"A sign that I am not alone": A grounded theory-informed qualitative study on spirituality after suicide bereavement.

Suicide bereavement is known to be highly distressing and to negatively affect the mental health of the bereaved. The role of religion and spirituality after suicide bereavement remains understudied. We aimed to specifically explore the role of spirituality after suicide bereavement by conducting a qualitative study through semi-structured interviews with fifteen people bereaved by suicide. The grounded theory-informed thematic analysis identified five main themes, namely "continuing bonds with the deceased," "lightening the burden," "grounded spirituality," "perceptual and conceptual shift" and "the movement of giving." For many participants, spirituality was a resource that facilitated the process of accepting their loss by offering a larger entity to which to hand over their suffering. Moreover, the continuing bonds with the deceased helped them to get through this ordeal. Our results can enable mental health professionals to better understand how spirituality can facilitate post-traumatic growth in people bereaved by suicide.

Spiritual well-being and associated factor among adult cancer patients in Hawassa University Comprehensive Specialized Hospital, Oncology Center, Hawassa, Ethiopia.

Background: Spiritual well-being has been shown to boost resistance to mental health crises in cancer patients during the diagnosis and treatment process, but there is a paucity of studies about spirituality in cancer patients, which may make it difficult for healthcare clinicians to assess spirituality and provide spiritual care. Objective: The aim of this study was to assess the level of spiritual well-being and associated factors among cancer patients in HUCSH Oncology Center in 2022. Methods and materials: An institution-based cross-sectional study was done from May 30 to June 30, 2022 among 267 cancer patients, and the respondents were selected by a simple random sampling technique. Data was collected by using standardized interviewer-administered questionnaires (FACIT sp12). Data was entered using Epi data version 4.6, and analysis was carried out by using Statistical Package for Social Science version 25. Bivariate and multivariate logistic regression was conducted to determine the relationship between the independent and dependent variables. The strength of association was tested by using p-value at 95% CI. Ethical clearance was obtained from the Institutional Review Board of Hawassa University College of Medicine and Health Science. During data collection, the purpose of the study was clearly explained to the patients, and consent was obtained. Result: A total of 267 cancer patients were included in the study. There was 100% response rate. Majority of the patients (80.5%) were in a poor spiritual well-being state. Mental distress (AOR = 0.246; 95% CI: 0.114-0.531) and religious education (AOR = 1.288; 95% CI: 1.438-9.142) were factors significantly associated with spiritual well-being among cancer patients. Conclusion and recommendation: This study showed that more than two-thirds of patients had poor spiritual well-being. Mental distress and religious education were factors associated with spiritual well-being. Attention should be given by nurses of the center for spiritual well-being assessment in clinical practices favoring holistic care in the center.

An Exploration of the Goodness of Fit of Web-Based Tools for Maori: Qualitative Study Using Interviews and Focus Groups.

BACKGROUND: Indigenous communities often have poorer health outcomes and services under traditional models of care. In New Zealand, this holds true for Maori people who are tangata whenua (the indigenous people). Several barriers exist that decrease the likelihood of indigenous communities often have poorer health outcomes and poor service fit under traditional models of care, including access issues, systemic and provider racism, and a lack of culturally safe and responsive services. Web-based interventions (WBIs) have been shown to be effective in supporting mental health and well-being and can overcome some of these barriers. Despite the large number of WBIs developed, more investigation is needed to know how well WBIs fit with an indigenous worldview and how they meet the needs of indigenous communities so that a digitally based future does not drive social and health inequities. OBJECTIVE: This study aims to explore the goodness-of-fit of WBIs of Maori individuals, the indigenous people of Aotearoa/New Zealand. METHODS: We used interviews (n=3) and focus groups (n=5) with 30 Maori participants to explore their views about WBIs. Interviews were analyzed using reflexive thematic analysis by members of the research team. RESULTS: Overall, there was a perception that the design of WBIs did not align with the Maori worldview, which centers around people, relationships, spirituality, and holistic views of well-being. A total of 4 key themes and several subthemes emerged, indicating that WBIs were generally considered a poor fit for Maori. Specifically, the themes were as follows: (1) WBIs are disconnected from the core values of te ao Maori (the Maori worldview), (2) WBIs could be helpful in the right context, (3) there are significant barriers that may make it harder for Maori to use WBIs than other groups, and (4) ways to improve WBIs to help engagement with Maori. CONCLUSIONS: While WBIs are often considered a way to reduce barriers to care, they may not meet the needs of Maori when used as a stand-alone intervention. If WBIs are continued to be offered, developers and researchers need to consider how to develop WBIs that are responsive and engaging to the needs of indigenous communities rather than driving inequities. Ideally, WBIs should be developed by the people they are intended for to fit with those populations' world views.

Is religiosity/spirituality in patients with Crohn's disease important to their quality of life?

The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes. METHODS: Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index - Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire - Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques. RESULTS: The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes. CONCLUSIONS: The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients' lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.

Investigating spiritual care perceptions and religious coping methods among the relatives of terminally ill patients during the COVID-19 pandemic: the case of Turkey.

BACKGROUND: The COVID-19 pandemic in Turkey and around the world has had a profound impact on the families of terminally ill patients. In this challenging period, investigating the spiritual care perceptions and religious coping methods of patients' relatives is an essential step towards understanding the experiences in this process with the additional challenges brought by the pandemic and developing appropriate support services. This study aims to determine the spiritual care perceptions and the use of religious coping methods among the relatives of terminally ill patients in Turkey during the COVID-19 pandemic. METHODS: The sample of this descriptive and correlational study consisted of the relatives of terminally ill patients (n = 147) who were receiving treatment in the Anesthesiology and Reanimation Intensive Care Unit of a state hospital in Turkey. Spirituality and Spiritual Care Rating Scale and the Religious Coping Scale to them using face-to-face interviews. Mann-Whitney U test, Kruskal-Wallis test, and Spearman's correlation analysis were used to analyze the data. RESULTS: The mean age of the participants was 38.84 ± 11.19 years. Also, 63.3% of them were employed. The participant's total score on the Spirituality and Spiritual Care Rating Scale was 57.16 ± 6.41, and it was determined that the participants' level of perception of spirituality and spiritual care concepts was close to good. When the Religious Coping Scale scores of the participants were examined, it was found that both Positive Religious Coping levels (23.11 ± 2.34) and Negative Religious Coping levels (9.48 ± 1.47) were close to high. There was no correlation between the scores of RCOPE and SSCRS (p > 0.05). CONCLUSION: As a result, it was determined that the level of perception of spirituality and spiritual care concepts of the relatives of terminally ill patients during the COVID-19 pandemic was close to sound, and their Positive Religious Coping levels were high. Epidemics are a reality of the world, and it is essential to learn lessons from this process and take precautions for the future. We offer a perspective to realize the coping power of religion and spirituality, which are integral parts of life. The needs of terminally ill patients' relatives, a sensitive group, become visible.

Spiritual places: Spatial recognition of Tibetan Buddhist spiritual perception.

Tibetan Buddhism, as an indigenous religion, has a significant and far-reaching influence in the Tibetan areas of China. This study, focusing on Lhasa, explores the integration of Tibetan Buddhist spiritual perceptions within urban spaces. Employing a novel approach that combines street view data and deep learning technology, the research aims to identify and map the spatial distribution of Tibetan Buddhist spiritual sites against the backdrop of the urban landscape. Our analysis reveals a notable concentration of these spiritual places near urban architectural and cultural heritage areas, highlighting the profound connection between residents' cultural life and spiritual practices. Despite challenges posed by modern urbanisation, these spiritual sites demonstrate resilience and adaptability, continuing to serve as cultural and spiritual pillars of the Tibetan Buddhist community. This study contributes to the fields of urban planning, religious studies, and digital humanities by demonstrating the potential of technology in examining the impact of urban development on cultural and religious landscapes. The research underscores the importance of protecting and integrating spaces of spiritual perception in urban development planning. It shows that safeguarding these spaces is crucial not only for cultural heritage preservation but also for achieving sustainable urban development and social harmony. This study opens new avenues for interdisciplinary research, advocating for a deeper understanding of the dynamic relationship between urban development and spiritual spaces from psychological, sociological, and environmental science perspectives. As urban landscapes evolve, the study emphasises the need to maintain a balance between material sustainability and cultural and spiritual richness in urban planning.

A Comparative Study of the Impact of the Covid-19 Pandemic on Mental Health, Healthcare Access, and Pain Levels of Patients with Chronic Pain from Spring 2020 to Spring 2021.

Purpose: The short-term impact of the Covid-19 pandemic on patients with chronic pain has been under the microscope since the beginning of the pandemic. This time-lag design study aimed to track changes in pain levels, access to care, mental health, and well-being of Greek chronic pain patients within the first year of the Covid-19 pandemic. Patients and Methods: 101 and 100 chronic pain patients were contacted during the Spring of 2020 and 2021, respectively. A customized questionnaire was used to evaluate the perceived impact of the pandemic on pain levels and healthcare access. Psychological responses, personality characteristics, and overall well-being were evaluated using the Depression, Anxiety, and Stress Scale (DASS-42), the Ten-Item Personality Index (TIPI) and the Personal Wellbeing Index (PWI). Results: The perceived effect of the pandemic and the Covid-related restrictions affected significantly access to healthcare, pain levels and quality of life. Differences were detected in the PWI sub-scales regarding Personal Safety, Sense of Community-Connectedness, Future Security, Spirituality-Religiousness, and General Life Satisfaction. Marital status, parenthood, education and place of residence were associated with differences in pain levels, emotional and psychological responses. Conclusion: Changes in chronic pain levels, emotional responses, and overall well-being took place throughout the year. Also, an evident shift took place in the care delivery system. Both tendencies disclose an ongoing adaptation process of chronic pain patients and healthcare services that needs further monitoring.

Healthcare Students' Perceptions About Approaching Spirituality in Their Training and Patient Care: Online, Cross-Sectional Survey.

Objective: Recent scientific literature points out that religiosity and spirituality play a relevant role in many aspects of life, including health issues. We aimed to evaluate the healthcare students' perceptions about approaching spirituality in their training and patient care in Brazilian universities. Methods: A cross-sectional observational study was conducted following the STROBE guidelines. Through an anonymous online survey, adult healthcare students from two universities in the city of Pelotas (Brazil) answered a questionnaire about their perceptions on approaching spirituality in their training and patient care. Chi-squared tests were performed, and P ≤ .05 was considered statistically significant. Results: A total of 163 students were included in the analysis. Most believed that spirituality is important for their training (74.8%) and patient care (84%). However, a minority had had contact with the theme of spirituality during their training (48.5%) or had experienced a situation in which the spiritual aspects of a patient were addressed (47.2%). The students from the private university had more contact with the theme of spirituality in healthcare during their training. Nursing students had significantly more contact with the theme of spirituality in healthcare (P = .008) and had experienced more situations in which the spiritual aspects of a patient were addressed (P = .031) than other students. Conclusion: Most students believed that the theme of spirituality in healthcare is important for their training and patient care. However, they still had insufficient contact with it during their education. More studies with greater statistical power are needed to better understand this situation globally.

The Effect of Spiritual Well-being on the Self-efficacy Level of Individuals with an Intestinal Stoma.

OBJECTIVE: To investigate the spiritual well-being and self-efficacy levels in patients with intestinal stomas. METHODS: For this descriptive study, researchers conducted face-to-face interviews with 51 participants. Data were analyzed using a descriptive characteristics questionnaire, the Stoma Self-efficacy Scale (SSES), and the Three-Factor Spiritual Well-being Scale (TF-SWBS). RESULTS: Participants had a mean SSES score of 56.98 ± 21.24. Education level and stoma type affected the SSES scores. Income level affected TF-SWBS scores. There was no correlation between SSES and TF-SWBS total scores. There was a positive correlation between TF-SWBS scores and stoma duration and age. CONCLUSIONS: Nurses should provide trainings to develop self-efficacy among and enhance psychosocial and spiritual support for patients with a stoma.

Masculine Discrepancy Stress, Subjective Well-Being, and the Buffering Role of Religiosity.

Although several studies have reported an inverse association between masculine discrepancy stress-the perceived failure to conform to internalized normative expectations of masculinity-and well-being, researchers have yet to consider the potential moderating or buffering role of religiosity. Regression analyses of data collected from a national sample of men (n = 2,018), the 2023 Masculinity, Sexual Health, and Politics survey indicated that masculine discrepancy stress was consistently associated with lower levels of subjective well-being, including poorer self-reported mental health, less happiness, and lower life satisfaction. We also observed that these associations were attenuated or buffered among men who reported regular religious attendance and greater religious salience. Taken together, our findings suggest that different expressions of religiosity may help to alleviate the psychological consequences of masculine discrepancy stress. More research is needed to incorporate dimensions of religion and spirituality into studies of gender identity and subjective well-being.

Socio-cultural beliefs and perceptions influencing diagnosis and treatment of breast cancer among women in Ghana: a systematic review.

BACKGROUND: Breast cancer is currently the most commonly diagnosed cancer in Ghana and the leading cause of cancer mortality among women. Few published empirical evidence exist on cultural beliefs and perceptions about breast cancer diagnosis and treatment in Ghana. This systematic review sought to map evidence on the socio-cultural beliefs and perceptions influencing the diagnosis and treatment of breast cancer among Ghanaian women. METHODS: This review was conducted following the methodological guideline of Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The literature search was conducted in PubMed, CINAHL via EBSCOhost, PsycINFO, Web of Science, and Embase. Studies that were conducted on cultural, religious, and spiritual beliefs were included. The included studies were screened by title, abstract, and full text by three reviewers. Data were charted and results were presented in a narrative synthesis form. RESULTS: After the title, abstract, and full-text screening, 15 studies were included. Three categories were identified after the synthesis of the charted data. The categories included: cultural, religious and spiritual beliefs and misconceptions about breast cancer. The cultural beliefs included ancestral punishment and curses from the gods for wrongdoing leading to breast cancer. Spiritual beliefs about breast cancer were attributed to spiritual or supernatural forces. People had the religious belief that breast cancer is a test from God and they resorted to prayers for healing. Some women perceived that breast cancer is caused by spider bites, heredity, extreme stress, trauma, infections, diet, or lifestyle. CONCLUSION: This study adduces evidence of the socio-cultural beliefs that impact on the diagnosis and treatment of breast cancer among women in Ghana. Taking into consideration the diverse cultural and traditional beliefs about breast cancer diagnosis and treatment, there is a compelling need to intensify nationwide public education on breast cancer to clarify the myths and misconceptions about the disease. We recommend the need to incorporate socio-cultural factors influencing breast cancer diagnosis and treatment into breast cancer awareness programs, education, and interventions in Ghana.

Wiidookaage'win: Beta-test of a Facebook group intervention for Native women to support opioid use recovery.

INTRODUCTION: The ongoing opioid misuse epidemic has had a marked impact on American Indian/Alaska Native (AI/AN) communities. Culture- and gender-specific barriers to medically assisted recovery from opioid use disorder (OUD) have been identified, exacerbating its impact for AI/AN women. Wiidookaage'win is a community-based participatory research study that aims to develop a culturally tailored, moderated, private Facebook group intervention to support Minnesotan AI/AN women in medically assisted recovery from OUD. The current study assessed the preliminary feasibility and acceptability of the intervention in a beta-test to inform refinements before conducting a pilot randomized controlled trial (RCT). METHODS: The intervention was beta-tested for 30 days. Moderators were trained prior to delivering the intervention. Study assessments were conducted at baseline and post-intervention. The post-intervention assessments included substance use (self-report and urine drug screen), treatment acceptability, mental health, and spirituality outcomes. We examined intervention engagement patterns using Facebook metrics and qualitatively explored common topics that emerged in participant posts and comments. RESULTS: Ten AI/AN women taking medication for OUD (MOUD) were accrued (age range 25-62 years). Participants had been in opioid recovery a mean of 15.2 months (SD = 16.1; range = 3-60). The study participation rate (accrued/eligible) was 91 %. Nine participants completed the post-intervention survey assessment and eight completed a UDS. Acceptability was high based on the mean treatment satisfaction score (M = 4.8, SD = 0.2 out of a possible 5.0), Facebook group engagement, and positive qualitative feedback. All participants retained at post-intervention continued their MOUD treatment, and none had returned to opioid use. CONCLUSIONS: The beta-test indicated that the Facebook platform and study procedures generally worked as intended and that the intervention was largely acceptable to study participants. The results of this study phase provided valuable insights to inform refinements prior to conducting a pilot RCT to further assess the feasibility, acceptability, and potential efficacy of the intervention.

Trait Courage, Attachment to God, and Mental Well-Being Among U.S. Collegiate Athletes.

In recent decades, scholars and practitioners alike have devoted increased attention to the psychological well-being of student-athletes. However, to date, far less research has examined the role of virtues, religion, and spirituality in contributing to well-being in student-athlete populations. In this study, we attempt to address these gaps by (a) assessing the association between trait courage, an understudied virtue in the sporting realm, and mental well-being, and then (b) considering how student-athletes' attachment to God might moderate the association between trait courage and depressive symptoms. Drawing on a sample of 415 student-athletes from the USA, regression results illustrate that courage was not significantly associated with lower depressive symptoms among student-athletes. However, a secure attachment to God appeared to function as a compensatory resource for student-athletes lacking in courage. On the contrary, athletes with low trait courage but who reported greater avoidant attachment to God reported greater depressive symptoms. Taken together, a more positive relationship with God could help provide athletes with lower trait courage a way to find meaning and strength that helps them with emotion-regulation strategies to deal with the pressures within and beyond their sport. This study clearly shows that greater attention should be paid to the religious and spiritual development of student-athletes.

How Mental Health and Suicidality Changed during the COVID-19 Pandemic: A Longitudinal Study in the General and Psychiatric Population Illustrating Risk and Protective Factors.

The COVID-19 pandemic has led to an increase in psychological distress in the general population, but contrasting results have been shown regarding its impact on psychological symptoms in clinical and non-clinical samples. Consequently, the aim of the present study was to compare in a longitudinal design (September-November 2020 and February-April 2021) the mental health outcomes of a clinical and a control sample and to determine the implications of various risk and protective factors in this regard. A total of 234 participants from the general population and 80 psychiatric patients took part in the present online study using the following measurements: the Brief Symptom Checklist (BSCL); Three-Item Loneliness Scale (TILS); Resilience Scale-13 (RS-13); and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-Non-Illness (FACIT-Sp Non-Illness). The results show an overall decrease in active suicidal ideation as well as "peace", a subscale of spiritual well-being, as well as increases in passive suicidal activation in the clinical sample, which did not change in the control sample. Psychological symptoms did not significantly change in either group. Significant group effects show an increase in resilience in the clinical sample. Resilience and peace turned out to be protective factors for negative mental health outcomes. However, loneliness, which interestingly increased only in the control sample, was shown to be an overall potential risk factor. Our results highlight the complex implications of the COVID-19 pandemic on the mental health outcomes of different groups in the population, demonstrating the necessity of further research, specifically regarding the risk of active and passive suicidal activation. Highlighted protective factors are discussed in regards to spirituality (i.e., peace), which is not strictly related to religion but rather personal spirituality related to the meaning of situations of one's life, as well as in terms of mental health interventions.

Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims - A Randomised Controlled Trial.

BACKGROUND: Ramadan fasting has seen increased attention in research, often with inconsistent findings. This study aims to investigate whether dietary and lifestyle modifications during Ramadan can improve well-being and health in healthy adult Muslims. METHOD: A randomised controlled trial with two parallel groups was conducted in an outpatient clinic of a university hospital in Essen, Germany, in 2016. Healthy adult Muslims (n = 114) aged 18-60 years were randomised to a modified fasting group; i.e., they received educational material prompting dietary and lifestyle modifications pre-Ramadan, and a control group who undertook Ramadan fasting as usual. Primary outcome was quality of life (WHO-5 Well-Being Index). Secondary outcomes included sleep quality, spirituality, and mindfulness (all self-report), body weight, body mass index, body fat, waist circumference, hip circumference, blood pressure, and heart rate, as well as blood serum biomarkers. Safety was examined via adverse events. RESULTS: The modified fasting group reported significantly higher quality of life (WHO-5) compared to the control after Ramadan (MD 5.9; 95% CI, 0.02-11.8; p < 0.05). Group differences in favour of the modified fasting were also found for satisfaction with health (MD 5.9, 95% CI 0.19-11.67), ease of life (MD 4.1, 95% CI 0.38-7.80) and mindfulness (MD 7.6, 95% CI 2.68-12.52), reductions in weight (MD, - 0.9 kg; 95% CI - 1.39 to - 0.42), BMI (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), hip circumference (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), and diastolic blood pressure (MD - 2.8 mmHg, 95% CI - 5.15 to - 0.43). About 60% of participants reported adverse events, mostly headaches/migraines, dizziness/fatigue, common cold, and gastrointestinal symptoms, with no group differences. One serious non-related adverse event each occurred in both groups. CONCLUSION: Pre-Ramadan dietary and lifestyle advice can lead to short-term improvements in mental and physical well-being of adult Muslims observing Ramadan. As such, this study demonstrates the potential benefits of culturally appropriate health interventions in a religious context. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier NCT02775175).

Mental health analysis and resilience psychological factors during pandemic among port health 0fficers: A study in Sabang, Indonesia.

The coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on the mental health of health workers worldwide. Many studies examined the mental health of the frontline health workers in hospitals, but similar research on health workers at the port entries has yet to be found. The aim of this study was to determine the mental health issue and its associated factors and to determine the psychological resilience factors of port health workers in Sabang, Indonesia during the COVID-19 pandemic. A retrospective mixed-method study was conducted among 38 port health officers. Total sampling included those working from January 2020 to March 2023. The information on age, gender, qualification, working time and working place of the respondents were collected and the mental health was assessed using the Depression Anxiety Stress Scale (DASS-21). The correlation and association between the socio-demographic data and mental health were tested with Spearman and chi-squared tests, respectively. The qualitative study on psychological resilience factors were performed with interviews and analyzed with NVivo. This study indicated that 47.4% of port health officers experienced depression, 63.1% anxiety and 50.0% stress. Age and working time significantly affected the mental health. Age correlated positively and significantly with anxiety (p<0.0001) and stress (p<0.0001), while working time significantly affected the anxiety (p=0.003). The psychological resilience factors identified were spirituality, positive emotions, official support, and personal well-being that helped the workers taking away learn lessons. In conclusion, mental health issues are high among frontline workers during the pandemic highlighting the importance of the prevention measures to ensure the work performance among employees.

A Study on the Psychological Profile and Coping With the Disease in Patients With Lymphangioleiomyomatosis.

Introduction: Lymphangioleiomyomatosis (LAM) is a rare disease that affects women almost exclusively. We aimed to determine the psychological profile in patients with LAM, and their potential association with sociodemographic and clinical features, and to know their role in coping with the disease. Material and methods: Cross-sectional and descriptive study in collaboration with the Spanish Association of LAM (AELAM). The variables measured were: socio-demographic, psychological (anxiety, depression, demoralization, spirituality, resilience, social support), clinical (treatment) and health-related quality of life. Results: We studied 87 LAM patients, with a mean (SD) age of 47.7 (7.7) years, and time since diagnose was 10.1 (5.4) years. 75.9% of patients were receiving sirolimus or everolimus, and oxygen therapy was required in 34.5% of patients. Anxiety was found in 46% of patients, depression in 55%, while only 2% presented demoralization and 14% deficit in spirituality. Social support and resilience were adequate. The "non-severe" group (without oxygen therapy) presented worse results in anxiety. A structural equation model to explore association between variables, showed very adequate fit indices: χ2(14) = 29.743 (p = .074); CFI = .983; TLI = .967; SRMR = .058; RMSEA = .075[.000-.128]. The model identifies resilience, spirituality and social support as "protective factors" from anxiety, depression, and demoralization. Conclusions: This study performed on a large series of women with LAM describes their psychological profile, in addition to showing how they cope with the disease. We have found that other psychological constructs, such as perceived social support and resilience, are protective factors. Early psychological evaluation and intervention is necessary to reduce comorbidities and prevent mental health problems in women with LAM.

Introducción: La linfangioleiomiomatosis (LAM) es una enfermedad rara que afecta casi exclusivamente a las mujeres. Nuestro objetivo fue determinar el perfil psicológico en los pacientes con LAM, y su potencial asociación con características sociodemográficas y clínicas, y conocer su papel en el afrontamiento de la enfermedad. Material y métodos: Estudio transversal y descriptivo en colaboración con la Asociación Española de LAM (AELAM). Las variables medidas fueron: sociodemográficas, psicológicas (ansiedad, depresión, desmoralización, espiritualidad, resiliencia, apoyo social), clínicas (tratamiento) y calidad de vida relacionada con la salud. Resultados: Se estudiaron 87 pacientes con LAM, con una edad media (DE) de 47,7 ± 7,7 años y un tiempo desde el diagnóstico de 10,1 ± 5,4 años. El 75,9% de los pacientes estaban recibiendo sirolimus o everolimus, y el 34,5% de los pacientes requirió oxigenoterapia. La ansiedad se encontró en el 46% de los pacientes, la depresión en el 55%, mientras que solo el 2% presentó desmoralización y el 14% déficit en la espiritualidad. El apoyo social y la resiliencia fueron adecuados. El grupo «no grave¼ (sin oxigenoterapia) presentó peores resultados en ansiedad. Un modelo de ecuaciones estructurales para explorar asociación entre variables, mostró índices de ajuste muy adecuados: χ2(14) = 29,743 (p = 0,074); CFI = 0,983; TLI = 0,967; SRMR = 0,058; RMSEA = 0,075 (0,000-0,128). El modelo identifica la resiliencia, la espiritualidad y el apoyo social como «factores protectores¼ contra la ansiedad, la depresión y la desmoralización. Conclusiones: Este estudio realizado en una amplia serie de mujeres con LAM describe su perfil psicológico, además de mostrar cómo afrontan la enfermedad. Hemos descubierto que otros constructos psicológicos, como el apoyo social percibido y la resiliencia, son factores protectores. La evaluación e intervención psicológica temprana es necesaria para reducir las comorbilidades y prevenir problemas de salud mental en mujeres con LAM.

The interplay of spiritual health, resilience, and happiness: an evaluation among a group of dental students at a state university in Turkey.

BACKGROUND: Dental education is one of the disciplines where students are most significantly affected psychologically. The aim of this study was to evaluate the relationship between spiritual health, resilience and happiness levels of dental students at a state university in Turkey. METHODS: This cross- sectional study included 212 students from the 3rd, 4th and 5th grades of the faculty of dentistry. A questionnaire consisting of 4 sections was used in the study. The sections of the questionnaire include students' general and academic information, Turkish adaptations of the Spiritual Well-Being Scale, The Brief Resilience Scale, and the Oxford Happiness Questionnaire-Short Form. Data analysis was performed with IBM SPSS 25 package program. The Shapiro-Wilk test was used to assess the normal distribution of the data. The Mann-Whitney U test was preferred for comparisons between two categorical variables and one numerical variable. The Kruskal-Wallis H test was employed for comparisons involving two categorical variables and one numerical variable. The presence of a relationship between two numerical variables was examined using the Spearman test. RESULTS: In terms of resilience and happiness scores, males had higher scores than females. It was determined that third graders scored higher than fifth graders in harmony with nature scores, and third graders scored higher than fourth graders in deregulation scores. There was a positive correlation between happiness, spiritual well-being and resilience; a negative correlation between happiness and anomie. There was no significant relationship between age and happiness scores. As a result of multiple linear regression to determine the factors affecting happiness; increases in spiritual well-being and resilience will lead to an increase in happiness levels. CONCLUSION: This study concluded that increased levels of spiritual well-being and resilience among a group of dental students would lead to increased levels of happiness. However, further research is needed to understand the relationship between mental health, resilience and happiness levels during dental education.

Should Healthcare Organizations Promote a Spiritually Healthy Work Environment?

Both personal spirituality/religiosity and perception of a spiritually respectful work climate are inversely related to burnout among nurses. In addition to briefly reviewing the empirical evidence that consistently supports these assertions, this essay offers some practical suggestions for how nurses can promote a spiritually healthy work environment.