Claims about religious involvement and health outcomes

Quantitative and Qualitative Research in the Field of 'Spirituality and Health': An Introductory How-to-Guide from a Brazilian Perspective

The present article aims to describe the different steps on how to design, develop and conduct quantitative and qualitative Spirituality and Health (S/H) studies from a Brazilian perspective, discussing definitions and instruments, and proposing a "how-to guide" for those interested in this field of research. A narrative review of the literature has been conducted by experts in the field of S/H aiming to develop a "how-to-guide". Spirituality is a very complex concept that has several challenges in the current scientific literature, including the lack of consensus in the definitions, the numerous dimensions assessed, the diverse instruments for measurement, the criticisms from other scholars, the great diversity of religious and cultural traditions and the growing number of "spiritual but not religious" individuals. This review supports that S/H studies may follow the high scientific standards, using consolidated research procedures and solid methods for both qualitative and quantitative research. Some peculiarities of the research methods for this field are discussed. S/H research is still under development, and there are several future directions for S/H studies, aiming to minimize previous criticisms and generating stronger evidence.

Supporting elderly patients in strengthening their personal and spiritual health resources

Care for the sick, including spiritual support is sometimes called holistic medicine. The term bio-psycho-social-spiritual model is sometimes used to describe this type of therapeutic approach patient-oriented medicine. This report indicates the importance of taking into account the spiritual aspect of life due to its beneficial impact on the coping resources activated and the patient's well-being. Existential and spiritual issues are on the verge of new clinical and research interest in medicine, especially in gerontology, oncology, and palliative care. Clinicians focus not only on symptom control but also on spiritual and existential issues such as spirituality, hope, and meaning. This paper reviews the topic of spirituality in the context of illness and end-of-life care trying to define spirituality within the context of health resources of the subject. Spirituality is perceived in two of its main components: faith/religious beliefs and spiritual well-being. Especially this second construct is reviewed and described as a health resource.

The Relationship Between Religious/Spiritual Beliefs and Subjective Well-Being: A Case-Based Comparative Cross-National Study

The most unique aspect of religiosity/spirituality (R/S), supernatural beliefs, and their relationship with SWB has hardly been examined. This study explores the relationship between six R/S supernatural beliefs and SWB, in a case-based comparative cross-national design including two religious and two secular nations. Data were obtained from the International Social Survey Programme (ISSP) Religion IV module from the religious countries of the USA (n = 1060) and Turkey (n = 1353) and the secular countries of Denmark (n = 1281) and Czech Republic (n = 1112). SWB was measured as happiness and self-rated health. Statistical analyses were performed using binary logistic regression models replicated across countries. Results indicated that the American sample showed no evidence of relationships between R/S and SWB outcomes capable of improving the model over demographic and service attendance covariates. In Turkey, some R/S beliefs were found to be statistically significantly related to SWB, with positive and negative associations with happiness. No associations were found in the secular countries. Findings were discussed in the light of previous research and interpreted from a terror management theory perspective.

Intercessory Rote Prayer, Life Longevity and the Mortality of Roman Catholic Bishops: An Exploratory Study

Based on a computational analysis of a large dataset, this study explores if there is a significant longevity effect of intercessory prayer for a named individual's well-being, if he receives a very high number of prayers per annum for an extended period. We relied on an observational cohort study, based on data from 1988 to 2018, including 857 Roman Catholic bishops, 500 Catholic priests, and 3038 male academics from six countries. We measured the covariance of the mean length of life, controlled for nationality. It was found that there is a main effect for occupation F(2, 4391) = 4.07, p = 0.017, η_p² = 0.002, with pairwise comparisons indicating significant differences between the mean life duration of bishops (M = 30,489) and of priests (M = 29,894), but none between the academic teachers (M = 30,147) and either of the other groups. A comparison analysis between bishops from the largest and the smallest dioceses showed no significant difference t(67.31) = 1.61, p = 0.11. The first analysis proved that bishops live longer than priests, but due to a marginal effect size this result should be treated with caution. No difference was found between the mean length of life of bishops from the largest and the smallest dioceses.

Characteristics of Danish Centenarians' Religious Beliefs: A Nationwide Population-Based Study

Research has shown that in groups of increasing age, religiousness becomes more prevalent. However, centenarians have only to a very limited extent been included in studies. The aim of this study is to characterize religious beliefs and practices in a larger sample of centenarians than have before been included in research on the matter. Using the Danish Civil Registration System, all individuals turning 100 in 2015 in Denmark were invited to participate (N = 498); 364 participated (73%) (82% women). Descriptive statistics on the centenarians' self-reported belief, frequency of prayer and attendance at service were compared to the Danish general population. Associations between religious measures and age were examined using multivariable logistic regressions, controlling for sex and region. Centenarians more often reported being believers, praying and attending religious service, compared to all other age groups. Age, gender and region were all significant predictors of religiousness. The results of this study add to the body of the literature on religiousness and ageing, but extend it by including older age groups than have before been investigated. These findings warrant further investigations into the role of belief in this group and how it relates to mental health.

Coronavirus pandemic and spirituality in southwest Nigeria: A sociological analysis

Introduction

The coronavirus pandemic outbreak is wreaking much havoc across the globe, with many nations shutting down their economy and social life with the hope of flattening the curve while health practitioners are also gearing efforts in providing a cure for it. Part of the coronavirus challenges is the various spiritual undertones attributed to it in many quarters. Hence, this study seeks to understand the various spiritual undertones attributed to the coronavirus incidence in southwest Nigeria.

Methodology

This paper examined the coronavirus pandemic and spirituality sociologically in southwest Nigeria, using secondary and primary data. Secondary data includes a review of literature, social media comments, official records, and newspaper reports. Primary data entails using google form (questionnaire) circulated via social media with 221 responses retrieved and analyzed using the frequency distribution tables and bar charts. Also, a one-sample t-test was used for further statistical analysis.

Results

Findings show that rather than attributing coronavirus incidence to spirituality alone, most of the respondents also see it as a public health concern, and precautionary measures should adhere. They see the government ban on social gathering, which affected the religious houses as the right thing to do and not solely targeted as religious houses. However, most believe that religious houses provide 'essential' emotional and spiritual support to the people. Respondents also believe they can get their healing from their place of worship even if infected with the coronavirus.

Conclusion

Based on the findings it was recommended that religious organizations should source valid data so that policy-makers can make informed decisions. Also, there is a need to have an accurate record of the number of infected persons and death rates to know the right time to ease lockdown and lift the social gathering measures. There should also be a place for easy and free testing for people. This will help the government ascertain the number of infected persons, reduce the associated fear with the pandemic, and lessen the people's economic, social, and religious effects.

Relationship between religiosity and smoking among undergraduate health sciences students

INTRODUCTION

The university period is often characterized as a critical period of vulnerability for smoking habit initiation.

OBJECTIVE

The purpose of this cross-sectional study was to assess the relationship between religiosity and smoking among undergraduate students on health sciences courses.

METHODS

A total of 336 students on four health sciences courses (occupational therapy, speech therapy, nutrition, and physiotherapy) completed a cigarette smoking questionnaire along with the Duke University Religion Index.

RESULTS

Smoking prevalence was 8.3% among females and 12.7% among males. Prevalence among students who do not have a religion, but do believe in God, was higher than among those who do have a religion (16.3 and 6.3%, respectively). Organizational religious activity has a significant effect on smoking status.

CONCLUSION

The students have health habits that are not only motivated by the technical knowledge acquired on their undergraduate courses, since there was a possible influence of social norms stimulated by religious institutions on their attitudes, knowledge and practices in health.

Multidimensional understanding of religiosity/spirituality: relationship to major depression and familial risk

BACKGROUND

Previous research has shown prospectively that religiosity/spirituality protects against depression, but these findings are commonly critiqued on two grounds, namely: (1) apparent religiosity/spirituality reflects merely an original absence of depression or elevated mood and (2) religiosity/spirituality too often is measured as a global construct. The current study investigates the relationship between depression and religiosity/spirituality by examining its multidimensional structural integrity.

METHOD

Confirmatory factor analyses with a previously observed cross-cultural factor structure of religiosity/spirituality variables were conducted on an independent sample, diagnostic and familial risk subgroups from this sample, and a subsample of the original cross-cultural sample. Linear regressions onto a previous diagnosis of major depressive disorder (MDD) 5 years prior to assess the potential attenuating impact of a previous depression was explored.

RESULTS

Across familial risk groups and clinical subgroups, each of the previously validated religiosity/spirituality domains was confirmed, namely: religious/spiritual commitment, contemplative practice, sense of interconnectedness, the experience of love, and altruistic engagement. Previous MDD diagnosis was associated with a lower religious/spiritual commitment among high-risk individuals, higher contemplation among low-risk individuals, and lower importance of religion or spirituality regardless of risk group.

CONCLUSIONS

Structural integrity was found across familial risk groups and diagnostic history for a multidimensional structure of religiosity/spirituality. Differential associations between a previous diagnosis of MDD and level of religiosity/spirituality across domains suggest a complex and interactive relation between depression, familial risk, and religiosity/spirituality. Accounting for an empirically valid, multidimensional understanding of religiosity/spirituality may advance research on mechanisms underlying the relationship between religiosity/spirituality and mental health.

Spirituality and quality of life in epilepsy and other chronic neurological disorders

PURPOSE

The patients with neurological disorders often report a different quality of life (QoL), which is in part explained by clinical-pathological or psychosocial variables. This study evaluated spirituality in patients with chronic brain pathologies, aiming to clarify its specificity and position to a multidimensional model of QoL.

METHODS

A hundred and ninety-nine adult patients with epilepsy (E) (n = 88), mild cognitive impairment (MCI) (n = 32), ischemic vascular disorders (n = 29), tumors (n = 28), or multiple sclerosis (MS) (n = 22), and 66 healthy subjects were assessed using the World Health Organization Quality of Life (WHOQoL) 100, Spiritual, Religious and Personal Beliefs (SRPB), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) for the QoL, spirituality, depression, and anxiety. The Multiple Ability Self-Report Questionnaire (MASQ) and neuropsychological tests evaluated the cognitive functions.

RESULTS

Factor analysis of the SRPB, STAI, and BDI scores yielded four factors: Personal Meaning, Inner Freedom, Awe and Openness, and Mood. Quality of life and spirituality were very similar between the patient groups. In comparison with the controls, all of the patients showed worse QoL, spirituality, mood, and lexical-memory abilities, and the patients with MCI and brain vascular disorders (BVD) also revealed worse cognitive impairments. Trait anxiety, self-rated health, age, and the SRPB Inner independence and Hope and optimism facets predicted the patients' WHOQoL 100 total score; the spiritual, affective, and socioeconomic variables predicted many QoL domains, but diagnosis only affected the Physical domain. Anxiety, self-rated health, Hope and optimism, and Personal beliefs predicted the controls' WHOQoL 100 total score.

CONCLUSIONS

Spirituality, as marked by the meaning of self, inner independence, and transcendence, is distinct from mood. It cooperates, together with the affective states, to determine the QoL of the patients with chronic brain pathologies whereas diagnosis has a limited impact. These findings support a multidimensional cross-disease model for the QoL in neurological disorders.

Relational spirituality and quality of life 2007 to 2017: an integrative research review

BACKGROUND

Despite the increasing number of evidence-based research on relational spirituality (RS) and quality of life (QoL) in medical-health research, little is known about the links between RS and QoL outcomes and the mechanisms by which RS aspects are functionally tied to QoL.

OBJECTIVE

To determine how RS is perceived/positioned in relation to QoL, we (a) examined recent available data that identify and appraise the links between RS and QoL; (b) identified themes emerging from the association between RS and QoL, and (c) discussed the implications of the effects of RS on QoL outcomes.

METHODS

We conducted an integrative research review of English-language peer-reviewed articles published between 2007 to March 2017 which examined an association between RS and QoL, as identified from a search of three databases: PubMed, PsycINFO, and ScienceDirect.

RESULTS

A total of 20 studies were analysed. Of these, twelve (60%) reported positive association between RS and QoL, three (15%) studies reported inverse associations, whereas five (25%) studies showed evidence of lack of association (with two out of the five studies showing an indirect association). Physical health and psychological functioning were the most researched domains of QoL, and some studies suggest an attachment-based model of RS in the last 10 years of RS and QoL research. Studies conducted with participants with serious illnesses ranging from dementia, cardiac arrest, and breast cancer reported no association between RS and physical health. Our review shows evidence of both the direct and/or indirect effects of RS on QoL as a possible spiritual coping model for complementary alternative health therapy, albeit occurring through several religious-related psychosocial conduits.

CONCLUSION AND IMPLICATION

RS appears to be associated with health benefits as indicated across QoL domains. General medical practitioners and other healthcare agencies could benefit from the understanding that a spiritual coping model could aid their patients, and therefore their clinical practices, in the healing process.

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.

Demographic differences of perceived service quality in emergency rooms of hospital organizations

Purpose

The purpose of this paper is to test three visual, demographically based perceptions of service quality at several emergency rooms (ERs) of hospital organizations in Israel.

Design/methodology/approach

This research is based on the evaluations of 1,002 people who accompanied a patient to hospital ERs in Israel. The data were collected randomly from an internet panel that comprised more than 50,000 people aged over 18 years.

Findings

The findings showed that female patients were perceived as receiving significantly lower service quality than males; elderly patients were treated well by medical staff, and treatment was similar to all other adult groups; children were perceived as receiving the best service; and religious individuals perceived service quality in ERs at a higher level than non-religious patients.

Research limitations/implications

The current study uses a service quality scale derived from a marketing scale that was modified to study the quality of service in hospital ERs. The current study measures only differences in visual demographics.

Originality/value

This paper attempts to provide the ER staff of hospital organizations with some knowledge about the ways which their service is perceived and encourages a more sensitive attitude toward their patients’ needs. This may influence the hospital customer satisfaction and the hospital financial bottom-line.

Advancing our understanding of religion and spirituality in the context of behavioral medicine

Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

What Mediates the Relationship Between Religious Service Attendance and Aspects of Well-Being?

Religious service attendance predicts increased well-being across a number of studies. It is not clear, however, whether this relationship is due to religious factors such as intrinsic religiosity or due to nonreligious factors such as social support or socially desirable responding. The purpose of the present study was to examine the relationship between religious service attendance and well-being while simultaneously examining intrinsic religiosity, social support, and socially desirable responding as potential mediators of the relationship. A sample of 855 participants (71 % female, average age 19.5) completed questionnaires assessing religiosity, social support, socially desirable responding, and well-being. Path models were estimated using maximum likelihood estimation to analyze the data. Intrinsic religiosity was the strongest mediator of the relationship between religious service attendance and depressive and anxiety symptoms. This suggests that the mental health benefits of religious service attendance are not simply the result of increased social support or a certain response style on questionnaires; rather, it appears that the relationship is at least partly the result of people trying to live their religion in their daily lives.

Exploring Existential Coping Resources: The Perspective of Koreans with Cancer

The present study aimed to explore the use of meaning-making coping (existential, spiritual, and religious coping) among cancer patients in Korea and to investigate the impact of culture on their choice of coping methods. Thirty-three participants with various kinds of cancer were interviewed. Four different kinds of coping resources emerged from analyses of the interview transcripts: (1) belief in the healing power of nature; (2) mind-body connection; (3) relying on transcendent power; and (4) finding oneself in relationships with others. The findings of this study suggest the importance of investigating cultural context when exploring the use of the meaning-making coping strategies in different countries.

Methodological Pitfalls in the Study of Religiosity and Spirituality

The number of studies demonstrating a relationship between religiosity and spirituality and physical and psychological health have increased rapidly during the past decade. There are significant disputes in the literature regarding the methodological quality of research in this area. Despite nursing scholars’ interest in this area, no thorough review of the methodological critiques is available. The purpose of this study is to review areas of methodological difficulty in the study of religiosity and spirituality by identifying contemporary methodological critiques, critically evaluating the critiques and the underlying issues, and making suggestions for methodological advancement in the field. Three main areas of methodological critique exist: construct measurement, study design, and data analysis. Research in this area should aim for conceptual clarity, deliberate design, and appropriate analysis. Considerations of these critiques are instructive for nursing research done in the area of religiosity and spirituality.

Leaving my religion: Understanding the relationship between religious disaffiliation, health, and well-being

Religious disaffiliation-leaving the religious tradition in which one was raised for no religious affiliation in adulthood-has become more common in recent years, though few studies have examined its consequences for the health and well-being of individuals. We use an innovative approach, comparing the health and subjective well-being of religious disaffiliates to those who remain affiliated using pooled General Social Survey samples from 1973 through 2012. We find that religious disaffiliates experience poorer health and lower well-being than those consistently affiliated and those who are consistently unaffiliated. We also demonstrate that the disadvantage for those who leave religious traditions is completely mediated by the frequency of church attendance, as disaffiliates attend church less often. Our results point to the importance of the social processes surrounding religious disaffiliation and emphasize the role of dynamics in the relationship between religious affiliation and health.

What's God Got to Do with It? How Religiosity Predicts Atheists' Health

The relationship between atheism and health is poorly understood within the Religion/Spirituality-health literature. While the extant literature promotes the idea that Attendance, Prayer, and Religiosity are connected to positive health outcomes, these relationships have not been established when controlling for whether a person is an atheist. Data from the 2008-2012 American General Social Survey (n = 3210) were used to investigate this relationship. Results indicated that atheists experienced Religiosity more negatively than non-atheists. Additionally, results demonstrated that non-belief in God was not related to better or worse perceived global health, suggesting that belief in God is not inherently linked to better reported health.

Forms of Attrition in a Longitudinal Study of Religion and Health in Older Adults and Implications for Sample Bias

The use of longitudinal designs in the field of religion and health makes it important to understand how attrition bias may affect findings in this area. This study examines attrition in a 4-wave, 8-year study of older adults. Attrition resulted in a sample biased toward more educated and more religiously involved individuals. Conditional linear growth curve models found that trajectories of change for some variables differed among attrition categories. Ineligibles had worsening depression, declining control, and declining attendance. Mortality was associated with worsening religious coping styles. Refusers experienced worsening depression. Nevertheless, there was no evidence of bias in the key religion and health results.

Can the Effects of Religion and Spirituality on Both Physical and Mental Health be Scientifically Measured? An Overview of the Key Sources, with Particular Reference to the Teachings of Said Nursi

Within Western secular societies, everything has to be substantiated by empirical evidence; this means it has to be quantifiable and measurable. Research, particularly quantitative research, then, is the criterion by which everything, including religion, is either accepted or rejected. The separation of religion from science began with the Renaissance, the Reformation and the advent of the Enlightenment. It was perceived that religion did not match the language of science and that there was no logical proof or empirical evidence for the existence of God. Religion therefore, due to its inability to be measured and quantified, has since been largely marginalised. In recent times, in order to integrate 'religion' into everyday life, attempts have been made to argue and bring in scientific proof for the effectiveness of religion for improved health and well-being. The psychiatrist Harold Koenig has been one of the key people whose collation of research evidence has shown that religion has a positive effect on both physical and mental health. By looking firstly at the definitions of religion and spirituality and then discussing various opinions from both secular and religious perspectives, including those of Said Nursi, this paper aimed to determine whether religion and spirituality can indeed be measured.

Spirituality and religion in older adults: building knowledge in an emerging discipline

So what is known in the scholarship of religion and spirituality at this point of the 21st century? Definitions of spirituality show a growing understanding of the breadth and content of spirituality, and yet, there remains no firm definition. In one sense, it might be good that spirituality has not been tightly defined. Swinton and Pattison (2010, p231) note, “multiple definitions may be indicative of the necessity and the flexibility of the term to meet particular needs that would otherwise go unmet.” The publication of the paper written by Agli et al. in this edition of the journal, is timely and provides an excellent systematic review of the recent literature.

Parental participation in religious services and parent and child well-being: findings from the National Survey of America's Families

Using data from the 1999 and 2002 National Survey of America's Families, a large-scale nationally representative sample, this study finds that parental religious attendance is positively associated with parent self-rated health, parent mental well-being, positive parenting attitudes, child health, and child school engagement. Although the strength of these associations varies to some extent according to socio-demographic factors, the interactive patterns are not consistently predictable. Moreover, parental health and well-being and positive attitudes toward parenting appear to be important pathways linking parental religious attendance to child well-being. These findings suggest that opportunities for participation in local religious services offered by faith-based organizations may be fruitful avenues through which the government and society can help American families enhance parent and child well-being.

Explaining the relationship between post-critical beliefs and sense of coherence in Polish young, middle, and late adults

The subject of the presented research is the analysis of relations between Post-Critical Belief and Sense of Coherence in women and men in early, middle, and late adulthood. Six hundred and thirty-six individuals participated in the research, 332 women and 304 men, at the age of 18-79 years. We applied the Post-Critical Belief scale by Hutsebaut (J Empir Theol 9:48-66, 1996) and the Sense of Coherence scale (SOC-29) by Antonovsky (Soc Sci Med 36:725-733, 1993). The results suggest that the salutogenic function of religiosity is related to age and gender--in women, it is most strongly marked in late, and in men, in middle adulthood.

Religious and cultural aspects of psychotherapy in Muslim patients from tradition-oriented societies

Patients from collective cultures with a tradition-bound Islamic cultural background (e.g. people from the Middle East and some Far-East countries such Pakistan and Indonesia), have a different perception of disease and different conceptions of healing, which up till now have not been sufficiently appreciated in modern multimodal therapeutic approaches and health management. Taking patients' value systems into consideration in a culture-sensitive way, with reference to their notions of magic, healing ceremonies and religious rituals and especially patterns of relations and experience in the treatment of psychological diseases in medical psychotherapeutic work, with due regard to scientific psychotherapeutic standards, can be used as an intercultural resource and lead to establishing partnership-like relationships between patients and therapists.

The neuroscientific study of spiritual practices

The purpose of this paper will be to provide a perspective on the current state of the research evaluating the neurobiological correlates of spiritual practices and review the methodological issues that confront this research field. There are many types of spiritual practices that might be studied including prayer and meditation, as well as unusual practices such as mediumistic trance states, speaking in tongues, and also drug-induced experiences. Current studies have utilized neuroimaging techniques including functional magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography. These studies have helped elucidate the neurobiological mechanisms associated with spiritual practices. Such studies confront unique challenges for scientific methodology including determining the most appropriate objective measures such as neuroimaging studies and physiological parameters, and correlating them with subjective measures that help capture states of spiritual significance. Overall, a neuroscientific study of spiritual practices and experiences has the potential to provide fascinating data to further our understanding of the relationship between the brain and such phenomena.

Religiosity and sexual risk behaviors among African American cocaine users in the rural South

PURPOSE

Racial and geographic disparities in human immunodeficency virus (HIV) are dramatic and drug use is a significant contributor to HIV risk. Within the rural South, African Americans who use drugs are at extremely high risk. Due to the importance of religion within African American and rural Southern communities, it can be a key element of culturally-targeted health promotion with these populations. Studies have examined religion's relationship with sexual risk in adolescent populations, but few have examined specific religious behaviors and sexual risk behaviors among drug-using African American adults. This study examined the relationship between well-defined dimensions of religion and specific sexual behaviors among African Americans who use cocaine living in the rural southern United States.

METHODS

Baseline data from a sexual risk reduction intervention for African Americans who use cocaine living in rural Arkansas (N = 205) were used to conduct bivariate and multivariate analyses examining the association between multiple sexual risk behaviors and key dimensions of religion including religious preference, private and public religious participation, religious coping, and God-based, congregation-based, and church leader-based religious support.

FINDINGS

After adjusting individualized network estimator weights based on the recruitment strategy, different dimensions of religion had inverse relationships with sexual risk behavior, including church leadership support with number of unprotected vaginal/anal sexual encounter and positive religious coping with number of sexual partners and with total number of vaginal/anal sexual encounters.

CONCLUSION

Results suggest that specific dimensions of religion may have protective effects on certain types of sexual behavior, which may have important research implications.

Re-examining definitions of spirituality in nursing research

AIM

To discuss the definition of spirituality and its limitations for nursing research. It proposes a definition that will capture more accurately the role of spirituality in health outcomes.

BACKGROUND

Studies have increasingly examined spirituality in nursing research as a coping mechanism attenuating the negative impact of traumatic stress on mental health. Existing definitions of spirituality in nursing research include elements of positive emotional states (meaning, purpose, general well-being) which confound mental health outcomes.

DATA SOURCES

Medline and CINAHL databases were searched from 2007-2011 for research articles examining spirituality definitions and measures used by nurse researchers.

DISCUSSION

An analysis of the definitions of spirituality in nursing research reveals inconsistencies and confounding mental health concepts. The authors propose defining spirituality in the context of religious involvement when conducting research, while using a broader definition of spirituality when providing spiritual care. They argue such definition provides a more appropriate method of measuring this concept in research aimed at evaluating mental health outcomes while preserving the currently used patient-defined definition of spirituality when providing spiritual care.

NURSING IMPLICATIONS

A consistent definition of spirituality in nursing research evaluating mental health outcomes, distinct from 'spiritual care' in a clinical setting, is essential to avoid tautological results that are meaningless. Appropriate definitions will enable nursing researchers to more clearly identify resilience mechanisms and improved health outcomes in those exposed to traumatic stress.

CONCLUSION

A definition of spirituality that focuses on religious involvement provides a more uniform and consistent measure for evaluating mental health outcomes in nursing research.

It is out of my hands: how deferring control to God can decrease quality of life for breast cancer patients

OBJECTIVE

This paper seeks to contribute to the understanding of how and why religion affects psychosocial health outcomes. We propose a theoretical model predicting that when women with breast cancer defer control to God they will experience fewer breast cancer related concerns. Deferring control to God, however, should also reduce the likelihood that they take a proactive coping approach, which will be exacerbated by lowered breast cancer concerns. We therefore predict that this passive coping style will ultimately result in lower levels of quality of life.

METHODS

Data were collected as part of a randomized clinical trial funded by the National Cancer Institute. A total of 192 women with breast cancer participated in a computer-mediated social support group. Deferring control to God statements were captured by using computer-aided content analysis of discussion posts. Psychosocial outcomes were measured using longitudinal survey data. Analysis was performed using structural equation modeling.

RESULTS

The results of our analysis largely confirm our mediation model for which we find significant model fit. As predicted, deferring control to God leads to lower levels of breast cancer concerns but also to more passive coping styles. Ultimately, deferring control to God can lead to lower levels of quality of life.

CONCLUSIONS

Our study demonstrates how and why religious coping can lead to both positive and negative psychosocial health outcomes. Health care practitioners should encourage patients who are relying on religion to keep their end of the bargain and maintain an active coping style.

Frequency of private spiritual activity and cardiovascular risk in postmenopausal women: the Women's Health Initiative

PURPOSE

Spirituality has been associated with better cardiac autonomic balance, but its association with cardiovascular risk is not well studied. We examined whether more frequent private spiritual activity was associated with reduced cardiovascular risk in postmenopausal women enrolled in the Women's Health Initiative Observational Study.

METHODS

Frequency of private spiritual activity (prayer, Bible reading, and meditation) was self-reported at year 5 of follow-up. Cardiovascular outcomes were centrally adjudicated, and cardiovascular risk was estimated from proportional hazards models.

RESULTS

Final models included 43,708 women (mean age, 68.9 ± 7.3 years; median follow-up, 7.0 years) free of cardiac disease through year 5 of follow-up. In age-adjusted models, private spiritual activity was associated with increased cardiovascular risk (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.02-1.31 for weekly vs. never; HR, 1.25; 95% CI, 1.11-1.40 for daily vs. never). In multivariate models adjusted for demographics, lifestyle, risk factors, and psychosocial factors, such association remained significant only in the group with daily activity (HR, 1.16; 95% CI, 1.03-1.30). Subgroup analyses indicate this association may be driven by the presence of severe chronic diseases.

CONCLUSIONS

Among aging women, higher frequency of private spiritual activity was associated with increased cardiovascular risk, likely reflecting a mobilization of spiritual resources to cope with aging and illness.

The role of patient religiosity in the evaluation and treatment outcomes for chronic HCV infection

To determine the influence of patient religiosity on the outcome of treatment of hepatitis C infection, a prospective, blinded, cohort study was performed on hepatitis C-infected patients categorized as 'higher religiosity' and 'lower religiosity' based on responses to a religiosity questionnaire. Comparisons were made between high and low religiosity patients on demographics, pre-treatment laboratory values, and response to treatment. Eighty-seven patients with complete questionnaires were placed in either higher (38) or lower (49) religiosity cohort. The patients (60% female) were ethnically diverse: African-American 39%; Hispanic 31%; white 29%. African-American race (P = 0.001) and female gender (P = 0.026) were associated with higher religiosity. The frequency of being offered treatment, accepting treatment, and completing treatment was similar in both religiosity cohorts (P = 0.234, 0.809, 0.367). Fifty-six patients completed the 24- or 48-week treatment with peginterferon and ribavirin. Depression was more frequent in the low religiosity group (38.2% vs. 4.6%, P = 0.005). Sustained viral response rate at 3-6-month post-therapy was similar in the higher (50%) and lower (57.6%) religiosity cohorts (P = 0.580; n = 55). Logistic regression modeling revealed that males having higher religiosity gave greater odds of SVR than those with lower religiosity (OR 21.3; 95% CI 1.1-403.9). The level of religiosity did not affect the decision to begin treatment for chronic HCV infection and was not associated with a better treatment outcome. A higher level of religiosity was associated with less depression among patients.

Beyond belief

Psychology, including health psychology, frequently invokes the concept of belief but almost never defines it. Drawing upon scholarship associated with the ‘affective turn’, this article argues that belief might usefully be understood as a structure of socialized feeling, contingently allied to discursive practices and positions. This conceptualization is explained, and its implications for health psychology discussed with respect to research on religiosity and spirituality and debates about the value of social cognition models such as the theory of planned behaviour.

Religion and Spirituality as Important Components of Men’s Health and Wellness

Men’s health has been receiving increased attention in health care research and practice because of associated negative outcomes and men’s reluctance to seek help. Religion or religiosity, defined as involvement in an organized, structured community focused on moral code, and spirituality, defined as the subjective, mystical, and holistic interpretation of personal beliefs and behaviors, have been associated with positive health outcomes. Specifically, religion and spirituality mediate an increase in positive health outcomes and a decrease in risk factors through social and existential well-being. However, men seem to be less religious and spiritual compared with women, a potential problem as men may be missing an important pathway to health and wellness. This state-of-the-art review examines the intersections of religion, spirituality, and health and focuses on how religion and spirituality relate specifically to men’s health and health behaviors. Subsequently, 4 health problems with religious and spiritual implications are examined that have been identified in the literature as pertinent to men’s health: (a) prostate cancer screening and coping, (b) HIV/AIDS prevention and coping, (c) addictions, and (d) palliative care. Finally, suggestions are offered for clinicians to incorporate an understanding of religion and spirituality into their patient encounters.

Religious competence as cultural competence

Definitions of cultural competence often refer to the need to be aware and attentive to the religious and spiritual needs and orientations of patients. However, the institution of psychiatry maintains an ambivalent attitude to the incorporation of religion and spirituality into psychiatric practice. This is despite the fact that many patients, especially those from underserved and underprivileged minority backgrounds, are devotedly religious and find much solace and support in their religiosity. I use the case of mental health of African Americans as an extended example to support the argument that psychiatric services must become more closely attuned to religious matters. I suggest ways in which this can be achieved. Attention to religion can aid in the development of culturally competent and accessible services, which in turn, may increase engagement and service satisfaction among religious populations.

Evaluation of a spiritually focused intervention with older trauma survivors

This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women survivors of interpersonal trauma were randomized into treatment (n = 21) or control (n = 22) groups. Participants in group psychotherapy discussed spiritual struggles related to abuse and developed spiritual coping resources. The treatment group had significantly lower depressive symptoms, anxiety, and physical symptoms at posttest compared with the control group. In a separate analysis, posttraumatic stress symptoms also dropped significantly in the treatment group. Gains were maintained at three-month follow-up. This study provides strong initial support for the effectiveness of spiritually focused group intervention for older survivors of interpersonal trauma from a Christian background.

Factors predicting quality of life in a group of Polish subjects with multiple sclerosis: accounting for functional state, socio-demographic and clinical factors

OBJECTIVES

Quality of life (QoL) has presently a firmly established position as an important endpoint in medical care. Multiple sclerosis (MS) is a chronic neurological disease with considerable effect on patients' QoL. QoL of MS patients from many European countries has already been assessed but little is known on health-related QoL of Polish subjects with MS. Few studies have taken into consideration multiple predictors of QoL. The aim of this study was to elicit the most relevant factors that determine QoL of Polish group of MS patients. Socio-demographic and clinical factors as well as the influence of disability level were analyzed in this study.

PATIENTS AND METHODS

173 MS patients and 86 healthy controls underwent assessment using the Mini Mental Status Examination, WHOQOL-100, Beck Depression Inventory and Fatigue Severity Scale. Data were analyzed by a stepwise linear regression analysis.

RESULTS

MS patients had significantly worse global QoL and worse QoL in physical and psychological health domains, lower level of independence, worse social relations and were less satisfied with the surrounding environment they lived in compared with healthy controls (p<0.05). MS subjects had also higher level of depression and fatigue compared to healthy controls (p<0.05).

CONCLUSIONS

The study determined that the strongest predictors of global QoL of Polish MS patients were depression, disability level and fatigue.

Extending religion-health research to secular minorities: issues and concerns

Claims about religion's beneficial effects on physical and psychological health have received substantial attention in popular media, but empirical support for these claims is mixed. Many of these claims are tenuous because they fail to address basic methodological issues relating to construct validity, sampling methods or analytical problems. A more conceptual problem has to do with the near universal lack of atheist control samples. While many studies include samples of individuals classified as "low spirituality" or religious "nones", these groups are heterogeneous and contain only a fraction of members who would be considered truly secular. We illustrate the importance of including an atheist control group whenever possible in the religiosity/spirituality and health research and discuss areas for further investigation.

Spirituality and religiosity in psychotherapy--a representative survey among German psychotherapists

We report a survey in a near-representative sample of 895 German psychotherapists. Fifty-seven percent of the respondents referred to themselves as either spiritual or religious. Psychotherapists estimated that on average 22% of their patients bring in topics around spirituality and religion during the course of therapy. Two-thirds thought that topics around spirituality and religion should be part of the postgraduate and/or graduate curriculum. There was a clear difference between therapeutic orientations regarding how they felt about such issues, with CBT and psychodynamically oriented therapists placing less emphasis on spiritual issues and integrative and humanistic therapists more. However, differences between schools were less important than commonalities. We conclude that spirituality and religiosity are important topics for training and further research.

Cancer survivors' spiritual well-being and use of complementary methods: a report from the American Cancer Society's Studies of Cancer Survivors

We examined associations between spiritual well-being and CAM use among 4,139 cancer survivors. We also explored the classification of religious/spiritual practices (R/S) as CAMs and alternative subscale structures of the Functional Assessment of Chronic Illness Therapy--Spiritual Well-being (FACIT-Sp). We evaluated three aspects of spirituality, Faith, Peace, and Meaning, and use of 19 CAMs in 5 domains. Mind-body methods were subdivided into R/S and non-R/S. All FACIT-Sp factors were associated with CAM use, but in different directions: Meaning and Faith were positively associated; Peace was negatively associated. Peace was negatively associated with R/S CAMs, but not non-R/S CAMs. The prevalence of CAM use dropped from 79.3 to 64.8% when R/S items were excluded. These findings confirm an association between spiritual well-being and CAM use, including some non-R/S CAMs, and provide evidence of the benefits of using the three-factor FACIT-Sp solution and treating R/S CAMs as a separate category.

Religiosity as a protective factor against substance use among Hungarian high school students

Gender differences in the relationship between religiosity and substance use (lifetime prevalence and current use) were examined among high school students in Szeged, Hungary (N = 881). Experimenting with and consuming tobacco and alcoholic beverages were characteristic in the sample to a great extent, whereas marijuana use was not as frequent. Logistic regression analyses were employed to test how variables of religiosity, that is, denominational affiliation, religiosity, and religious attendance, were related to substance use of youth by gender. Our findings confirmed the importance of the protective role of religious involvement, particularly among females.

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

OBJECTIVE

We studied whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of "Spiritual and Religious Attitudes in Dealing with Illness"), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of "Adaptive Coping with Disease"), life satisfaction, and appraisal dimensions.

PATIENTS

In a multicenter cross-sectional study, 580 patients with chronic pain conditions were enrolled.

RESULTS

We found that the patients relied on both external powerful sources of disease control and on internal powers and virtues, while Trust in Higher Source (intrinsic religiosity) or Illness as Chance (reappraisal) were valued moderately; Search for Meaningful Support/Access (spiritual quest orientation) was of minor relevance. Stepwise regression analyses revealed that the internal sources of disease control, such as Conscious and Healthy Way of Living and Positive Attitudes, were (apart from the religious denomination) the strongest predictors of patients' reliance on spirituality/religiosity. Both behavioral styles were rated significantly lower in patients who regarded themselves as neither religious nor spiritual. Positive disease interpretations such as Challenge and Value were clearly associated with a spiritual quest orientation and intrinsic religiosity.

CONCLUSION

The associations between spirituality/religiosity, positive appraisals. and internal adaptive coping strategies indicate that the utilization of spirituality/religiosity goes far beyond fatalistic acceptance, but can be regarded as an active coping process. The findings support the need for further research concerning the contributions of spiritual coping in adjustment to chronic pain.