The role of religion and spirituality in psychological distress prior to surgery for urologic cancer

Prostate Cancer and Spirituality: A Systematic Review

The diagnosis, treatment, and sequels of cancer are relevant sources of stress, conflicts, and suffering, but spirituality may be a positive coping element. However, studies involving the correlation between prostate cancer patients and spirituality are few and heterogeneous. MEDLINE (PUBMED), SCOPUS, and EMBASE were the databases used for this review with the keywords "spirituality," "religion," and "prostate cancer." The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. About 250 articles were found, and 30 were eligible. Most studies (N = 26; 86.6%) reported the relationship between spirituality and better health findings such as 80% being positively associated with more screening for prostate cancer and better patients' quality of life. More interventional, randomized, and multicentric trials are needed to clarify this relationship.

Impact of Mental Health on General Surgery Patients and Strategies to Improve Outcomes

Mental Health Disorders (MHD) are a growing concern nationwide. The significant impact MHD have on surgical outcomes has only recently started to be understood. This literature review investigated how mental health impacts the outcomes of general surgery patients and what can be done to make improvements. Patients with schizophrenia had the poorest surgical outcomes. Mental health disorders increased post-surgical pain, hospital length of stay, complications, readmissions, and mortality. Mental health disorders decreased wound healing and quality of care. Optimizing outcomes will be best accomplished through integrating more effective perioperative screening tools and interventions. Screenings tools can incorporate artificial intelligence, MHD data, resilience and its biomarkers, and patient mental health questionnaires. Interventions include cognitive behavioral therapy, virtual reality, spirituality, pharmacology, and resilience training.

Considering religion and spirituality in precision medicine

The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.

Examining the impact of a Mindfulness-Based Stress Reduction intervention on the health of urban South Africans

Background

Mindfulness-based stress reduction (MBSR) has been found to have significant health benefits in studies conducted in the global North.

Aim

This study examined the effects of MBSR on stress, mood states and medical symptoms among urban South Africans to inform future research and clinical directions of MBSR in local settings.

Setting

Participants completed an 8-week MBSR programme based in central Cape Town.

Method

A retrospective analysis of 276 clinical records was conducted. Mindfulness, stress, negative and positive mood, medical symptoms and psychological symptoms were assessed before and after the intervention using self-report questionnaires. We compared pre and post-intervention scores and examined the relationship between changes in mindfulness and changes in stress, mood and medical symptoms.

Results

Mindfulness scores were significantly higher after intervention, both on the Kentucky Inventory of Mindfulness Skills (KIMS) and the Mindful Attention Awareness Scale (MAAS). Changes on the KIMS were associated with reductions in stress, negative mood, psychological symptoms and total medical symptoms, and improvement in positive mood. Changes in mindfulness, as measured by the MAAS, were significantly correlated only with reduced total number of medical symptoms.

Conclusion

This study provides preliminary evidence for the positive health impact of MBSR on urban South Africans, and in turn acceptability and feasibility evidence for MBSR in South Africa and supports the case for larger trials in different local settings.

Relationships between Death Anxiety and Quality of Life in Iranian Patients with Cancer

Objective:

The purpose of the study was to examine relationships between death anxiety and quality of life (QOL) parameters of patients with cancer in the Iranian sociocultural context.

Methods:

A descriptive, correlational methodology was used. The sample included 330 patients. Demographics, health information, religious behaviors, death anxiety, and QOL data were collected.

Results:

Overall death anxiety levels were moderate with satisfactory overall QOL. Death anxiety was predictive of lowered QOL. Female patients had lower QOL and higher death anxiety compared to men

Conclusions:

Findings support that higher death anxiety negatively impacts QOL in an Iranian sample with cancer. Alleviation of existential concerns in vulnerable patients may palliate mental health distress associated with facing cancer and its challenging treatments.

Community-Level Interventions for Reconciling Conflicting Religious and Sexual Domains in Identity Incongruity

Two of the most unstable domains involved in identity formation, the religious and sexual domains, come into conflict when vulnerable populations of the lesbian, gay, bisexual and transgender community experience oppression from the indoctrination of religious beliefs that persecute their sexual orientation. This conflict, aptly termed identity incongruity in this article's discourse, results in a schism that adversely affects these vulnerable populations. This paper investigates the roles of religion, spirituality and available institutional solutions to propose customized, culturally adapted, contextually based and collaborative community-level interventions that would facilitate the reconciliation of the conflicting identity domains.

Getting going and letting go: Religiosity fosters opportunity-congruent coping with work-related uncertainties

This study investigated how religiosity relates to goal engagement (i.e., investing time and effort; overcoming obstacles) and goal disengagement (i.e., protecting self-esteem and motivational resources against failure experiences; distancing from unattainable goals) in coping with perceived work-related uncertainties (e.g., growing risk of job loss) that arise from current social change. We hypothesised that religiosity not only expands individuals' capacities for both engagement and disengagement but also fosters an opportunity-congruent pattern of engagement and disengagement, promoting engagement especially under favourable opportunities for goal-striving in the social ecology and facilitating disengagement especially under unfavourable opportunities. Multilevel analyses in a sample of N = 2089 Polish adults aged 20-46 years partly supported these predictions. Religiosity was associated with higher goal engagement, especially under favourable economic opportunities for goal-striving in the social ecology (as measured by the regional net migration rate). For disengagement, the results were more mixed; religiosity was related to higher self-protection independently of the economic opportunity structure and predicted higher goal-distancing only under the most unfavourable opportunities. These results suggest that religiosity can promote different coping strategies under different conditions, fostering a pattern of opportunity-congruent engagement and, to some extent, disengagement that is likely to be adaptive.

Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care

Objectives

Despite growing research interest in spirituality and health, and recommendations on the importance of spiritual care in advanced cancer and palliative care, relationships between spiritual belief and psychological health near death remain unclear. We investigated (i) relationships between strength of spiritual beliefs and anxiety and depression, intake of psychotropic/analgesic medications and survival in patients with advanced disease; and (ii) whether the strength of spiritual belief changes as death approaches.

Methods

We conducted a prospective cohort study of 170 patients receiving palliative care at home, 97% of whom had a diagnosis of advanced cancer. Data on strength of spiritual beliefs (Beliefs and Values Scale [BVS]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), psychotropic/analgesic medications, daily functioning, global health and social support were collected at recruitment then 3 and 10 weeks later. Mortality data were collected up to 34 months after the first patient was recruited.

Results

Regression analysis showed a slight increase in strength of spiritual belief over time approaching statistical significance (+0.16 BVS points per week, 95% CI [−0.01, 0.33], p = 0.073). Belief was unrelated to anxiety and depression (−0.15 points decrease in HADS for 10 points increased in BVS (95% CI [−0.57, 0.27], p = 0.49) or consumption of psychotropic medication). There was a non-significant trend for decreasing analgesic prescription with increasing belief. Mortality was higher over 6 months in participants with lower belief at recruitment.

Conclusion

Results suggest that although religious and spiritual beliefs might increase marginally as death approaches, they do not affect levels of anxiety or depression in patients with advanced cancer. © 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.