Religion, Spirituality, and Health Revisited: Bringing Mainline Western Protestant Perspectives Back into the Discourse-Theology's "Seat at the Table".

Theological perspectives have been given short shrift in the literature on religion and health research. This study demonstrates how including different schools of mainline Western Protestant theological thought (evolutionist, correlationist, and dialectical) in the scientific process could contribute to clarifying controversies. The issue is not just theoretical: Theology can even challenge assumptions on elicitability and reproducibility. Theology perceives spirituality as a dialogue with the Total Other, thus making each encounter with the transcendent (not just the individuality of the person) unique and unpredictable. By accepting setbacks on a journey with wide-ranging aspirations, theology redefines health as the momentum of constant striving toward the divine spirit. Since these theological insights relate to interventions that affect patients' intimacy, attempting to recognize the (albeit implicit) spiritual-theological standpoint of the patient and the self-and how these relate to authentic traditions of spirituality-appears to be an essential prerequisite for ethical spiritual intervention.

A Testimony of Christian Drug Rehabilitation: Transformed by the Power of God.

ABSTRACT: Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)-translated and summarized in this article-of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.

A Systematic Review of Interventions Based on Judeo-Christian Principles for Patients with Substance Dependence.

Substance use disorders have significant consequences for patients and those around them. A qualitative systematic review was conducted to examine the effectiveness of religiosity and spirituality (R/S) interventions based on Judeo-Christian principles during the multidisciplinary treatment of patients with substance dependence disorder. Studies of patients of both sexes, at any age, of any nationality, and from any geographic location who were participating in treatment programs with religious elements explicitly tied to Christianity or Judaism were eligible for inclusion. Other religious interventions were excluded. Seven electronic databases were searched to identify eligible intervention studies published in English until August 2021. Two reviewers independently screened studies and extracted data. JBI tools were used to assess risk of bias. Of 146 articles retrieved for full text reading, five were ultimately included in this review published from July 2008 to August 2021. The R/S interventions used in the included studies were music therapy in a religious context, reading of the Bible or Torah, reflexive readings, personal prayer and reflection, and religiously integrated cognitive behavioral psychotherapy with or without a comparison group. Despite the broad search, there were found only a small number of studies and little homogeneity in the data of patients that reported positive impacts of treatments. Well-designed controlled studies are needed to truly investigate the efficacy of Judeo-Christian religious interventions for helping people with substance use problems, so as to strengthen the evidence of the benefits of these type of approaches in the treatment of drug addicts.

Chaplains of Color: Histories and Practices.

From the gallows and fields of war to the street and bedside, chaplains of color have been present and instrumental in providing spiritual and emotional support in public and private settings across the United States. Their histories and experiences are not well documented and integrated into the field of spiritual care and chaplaincy, a field often understood as predominantly White, male, and Christian. This article introduces this special issue by offering historical context-particularly for Black chaplains-and naming the key themes that weave through the articles included. Naming the experiences of chaplains of color is a central step in responding to historically grounded racial inequities in the work of chaplaincy and spiritual care in the United States.

Spirituality in Parkinson's Disease within a Sample from the USA.

Spirituality and religious beliefs are important for coping with medical conditions. The dopaminergic system is involved in reward behavior, and its dysfunction in Parkinson Disease (PD) raises questions about religiosity and spirituality in people with PD. This study examines the association between levels of spirituality and religiosity and the severity of PD motor and non-motor symptoms. The secondary aim investigates the perceived impact of PD diagnosis on spirituality and religiosity. This was a cross-sectional analysis of demographic, physical, mental, and spirituality and religiosity status in patients with PD recruited for the Health Outcomes Measurement (HOME) Study at the University of Maryland Parkinson Disease and Movement Disorders Center, Baltimore, USA. Spirituality and religiosity were assessed using the Spiritual Well-being Scale, and the World Health Organization Quality of Life Spiritual Religious and Personal Belief field-test instrument. The sample size was 85 PD patients. The mean age (standard deviation) was 65.5 (9.4) years and 67.1% were male. Higher levels of spirituality and religiosity were associated with younger age, sex (female), less education, religious affiliation (Christian), and mental health status. After adjusting for age, education, gender, race, marital status, religion, physical health, mental health, and comorbidity, only anxiety was associated with all of the spirituality/religiosity assessments. The majority of patients reported no change in their religious or spiritual beliefs following diagnosis. Greater spirituality and religiosity were associated with less anxiety. Also, younger women with PD showed higher levels of spirituality and religiosity. Longitudinal studies on more diverse populations are needed.

The Effects of Spiritual Wellbeing on Self-Perceived Health Changes Among Members of the Church of England During the COVID-19 Pandemic in England.

This paper tests whether changes in spiritual wellbeing were correlated with self-rated changes in mental and physical health after controlling for changes in psychological wellbeing in a sample from the Church of England taken during the third national COVID-19 lockdown in 2021. During the third lockdown in England an online survey, named Covid-19 and Church-21, was delivered through the Qualtrics XM platform from 22 January to 23 July 2021. The responses included 1878 Anglicans living in England. The change in spiritual wellbeing scale was produced using self-reported changes in the frequency of key spiritual practices (prayer and Bible reading), trust in God, the quality of spiritual life, and spiritual health. Changes in mental and physical health were assessed using single self-report items. Changes in psychological wellbeing were assessed using the Index of Balanced Affect Change (TIBACh). After controlling for changes in psychological wellbeing, better change in spiritual wellbeing was positively correlated with better change in both mental and physical health. Negative affect may have mediated the relationship between spiritual wellbeing and both mental and physical health, and positive affect may also have mediated the relationship with mental health. The results suggest changes in spiritual wellbeing, as defined within a Christian religious context, may have had positive effects in promoting better mental and physical health during a sudden crisis such as the COVID-19 pandemic.

Christian Orthodox Fasting as a Traditional Diet with Low Content of Refined Carbohydrates That Promotes Human Health: A Review of the Current Clinical Evidence.

INTRODUCTION: Christian Orthodox fasting is a pattern high in complex carbohydrates and low in refined carbohydrates. It has been explored in association with its potential health benefits. The present review aims to comprehensively explore the existing available clinical data concerning the potential favorable impact of the dietary pattern of Christian Orthodox fasting on human health. METHODS: PubMed database, Web of Science and Google Scholar were extensively searched in order to identify the more appropriate clinical studies that explore the effect of Christian Orthodox fasting on health-related outcomes in humans utilizing relative keywords. We initially retrieved 121 records through database searching. After applying several exclusion criteria, 17 clinical studies were finally included in this review study. DISCUSSION: Christian Orthodox fasting showed beneficial effects concerning glucose and lipid control, whereas the data for blood pressure remain inconclusive. Concerning weight control, fasters were characterized by lower body mass and lower caloric intake in the course of the fasting periods. During fasting, this pattern is higher in fruits and vegetables, showing the absence of dietary deficiencies for iron and folate. Nevertheless, dietary deficiencies were recorded for calcium and vitamin B2, and also hypovitaminosis D has been noticed in monks. Interestingly, the vast majority of monks do present with both good quality of life and mental health. CONCLUSIONS: Overall, Christian Orthodox fasting is a dietary pattern low in refined carbohydrates and high in complex carbohydrates and fiber that may be beneficial for human health promotion and chronic disease prevention. However, further studies are strongly recommended on the impact of long-term religious fasting on HDL cholesterol levels and blood pressure.

How Christian Nurses Respond to Patient Requests for Prayer: An Observational Study.

ABSTRACT: Nurse-provided spiritual care includes support of patient spiritual practices such as prayer. However, limited evidence exists about how nurses respond when a patient requests prayer. A subsample of nurses (n = 381) from a larger study responded to two open-ended questions in an online survey in response to a prayer scenario. Among these mostly Christian nurses, 97% indicated willingness to pray. Content analysis revealed a five-component structure for praying: Open, Set the Stage, Request, Wrap-up, Close. The structure provides a template for future research and nurse prayer in clinical contexts.

Frequency of nurse-provided spiritual care: An international comparison.

AIMS AND OBJECTIVES: To compare the frequency of nurse-provided spiritual care across diverse cultures. BACKGROUND: Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. DESIGN: This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. METHODS: Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed. RESULTS: Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. CONCLUSIONS: In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. RELEVANCE TO CLINICAL PRACTICE: Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.

Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

Reflections on Doing Counseling and Christian Family Therapy.

Reflecting on his long career that integrated medicine, therapy, and Christian theology, the author shares his insight to help future students to have a simple framework of doing counseling, family therapy, and relating to the Christian faith. This article offers his personal views on how to do therapy, and proposes a way of looking at a Christian theory of personality, and towards a Christian theory of marriage and family therapy.

"Calling the Spirit Back:" Spiritual Needs Among Great Plains American Indians.

CONTEXT: American Indians (AIs) are disproportionately affected by serious illness such as cancer. Colonization, cultural genocide, and trauma have adversely affected AIs' ability to attain health and well-being, and in many cases led to the loss of the right to practice traditional ceremonies and rituals. Still many AIs describe well-being as being rooted in spirituality. OBJECTIVES: The purpose of this project was to learn about the perspectives of AI cancer survivors, caregivers, and Tribal leaders and healers specific to spirituality while on the cancer journey. METHODS: Qualitative interviews and Indigenous talking circle methodologies were used to explore AIs cancer survivors, caregivers, and Tribal leaders and healers' perspectives on spirituality while on the cancer journey. A data analysis team consisting of AI and non-AI members analyzed the narrative data. RESULTS: Qualitative analysis of interviews and talking circles revealed 4 major themes related to spirituality: the chasm of colonialism, coexistence of Traditional and Christian religions, calling the Spirit back, and prayer as sacred energy. CONCLUSION: It is critical that clinicians caring for AIs with serious illness seek to understand their patients' spiritual beliefs about disease treatment and death and work with them and their families to support quality of life throughout their illness journey. In addition, clinicians must recognize the systemic racism inherent in our healthcare systems, and dismantle cultural clashes and bias for all patients, particularly AIs, who have long suffered from poorer health outcomes.

Providing Spiritual Care to In-Hospital Patients During COVID-19: A Preliminary European Fact-Finding Study.

Historically, there has be a close relationship between the nursing services and spiritual care provision to patients, arising due to the evolvement of many hospitals and nursing programmes from faith-based institutions and religious order nursing. With increasing secularism, these relationships are less entwined. Nonetheless, as nurses typically encounter patients at critical life events, such as receiving bad news or dying, nurses frequently understand the need and requirement for both spiritual support and religious for patients and families during these times. Yet there are uncertainties, and nurses can feel ill-equipped to deal with patients' spiritual needs. Little education or preparation is provided to these nurses, and they often report a lack of confidence within this area. The development of this confidence and the required competencies is important, especially so with increasingly multicultural societies with diverse spiritual and religious needs. In this manuscript, we discuss initial field work carried out in preparation for the development of an Erasmus Plus educational intervention, entitled from Cure to Care Digital Education and Spiritual Assistance in Healthcare. Referring specifically to post-COVID spirituality needs, this development will support nurses to respond to patients' spiritual needs in the hospital setting, using digital means. This preliminary study revealed that while nurses are actively supporting patients' spiritual needs, their education and training are limited, non-standardised and heterogeneous. Additionally, most spiritual support occurs within the context of a Judeo-Christian framework that may not be suitable for diverse faith and non-faith populations. Educational preparation for nurses to provide spiritual care is therefore urgently required.

Contemplative practice, acceptance, and healing in moral injury.

Moral injury is a soul struggle for many veterans. It includes a deep sense of regret, shame, and division within themselves due to morally injurious events. Spiritual practices like Centering Prayer are complementary disciplines that help veterans heal from moral injury and process embedded trauma, guilt, and shame. Contemplative practices can help with acceptance of difficult emotions and thoughts connected to past moral injury and help veterans refocus on values that are part of their community, faith, and social backgrounds. At the Loveland VA, a group of veterans are following the guidelines outlined by Contemplative Outreach for a Centering Prayer practice. The guidelines and the intended outcomes are outlined in this paper and include previously researched benefits of mindfulness and meditation-based practices for PTSD, which often co-occurs with moral injury. Veterans' feedback from both in-person and online versions of the Centering Prayer group are included in the paper. While encouraged as an individual discipline, veterans are also encouraged to practice Centering Prayer within groups at the VA or in the community for deeper inter-relational healing and trust. Veteran peer supports provide links to Contemplative Prayer outreach groups as well as AA groups in the community. As a mindfulness-based spiritual practice with Judeo-Christian roots, Centering Prayer is a powerful addition to a chaplaincy program that promotes whole health healing and growth.

Patient blood management when blood is not an option: a report of two cases.

There are many patients who refuse to receive blood transfusions for religious or other reasons. Bloodless medicine and surgery are no longer new concept, but patients who refuse blood transfusion are still transferred to the bloodless center, regardless of patients' intention, for treatment. Here, we discuss the need for patient blood management when blood is not an option to treat them. Two patients of advanced age were transferred to our bloodless center due to refusal of transfusion. They are Jehovah's Witnesses and refused to receive blood transfusion despite life-threatening anemia and severe underlying diseases. Patient blood management protocols including iron supplementation, subcutaneous erythropoietin, folic acid and vitamin B were implemented to improve hematopoiesis, and supportive care was also performed to treat underlying diseases. Levels of Hemoglobin/Hematocrit and their symptom gradually improved about a week after treatment, and their condition had gradually stabilized. They were discharged safely. We treated patients of advanced age with severe underlying diseases and life-threatening anemia using patient blood management due to refusal of a blood transfusion. The patient blood management may be a useful alternative strategy, which meet the needs of patients who refuse blood transfusions as well as the need to reduce the use of blood products due to limited supply.

"I Struggle with Breast Cancer and I Struggle with God": Insights from African American Breast Cancer Survivors.

PURPOSE: Recognizing that spiritual and religious beliefs are personal and vary within communities, the purpose of this qualitative study was to explore the influence of these beliefs on experiences with breast cancer care and social support among African American Christian breast cancer survivors. METHODS: Forty-seven African American breast cancer survivors participated in focus groups (n = 7) in three northeastern urban cities. We used thematic analyses to identify major themes. RESULTS: Three themes emerged relating to how spirituality influenced participants' cancer journeys: (1) struggling with God, (2) reclaiming my power, and (3) needing religious social support. Participants described the rhythmic flow of their spiritual beliefs as they navigated their lived experiences during diagnosis, treatment, and post-treatment. Spirituality was intimately intertwined with their illness experience as they grappled with their health and well-being. CONCLUSIONS: Participants used spirituality as an avenue to cope and navigate through their diagnosis and treatment. These spiritual relationships created "church families" and provided the survivors' access to cancer support groups, financial support, and therapeutic support. Our findings support faith-based approaches to health promotion and call for more studies to understand the influence of religion on health.

Operating on Jehovah's Witnesses: A Challenging Surgical Issue.

Blood transfusion is often utilized in surgery. Greece is the second-highest consumer of blood components in Europe. It has been shown that at least half of all transfusions are unnecessary and could be avoided. Jehovah's Witnesses (JWs) are a Christian religion that do not accept transfusion of whole blood or the four primary components of blood-namely, red blood cells, white blood cells, platelets, and plasma. This a retrospective study from September of 2015 to January of 2018, analyzing all JWs who underwent an elective operation at the Second Department of Propaedeutic Surgery in Laiko University Hospital. Twenty-nine (Rogers et al. in NCCN Guidelines Version 2.2014 Cancer- and Chemotherapy-Induced Anemia. NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network, Fort Washington, 2013) JW patients, 23 females (74.1%) and eight males, were operated on during the aforementioned period. The median ASA score was 1 (range 1-3), and only two of the patients needed postoperative monitoring in the ICU. Almost half of the patients (45.1%) needed iron infusion and EPO injection preoperatively. Two patients presented with postoperative complications, with no postoperative deaths. In conclusion, we found that surgery, in our small group of JW patients, was safe and successful despite the lack of blood transfusion. Techniques developed to treat JW patients should be more widely used to improve clinical outcomes and reduce costs to the healthcare system.

Understanding religious attachment among christians seeking spiritually integrated psychotherapies: A mixed methods study.

OBJECTIVE: This mixed methods study aimed to understand ways of viewing and experiencing religious attachment among Christians in spiritually integrated psychotherapies. METHOD: In total, 190 Christian-affiliated clients completed narrative responses about religious and parental attachment along with validated measures of spiritual and psychological functioning toward the start of treatment. RESULTS: An inductive content analysis revealed ten ways in which clients were viewing and experiencing God. Although painful themes were expressed, clients more frequently discussed comforting themes related to religious attachment. Additional analyses demonstrated convergence with parental attachment and quantitative measures of spirituality and mental health. CONCLUSION: Religious attachment appears to primarily provide a sense of strength and comfort for Christians seeking care. Findings also indicate clients view and experience God in similar ways as their parents or caregivers. As such, assessing and affirming clients' faith may facilitate positive changes in how they view and experience themselves and others in treatment.

Faith-based intervention, change of religiosity, and abstinence of substance addicts.

OBJECTIVE: To investigate the effects of developing religiosity on abstinence of substance abuse among recovering addicts in a faith-based and a secular-based treatment program. METHODS: Religiosity of recovering addicts was measured using the 38-item Brief Multidimensional Measure of Religiousness/Spirituality at three points in time: at initiation of substance addiction treatment (wave 1), discharge from treatment (wave 2), and 6 months after treatment (wave 3). Latent growth curve modeling was used to assess the dynamic and developing effects of religiosity on after-treatment abstinence. Secular-based treatment emphasized the role of biological, psychological, and environmental determinants of substance abuse and provided detoxification interventions, such as counseling and group therapies, skill training, health care, and social support, however also relying on religious and spiritual growth to help recovery. Faith-based treatment fundamentally emphasized the Christian theory of addiction to consider substance abuse a sin caused by one's spiritual void and separation from God, although it also acknowledged the importance of biological, psychological, and social needs of rehabilitants. RESULTS: Recovering addicts in faith-based treatment had significantly higher levels of religiosity at each wave (intercept factor) and better religious development across the three waves (slope factor). This contributed to after-treatment abstinence and mediated the effect of treatment mode on after-treatment abstinence. CONCLUSION: Service practitioners and researchers should note the importance of dynamic and developing nature of religiosity in relation to the maintenance of abstinence after treatment is completed.

Examining Cultural, Ethnic, and Religious Differences with the Brief Multidimensional Measure of Religiousness and Spirituality in the U.S. and India.

The Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) is regularly used to measure spirituality and religiosity in U.S. Christian populations, although it has not been used for making comparisons with non-Western groups. This study compared BMMRS results for 109 individuals (60 in the U.S. and 49 in India) with traumatic brain injury (TBI) from different cultures (U.S., India), ethnic groups (African American, Caucasian, South Asian), and religions (Christian, Hindu, Muslim). In general, the results indicated that U.S. African Americans and Christians reported being the most spiritual, South Asians and Hindus the least. Groups differed significantly in self-reported spiritual experiences, but less in frequency of religious activities. Results suggest using caution when applying Western-based measures of religion and spirituality in non-Western, non-Christian populations.