A mixed-method evaluation of implementation determinants for chaplain intervention in a hospital setting

Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). Most residents reported favorable attitudes toward manualized approaches prior to training. Interviews revealed complex decision-making processes and highlighted personal motivations and challenges to learning and implementing CCSH. Implementation science can reveal factors related to motivation, intention, and training that may be optimized to improve the implementation of healthcare chaplaincy interventions.

Spiritual Health and Its Determinants Among Urban Adolescents in Northern India: A Cross-Sectional Survey

INTRODUCTION

Spiritual health is an important dimension of positive health and is often ignored as it is not amenable to measurement. The present study was conducted to generate relevant evidence on spiritual health among adolescents living in urban areas of Northern India.

METHODS

A cross-sectional study was done from June 2019 - May 2020 in an urban area of Northern India on a sample of 300 adolescents selected purposively. After collection of demographic details of the participants, the Index of Core Spiritual Experiences (INSPIRIT) tool was used to capture their spiritual health.

RESULTS

The Cronbach's alpha for the scale was 0.832 (0.797-0.863) indicating good internal consistency of the measure. As far as spiritual health is concerned, 217 (72.3%) of the study participants scored medium-high to high, followed by 83 (27.7%) who scored medium-low to low on the spiritual health scale. Adjusted multivariate analysis using binary logistic regression showed that positive traits like caring (odds ratio (OR) 1.19, 95% CI: 1.08-1.33), connection to school (OR 1.16, 95% CI: 1.04-1.29), having positive identity (OR 1.19, 95% CI: 1.04-1.36) and having highly educated (post-graduate) parents (OR 2.18, 95% CI: 1.13-4.21) lead to significantly higher spiritual health scores.  Discussion: Although spiritual health is not routinely measured among adolescents, the current study demonstrated high levels of spiritual health among half of the urban adolescents. Parental education was found to have a positive association with spiritual health scores, indicating the indirect effect of parental spiritual inclination. The study has important implications for policy, as it demonstrates the feasibility of measuring a covert dimension of health which tends to have an indirect effect on holistic youth development.

Digital Methods for the Spiritual and Mental Health of Generation Z: Scoping Review

BACKGROUND

Generation Z (Gen Z) includes individuals born between 1995 and 2012. These individuals experience high rates of anxiety and depression. Most Gen Z individuals identify with being spiritual, and aspects from religion and spirituality can be integrated into mental health treatment and care as both are related to lower levels of depression. However, research on the spiritual and mental health of Gen Z is sparse. To date, there are no systematic or scoping reviews on digital methods to address the spiritual and mental health of Gen Z.

OBJECTIVE

This scoping review aimed to describe the current state of digital methods to address spiritual and mental health among Gen Z, identify the knowledge gaps, and make suggestions for how to leverage digital spiritual and mental health interventions for Gen Z.

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, PsycInfo, CINAHL, Education Full Text, Google Scholar, SocIndex, and Sociological Abstracts. The inclusion criteria were as follows: (1) study population born between 1995 and 2012 (ie, Gen Z); (2) reporting on spiritual health or well-being, spirituality or religion, and mental health or well-being; (3) reporting on using digital methods; (4) publication in 1996 or beyond; (5) human subject research; (6) full text availability in English; (7) primary research study design; and (8) peer-reviewed article. Two authors screened articles and subsequently extracted data from the included articles to describe the available evidence.

RESULTS

A total of 413 articles were screened at the title and abstract levels, of which 27 were further assessed with full text for eligibility. Five studies met the inclusion criteria, and data were extracted to summarize study characteristics and findings. The studies were performed across 4 different countries. There were 2 mixed-methods studies (South Africa and Canada), 2 cross-sectional studies (China and United States), and 1 randomized controlled trial (United States). Of these studies, only 2 discussed digital interventions (a text messaging-based intervention to improve spiritual and mental health, and a feasibility study for a mental health app). Other studies had a digital component with minor or unclear spiritual and mental health measures. Overall, there was a lack of consistency in how spiritual and mental health were measured.

CONCLUSIONS

Few studies have focused on assessing the spiritual and mental health of Gen Z in the digital context, and no research to date has examined a digital spiritual and mental health application among Gen Z. Research is needed to inform the development and evaluation of approaches to address the spiritual and mental health of Gen Z via digital means (eg, mobile apps).

Perceived Benefits of Magdalena Energy Healing Sessions: An Exploratory Study of Clients' Perspectives

BACKGROUND

Energy healing techniques are associated with many physical and mental benefits. A qualitative study was conducted to understand clients' experiences of a new energy healing modality called Magdalena Energy Healing.

METHODS

Semi-structured qualitative interviews were conducted after clients experienced 60 min Magdalena energy healing session(s). Twenty-five adults participated in the study. All participants received Magdalena energy healing from a certified, trained practitioner. Thematic analysis was conducted to determine clients' perceived benefits of the Magdalena energy healing session(s).

RESULTS

Four themes emerged from the data: Physical, Mental, Social, and Spiritual Benefits. Physical health benefits included relief from a variety of medical symptoms, improved sleep quality, and physical body awareness. Mental Health benefits included relaxation and peace, decision-making clarity, relief of mental health symptoms, and an increased ability to cope with life. Social Benefits included improved attitudes in relationships. Spiritual Benefits included optimism, gratitude, self-acceptance, and increased spiritual connection.

CONCLUSIONS

Participants' perceptions are that Magdalena energy healing sessions offer peace, symptom relief, and gratitude. Magdalena energy healing can address priorities of The National Center for Complementary and Integrative Health (NCCIH). Sessions can be seamlessly integrated into traditional medical care as a useful complementary/integrative healing option to improve physical, mental, and/or spiritual wellbeing across a variety of diseases.

Relationships between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1-6 months

BACKGROUND

Previous studies have shown that psycho-spiritual state of mothers may have significant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding is inadequate breastfeeding; therefore, this study examined the relationship between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1-6 months.

MATERIALS AND METHODS

This cross-sectional, descriptive, correlational study was performed on 186 mothers with infants aged 1-6 months, who referred to the health centers in Dorud city of Lorestan province, Iran, in 2021, which were selected based on cluster sampling. Data were collected through four questionnaires including demographic-fertility, spiritual health, perceived stress, and breastfeeding adequacy. Data was analyzed by Statistical Package for the Social Sciences (SPSS) software version 22 using descriptive and analytical statistics.

RESULTS

The mean ± standard deviation (SD) values of spiritual health, perceived stress, and breastfeeding adequacy were 99.59 ± 12.96, 23.8 ± 72.19, and 55.67 ± 7.67, respectively. There was a significant positive relationship between spiritual health and breastfeeding adequacy (P < 0.001, r = 0.268). In addition, there was a significant negative relationship between perceived stress and breastfeeding adequacy (P = 0.002, r = -0.231).

CONCLUSION

Breastfeeding adequacy has a significant positive relationship with spiritual health and a significant negative relationship with perceived stress. Since infants are one of the most vulnerable groups and breastfeeding is the best way to support their health and reduce infant mortality rates, breastfeeding adequacy can be improved by reducing stress and promoting spiritual health.

Factors Influencing Spiritual Health among Nursing Students in the Prolonged COVID-19 Situation

The COVID-19 pandemic is not only an epidemiological crisis but also a spiritual health crisis that affects nursing students. Spiritual health is essential in maintaining and promoting physical and mental health to achieve happiness, potential, meaning, and purpose of life even during a pandemic. This descriptive cross-sectional study aimed to examine factors affecting spiritual health of nursing college students. The study adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A total of 219 nursing students from three nursing colleges in Metropolitan D city participated in the study through an online Google Form questionnaire from 2-18 September 2021. The mean score of spiritual health was 96.98 ± 11.54 (out of 120 points); spiritual health was significantly positively correlated with life satisfaction and academic performance (p < 0.001) and negatively correlated with academic stress (p < 0.001). Factors significantly affecting spiritual health were academic stress (ß = -2.21, p = 0.045), life satisfaction (ß = 3.85, p < 0.001), and academic performance; below score of 3.0 (ß = -2.08, p = 0.039). The explanatory power of these effects was 30.7%. As a future professional nurse who will work in the clinical field where the demand for the spiritual care of patients is increasing, it is necessary to develop and apply a curriculum that can improve the spiritual health of nursing students.

Prevalence of elective cosmetic surgery and its relationship with socioeconomic and mental health: A cross-sectional study in west of Iran

Background and Aims

The aim of this study was to investigate the prevalence and desire towards performing elective cosmetic surgery and its relationship with socioeconomic, mental, and spiritual health in Sanandaj, the capital of Kurdistan province in the west of Iran.

Methods

This cross‐sectional descriptive‐analytical study was performed on 492 subjects in Sanandaj using multistage sampling method. Data collection tools included two checklists and two questionnaires. Data analysis was performed using the Chi‐square test and multiple logistics regression model by the help of SPSS software version 20.

Results

The mean (standard deviation) age of participants was 32.58 (9.67) years. The prevalence of cosmetic surgery and the desire to perform it were 12.8% (n = 63) and 19.1% (n = 94), respectively. The most common type of cosmetic surgery was rhinoplasty with 5.5% (n = 27). The prevalence of symptoms of mental disorders among people with cosmetic surgery and people willing to perform cosmetic surgery was significantly higher than all subjects (p < 0.001). Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]: 1.06–3.68) and having mild (OR = 3.01 95% CI: 1.06–3.68) and moderate to severe symptoms of mental disorder (OR = 7.59; 95% CI: 3.90–14.75) were among the influential variables on performing cosmetic surgery.

Conclusion

Both the prevalence and desire towards performing cosmetic surgery are high in Sanandaj and this needs the attention of health policy makers. Designing targeted interventions with an emphasis on the findings of this study is proposed to reduce these practices.

The relationship between personality dimensions with resiliency and sense of coherence with respect to the role of spiritual health in the patients' candidate for eye surgery

Introduction

This research aimed to determine the relationship between personality dimensions with the rate of resiliency and internal cohesion regarding the intermediary role of spiritual health in candidate patients for eye surgery.

Methods

The method used in this is of correlation type, and statistical population in this project included all eye patients chosen for eye surgery who were examined at technical eye clinics in Tehran. The statistical sample included 200 patients from the statistical population who were chosen through a targeted sampling method. The data collection tools were Conner and Davidson's tolerance questionnaire (2003), Maccary and Costa's personality questionnaire (1985), Antonowski's internal cohesion scale (1970), and Politzin and Elison's spiritual health questionnaire (1982). The research hypotheses were examined through regression analysis, Pearson's correlation, and path analysis.

Results

The results showed that the calculated fit indices of the structural model of the research were correlated with the five dimensions of personality and internal cohesion of patients undergoing eye surgery with respect to the mediator role of spiritual health with 88% confidence. Investigation of path analysis coefficients showed a significant relationship between exogenous and intermediary variables on resiliency and internal cohesion (P value = 0.00).

Conclusion

According to the results of the research, the spiritual health variable plays a significant mediating role for exogenous and endogenous variables in this model. Therefore, personality traits not only directly influence resilience and internal cohesion but also indirectly influence spiritual well-being.

Spiritual Health in Iranian Patients With Cardiovascular Diseases: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aimed to evaluate the spiritual health status of Iranian patients with cardiovascular diseases. A literature search was conducted in national (MagIran and Scientific Information Database) and international (Scopus, PubMed, and Web of Science/ISI) databases from inception to December 2021. A random-effects model was used to estimate the pooled score of spiritual health. Based on the eligibility criteria, 22 articles were selected for the final analysis. The pooled score of spiritual health in Iranian patients with cardiovascular diseases was 61% (95% confidence interval: 54%-68%). In subgroup analysis, the pooled score in patients with heart failure was higher than other patients (67% vs. 58%). Publication bias was not significant (p = 0.554). Results indicated that the spiritual health of Iranian patients with cardiovascular diseases was moderate. Therefore, it is recommended that proper training be provided to these patients to enhance their adaptation to the complications of cardiovascular diseases.

Conceptualizing Indigenous Human-Animal Relationships in Aotearoa New Zealand: An Ethical Perspective

This article considers the complexity and diversity of ethical concepts and beliefs held by Māori, the indigenous people of Aotearoa New Zealand (hereafter New Zealand), relating to animals. A combination of interviews and focus group discussions were conducted with individuals who identify as Māori and were working with wildlife, primarily in an eco-tourism and conservation context. Two main themes emerged from the data: ethical concepts relating to the environment, and concepts relating to the spiritual relationships between people, animals and the environment. These findings highlight that the connections between humans and animals through a Māori lens are nuanced in ways not typically accounted for in Western philosophy. This is of particular importance because of the extent to which standard Western thought is embodied in law and policy related to human treatment of animals and the environment. In New Zealand, relationships and partnerships are informed by Te Tiriti ō Waitangi, one of New Zealand's founding documents. Where these partnerships include activities and environments involving human-animal interaction, policy and legislation should account for Māori knowledge, and diverse of thought among different hapū (tribal groups). We conclude by exploring ways of including Māori ethical concepts around animals in general, and wild animals in particular, in law and policy, providing a case study relevant to other bicultural or multicultural societies.

Spiritual connectedness through prayer as a mediator of the relationship between Indigenous language use and positive mental health

OBJECTIVE

The objective of this study is to understand how Indigenous language and spirituality revitalization efforts may affect mental health within Indigenous communities. Although Indigenous communities experience disproportionate rates of mental health problems, research supporting language and spirituality's role in improving mental health is under-researched and poorly understood.

METHOD

Data for this study are from a Community-based Participatory Research Project involving five Anishinaabe tribes in Minnesota and Wisconsin. Participants were sampled from clinic records of adults with a diagnosis of type 2 diabetes, living on or near the reservation, and self-identifying as American Indian (mean age = 46.3; n = 191).

RESULT

Structural equation modeling illustrates that language use in the home is associated with positive mental health through spiritual connectedness.

CONCLUSION

Results support tribal community expressions of the positive effects of cultural involvement for Indigenous wellbeing, and improve what is known about the interconnectedness of language and spirituality. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Developing a charter of spiritual care for patients

BACKGROUND

Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care.

METHODS

The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion.

RESULTS

The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients' opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements.

CONCLUSION

The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.

Elements of chaplaincy in Danish intensive care units: key-informant interviews with hospital chaplains

Critically ill patients often require spiritual counseling. In Denmark, most hospital chaplains are provided by the State Church. More knowledge is needed regarding health care chaplaincy in this semi-agnostic non-secular welfare society. Our study aimed to explore how hospital chaplains describe their role and elements of chaplaincy in relation to patient, family and healthcare professionals in Danish intensive care units. Using a multicenter qualitative design, we performed semi-structured key-informant interviews with ten hospital chaplains. Content analysis exposed elements of chaplaincy based on spirituality, rituality, neutrality, confidentiality, advocacy, and equality. Most elements are similar in other countries; the main differences are related to educational requirements, institutional integration, research activity, and documentation practice. Chaplains fill an ambiguous role, negotiating values of church and hospital. Modern chaplaincy is propelled toward professionalism, quantification, certification and evaluation. We discuss the contemporary role of hospital chaplains and the consequences of categorizing them as part of the ICU team.

Culturally based coping with COVID-19 pandemic: using constructive roles of the spiritual systems with appropriate function

Considering the global number of confirmed COVID-19 cases and deaths, it is not strange that COVID-19 disease is a reminiscent of concepts such as death and affliction with a serious disease. Furthermore, it might remind people of issues such as the reason(s) for occurrence of deplorable events in the universe, the meaning of life, individuals’ duties toward themselves and others, the relationship between the nature and human beings, and individuals’ relationship with a higher being (in case there is a belief in a higher being), i.e. the subjects spirituality deals with. The constructive or destructive role of each of religious and non-religious spiritual systems at the time of crises are observed more clearly than ever. The present paper addresses roles which spiritual systems might play in facing the COVID-19 disease crisis, considering different areas of spiritual well-being and the possibility that spiritual systems might be affected by perceived challenges during a pandemic. Because of the problems interfering with overcoming COVID-19 pandemic and the risk of next waves of its epidemics and pandemics, it is necessary for health policy-makers to use all available capacities and capabilities to counteract the disease, including using both internal motivations (such as spiritual beliefs which prohibit hurting oneself and others and which emphasize performing social responsibilities) and external ones (e.g. regulations) to cope with it. It makes sense for public health officials in different countries to use more actively the potential of those spiritual systems that support COVID-19 public health recommendations, as a culturally based intervention and policy.

Lay summary

COVID-19 disease might remind people of issues such as the reason(s) for occurrence of deplorable events in the universe, the meaning of life, individuals’ duties toward themselves and others, the relationship between the nature and human beings, and individuals’ relationship with a higher being as an omnipotent (in case there is a belief in a higher being). These are the subjects which spirituality deals with. Some spiritual packages (or say spiritual systems), religious or non-religious, might respond appropriately to our questions about the above topics and help us to get through the disasters such as COVID-19 disease with the least complications and some might not. Given what health officials and scientists have said regarding COVID-19 pandemic, it is important to adhere to those spiritual systems which could help us:

- Do our best in order to prevent endangerment of our life and that of other people.

- Lead, despite all the bitter facts, a meaningful life during the pandemic.

- When afflicted with the disease, cope with it well and also cope with the possibility of death.

- Learn the lesson ‘every good thing you wish for yourself, wish it for others too, and every evil thing you do not like for yourself, do not like it for others either’.

Impact of an artist-in-residence program in a complex continuing care hospital: a quality improvement investigation

Background: The objective was to assess the impact of an Artist-in-Residence (AiR) program on the quality of life of patients living at a complex continuing care hospital.Methods: In the AiR program, a professional Artist facilitated the creation of community art projects by patients in groups (before COVID-19) and individually (during COVID-19). Four patients, four staff and one family member involved with the program were interviewed to assess their experiences.Results: Themes identified included improvements in spiritual, mental and community health, creation of a sense of community, learning skills and knowledge surrounding art and culture, and the importance of the Artist's personal characteristics/personality. It was recommended to continue and expand the program.Conclusions: The patients deeply enjoyed the AiR program and working with the Artist. Non-patient participants also recognized benefits for the hospital community. Procurement of stable funding and expansion of the program are areas to focus on next.

Spiritual Health First Aid for Self-Care: Nursing During COVID-19

ABSTRACT

Nurses who provided care to patients with coronavirus (COVID-19) and supported patients in their transition from life to death in the absence of patients' families have been especially needful of spiritual self-care. A spiritual first aid kit can help nurses cope with these difficult times. Spiritual self-care is vital for all nurses to renew and preserve the psychological, spiritual, and physical self.

Distinguishing between spiritual health and religious involvement as determinants of adolescent health in Canada and the Czech Republic

Spiritual health is a topic of emergent interest; however, lack of a clear distinction between spiritual health and religious involvement makes it difficult to understand the potential role of spiritual health as a determinant of health. Analyses of such relationships that cross countries and cultures are rare. We therefore assessed whether differences exist between spiritual health and religious involvement and their respective associations with general indicators adolescent health. The study was based on the 2013/2014 Health Behaviour in School-aged Children study conducted in Canada (n = 10 761) and the Czech Republic (n = 4411). In both countries, we failed to identify strong or statistically significant associations between self-reported religiosity and adolescent health. In contrast, adolescents with higher spiritual health scores consistently reported enhanced levels of general health status. Study findings point to the importance of a strong sense of spiritual health as a protective determinant of adolescent health, and raise questions about religious involvement as protective to adolescent health outcomes.

Exploring the place of spirituality in Canadian health promotion

The field of health promotion advocates a socioecological approach to health that addresses a variety of physical, social, environmental, political and cultural factors. Encouraging a holistic approach, health promotion examines many aspects of health and wellbeing, including physical, mental, sexual, community, social and ecological health. Despite this holism, there is a noticeable absence of discussion surrounding spirituality and spiritual health. This research study explored how leading scholars in Canadian health promotion understand the place of spirituality in health promotion. Using the fourth edition of Health Promotion in Canada (Rootman et al., 2017) as the sampling frame of recognized leaders in the field, 13 semi-structured qualitative interviews were conducted with authors from the book. This study is situated within a critical health promotion approach that utilizes methodologies aiming for social justice, equity and ecological sustainability. I argue that by avoiding spirituality within health promotion frameworks and education, the secularism of health promotion and its underlying values of Eurocentric knowledge production and science remain invisible and rarely critiqued. This study intends to open up possibilities for centering spiritual and non-Western epistemologies and ways of knowing that have been marginalized, such as Indigenous understandings of health and wellbeing. Restoring right relations with Indigenous peoples in Canada has taken on new urgency with the calls to action of the Truth & Reconciliation Commission report (NCTR, 2015). This is one important way that health promotion can fulfill its promise of being inclusive, relevant and effective for human and planetary wellbeing.

Identification of dimensions and indicators of spiritual health: A qualitative study

INTRODUCTION

Spiritual health is considered one of the important dimensions of health and has been given serious attention by the scientific community, World Health Organization, health discourse, and medical education. However, despite these considerations, there is a controversy in defining the nature of this category and its dimensions and indicators. The purpose of this study is to identify the indicators and dimensions of spiritual health for medical students.

MATERIALS AND METHODS

This qualitative study with exploratory approach utilized conventional content analysis and individual in-depth interviews with experts in the area of spiritual health and spirituality in medical sciences selected through purposeful sampling. The study was conducted at Aja University of Medical Sciences in Tehran in 2018. The semi-structured interview was a tool used to achieve data saturation, that interviewed with 19 experts. Member check, credibility, and reliability were measured to increase the validity and reliability of the results. Inductive content analysis was used for the analysis of data in three main phases: preparation, organization, and categories and creating categories.

RESULTS

Based on the findings of the interviews, 52 indicators were identified.Then, the indicators of spiritual health were identified in the following four categories) relationship with God, relationship with himself, relationship with others, relation with the environment (and these categories were divided inthree dimentions (cognitive, attitudes and emotions, behavioral).

CONCLUSION

The findings of the present study showed that in order to have spiritual health, it is important to pay attention to one's relationship with God and one's relationship with oneself, one's relationship with others, and one's relationship with the environment, and it is necessary to pay attention to it in medical science curricula.

Abortion Helpline, This Is Lisa (2019)

A film review of "Abortion Helpline, This Is Lisa (2019)".

Factors related to spiritual health in Chinese haemodialysis patients: A multicentre cross-sectional study

Aim

This study aimed to investigate the current situation of the spiritual health of maintenance haemodialysis (MHD) patients in China and analyse the influencing factors.

Methods

A total of 418 patients who underwent maintenance haemodialysis in three grade A tertiary hospitals were selected. The influencing factors were evaluated with demographic questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12), Family APGAR Index, Herth Hope Index (HHI) and Acceptance of Illness Scale (AIS).

Results

Spiritual health was positively correlated with the HHI, Family APGAR and AIS scores. Nationality, HHI score, Family APGAR score and AIS score were independent influencing factors of spiritual health. MHD patients had a moderate level of spiritual health. Nationality, hope, family function and acceptance of illness were significant predictors of spiritual health. Patients who have higher hope levels, better family functioning and better illness acceptance may maintain better spiritual health.

What's the Point of Clinical Pastoral Education and Pastoral Counselling Education? Political, Developmental, and Professional Considerations

Further clarity is needed regarding the uniqueness of spiritual care and psycho-spiritual therapy. In this article, this uniqueness is described as the relative spiritual health of spiritual health professionals. Drawing upon political philosophy, spiritual development theories, and studies in spiritual health, three traits of spiritual health are revealed that spiritual health professionals need to function effectively in their work environments. The article ends with four recommendations for both clinical pastoral education and pastoral counselling education.

[Exploring Sleep Quality, Spiritual Health, and Related Factors in Nurses in the Intensive Care Unit]

BACKGROUND

Nurses in intensive care units (ICUs) care for critically ill and dying patients. The stressful nature of the work performed by these nurses may affect their spiritual health and sleep quality.

PURPOSE

The purpose of this correlational study was to explore the sleep quality, spiritual health, and related factors in a sample of ICU nurses.

METHODS

A cross-sectional correlational design with stratified random sampling was applied. A total of 170 clinical nurses were recruited from the ICUs of a medical center in northern Taiwan. A demographic characteristics questionnaire, the spiritual health scale-short form, and the Pittsburgh Sleep Quality Index (PSQI) were used for data collection.

RESULTS

The average PSQI score was 7.07, with 62.9% of the participants reporting poor sleep quality. A significantly negative correlation was identified between the spiritual-health-scale item "connections to others" and the PSQI. "Connections to others", "chronic diseases", and "menstrual cycle discomfort" were the important predictive factors of sleep quality in the ICU nurses in this study.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

The findings of this study support nurses engaging in regular exercise that is both low-intensity and not subject to time or space restrictions in order to help prevent chronic diseases and relieve dysmenorrhea. Furthermore, education and training related to spiritual health should be incorporated into the whole-person education curriculum in order to enhance spiritual status and improve sleep quality.

Associations between sex, age and spiritual well-being scores on the EORTC QLQ-SWB32 for patients receiving palliative care for cancer: A further analysis of data from an international validation study

OBJECTIVE

The EORTC QOL Group has recently completed the cross-cultural development and validation of a standalone measure of spiritual well-being (SWB) for cancer patients receiving palliative care: the EORTC QLQ-SWB32. The measure includes four scales: Relationships with Others, Relationship with Self, Relationship with Someone or Something Greater, and Existential, plus a Global-SWB item. This paper reports on further research investigating relationships between sex, age and SWB for patients receiving palliative care for cancer-adjusting for other socio-demographic, clinical and function variables, including WHO performance status and EORTC QLQ-C15-PAL emotional and physical function scores.

METHODS

Cross-sectional data from the validation study were used, and chi-square, independent t tests, Mann-Whitney U tests and multiple regression analyses applied.

RESULTS

The study included 451 participants with advanced and incurable cancer, from 14 countries. Adjusted analyses found better scores for female participants than males on three of the four EORTC QLQ-SWB32 subscales; Relationship with others, Relationship with Someone or Something Greater and Existential plus Global-SWB. Older age was positively associated with better Relationship with Self.

CONCLUSION

The findings from our participants suggest that it might be beneficial if healthcare providers seeking to address patients' spiritual needs pay particular attention to male patients, younger patients and those with poor emotional functioning.

Loneliness in the United States: A 2018 National Panel Survey of Demographic, Structural, Cognitive, and Behavioral Characteristics

Purpose:

To inform health behavior intervention design, we sought to quantify loneliness and its correlates, including social media use, among adults in the United States.

Design:

Cross-sectional research panel questionnaire.

Setting:

Responses were gathered from individuals in all 50 states surveyed via Internet from February 2018 to March 2018.

Participants:

A total of 20 096 US panel respondents aged 18+.

Measures:

The University of California at Los Angeles (UCLA) Loneliness Scale (theoretical score range = 20-80) was administered along with demographic, structural, cognitive, and behavioral items.

Analysis:

After calibrating the sample to population norms, we conducted multivariable linear regression analysis.

Results:

The overall mean survey-weighted loneliness score was 44.03 (standard error = 0.09). Social support (standardized β [sβ] = −0.19) and meaningful daily interactions (sβ = −0.14) had the strongest associations with lower loneliness, along with reporting good relationships, family life, physical and mental health, friendships, greater age, being in a couple, and balancing one’s daily time. Social anxiety was most strongly associated with greater loneliness (sβ = +0.20), followed by self-reported social media overuse (sβ = +0.05) and daily use of text-based social media (sβ = +0.03).

Conclusion:

Our findings confirm that loneliness decreases with age, and that being in a relationship as well as everyday behavioral factors in people’s control are most strongly related to loneliness. Population health promotion efforts to reduce loneliness should focus on improving social support, decreasing social anxiety, and promoting healthy daily behaviors.

Spiritual health: is it a determinant factor for preventing risky behaviors among university students?

BACKGROUND

The most common high-risk behaviors that have profound and adverse effects on the health of the community take place in the university environment. Nowadays, the necessity of exploring ways to correct and reduce the high-risk behaviors requires identification of its determinant factors. Therefore, the present study aimed to investigate the correlation between spiritual health and high-risk behaviors among university students in the southeast of Iran in 2017-2018.

METHOD

This survey was a cross-sectional study. The population was all students studying at three central Universities in Kerman. Eight hundred and four students participated in the survey using a quota sampling method. The research instrument was a demographic questionnaire and the 20-item spiritual well-being Palutzian and Ellison scale and the Iranian Adolescent Riskiness Scale (IARS), which includes 39 items for high-risk behaviors.

RESULTS

The mean total score of high-risk behaviors was 79.16 ± 24.6 which was lower than the median (117). The spiritual health of the majority of subjects (66.7%) was moderate with an average of 90.65 ± 16.64. There was a significant negative correlation between the students' spiritual health and their high-risk behaviors.

CONCLUSION

It is necessary and essential to plan and implement spiritual-based interventions to reduce the incidence of high-risk behaviors.

A correlational study of hope and its relationship with spiritual health on hemodialysis patients

BACKGROUND

One of the main psychological problems in hemodialysis patients is hopelessness. Spiritual health leads the patients toward hope and goal in life. Given the importance of the issue and the little research in this area, this study aimed to assess hope and its relationship with spiritual health on hemodialysis patients in Rasht Razi Hospital of Iran.

MATERIALS AND METHODS

This correlational study carried out on 103 patients who admitted in Rasht Razi Hospital Hemodialysis Center by simple random sampling. The data were collected through Snyder's Hope Scale and Spiritual Health. The psychomotricity of these questionnaires has been confirmed in domestic studies. The data were analyzed by using descriptive and inferential statistics (Pearson correlation coefficient).

RESULTS

The majority of the patients were male (59.2%), in the age group of above 60 (46.60%), married (83.5%), with low income (60.2%), and under diploma (53.4%). The mean of hope score was 36.36 (±9.10) that showed the high level of hope in the majority of the patients. The mean of the total spiritual health score was 227.93 (±19.01) that indicates the high level of spiritual health in hemodialysis patients. There was a positive and significant correlation between spiritual health and its dimensions and hope (P < 0.05).

CONCLUSIONS

The results of this study approve the importance of spiritual health as an effective variable on hope among hemodialysis patients. Hence, health-care providers and clinical experts are recommended to focus on spiritual health to increase hope among such patients.

[The Spiritual Health Status and Spiritual Care Behaviors of Nurses in Intensive Care Units and Related Factors]

BACKGROUND

Patients suffer sudden and life-threatening conditions in intensive care units (ICU), which frequently result in traumatic changes in physical, mental, and spiritual health. Little research has been conducted on the spiritual health and spiritual care behaviors of nurses in ICU.

PURPOSE

To explore the relationship among demographic characteristics, spiritual health, and spiritual care behaviors in ICU nurses.

METHODS

A descriptive correlational research was used and 219 nurses from three teaching hospitals were enrolled as study participants. A structured questionnaire consisting of a demographic datasheet, a spiritual health scale, and a spiritual care behavior scale was used for data collection. SPSS for Windows version 22.0 was used for statistical analysis.

RESULTS

The participants received few hours of spiritual-care education. The highest scored item for spiritual health was "connecting with people". The highest scored item for spiritual care behavior was "helping the patient out of adversity". Participants who were older in age and who had more years of clinical experience exhibited spiritual care behaviors such as "helping the patient out of adversity" and "retaining hope" more frequently with their ICU patients.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

The older and more clinically experienced nurses in this study performed spiritual care behaviors at a higher frequency than their younger, less experienced counterparts. Therefore, it is recommended that hospitals retain more-experienced nursing staff to elevate the level of holistic health care. Concurrently, training in spiritual care skills should be provided to younger and less experienced nurses in order to facilitate more spiritual care behaviors. The results of this study provide a reference for providing spiritual care behaviors to patients.

[Establishing a Nursing Informatics System to Improve the Completion Rate of Computed Tomography Simulation With Contrast Injection]

BACKGROUND & PROBLEMS

Problems that influence the safety and quality of the patient-positioning process during computed tomography (CT) simulation with contrast injection include: 1) inconsistent and incomplete procedures performed by medical staffs, 2) poor prevention of developer leakage and handling of side-effects, and 3) the lack of a standardized protocol. Desire to improve this situation encouraged us to do this project. Adverse events during CT simulation with contrast injection procedures are largely attributable to the lack of a standardized nursing informatics system, with other causes including nurses incorrectly performing allergy history assessments, incorrect communications with the doctor due to verbal orders given by phone, failure to perform proper patient identification and intravenous catheterization procedures, lack of assessment and knowledge about contrasts, lack of guidelines for warming contrast in the incubator, and lack of oxygen and sputum suction equipment.

PURPOSE

To improve the rate of completion of CT simulation with contrast injection procedures from 65% to 95%.

RESOLUTION

This project was conducted between April 2016 and December 2016. Our strategy included establishing a nursing informatics system for the CT simulation with contrast injection process. This system included a standard patient-identification procedure, protocol for the correct placement of intravenous needles, standard specifications for the using an incubator with contrast, installation of oxygen and sputum suction equipment, and implementation of a nursing education and training program.

RESULTS

This project with associated strategies improved CT simulation with contrast injection completion rates in all domains from the original 65% to 95% at the end of the project period.

CONCLUSIONS

This project improved significantly the completion rates of the CT simulation with contrast injection process. We want to share this experience to help other hospitals and to improve patient safety and quality of care.

Spiritual health mediates the relationship between ego-strength and adjustment to heart disease

This study aimed to investigate the mediating role of spiritual health in the relationship between ego-strength and adjustment to heart disease. In total, 327 patients with coronary artery disease (138 women, 189 men) completed the Ego-Strength Scale, Adjustment to Illness Scale, and Spiritual Well-Being Scale. Results showed that both ego-strength and spiritual health had a significantly positive correlation with adjustment to heart disease. Results also revealed that spiritual health mediated the relationship between ego-strength and adjustment to heart disease. More improvement in adjustment to heart disease requires more improvement in patients’ spiritual health as well as to ego-strength.

Developing a Training Course for Spiritual Counselors in Health Care: Evidence from Iran

Background:

Spiritual health can cause mental health promotion and well-being of the people's lives but it is still neglected in practice so that there is no trace of spiritual training in medical education in Iran. This study was conducted to develop a training course for spiritual counselors in the Iranian health-care system.

Methods:

In this qualitative study, senior managers of the Ministry of Health (MOH) and experts in the related fields were purposively selected as the participants. Semi-structured interviews and focused group discussions (FGDs) were conducted to collect the data. After transcription of the interviews and FGDs, the data were analyzed using content analysis.

Results:

In this package, community-based spiritual health services are offered in three forms of spiritual lifestyle education, introducing social facilities, and collaborating with the related organizations. Hospital services are offered in four forms of assessment of the spiritual status and referral, spiritual care, spiritual counseling, and providing a spiritual environment in the hospital.

Conclusion:

According to the results of the study, it is suggested that a strategic committee be established at the MOH level for establishment of these training courses as well as another strategic committee for evaluation, review, and service package promotion, and its training courses should be formed. In addition, a set of skills for spiritual assessment of patients and the related interventions should be designed for clinical skill centers of the country in the form of skill training packages.

Religiosity and Health Through the Decades: Is There a Gender Difference?

PURPOSE

An empirical examination of the long-term association, disaggregated by gender, between religiosity and self-rated health with reference to demographic shifts in labor force participation, education, and income.

DESIGN

General Social Survey data.

SETTING

United States, 1974 to 2012.

PARTICIPANTS

A total of 23 353 respondents.

MEASURES

Self-assessed health; 2 key religiosity variables: attendance and intensity of belief; income, labor market variables, education, standard demographic variables, household size, region, and time dummies.

ANALYSIS

Probit estimation conducted for the aggregate sample by gender as well as by decades to examine possible gender differential changes over time.

RESULTS

Attendance has declined overall with a much greater decline for women. The overall positive association between religiosity and health masks considerable heterogeneity across gender and time; higher and stable for males, there is no longer a significant association for females. Increased education, income, and labor force participation can explain only part of this association. Education is the strongest mediator.

CONCLUSION

The way women and men benefit from religious attendance has changed, suggesting that some pathways may be working differently for women now, especially those with less education. Moving away from church networks could be due to a perceived lack of support or substitution by other social networks. Ceteris paribus, since religious participation has been shown to weaken preference for risky consumption, declining participation, especially for women, may show up as an increase in risky behavior.

LIFE QUALITY RELATED TO SPIRITUAL HEALTH AND FACTORS AFFECTING IT IN PATIENTS AFFLICTED BY DIGESTIVE SYSTEM METASTATIC CANCER

INTRODUCTION

Spiritual health is of the basic elements in chronic patients. This concept can be considered as an important approach in promoting physical & spiritual health & life quality.

GOAL

The present study has been planned aiming to study life quality related to metastatic phase gastrointestinal (digestive) cancer referring to Mazandaran Medical Science University Educational Center in Iran.

MATERIAL AND METHODS

This research has been done by descriptive-analytical method with 250 patients through available sampling method. The data has been collected via spiritual health & life quality questionnaire. The data analysis has been performed by calculating X², T Test, variance analysis and Pearson correlation coefficient.

RESULTS

The mean & standard deviation of the patients were 12.56 ±94/47. The highest relationship between age & spirituality was related to ages over 60. There was a meaningful statistical relationship between spirituality & life quality scale (p<0.001), between spirituality & respiratory disorder (p<0.047), anorexia (p<0.004), exhaustion (p<0.006), financial problems (p<0.006).

CONCLUSION

regarding the results, we can perceive the necessity behind improving spiritual health aspect as an influencing factor on the patients' life quality. Through enhancing spiritual beliefs, it is possible to help the patients' spiritual quality get promoted.

Accepted Common Interest Community (CIC) Proposals

These are the 18 accepted proposals for the three Common Interest Community (CIC) sessions at IAYT's Symposium on Yoga Therapy and Research (SYTAR), June 5-8, 2014, in Austin, Texas and published in the Final Program Guide and CIC Works for SYTAR 2014. The sessions were CIC#1 Rehab Professionals: Bridging the Past with the Future and CIC#2a & CIC#2b Mental, Emotional and Spiritual Health.

Spiritual health scale 2011: defining and measuring 4 dimension of health

In the midst of physical comforts provided by the unprecedented developments in all spheres of life, the humanity is at cross roads and looking at something beyond these means. Spirituality has now been identified globally as an important aspect for providing answers to many questions related to health and happiness. The World Health Organization is also keen at looking beyond physical, mental and social dimensions of the health, and the member countries are actively exploring the 4^th Dimension of the health i.e. the spiritual health and its impact on the overall health and happiness of an individual. National Institute of Health and Family Welfare (NIHFW), realized this need and initiated a research study in this direction. In this study, an effort was made to define this 4^th Dimension of health from a common worldly person's perspective and measure it. 3 Domains, 6 Constructs and 27 Determinants of spiritual health were identified through a scientific process. A statistically reliable and valid Spiritual Health Scale (SHS 2011) containing 114 items has been developed. Construct validity and test- retest reliability has been established for urban educated adult population. The scale is first of its kind in the world to measure the spiritual health of a common worldly person, which is devoid of religious and cultural bias. Its items have universal applicability.