft alle menschlichen Lebensdimensionen und wirft auch spirituelle Fragen auf, die im Rahmen eines multimodalen Behandlungsmodells berücksichtigt werden sollten.

Ziel der Arbeit

Wir untersuchten die Perspektive von Patienten mit chronischen Schmerzen zu spirituellen Themen und deren möglicher Integration in den Behandlungsprozess.

Material und Methoden

Es wurden fünf Fokusgruppen- und zwei Kleingruppeninterviews an fünf Studienzentren durchgeführt. Daran nahmen 42 Patienten mit chronischen Schmerzen teil, die aktuell in ambulanter oder stationärer Schmerzbehandlung waren. Die Interviews wurden transkribiert und einer thematischen Analyse unterzogen.

Ergebnisse

Drei Themen traten hervor: 1. Chronischer Schmerz durchdringt die gesamte menschliche Existenz. 2. Spirituelle Ressourcen stellen eine Möglichkeit im Umgang mit chronischen Schmerzen dar. 3. Patienten ist es ein Anliegen, mit Fachpersonen in einen Dialog treten zu können, der auch für spirituelle Themen offen ist. Diese haben aus Sicht der Teilnehmenden große Relevanz. Sie verknüpften sie vielfach, aber nicht ausschließlich mit religiösen Überzeugungen. Häufig wurde geschildert, in der Schmerzerfahrung nicht ernst genommen zu werden.

Diskussion

Strategien für einen effektiven Umgang mit chronischem Schmerz zu finden, stellt einen Wendepunkt im Leben dar. In diesem Prozess unterstützt ein offener Dialog mit Fachpersonen, der auch spirituellen Themen Rechnung trägt.

Do Chronic Pain Patients Wish Spiritual Aspects to Be Integrated in Their Medical Treatment? A Cross-Sectional Study of Multiple Facilities

Background: Chronic pain is a complex, multidimensional experience. Spirituality is hypothesized to impact pain experience in various ways. Nevertheless, the role that spirituality plays in multimodal pain therapy remains controversial and, to date, quantitative data on whether and for which patients spiritual aspects should be considered in the treatment of chronic pain is lacking. The aim of this study was thus to investigate the proportion and characteristics of patients with chronic pain who wish spiritual aspects to be integrated in their treatment. Methods: Two hundred nine patients with chronic pain were recruited from five inpatient departments and outpatient clinics in the German-speaking part of Switzerland. Patients filled out validated questionnaires, such as the Hospital Anxiety and Depression Scale (HADS), the Resilience Scale (RS-11), the Spiritual and Religious Attitudes in Dealing with Illness (SpREUK), and the 12-item Spiritual Well-Being Scale (FACIT-Sp-12). Results: More than 60% (CI_95%: 55.5-67.9%) of the patients wanted to address spiritual aspects in their treatment. These patients were significantly younger, had higher levels of education, and suffered from more frequent and more severe pain than patients who did not wish to address spiritual aspects. Furthermore, there were high correlations with existing spiritual resources and higher scores of spirituality. Conclusions: These results confirm that the majority of chronic pain patients wish spiritual aspects to be considered in their treatment. Additionally, the finding that these patients had more spiritual resources underlines the importance of integrating spiritual aspects in a resource-oriented, patient-centered care approach for this condition.

Views of patients suffering from Failed Back Surgery Syndrome on their health and their ability to adapt to daily life and self-management: A qualitative exploration

Background

The clinical outcomes of Spinal Cord Stimulation (SCS) therapy in patients with a Failed Back Surgery Syndrome (FBSS) is mostly done by standardized pain and quality of life measurements instruments and hardly account for personal feelings and needs as a basis for a patient-centred approach and shared decision making.

Objectives

The objective of this study is to explore perspectives on personal health and quality of life (QoL) in FBSS patients concerning their physical-, psychological and spiritual well-being prior to receiving an SCS system.

Methods

We performed face-to-face, semi-structured, in-depth interviews to obtain descriptive and detailed data on personal health, guided by the Web diagram of Positive Health (Huber et al.) and a topic list. The following main topics were assessed qualitatively: 1) Bodily functioning, 2) Mental function and perception 3) Spiritual dimension, 4) Quality of life, 5) Social and societal participation and 6) Daily functioning.

Results

Seventeen FBSS patients (eight male, nine female) were included from April–November 2019 at the department of pain medicine in the Albert Schweitzer Hospital in the Netherlands. Median age 49 years; range 28 to 67 years, and patients underwent between one and five lumbar surgical operations. The duration of their chronic pain was between four and 22 years. After analyzing the interviews, three themes emerged: 1) dealing with chronic pain, 2) the current situation regarding aspects of positive health, and 3) future perspectives on health and quality of life. These themes arose from eleven categories and a hundred ninety codes.

Conclusion

This qualitative study explored FBSS patients ‘views on their health and the ability to adapt to daily life having complex chronic pain, and showed that patients experienced shortcomings in daily life within the six dimensions of the Web diagram of Positive Health before the SCS implant.

'Maybe we are losing sight of the human dimension' - physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study

Objective

Research suggests that existential, spiritual, and religious issues are important for patient’s psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients’ needs.

Design

Physicians’ experiences with and approaches to existential, spiritual, and religious needs when treating chronic pain or multiple sclerosis were studied in eight semi-structured interviews and analysed using interpretative phenomenological analysis (IPA).

Results

Physicians found that only few patients had spiritual and religious needs; however, they experienced that every patient were struggling with existential challenges related to the illness and rooted in a changed identity and approaching death. How the physicians approached these needs appeared to be influenced by six conditions: Their medical culture, training, role, experiences of time pressure, their personal interests, and interpersonal approach.

Conclusion

Physicians’ training seems better suited to meet biomedical objectives and their patients’ concrete needs than patients’ wish for a relational meeting focused on their subjective lifeworld. This challenge is discussed in relation to modern patient-centeredness, doctor-patient relationship, culturally constructed experiences of privacy, and future clinical practice and research needs.

Spiritual Care, Pain Reduction, and Preferred Place of Death Among Advanced Cancer Patients in Soweto, South Africa

CONTEXT

When religious and spiritual (R/S) care needs of patients with advanced disease are met, their quality of life (QoL) improves. We studied the association between R/S support and QoL of patients with cancer at the end of life in Soweto, South Africa.

OBJECTIVES

To identify R/S needs among patients with advanced cancer receiving palliative care services and to assess associations of receipt of R/S care with patient QoL and place of death.

METHODS

A prospective cohort study conducted from May 1, 2016 to April 30, 2018 at a tertiary hospital in Soweto, South Africa. Nurses enrolled patients with advanced cancer and referred them to the palliative care multidisciplinary team. Spiritual counselors assessed and provided spiritual care to patients. We compared sociodemographic, clinical, and R/S factors and QoL of R/S care recipients and others.

RESULTS

Of 233 deceased participants, 92 (39.5%) had received R/S care. Patients who received R/S care reported less pain (2.82 ± 1.23 vs. 1.93 ± 1.69), used less morphine, and were more likely to die at home than patients who did not (57.5% compared with 33.7%). On multivariate logistic regression analysis, adjusting for significant confounding influences and baseline African Palliative Care Association Palliative care Outcome Scale scores, receipt of spiritual care was associated with reduced pain and family worry (odds ratio 0.33; 95% CI 0.11-0.95 and odds ratio 3.43; 95% CI 1.10-10.70, respectively).

CONCLUSION

Patients with cancer have R/S needs. R/S care among our patients appeared to improve their end-of-life experience. More research is needed to determine the mechanisms by which R/S care may have improved the observed patient outcomes.

Assessing Perception of Patients and Physicians Regarding Spirituality in Karachi, Pakistan: A Pilot Study

INTRODUCTION

Spirituality plays an important part in coping with life problems, health concerns, and well-being issues at individual and collective levels. In Pakistan, few studies have looked at the role of religion in patients' illnesses.

OBJECTIVE

To assess patients' and health care professionals' beliefs concerning spirituality and illness to understand the role of spirituality and religion in clinics.

METHODS

A total of 52 patients and 50 health care professionals from different specialties were interviewed. A self-devised tool was used to gain information from patients. For health care professionals a 17-item questionnaire was used.

RESULTS

The study results show that most patients view spirituality positively and want their physicians to discuss spirituality with them. Most patients believed that having a strong belief in spirituality helped them cope with their condition better. Most health care professionals surveyed believed that spirituality plays an important part in a patient's illness and its prognosis, but only a minority asked patients about spirituality. Most health care professionals quoted lack of time as one of the main reasons for not discussing spirituality with patients, and some believed it was a private matter.

DISCUSSION

Many health care professionals are hesitant to discuss spiritual issues with patients because of lack of time, insufficient training, or their own discomfort. There is a need to incorporate training about spirituality in the medical curriculum, especially in religious societies such as in Pakistan. Further research is needed in this area.

Complementary and alternative medicine is positively associated with religiousness/spirituality

BACKGROUND

Complementary and alternative medicine (CAM) is used often by patients with different diseases. While some authors subsume religiousness and spirituality to CAM, others do not. The objective of the present study was to assess the prevalence and types of CAM usage as well as the participants' spirituality/religiousness in an outpatient department for endocrinology and metabolic diseases.

METHODS

All individuals visiting the outpatient department at a German university hospital from April to June 2009 were offered a standardized questionnaire on the use of dietary supplements and alternative therapies as well as their religiousness/spirituality. Demographic and clinical data of 428 respondents were taken from the electronic health record.

RESULTS

Of the respondents, 16.4% (n = 66) classified themselves to be religious/spiritual and 67.9% (n = 273) as not religious/spiritual. Women were more religious/spiritual than men (p = 0.02). 41.4% of the respondents used supplements and 27.4% additional therapies. The use of supplements and additional therapies was more frequent in people with higher religiousness/spirituality (p = 0.005 and p = 0.01,resp.) but there were no associations between religiousness/spirituality and the number of consultations, costs for drugs, appraisal of the physicians treatment methods, the perceived effectiveness of prescribed drugs, fear of late complications or of side effects.

CONCLUSIONS

A higher religiousness/spirituality is associated with a more frequent use of supplements or additional therapies in individuals with endocrinopathies or metabolic diseases. As CAM has been shown to be associated with worse outcome, addressing religiousness/spirituality which stresses the responsibility of the person for his life might offer an additional resource and should be further studied.

Self-reported specific learning disorders and risk factors among Hungarian adolescents with functional abdominal pain disorders: a cross sectional study

BACKGROUND

Despite its increasing clinical significance and diagnostic challenges, little is known about functional abdominal pain disorders (FAPDs) in Central-Eastern Europe. In this paper, the prevalence and potential sociodemographic correlates of FAPDs among Hungarian adolescents are explored.

METHODS

A cross-sectional, nationwide, questionnaire study in a representative sample of 657 adolescents has been conducted. With a response rate of 80.2%, 522/527 (99.1%) questionnaires were eligible for data analysis (N = 267, 51.1% girls, mean age 14.8, SD 2.4 years). The questionnaire included sociodemographic variables (age, sex, place of residence, marital status of the parents, family income, religion, educational level of parents), questions regarding self-reported specific learning disorders and the Questionnaire for Paediatric Gastrointestinal Symptoms Rome ΙΙΙ Edition.

RESULTS

The prevalence of FAPDs was 11.9% (N = 62). FAPDs were significantly associated with female sex. Living in a county town showed a negative correlation with FAPD. Adolescents with self-reported arithmetic learning disorders had an 8.7-fold likelihood of FAPD (OR, 8.7; 95% CI (3.5-21.9). Adolescent girls reported pain in all subtypes of FAPDs more frequently than adolescent boys except functional abdominal pain syndrome. The most prevalent FAPD was abdominal migraine (N = 32, 6.1%), followed by irritable bowel syndrome (N = 24, 4.6%).

CONCLUSIONS

The prevalence of FAPDs in Hungary is similar to that reported worldwide, however, contrary to international data, abdominal migraine is the most frequently encountered FAPD in Hungary. In addition to well-known correlates of FAPDs, such as female sex and place of residence, arithmetic learning disorders have also been identified as correlating with the prevalence of FAPDs. Our results suggest culture-specific differences in the distribution of FAPDs, and confirm the significance of school performance indicators such as specific learning disorders as a correlate of FAPDs.

An existential support program for people with cancer: Development and qualitative evaluation

PURPOSE

To describe the development process of an existential support program and to explore participants' evaluation of supportive/unsupportive processes of change.

METHOD

A five-day existential support program called "Energy for life" was designed including three main elements: 1. existential group counseling, 2. art therapy and 3. interaction with nature and aesthetic surroundings. The program was implemented at two different study sites. Focus group interviews were conducted to evaluate the program.

RESULTS

40 subjects were recruited (20 for each one of the two study sites) and 36 completed the study (31 women, five men) in the age range from 31 to 76 years and living with cancer across all stages and types. The program resulted in supportive processes of "existential sharing". The existential group counseling included a sharing process which led to an increased awareness and acceptance of one's existential situation and a preparation for the next steps in one's life. Art therapy offered a respite from the illness or the opportunity to express and share difficult thoughts and feelings connected to the illness experience. The interaction with nature/surroundings induced feelings of calmness and peace, increasing self-worth and spiritual belonging. Unsupportive processes of change related to the organization of the existential counseling groups, feelings of discomfort with creative engagement and feelings of distress provoked by a hospital environment.

CONCLUSION

Through "Energy for life" existential concerns and distress were shared, contained and transformed. Knowledge has been gained about how an existential support program can be designed that explicitly focuses on alleviating patients' existential distress.

Religiosity/Spirituality and Mental Health: A Meta-analysis of Studies from the German-Speaking Area

The meta-analysis presented here investigates the relationship between religiosity/spirituality (R/S) and mental health based on 67 studies from the German-speaking area (Germany, Austria, Switzerland). The weighted average correlation is .03 (95% CI [.01, .05]), indicating that a greater R/S is minimally but significantly associated with better mental health. The results are moderated by the type of R/S measure: negative R/S types correlate - .20 with mental health, whereas other R/S measures exhibit small positive associations. In comparison with US-American meta-analyses, the average effect size is lower, and the associations between negative R/S types and lower mental health are particularly strong.

Effects of religious and spiritual care on burn patients' pain intensity and satisfaction with pain control during dressing changes

OBJECTIVE

Spiritual care, beside other nursing interventions, creates a balance in body, psyche and soul in order to holistically recover one's health. This research aims to study the effects of a religious and spiritual care program on the intensity of pain and the satisfaction with pain control during the dressing changes for the burn patients in a hospital in Iran in 2017.

METHODS

This research is a clinical trial study conducting 68 burn patients. The samples were randomly divided into 'experimental' and 'control' groups. The experiment consists of three sessions of spiritual care carried out by the help of the nurse, a clergy and the patient's companion. These sessions have been done before, during and after the dressing change. The pain intensity and the satisfaction with pain control are measured by VAS¹ and NRS² devices. The data is analyzed via SPSS version 20 and through the statistical exams of independent t-test, paired t-test, chi-squared test and Mann-Whitney exam.

RESULTS

Before the intervention, there was no significant difference in the average rate of pain (P = 0.25) and the satisfaction with pain control (P = 0.59) between the experimental and the control groups. While, after the spiritual care program was conducted, there appeared a significant difference (P < 0.001): there was a substantial reduction of pain intensity in the experimental group and the satisfaction with pain control in this group increased as well.

CONCLUSIONS

A religious and spiritual care can help decrease the pain intensity caused by the dressing change and can increase the satisfaction of these patients with pain control. Therefore, it is recommended that the nurses apply the spiritual cares to alleviate the pain and to increase the satisfaction with pain control in burn patients.

Spirituelle Bedürfnisse und Belastungserleben von Müttern mit Kindern mit Down-Syndrom

Über die spirituellen Bedürfnisse von Müttern mit Kindern mit Down-Syndrom ist noch wenig bekannt. Ziel war es daher, ihre spirituellen Bedürfnisse und ihr Belastungserleben zu identifizieren und in Beziehung miteinander zu setzen. Dazu wurde eine anonyme Querschnittserhebung mit standardisierten Instrumenten unter 203 Müttern von Kindern mit Down-Syndrom in Deutschland durchgeführt. Es zeigte sich, dass bei nur moderat ausgeprägter Lebenszufriedenheit in der Gruppe viele das Gefühl haben, unter Druck zu stehen und im Alltag beeinträchtigt zu sein. Das Bedürfnis nach innerem Frieden und Generativität hatte für sie eine große Bedeutung, religiöse und existenzielle Bedürfnisse jedoch weniger. Empfundene Hoffnungslosigkeit und Trauer korrelierten stark mit existenziellen Bedürfnissen, das Gefühl unter Druck zu stehen und emotionale Müdigkeit stark mit dem Bedürfnis nach innerem Frieden. Religiöse Bedürfnisse korrelierten stark mit dem Gefühl, Stärke im Glauben an Gott zu haben. Da sich hier abzeichnet, dass ein Belastungserleben von eigentlich „zufriedenen“ Müttern mit der Ausprägung spiritueller Bedürfnisse assoziiert ist, ist eine weitergehende Unterstützung angezeigt.

Understanding the Relationship Between Spiritual Well-Being and Depression in Chronic Pain Patients: The Mediating Role of Pain Catastrophizing

BACKGROUND

It is well established that there is an association between chronic pain and depression.

AIMS

The present study aimed to identify whether pain catastrophizing and spiritual well-being may influence depression in chronic pain patients when other variables are controlled for (sociodemographic characteristics and pain intensity). Furthermore, it investigated possible mechanisms by which spiritual well-being can influence depression in these patients.

DESIGN

The present study employed a cross-sectional design.

SETTINGS AND PARTICIPANTS

This study was performed with a convenience sample of 300 consecutive patients with different types of chronic pain (defined as recurrent or persistent pain over >3 months), referred to clinics affiliated with Shiraz university of Medical Sciences between March and October 2017.

METHODS

Patients completed validated self-report questionnaires: Spiritual Well-being Questionnaire, Patient Health Questionnaire, Pain Catastrophizing Scale, and Numeric Rating Scale.

RESULTS

Hierarchical multiple regression analysis indicated that a significant portion of the variance in depression scores can be explained by catastrophizing and spiritual well-being. In Multiple Mediation Procedure, pain catastrophizing could negatively mediate the relationship between spiritual well-being and depression when controlling for sociodemographic characteristics and pain intensity.

CONCLUSIONS

The findings add some evidence to further support the influence of spiritual well-being on depression levels through diminished pain catastrophizing. The present results could help clinicians to determine which variables should be emphasized for a successful treatment of depression in pain patients. Clinical interventions that increase meaningfulness and purpose in life may allow patients with chronic pain to overcome the maladaptive cognitions associated with pain, thereby reducing depressive symptoms.

Self-Care in Iranian Cancer Patients: The Role of Religious Coping

Religious and spiritual practices are related to physical and mental health. Social support is an important source to aid coping, but this is not without its difficulties. This study was conducted to investigate the relationship between religious coping and self-care in a sample of Iranian cancer patients. In this cross-sectional study (October-December, 2015), 380 cancer patients were entered into the study using non random sampling (accessible sampling). Data were collected using socio-demographic, religious coping (R-COPE), and self-care questionnaires. Male patients (48.39 ± 13.39; 95% CI 46.41-50.38) were older than the females patients (45.33 ± 18.44; 95% CI 42.79-47.87). The findings indicated that there was a significant correlation between self-care and positive religious coping (r = .188, p = .009). Also there was a significant relationship between self-care and a history of smoking (p < .05). It seems that improving the level of positive religious affiliation can have beneficial effect on the self-care of cancer patients. Therefore, it is necessary to conduct these studies with greater scale and more different societies to achieve more reliable results about the effects of religious coping on self-care behaviors in cancer patients.

Characteristics of Religious and Spiritual Beliefs of Danish Physicians: And Likelihood of Addressing Religious and Spiritual Issues with Patients

This study investigated the association between physicians' R/S characteristics and frequency of addressing patients' R/S issues. Information was obtained through a questionnaire mailed to 1485 Danish physicians (response rate 63%) (42% female). We found significant associations between physicians' personal R/S and the frequency of addressing R/S issues. Moreover, we identified significant gender differences in most R/S characteristics. However, no differences in frequency of addressing R/S issues were identified across gender. This raises some questions regarding the effects of gender on associations between R/S characteristics and frequency of addressing R/S issues.

Experience of Guilt and Strategies for Coping with Guilt in Patients with Severe Copd: A Qualitative Interview Study

Guilt is associated with an increased level of mood disturbance and a poorer quality of life. The aim of this study was to explore how patients with severe COPD view and experience guilt and the ways in which they cope with this guilt. A total of 31 COPD patients were interviewed about their perceptions and experiences of guilt. Qualitative content analysis was used to examine the interviews. In the descriptive (manifest) analysis, the categories “not feeling personal guilt” and “experiencing guilt” emerged; in the interpretative (latent) analysis, various strategies for dealing with guilt were identified — for example, acceptance or blaming others. Relatively few patients reported that they felt guilt on a conscious level, but those who did expressed anguish, and remorse before God; some felt blamed by others. It is important that healthcare providers acknowledge the guilt that their patients express, since guilt may have adverse effects on the patients’ overall health.

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.

Translation and Psychometric Testing of the Persian Version of the Spiritual Needs Questionnaire Among Elders With Chronic Diseases

CONTEXT

Spirituality plays an important role in coping with chronic diseases for patients and they often report unmet spiritual and existential needs, which should be considered for a holistic view of their health. Studying spiritual needs in this generation requires culturally appropriate and valid instruments. The aim of this study was to determine the psychometric properties, such as validity, reliability, and factor structure of the Persian version of Spiritual Needs Questionnaire (SpNQ).

OBJECTIVES

The aim of this study was to determine the psychometric properties, such as validity, reliability, and factor structure of the Persian version of Spiritual Needs Questionnaire (SpNQ).

METHODS

The "forward-backward" procedure was applied to translate the SpNQ from English into Persian. The SpNQ-Persian Version (SpNQ-PV) was checked in terms of validity and reliability with a convenience sample of 100 elders with chronic diseases who were recruited from the inpatient wards at two university hospitals in Qom, Iran. The validity was assessed using content, face, and construct validity. The Cronbach alpha and test-retest were used to assess the reliability of the questionnaire.

RESULTS

The results of the exploratory factor analysis indicated a five-factor solution for the questionnaire, which included religious needs, existential needs, forgiveness/generativity needs, need for inner peace, and emotional needs. These accounted for 60.1% of the total observed variance. One item was removed (factor loading <0.4). Convergent validity was supported mostly by the pattern of association between SpNQ-PV and the Spiritual Well-being Scale. Cronbach alpha of the subscales ranged from 0.56 to 0.78 and the test-retest reliability ranged from 0.72 to 0.91, which indicated an acceptable range of reliability.

CONCLUSION

The SpNQ-PV showed a minor difference in structuring and indicated good psychometric properties, which can be used to assess the spiritual needs of Iranian elders suffering from chronic diseases.

The Relationship Between Religious Beliefs and Quality of Life Among Patients With Multiple Sclerosis

Patients with chronic diseases, such as multiple sclerosis (MS), are prone to emotional distresses and reduction in life quality more than others. This study aimed to assess the relationship between religious beliefs and quality of life among patients with MS. In this study, 145 MS patients completed 36-Item Short-Form Health Survey (SF-36) and the Duke University Religion Index (DUREL) questionnaires. The results indicated that unorganized religious activities were significantly associated with marital status and education level. Besides, internal religion was positively correlated to mental health. However, religious variables were not effective prognostic factors in physical and mental quality of life. Overall, further studies have to be conducted to determine the role of religion in quality of life of MS patients with different religious backgrounds.

Spirituality As a Coping Mechanism for Individuals with Parkinson's Disease

Parkinson's disease (PD) is a chronic neurodegenerative disease that can render individuals totally disabled. Spiritual practices can help mitigate stress and provide a source of strength in PD. This article demonstrates a gap that exists between PD and spiritual coping specific research; discusses existing spiritual coping research in chronic illness; and explores the use of spirituality in managing PD care. Healthcare providers need to provide holistic care and explore mechanisms to assist individuals to manage the demands of living with PD.

The Relationship Between Trust-in-God, Positive and Negative Affect, and Hope

We aimed to test the relationships between Trust-in-God, positive and negative affect, and feelings of hope. A sample of university students (N = 282, 50 % female) completed the Positive and Negative Affect Schedule, the Adult Dispositional Hope Scale, and a Persian measure of Trust-in-God for Muslims. The results of a series of hierarchical regression analyses indicated that Trust-in-God was positively associated with participants' scores for hope and positive affect but was negatively associated with their scores for negative affect. The results support the relationship between Trust-in-God and indices of mental health.

Sense of coherence mediates the relationship between the religious meaning system and coping styles in Polish older adults

OBJECTIVES

The links between religiousness and coping are complex, and previous research indicates that they may be mediated by coherence-related structures. The aim of this study was to examine whether sense of coherence (SOC) is a mediator in the relationships between the religious meaning system and coping styles in Polish older adults.

METHOD

In this study, 212 older adults (118 women and 94 men) participated. Their ages ranged from 65 to 79 years (M = 71.04; SD = 2.26). The group was a representative sample of Polish older adults in terms of social status, gender, and age. They completed three measures: the Religious Meaning System Questionnaire, the Sense of Coherence Scale (SOC-29), and the Coping Inventory for Stressful Situations.

RESULTS

Findings showed that the religious meaning system had significant relationships with SOC and three coping styles: emotion-oriented coping, avoidance-oriented coping, and social diversion. In addition, SOC mediated the relations between the religious meaning system and three coping styles: the emotion-oriented, avoidance-oriented, and social diversion.

CONCLUSIONS

The positive associations between meaning-oriented religiousness, SOC, and coping styles imply that their underlying mechanisms are based on the structures of significance and comprehension. The character of mediational relations (i.e. mediator vs. suppressor) depended on the emotional and social coping strategies used by older adults.