The prevalence of risk factors for chronic diseases such as smoking, alcohol abuse, low fruit and vegetable consumption, and lack of physical activity is high among young adults. Health behaviours are influenced by many factors and also by religious orientation, as American studies show. The aim of the present study was to explore whether a similar association with religion exists in Austria (Europe). A cross-sectional survey was carried out in seven randomly selected high schools, whereby a total of 225 11th-grade pupils (64% girls, 36% boys; average age 16.4 years) were surveyed by means of an online questionnaire. The study reveals a positive association between religion and healthy food choices as well as meal patterns. Smoking (number of cigarettes smoked daily) and alcohol consumption (getting drunk) was negatively associated with religion. These negative associations remained after adjusting for confounding factors using logistic regression analysis. Thus, the study showed that religion is associated with a reduction in these risky health behaviours in Austrian high school pupils. However, due to the limitations of the study design, causality cannot be inferred. Full article

Quantitative evidence is beginning to document the successful outcomes achieved from holistic interventions that include a spiritual element as an approach to self-manage obesity in the community. However, qualitative research, which helps us understand the reasons behind their success, is scarce. Our aim was to explore participants’ acceptance of and engagement with the Taste & See programme. Semi-structured interviews were carried out after participants had completed the Taste & See programme. Interviews were transcribed and analysed using deductive thematic analysis. Themes showing that ‘God and food issues had been kept separate’ at the start of the programme and that participants then ‘Began to use faith as a resource’ were identified. Also, while ‘Eating freely was a challenge’ initially, participants later found ‘empowerment and enjoyment in freedom’. ‘Addressing more than just a weight problem’ was valued highly and there were benefits and difficulties that arose from ‘Coping with other group members’. The rich level of evaluation provided through this study identifies that the participants found the programme a novel experience. The intervention was acceptable and participants engaged well with the programme content. Full article

There are numerous studies of quality of life (QOL) in chronic kidney disease (CKD) patients; however, there are a few studies of spirituality and its association with QOL. Previous studies were done focusing on Western cultures; thus, the study of CKD patients in Eastern cultures would reveal interesting insights. This study was conducted to explore the spirituality, QOL, and depression of Thai CKD patients, and the associations between spirituality, QOL, and depression. This cross-sectional descriptive study using structured questionnaires was approved by the Khon Kaen University Ethics Committee in Human Research, Thailand. A total of 63 pre-dialysis CKD stage V patients who visited the kidney diseases clinic as appointed at the outpatient department in a community hospital in northeastern Thailand were recruited. The patients were asked for consent and then interviewed. Spirituality was assessed by using the WHOQOL Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). The 9-item Thai Health Status Assessment Instrument (9-THAI) was used to assess QOL. The Beck Depression Inventory-II (BDI-II) was used to evaluate the depression. The study patients had high WHOQOL-SRPB and FACIT-Sp spirituality scores (median = 18.0, and 44.0, respectively). The 9-THAI QOL scores were within the normal range of the Thai general, healthy population (physical health score [PHS]; median = 48.0, mental health score [MHS]; median = 32.0). Based on BDI-II scores, most patients were in the minimal depression group (63.5%). The Spearman rho correlation coefficients (rs) of PHS and WHOQOL-SRPB and FACIT-Sp were moderate with 0.34 for both spirituality measures. Similarly, also the mental health scores (MHS) correlated moderately with WHOQOL-SRPB (rs = 0.46) and FACIT-Sp (rs = 0.37). Depressive symptoms (BDI-II) strongly negatively correlated with WHOQOL-SRPB (rs = −0.58) and FACIT-Sp (rs = −0.55). Overall results were consistent with previous studies in Western contexts. Understanding spirituality would lead to the better management of depression and improving patient survival. These significant associations suggest that further research is needed on how provider knowledge of patient spirituality could affect the outcomes for patients both in terms of depression and patient survival. Full article

Throughout centuries, many interpretations of miraculous healings have been offered by philosophers, theologians, physicians and psychologists. Different approaches to miracles originate from the differences in understanding of causative factors, concepts of nature and the relationship between God and nature. Despite many skeptical arguments, a vast majority of people (approximately 70%) in modern Western societies share a belief in miracles and millions of sick people pilgrimage to sanctuaries seeking their occurrence. The aim of the research was to describe the social perception of miraculous healings, and the relationship between beliefs in miraculous healings, religiosity and meaning in life. A survey was conducted on a group of 178 respondents aged 18 to 30 (M = 21.5; SD = 2.31), 90% Catholics. The obtained results show that it is possible to describe the perception of miraculous healings in category of the essence of the causative factors (natural/supranatural) and definiteness (defined/undefined). The majority (88%) of the respondents believed in miracles and most frequently associated them with God's action/intervention, less often with the still undiscovered possibilities of the human organism or the nature, and the least with medical biases. Respondents with stronger religiosity more often understood miraculous healings as an act of God than the activity of unspecified supernatural powers. Moreover, higher religiosity and understanding of miraculous healings as an effect of the supernatural specified determinant was connected with higher meaning in life. Full article

The present study examined the perception of contemporary German psychiatric staff (i.e., psychiatrists, psychotherapists and nurses) regarding their approach towards religious/spiritual issues in their clinical practice, and how clinical chaplains perceive attitudes and behaviors towards religiosity/spirituality of other psychiatric staff members. To answer these questions, two separate studies were conducted to include psychiatric staff and clinical chaplains. Curlin et al.’s questionnaire on Religion and Spirituality in Medicine: Physicians’ Perspectives was the main instrument used for both studies. According to the self-assessment of psychiatric staff members, most contemporary German psychiatric staff members are prepared and open to dealing with religiosity/spirituality in therapeutic settings. To some extent, clinical chaplains agreed with this finding, but their overall perception significantly differs from the staff’s own self-rating. Our results suggest that it may be helpful for psychiatric staff members and clinical chaplains to exchange their views on patients regarding religious/spiritual issues in therapeutic settings, and to reflect on how to apply such findings to clinical practice. Full article

To analyse how patients with chronic diseases would interpret their illness, and how these interpretations were related to spirituality/religiosity, life satisfaction, and escape from illness, we performed a cross-sectional survey among patients with chronic diseases from Poland (n = 275) using standardized questionnaires. Illness was interpreted mostly as an Adverse Interruption of life (61%), Threat/Enemy (50%), Challenge (42%), and rarely as a Punishment (8%). Regression analyses revealed that escape from illness was the best predictor of negative disease perceptions and also strategy associated disease perceptions, and a negative predictor of illness as something of Value, while Value was predicted best by specific spiritual issues. Patients’ religious Trust and partner status were among the significant contributors to their life satisfaction. Data show that specific dimensions of spirituality are important predictors for patients’ interpretation of illness. Particularly the fatalistic negative perceptions could be indicators that patients may require further psychological assistance to cope with their burden. Full article

Research concerning the relation between physical health and prayer typically employs an outcome oriented paradigm and results are inconsistent. This is not surprising since prayer per se is not governed by physiological principles. More revealing and logically compelling, but more rare, is literature examining health and prayer from the perspective of the participants. The present study examines the health–prayer experience of 104 Christians in the United States. Data were collected through recorded video interviews and analyzed by means of content analysis. Results show that prayer is used as a context nuanced spiritual tool for: dealing with physical suffering (spiritual-religious coping); sustaining hope and spirituality via a sacred dimension; personal empowerment; self-transcendence. These findings demonstrate that practitioners primarily engage prayer at a spiritual rather than a physical level, underscoring the limitations of a biomedical or “Complementary and Alternative Medicine” perspective that conceptualizes prayer as a mechanism for intentionally improving physical health. In clinical practice, regarding the medical, psychotherapeutic, or pastoral, the challenge is to understand prayer through the framework of the practitioner, in order to affirm its potential in healthcare processes. Full article

While the beneficial effects on mental health of spirituality and creativity as separate entities have been well documented, little attention has been given to the interactive effect of the two constructs in coping. Recently, the theory of transformative coping and associated Transformative Coping Model have been developed and examined from both theoretical and quantitative perspectives. To extend this work, the present study critically examined the theory of transformative coping and associated Transformative Coping Model from a qualitative perspective. Ten interviews were conducted among Northern Irish and Irish artists, contemplative prayer group members, and mental health service users. Data were analysed using Interpretative Phenomenological Analysis. The results showed that the majority of participants had experienced stress and trauma, and have suffered mental ill-health as a consequence. Most defined themselves as both creative and spiritual, and resorted to a spiritual attitude along with creative expression in order to cope with traumatic events and ongoing stressful situations. Most participants believed that their creativity was rooted in their spirituality and that the application of both helped them to transform negative emotional states into positive ones. This, in turn, gave them increased resilience to and a different perspective of stressful events, which aided and improved their coping skills throughout the lifespan. Full article

Patient care frequently focuses on physical aspects of disease management, with variable attention given to spiritual needs. And yet, patients indicate that spiritual suffering adds to distress associated with illness. Spirituality, broadly defined as that which gives meaning and purpose to a person’s life and connectedness to the significant or sacred, often becomes a central issue for patients. Growing evidence demonstrates that spirituality is important in patient care. Yet healthcare professionals (HCPs) do not always feel prepared to engage with patients about spiritual issues. In this project, HCPs attended an educational session focused on using the FICA Spiritual History Tool to integrate spirituality into patient care. Later, they incorporated the tool when caring for patients participating in the study. This research (1) explored the value of including spiritual history taking in clinical practice; (2) identified facilitators and barriers to incorporating spirituality into person-centred care; and (3) determined ways in which HCPs can effectively utilize spiritual history taking. Data were collected using focus groups and chart reviews. Findings indicate positive impacts at organizational, clinical/unit, professional/personal and patient levels when HCPs include spirituality in patient care. Recommendations are offered. Full article

This paper reports on a descriptive qualitative study that explored the value and benefit of Serenity Spirituality Sessions programme for older nursing home residents. The research was carried out in six nursing homes in the Republic of Ireland. The facilitators of these sessions, who worked in the nursing homes, were interviewed about their experiences of delivering the programme and their views on the impact that the programme had on resident participants. Emergent themes revealed benefits of the intervention for clients, including inducing a calming effect, increased sense of belonging and benefits of ritual use. The programme yielded positive results, and appears suited to the predominantly Christian population, and as such is deemed a useful adjunct to holistic and spiritual care in these settings. Full article

The Norwegian health authorities buy one third of their addiction treatment from private institutions run by organizations and trusts. Several of these are founded on religious values. The aim of the study was to investigate such value-based treatment and the patients’ experiences of spirituality and religiousness as factors of meaning-making in rehabilitation. The study was performed in an explorative qualitative design. Data were collected through focus-group interviews among therapists and in-patients at a religiously founded substance misuse service institution. The analysis was carried out by content analysis through systematic text-condensation. Through different activities and a basic attitude founded on religious values, the selected institution and the therapists facilitated a treatment framework which included a spiritual dimension and religious activity. The patients appreciated their free choice regarding treatment approaches, which helped them to make meaning of life in various collective and individual settings. Rituals and sacred spaces gave peace of mind and confidence in a situation that up to now had been chaotic and difficult. Sermons and wording in rituals contributed to themes of reflection and helped patients to revise attitudes and how other people were met. Private confessions functioned for several patients as turning point experiences influencing patients’ relations to themselves and their surroundings. Spirituality and religious activity contributed to meaning-making among patients with substance use disorder and had significance for their rehabilitation. Full article

Spiritual well-being is viewed as an essential component of health-related quality of life (HRQOL) in the modernized biopsychosocial-spiritual model of health. Understanding spiritual well-being should lead to better treatment plans from the patients’ point of view, and improved patient adherence. There are numerous studies of traditional HRQOL, physical, mental, and social well-being; however, studies of spiritual well-being in chronic kidney disease (CKD) patients are limited. Thus, this study compared spiritual well-being of chronic hemodialysis patients and pre-dialysis CKD patients. A total of 31 chronic hemodialysis and 63 pre-dialysis CKD patients were asked for consent and then interviewed for spiritual well-being using the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT-Sp). Analysis of covariance was applied to compare FACIT-Sp scores between pre-dialysis CKD and chronic hemodialysis groups that were adjusted by patient characteristics. The FACIT-Sp scores of pre-dialysis CKD patients were non-significantly greater than those of chronic hemodialysis patients after adjustment for gender, age, and marital status. However, all FACIT-Sp scores of males were significantly lower than those of females [FACIT Meaning −1.59 (p = 0.024), FACIT Peace −2.37 (p = 0.004), FACIT Faith −2.87 (p = 0.001), FACIT Total Score −6.83 (p = 0.001)]. The spiritual well-being did not significantly differ by stages of chronic kidney disease; however, patient gender was associated with spiritual well-being instead. To improve spiritual well-being, researchers should consider patient gender as a significant factor. Full article

We will soon be piloting a project titled “Integrating Spirituality into Patient Care” that will form “spiritual care teams” to assess and address patients’ spiritual needs in physician outpatient practices within Adventist Health System, the largest Protestant healthcare system in the United States. This paper describes the goals, the rationale, and the structure of the spiritual care teams that will soon be implemented, and discusses the barriers to providing spiritual care that health professionals are likely to encounter. Spiritual care teams may operate in an outpatient or an inpatient setting, and their purpose is to provide health professionals with resources necessary to practice whole person healthcare that includes spiritual care. We believe that this project will serve as a model for faith-based health systems seeking to visibly demonstrate their mission in a way that makes them unique and expresses their values. Not only does this model have the potential to be cost-effective, but also the capacity to increase the quality of patient care and the satisfaction that health professionals derive from providing care. If successful, this model could spread beyond faith-based systems to secular systems as well both in the U.S. and worldwide. Full article

Approximately 50% of patients do not adhere to medical therapy. Religious and spiritual factors may play an important role in determining medication compliance in mental illness. The aim of this paper is to review published evidence documenting a relationship between religion/spirituality (R/S) and treatment adherence in mental illness, in particular in schizophrenia, depression and substance abuse. This review summarizes, categorizes and defines the role of religious beliefs as a factor improving medication compliance in mental illness. Randomized controlled trials and observational studies were eligible for the review if they were published in December 2015 or earlier, analyzed the effects of religious beliefs or spirituality on medication compliance, or adherence to other therapeutic interventions in mental illness. The vast majority of published studies analyzed the effects of religion on medication compliance in schizophrenia and addiction. In schizophrenia patients, religious beliefs turned out to be a predictor of worse treatment adherence. However, spiritual orientation was shown to play an important role in the recovery from addiction, and to improve adherence in patients with this condition. Furthermore, better treatment adherence was observed in more religious patients diagnosed with depression. While religious beliefs and spirituality may represent an important source of hope and meaning, they often interfere with treatment adherence. Therefore, psychiatrists should consider religious and spiritual beliefs of their patients, and verify if and to what extent they improve their medication compliance. Full article

Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE); work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care. Full article