Spirituality and religion in modern medicine

Medicinal plants and foods with metaphorical concepts in Rumi's "Masnavi Manavi": The psychosomatic approach to human health

Objective

"Masnavi Manavi" is one of the most valuable texts of Persian literature. In this book, Rumi (Mevlana) with a unique method and in the form of moral stories teaches life lessons, mystical truths and even therapeutic advices to people. The aim of this study is to highlight the medicinal plants and foods that had been applied both in somatic and spiritual concept in "Masnavi Manavi' poems.

Materials and Methods

For this purpose, a library-based, descriptive and analytical method was used.

Results

Some medicinal plants and food terms such as rose-water, vinegar, honey, oxymel, common reed, grape, onion, garlic and wheat are mentioned in this study to show Rumi's metaphorical and therapeutic approach as a doctor who treats both soul and body. In fact, Rumi's intention to apply these terms was to express his ideas and views about the inseparability of physical and spiritual aspects in human health and well-being.

Conclusion

Rumi focus in "Masnavi Manavi" moral stories is the soul health and consider body as carrier of the soul. Therefore, because of this psychosomatic approach to human disease, he selects the most suitable herbs and foods for explaining spiritual and somatic medicine.

Spirituality and Suicidality Among Patients with Schizophrenia: A Cross-sectional Study from Nigeria

Studies which have explored the effect of spirituality on suicidality among patients with schizophrenia have been characterized by inconsistent results. The aim of this study was to examine the relationship between spirituality and suicidality among stable patients with schizophrenia in Nigeria. The Daily Spiritual Experience Scale was applied to measure spirituality. There was found a significant relationship between spirituality and having had suicidal thoughts in a lifetime. Spirituality was negatively correlated with the severity of negative symptoms, total positive and negative syndrome scale score (PANSS), the severity of depression, and positively correlated with functioning.

Implementation of spiritual care in patients with diabetic foot ulcers: a literature review

Lower extremity amputation is a complication of diabetic foot ulcers that can cause spiritual crisis. Integrating spiritual care into nursing practice is important to overcome this. However, studies articulating the role of nurses in spiritual care when caring for patients with diabetic foot ulcers is limited. This article aims to describe the importance of providing spiritual care for this group of patients. The interpretation of spiritual care with respect to the relationship between the patient and the family, and the role of the nurse are discussed. The findings offer a theoretical perspective on spiritual care that can be used to develop spiritual interventions, as well as prevent spiritual crises in patients with diabetic foot ulcers.

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.

The role of religion and spirituality in cancer care: An umbrella review of the literature

Although some studies have suggested a strong relationship between religion and spirituality (R&S) and patient outcomes in cancer care, other data have been mixed or even noted adverse effects associated with R&S in the healthcare setting. We sought to perform an umbrella review to systematically appraise and synthesize the current body of literature on the role of patient R&S in cancer care. A systematic search of the literature was conducted that focused on "cancer" (neoplasm, malignant neoplasm, malignancy), "spirituality" (beliefs, divine), and "religion" (specific practices like Christianity, faith, faith healing, prayer, Theology). A total of 41 review articles published from 1995 to 2019 were included: 8 systematic reviews, 6 meta-analyses, 4 systematic reviews and meta-analysis, and 23 other general reviews. The number of studies included in each review ranged from 7 to 148, while 10 studies did not indicate sample size. Most articles did not focus on a specific cancer diagnosis (n = 36), stage of cancer (n = 32), or patient population (n = 34). Many articles noted that R&S had a positive impact on cancer care, yet some reviews reported inconclusive or negative results. Marked variation in methodological approaches to studying R&S among cancer patients, including operational definitions and measurement, were identified. Resolving these issues will be an important step to understanding how patients seek to have R&S integrated into their patient-centered cancer care experience.

The attainment of physician's professional identity through meaningful practice: A qualitative study

Background: Medical professional identity is how an individual perceives him/herself as a doctor. Formation of professional identity includes development, advancement, and socialization through social learning of specific knowledge, skills obtained while performing professional roles, practicing, and new attitudes and values. A qualitative study was performed to examine live experience of undergraduate medical science students with regards to obtaining professional identity. Methods: This qualitative study was performed using a conventional content analysis method. Participants were students who were studying medicine at Iran University of Medical Sciences. Sampling was done based on a purposeful sampling method. A total of 23 students took part in semi-structured interviews until data saturation was reached. The interviews were transcribed verbatim. Also, to develop themes, data were analyzed using conventional content analysis. Moreover, data management was done using MAXQDA software. Results: Based on data analysis, 2 main themes were as follow: meaningful medical practice" and "professional medical practice". The first theme had 3 categories: (i) self-insight; (ii) manner; and (iii) values and beliefs. The second theme had 2 categories: (i) professionalism; and (ii) holistic view of medicine. Conclusion: Certain individual characteristics and personality type were factors that affected participants' choice of their field of study. The participants' understanding of their profession was formed, not only by studying in the university through learning relevant knowledge, skills, and practice, but also by perceived attitude, views, and values in their profession.

Whither Neurotheology?

Human culture has modernized at a much faster pace than has theology and religion. We are at the point where many moderns apparently think that religion is losing relevance. Satisfying the need for relevance and ecumenical harmony requires more reasoned and mature approaches to religion. Science is one of those secular activities that seems to undermine religious faith for many people. Unlike the sciences that give us the Big Bang, relativity, quantum mechanics, and theories of evolution, neuroscience is the one science that applies in everyday life toward developing a faith that promotes nurturing of self and others. Modern neuroscience and the mental health understanding that it creates can contribute to satisfying this need. Neuroscience and religion have numerous shared areas of concern, and each worldview can and should inform and enrich the other. Neuroscience may help us understand why we believe certain religious ideas and not others. It helps to explain our behavior and might even help us live more righteous and fulfilled lives. Religion can show neuroscientists areas of religious debate that scientific research might help resolve. New educational initiatives at all levels (secondary, seminary, and secular college) can provide a way to integrate neuroscience and religion and lead to religious perspectives that are more reasoned, mature, satisfying, and beneficial at both individual and social levels. Neurotheology is an emerging academic discipline that seems to focus on integrating neuroscience and theology. About only 10 years old, neurotheology has not yet consolidated its definition, ideology, purpose, or scholarly or applied strategies. Acceptance by the scholarly community is problematic. This manuscript raises the question of whether neurotheology will survive as a viable discipline and, if so, what form that could take.

Spirituality in medical education: a concept analysis

Spirituality in medical education is an abstract multifaceted concept, related to the healthcare system. As a significant dimension of health, the importance and promotion of this concept has received considerable attention all over the world. However, it is still an abstract concept and its use in different contexts leads to different perceptions, thereby causing challenges. In this regard, the study aimed to clarify the existing ambiguities of the concept of spirituality in medical education. Walker and Avant (Strategies for theory construction in nursing, Prentice Hall, Boston, 2011) concept analysis eight-step approach was used. After an extensive review of online national and international databases from 2000 to 2015, 180 articles and 3 books in English and Persian were retrieved for the purposes of the study. Analysis revealed that the defining attributes of spirituality in medical education are: teaching with all heart and soul, Life inspiring, ontological multidimensional connectedness, religious-secular spectrum, and socio-cultural intricacies. Moreover, innate wisdom, skillful treatment, transcendent education, and environmental requirements were antecedents to this concept, with the health of body and soul, intrapersonal development and elevation, and responsive treatment and education being its consequences. The defining attributes provided in this study can assist physicians, instructors, and professors to develop and implement evidence-based, health based and comprehensive education plans according to the guidelines of professional ethics and qualification of using spirituality in practice. The clarification of the noted concept facilitates further development of medical knowledge, research, and research instruments.

Toward Comprehensive Medicine: Listening to Spiritual and Religious Needs of Patients

Although great progress has been made in medicine, the spiritual and religious needs of patients have been slow to be acknowledged as a core principle of professional practice and care at end of life. Spiritual care, once regarded as the sole province of chaplains, has recently become increasingly recognized as part of a holistic management approach and the responsibility of all health care professionals. Almost two decades after the appearance of first recommendations, doctors still find it difficult to initiate discussions on religion and spirituality with their patients. In a local survey we conducted among junior doctors and nursing staff, only 2% of doctors would regularly enquire, whereas more than 50% never asked about religion. It appears that doctors are generally poorly prepared to tackle this issue, both during their medical student years and later as trainees. We present a case study that illustrates the intricacies of trying to deliver comprehensive care to an elderly patient with a potentially life-ending condition where the cultural, personal, and religious opinion of the relatives have played an important role in the patient's management. We then discuss the results of our survey and explore the literature as to why doctors, in particular, tend not to enquire about the religion and spirituality of their patients.

On the Inner Life of Physicians: Analysis of Family Medicine Residents' Written Reflections

This qualitative study introduces the broad and inclusive concept of the "inner life of physicians" and analyzes the written reflections (N = 756) of family medicine residents (N = 33) during their residency as indicative of the physicians' inner lives. Residents completed reflective entries without specific prompts. Researchers describe unsolicited emergent categorical themes indicative of a robust inner life of the physician. Nurturing physicians' inner life through reflection allows physicians to recognize, identify, and respond to daily emotional events. Reflections about the state of physicians' inner lives can formulate and express fundamental human questions that concern: (a) troubling human experiences (e.g., suffering, death, luck, destiny, and death); (b) questions that surface in practicing their profession; (c) spiritually explicit questions on their beliefs and practices. Physicians' inner lives can become a "place" where physicians look for answers and explore options for dealing with their human and professional challenges, thus enhancing the humanistic aspects of medical practice.

Cultivating the Inner Life of a Physician Through Written Reflection

All of us have an "inner life" that forms the core of who we are. It shapes and is shaped by our actions and experiences. During physician training, attention to residents' inner life requires a focus on their beliefs and emotions as well as their ethical and spiritual development, topics often considered to be outside the realm of clinical training and practice. We suggest that written reflections, as part of medical residency curriculum, can allow residents to explore their inner lives. The depth and range of residents' explorations show the value of adding brief, protected time for residents to explore their hopes, joys, struggles, and feelings, and to develop meaning from their experiences with patients.

Church attendance, allostatic load and mortality in middle aged adults

IMPORTANCE

Religiosity has been associated with positive health outcomes. Hypothesized pathways for this association include religious practices, such as church attendance, that result in reduced stress.

OBJECTIVE

The objective of this study was to examine the relationship between religiosity (church attendance), allostatic load (AL) (a physiologic measure of stress) and all-cause mortality in middle-aged adults.

DESIGN, SETTING AND PARTICIPANTS

Data for this study are from NHANES III (1988-1994). The analytic sample (n = 5449) was restricted to adult participants, who were between 40-65 years of age at the time of interview, had values for at least 9 out of 10 clinical/biologic markers used to derive AL, and had complete information on church attendance.

MAIN OUTCOMES AND MEASURES

The primary outcomes were AL and mortality. AL was derived from values for metabolic, cardiovascular, and nutritional/inflammatory clinical/biologic markers. Mortality was derived from a probabilistic algorithm matching the NHANES III Linked Mortality File to the National Death Index through December 31, 2006, providing up to 18 years follow-up. The primary predictor variable was baseline report of church attendance over the past 12 months. Cox proportional hazard logistic regression models contained key covariates including socioeconomic status, self-rated health, co-morbid medical conditions, social support, healthy eating, physical activity, and alcohol intake.

RESULTS

Churchgoers (at least once a year) comprised 64.0% of the study cohort (n = 3782). Non-churchgoers had significantly higher overall mean AL scores and higher prevalence of high-risk values for 3 of the 10 markers of AL than did churchgoers. In bivariate analyses non-churchgoers, compared to churchgoers, had higher odds of an AL score 2-3 (OR 1.24; 95% CI 1.01, 1.50) or ≥4 (OR 1.38; 95% CI 1.11, 1.71) compared to AL score of 0-1. More frequent churchgoers (more than once a week) had a 55% reduction of all-cause mortality risk compared with non-churchgoers. (HR 0.45, CI 0.24-0.85) in the fully adjusted model that included AL.

CONCLUSIONS AND RELEVANCE

We found a significant association between church attendance and mortality among middle-aged adults after full adjustments. AL, a measure of stress, only partially explained differences in mortality between church and non-church attendees. These findings suggest a potential independent effect of church attendance on mortality.

Incorporating Spirituality in Primary Care

Addressing cultural competency in health care involves recognizing the diverse characteristics of the patient population and understanding how they impact patient care. Spirituality is an aspect of cultural identity that has become increasingly recognized for its potential to impact health behaviors and healthcare decision-making. We consider the complex relationship between spirituality and health, exploring the role of spirituality in primary care, and consider the inclusion of spirituality in existing models of health promotion. We discuss the feasibility of incorporating spirituality into clinical practice, offering suggestions for physicians.

Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study

Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.