"Collective amnesia:" the absence of religious faith and spirituality in health communication research and practice

Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya

Background

Large-scale schistosomiasis control programs are implemented in regions with diverse social and economic environments. A key epidemiological feature of schistosomiasis is its small-scale heterogeneity. Locally profiling disease dynamics including risk factors associated with its transmission is essential for designing appropriate control programs. To determine spatial distribution of schistosomiasis and its drivers, we examined schoolchildren in Kwale, Kenya.

Methodology/Principal findings

We conducted a cross-sectional study of 368 schoolchildren from six primary schools. Soil-transmitted helminths and Schistosoma mansoni eggs in stool were evaluated by the Kato-Katz method. We measured the intensity of Schistosoma haematobium infection by urine filtration. The geometrical mean intensity of S. haematobium was 3.1 eggs/10 ml urine (school range, 1.4–9.2). The hookworm geometric mean intensity was 3.2 eggs/g feces (school range, 0–17.4). Heterogeneity in the intensity of S. haematobium and hookworm infections was evident in the study area. To identify factors associated with the intensity of helminth infections, we utilized negative binomial generalized linear mixed models. The intensity of S. haematobium infection was associated with religion and socioeconomic status (SES), while that of hookworm infection was related to SES, sex, distance to river and history of anthelmintic treatment.

Conclusions/Significance

Both S. haematobium and hookworm infections showed micro-geographical heterogeneities in this Kwale community. To confirm and explain our observation of high S. haematobium risk among Muslims, further extensive investigations are necessary. The observed small scale clustering of the S. haematobium and hookworm infections might imply less uniform strategies even at finer scale for efficient utilization of limited resources.

The World Health Organization is spearheading the war on neglected tropical diseases, including helminth infections, by encouraging its member states to intensify control efforts. This call has recently been answered in most endemic regions of helminthiasis and governments are scaling up chemotherapy-based control programs in collaboration with private and public partners. However, it is necessary to clearly understand factors driving local transmission dynamics of helminth infections to design effective control programs. Here, we conducted a cross-sectional survey of 368 primary schoolchildren in Kwale, Kenya, and identified factors associated with the intensity of Schistosoma haematobium and hookworm infections. The negative binomial generalized linear mixed model showed the intensity of S. haematobium infection was much higher among Muslims and schoolchildren from low socioeconomic status households. High intensity of hookworm infection was associated with sex, SES, distance to river and history of anthelmintic treatment. Our findings demonstrate considering social and cultural drivers of NTDs could be beneficial in designing of efficient control programs and expediting NTDs control.

Church Attendance as a Predictor of Number of Sexual Health Topics Discussed Among High-Risk HIV-Negative Black Women

Research suggests that sexual health communication is associated with safer sex practices. In this study, we examined the relationship between church attendance and sexual health topics discussed with both friends and sexual partners among a sample of urban Black women. Participants were 434 HIV-negative Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from Baltimore, Maryland using a network-based sampling approach. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews. Fifty-four percent of the participants attended church once a month or more (regular attendees). Multivariate logistic regression analyses revealed that regular church attendance among high-risk HIV-negative Black women was a significant predictor of the number of sexual health topics discussed with both friends (AOR = 1.85, p = .003) and sexual partners (AOR = 1.68, p = .014). Future efforts to reduce HIV incidence among high-risk Black women may benefit from partnerships with churches that equip faith leaders and congregants with the tools to discuss sexual health topics with both their sexual partners and friends.

Constructing and Communicating Privacy Boundaries: How Family Medicine Physicians Manage Patient Requests for Religious Disclosure in the Clinical Interaction

Religion/spirituality (R/S) is an important component of some patients' psychosocial framework when facing illness. While many patients report an increased desire for R/S dialogue in clinical interaction, especially when facing a frightening diagnosis, some physicians report discomfort talking about R/S and hold various beliefs regarding the appropriateness of such discussions. Not only do physicians manage conversations centering on patient disclosures in the clinical visit, they must also navigate requests to share their own personal information. Farber et al. (2000) found that over a 12-month period nearly 40% of physicians reported that patients asked questions that transgressed professional boundaries. This article uses Petronio's communication privacy management theory as a lens through which to situate our understanding of how family medicine physicians construct and communicate privacy boundaries in response to patient requests for religious disclosure. Results provide an in-depth theoretical understanding of issues surrounding religious disclosure in the medical visit and expand the discussion on health care providers' personal and professional privacy boundaries as documented by Petronio and Sargent (2011). Implications for health care training and practice are discussed.

A content analysis of research on religion and spirituality in general communication and health communication journals

Little research has been conducted within the field of communication regarding the intersection of religious faith and health communication. One step toward addressing the existing gap in health communication literature is to establish an accurate picture of the present state of affairs. The purpose of this study was to describe publication patterns in communication journals over the past 10 years with respect to the intersection and faith and health communication. We conducted a content analysis on four broad-based communication journals that have been identified as central in the communication field, and two health communication journals. We present results regarding specific health conditions, nationalities, faith communities, channels of communication, domains of religion, and purposes of communication studied; methods used; trends in publication across time and communication journals; and comparison to other disciplines.

Religiosity associated with prolonged survival in liver transplant recipients

We tested the hypothesis that religiosity (ie, seeking God's help, having faith in God, trusting in God, and trying to perceive God's will in the disease) is associated with improved survival in patients with end-stage liver disease who have undergone orthotopic liver transplantation. We studied a group of 179 candidates for liver transplantation who responded to a questionnaire on religiosity during the pretransplant psychological evaluation and underwent transplantation between 2004 and 2007. The demographic data, educational level, employment status, clinical data, and results of the questionnaire were compared with the survival of patients during follow-up, regardless of the cause of any deaths. Factorial analysis of responses to the questionnaire revealed 3 main factors: searching for God (active), waiting for God (passive), and fatalism. The consistency of the matrix was very high (consistency index = 0.92). Eighteen patients died during follow-up (median time = 21 months). In multivariate analysis, only the searching for God factor [hazard ratio (HR) = 2.95, 95% confidence interval (CI) = 1.05-8.32, χ(2) = 4.205, P = 0.040] and the posttransplant length of stay in the intensive care unit (HR = 1.05, 95% CI = 1.01-1.08, χ(2) = 8.506, P = 0.035) were independently associated with survival, even after adjustments for the waiting for God factor, fatalism, age, sex, marital status, employment, educational level, viral etiology, Child-Pugh score, serum creatinine level, time from the questionnaire to transplantation, donor age, and intraoperative bleeding. Patients who did not present the searching for God factor were younger than those who did, but they had shorter survival times (P = 0.037) and a 3-fold increased relative risk of dying (HR = 3.01, 95% CI = 1.07-8.45). In conclusion, religiosity is associated with prolonged survival in patients undergoing liver transplantation.

Health, religion, and meaning: a culture-centered study of Druze women

Against the backdrop of contesting the mainstream biomedical models of health communication, the culture-centered approach suggests dialogic research methodologies to coconstruct meanings of health through direct engagement with cultural communities. In this project, we engaged in in-depth interviews and informal conversations with elderly Druze women and their caregiver daughters to develop an understanding of the intersections of religion and health meanings in the context of aging women in this Lebanese community. Attending to the cultural constructions of health, particularly in religious contexts, opens up the discursive spaces of health communication to alternative cosmologies of health, illness, healing, and curing. Four themes emerged as a result of our grounded theory analysis: health as faith; mistrust, privacy, and modern medicine; polymorphic health experiences; and health as structure. These themes serve as the backdrop for playing out the competing tensions between the local and the global in the realm of interpretations of health meanings.

Great expectations: views of genetic research participants regarding current and future genetic studies

PURPOSE

Recruitment of prior participants in genetic research is one strategy suggested to maximize efficient use of research dollars in gene-environment studies. We explored attitudes toward genetic research participation among people in a case-control genetic epidemiology study of colon cancer, the North Carolina Colorectal Cancer Study (NCCCS).

METHODS

Quantitative and qualitative cross-sectional analysis of 801 NCCCS participants.

RESULTS

Participants were "very positive" (63%) or "positive" (32%) about genetic research, and "very likely" (49%) or "somewhat likely" (40%) to participate in future genetic research. Variables significantly associated with feeling "very positive" were white race, more education, nonreligious, hearing "a lot" about genetic research, and two measures of trust in medical research. Except for race and education, the same variables were significantly associated with being "very likely" to participate in future studies. Qualitatively, "good things" for self and family included discovering causes and cures for cancer, and the value of genetic information. Many could not list "bad things"; those who did mentioned anxiety, "knowing too much," losing confidentiality, or abuse of information.

CONCLUSIONS

Despite very positive attitudes of these participants toward genetic research, there is significant variation based on participant characteristics. These findings should encourage and caution researchers attempting to recruit prior participants into genetic studies.

From private to public: negotiating professional and personal identities in spiritual care

AIM

This paper is an exploration of the challenge of negotiating the highly personalized concept of spirituality within the public sphere of professional-patient interactions.

BACKGROUND

Spirituality has become increasingly prominent within the nursing discourse, and providing spiritual care is often positioned as an ethical obligation of care. However, bringing such a personal concept into the public domain of care creates some unique tensions and ethical risks.

DISCUSSION

Nurses bring three potentially competing identities to spiritual care encounters with patients. Firstly, they are professionals with a public trust in health promotion and restoration, including those areas that intersect with spiritual health. Secondly, they are citizens of a liberal society where non-judgmental pluralism as it relates to spirituality is enshrined. Thirdly, they are individuals who hold particular beliefs and values about spirituality. Each of these identities may result in particular, and potentially conflicting, approaches to spiritual care. Ultimately, the identity which nurses choose to adopt is often determined by how they view themselves in the spiritual care encounter, either as experts with legitimate authority to intervene in the spiritual lives of patients or as people in a shared relational encounter. Each of these approaches carries ethical risks, although the nature of these risks is different.

CONCLUSION

The identities which nurses bring to spiritual care encounters have far-reaching implications for patient experiences in those encounters. Nurses who position themselves as experts run the risk of objectifying the spiritual, being experienced as coercive and transcending nursings' competence. The work of Martin Buber is presented as a model that, while acknowledging competing identities, sets forth a vision of spirituality and spiritual care based upon relational reciprocity.

A theory of planned behavior study of college students' intention to register as organ donors in Japan, Korea, and the United States

This study investigated willingness of Americans, Koreans, and Japanese to register as organ donors using the theory of planned behavior. Although previous research showed that attitude toward donation and communication with family predicted organ donation behaviors for respondents in the United States, these variables were also significant for respondents in Japan and Korea. Perceived behavioral control predicted intention to register for Japanese participants whereas knowledge about organ donation was associated with reluctance to register for Koreans. Spiritual connection and concern were shown to be causal factors underlying attitude in all 3 countries. In spite of positive attitudes toward organ donation and comparable knowledge with Americans and Japanese, most Korean participants declined to take an application to register as a donor. Implications of these findings for future research are discussed.

Reservations of the spirit: the development of a culturally sensitive spiritual beliefs scale about organ donation

This study investigated whether spiritual beliefs offered any explanation for why participants from Korea (N = 146), Japan (N = 134), and the United States (N = 146) were willing or reluctant to register as organ donors. A culturally appropriate measure of spiritual beliefs about organ donation, the Spiritual Beliefs Scale, was developed consisting of 2 factors: (a) Spiritual Connection and (b) Spiritual Concern. Spiritual Connection was a significant predictor of behavioral intention to become an organ donor for Korean respondents, whereas Spiritual Concern was a significant predictor of reluctance to become an organ donor for American respondents. Spiritual beliefs correlated as predicted with attitude toward organ donation and fear of bodily mutilation, showing that the Spiritual Beliefs Scale exhibited internal, external, and predictive validity. Across the 3-country sample, Spiritual Connection was associated with greater willingness to become an organ donor for women, whereas Spiritual Concern inhibited participation for men. Implications of these findings are discussed for developing culturally effective education and procurement campaigns.

Social and Emotional Impacts of Farmwork Injuries: An Exploratory Study

CONTEXT

The physical hazards of farming have been extensively studied and reported upon. Far less studied are the social and emotional impacts of farmwork injuries and deaths.

PURPOSE

To investigate and document broad but targeted issues regarding the impact on individuals, families, and communities of farmwork injuries and fatalities of farmer leaders.

METHODS

Ten incidents of farmwork injuries with disabilities or fatalities in Pennsylvania were used for a collective case study. Data were collected through a total of 47 interview sessions with 66 individuals including next of kin, other family members, injured persons, and community members. Thematic analysis was used to identify themes and issues in this descriptive study.

FINDINGS

Community members missed the rich, broad, and comprehensive skills, abilities, and perspectives that farmers brought to community service. Participants expressed that the community assistance and support provided to injured persons and families benefited not only the injured persons and their families and farms but also the community members. Participants reported emotional anguish and loss as well as positive transformations and consequences. As expressed by participants, God and religion play an important role in their beliefs regarding the occurrence and outcome of farmwork injury incidents.

CONCLUSIONS

Social and emotional impacts on individuals, families, and communities are varied and multileveled. The role that religion and storytelling play in the process of dealing with serious injury incidents raises questions regarding agricultural injury prevention.