Religion, Spirituality and Health Research: Warning of Contaminated Scales.

The relationship between religiosity, spirituality and health has received increasing attention in the academic literature. Studies involving quantitative measurement of religiosity and/or spirituality (R/S) and health have reported many positive associations between these constructs. The quality of various measures, however, is very important in this field, given concerns that some measures of R/S have been contaminated with indicators of mental health. When this occurs, that is when R/S is defined and measured a priori, this subsequently guarantees a positive association between R/S and health (especially mental health). Such associations are called tautological, which involves correlating a construct with itself, thus producing associations that are uninterpretable and misleading. In this article, concerns about the measurement of R/S are discussed, examples of contaminated and potentially probelmatic measures of R/S are noted, and recommendations are made regarding uncontaminated measures of R/S that should be used in future studies of R/S and health.

Mental health needs and barriers to service in the Chinese American community: insights gained from focus groups.

OBJECTIVES: Mental health remains an unmet need among Chinese Americans. This study aims to identify specific needs and strategies that may address the needs. DESIGN: A total of 55 Chinese Americans consented and participated in online focus groups conducted in either Chinese or English using nominal group technique. Participants discussed the following questions, achieved themes, and provided ranking of themes in importance for each: (1) In general, what do people in the Chinese American community think about mental health or emotional well-being? (2) What have you found to be helpful for accessing mental health or emotional well-being services or care in the Chinese American population? And (3) What actions would you suggest to improve mental health and emotional well-being in the Chinese American population? RESULTS: Across the focus groups, we observed high consistency of top ranked themes including lack of knowledge and awareness, negative impression, lack of Chinese-speaking providers, and that the most helpful factor toward access to care was education and increased awareness. Seminars and trainings was the top actionable suggestion. CONCLUSION: The findings are consistent with previous findings and continue to show that Chinese Americans need more education and training and that providers who can speak the language and understand the culture would be very helpful to increase access to care. This study emphasizes addressing mental health disparities in the Chinese American community through awareness, tailored interventions, and barrier removal. Promoting equal access also underscores the need for ongoing assessment and responsive strategies.

Faith and Health in Israel, Türkiye and the USA.

This issue of JORH focuses upon faith and health within three nations that have contributed a great deal in terms of religion and health research during this century-namely Israel, Türkiye and the USA.

Do Positive Psychosocial Factors Contribute to the Prediction of Coronary Artery Disease? A UK Biobank-Based Machine Learning Approach.

AIM: Most prediction models for coronary artery disease (CAD) compile biomedical and behavioural risk factors, using linear multivariate models. This study explored the potential of integrating positive psychosocial factors (PPFs), including happiness, satisfaction with life, and social support, into conventional and machine learning-based CAD prediction models. METHODS: We included UK Biobank participants without CAD at baseline. First, we estimated associations of individual PPFs with subsequent acute myocardial infarction (AMI) and chronic ischaemic heart disease (CIHD) using logistic regression. Then, we compared the performances of logistic regression and eXtreme Gradient Boosting (XGBoost) prediction models when adding PPFs as predictors to the Framingham Risk Score (FRS). RESULTS: Based on a sample size between 160,226 and 441,419 of UK Biobank participants, happiness, satisfaction with health and life, and participation in social activities were linked to lower AMI and CIHD risk (all p-for-trend ≤ 0.04), while social support was not. In a validation sample, adding PPFs to the FRS using logistic regression and XGBoost prediction models improved neither AMI (AUC change: 0.02% and 0.90%, respectively) nor CIHD (AUC change: -1.10% and -0.88%, respectively) prediction. CONCLUSIONS: PPFs were individually linked to CAD risk, in line with previous studies, and as reflected by the new European Society of Cardiology guidelines on cardiovascular disease prevention. However, including available PPFs in CAD-prediction models did not improve prediction compared to the FRS alone. Future studies should explore whether PPFs may act as CAD-risk modifiers, especially if the individual's risk is close to a decision threshold.

Positive psychosocial factors like happiness, satisfaction with health and life, social support and social activities can aid in successfully managing life's challenges, stress and disease. Consequently, they may help lower the risk and progression of cardiovascular disease. The study confirmed that positive psychosocial factors were associated with lower risks of myocardial infarction and chronic ischaemic heart disease. These findings underscore the role of positive psychosocial factors as risk modifiers for coronary artery disease, as recom-mended by the 2021 ESC Guidelines on cardiovascular disease prevention. This means that the individual risk of getting a coronary artery disease can be shifted to the next lower risk category by higher levels of happiness, satisfaction with health and life, and social support.

Nurses, Clergy, Chaplains, Parkinson's Disease, Workplace Religiosity, Women's Health and Family Issues.

This issue of JORH explores a broad range of topics looking at the professions of nursing, clergy and chaplains. This issue also concludes the series on Parkinson's disease (Part 2), and for the first time, JORH presents a collation of articles relating to workplace religiosity. Finally, this issue revisits the topics of women's health and family issues in relation to religiosity and spirituality.

Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China.

OBJECTIVES: The relationship between spirituality and depressive symptoms among the Chinese elderly is not well known. The current study explores this relationship using longitudinal data and trajectory modeling of depressive symptoms. METHODS: A longitudinal study design was used to measure depressive symptoms repeatedly from 2012 to 2021 using the Geriatric Depression Scale (GDS). Group-based trajectory modeling analysis was conducted to determine the trajectories of depressive symptoms, and multiple logistic regression was used to explore the association between spirituality and depressive symptom trajectories. RESULTS: A total of 2333 participants completed at least two GDS measures, and these were included in the Group-based trajectory modeling analysis. An optimal model of three trajectories was derived: no depressive symptoms group (75.2%), new-onset depressive symptoms group (14.4%), and persistent depressive symptoms group (10.4%). Logistic regression modeling revealed that higher spirituality was associated with a lower risk of both new-onset depressive symptoms (OR = 0.68, 95% CI = 0.49-0.93) and persistent depressive symptoms (OR = 0.32, 95% CI = 0.23-0.45). CONCLUSIONS: Spirituality predicts a lower risk of new-onset depressive symptoms and persistent symptoms among older adults in mainland China.

Tribal Healing, Suicide, Ethical Issues, Cancer and Measuring Religiosity and Spirituality.

This issue of JORH considers the 'good, the bad and the ugly' of tribal or traditional healers, as well as articles relating to ethical challenges due to contemporary medicine and environmental issues. The concluding series on suicide (Part 2) is also finalized in this issue, as well as a number of research articles from multiple countries relating to cancer. Similar to previous issues, JORH once again adds to its increasing collection of articles relating to the empirical measurement of religion, spirituality and health. Readers are also reminded of the European Congress on Religion, Spirituality and Health (ECRSH) (Salzburg, Austria, May 2024), as well as the inaugural International Moral Injury and Wellbeing Conference (IMIWC) (Brisbane, Australia, September 2024).

An Exploratory Qualitative Analysis of the Stanford-Templeton Convenings on Islam and Suicide.

For over 70 years, studies have reported lower rates of completed suicide in Muslim-majority countries and individuals who identify as Muslim. To this point, the mechanisms underlying the relationship between Islam and lower risk of suicide remain understudied. In an effort to advance our understanding, we convened a bilingual international interdisciplinary panel of experts for a discussion of the current state and future directions of the field. In this paper, we present an exploratory qualitative analysis of the core themes that emerged from the group interviews. We also derive a general theoretical model of the association between Islam and suicide risk.

The Effect of the Holy Quran Recitation on Inflammatory Markers in Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Increased inflammation is a common complication in chronic hemodialysis (HD) patients. Addressing the psychological symptoms of patients may help reduce inflammation and its negative impact on the body. Considering the calming effects of listening to the Holy Quran, this may help reduce mental, psychological, and physical problems in Muslim patients. The present study sought to examine the effects of listening to Holy Quran recitation on the level of inflammatory markers in HD patients. This was a randomized controlled trial involving 50 HD patients at Kowsar Hospital in Semnan, Iran, in 2019-2020. The participants were divided into experimental and control groups using simple randomization by sealed envelopes. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in blood were measured before the intervention. The participants in the experimental group listened by headphones to the Holy Quran being recited three times a week, 20 min each time, for one month. For those in the control group, headphones were placed but on silent mode. At the end of the intervention one month later, inflammatory markers were measured again for participants in both groups. Data were analyzed in SPSS-16 using descriptive and inferential statistics (t test, Wilcoxon, and Mann-Whitney U). Mean IL-6 level decreased by 20.2 pg/ml, mean ESR level by 16.8 mm/hr, and mean CRP level by 19.9 mg/dl in the experimental group, while these values increased in the control group. The between-group differences in the intervention and control groups at follow-up were significant for all three inflammatory markers (p < 0.05). Listening to the Holy Quran being recited is recommended as a complementary therapy for reducing systemic inflammation (as indicated by inflammatory markers) in Muslim HD patients.Trial registration: Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N9. Registered 4 Nov 2019.

Gratitude and Religiosity in Psychiatric Inpatients with Depression.

Background: Gratitude and religiousness/spirituality are increasingly recognized resources that have potential influence on psychological states such as depression. However, only few studies have investigated this relationship in psychiatric patients. Objective: The present study examined gratitude in psychiatric inpatients with depression, exploring its relevance, course, and interaction with psychopathological and religious measures. Both general and religious gratitude will be evaluated. Methods: A total of 212 inpatients with depression completed a questionnaire both at the beginning and the end of treatment. Gratitude was measured with a general gratitude scale using the Gratitude Questionnaire and a religion-specific measure assessing gratitude to God as part of the Structure of Religiosity Test. The Beck Depression Inventory was used to evaluate depressive symptoms. General religiosity was assessed using the Centrality of Religiosity Scale. Results: Scores on the general and religious gratitude measures were in the upper range of these scales at baseline and demonstrated a significant increase during the hospital stay. Negative associations were found between general gratitude and depressive symptoms both on admission and at discharge (r = -0.505 and r = -0.478, respectively). General as well as religious gratitude was associated with the centrality of religiosity (r = 0.384 and r = 0.546, respectively). Religiosity accounted for approximately 10% of the variance in general gratitude on admission. Conclusions: Gratitude is highly prevalent in psychiatric patients with depression, and that may serve as a resource for these individuals. Both general and religious gratitude are associated with religiosity, which may also serve as a resource to these patients.

Spirituality, Mental Health, and COVID-19.

This issue of JORH presents a broad range of articles that consider spirituality and spiritual care from various international perspectives. It also looks at a diverse range of articles relating to mental health disorders and addictions. Lastly, this issue considers the aftermath of COVID-19. Readers are also reminded of the European Congress on Religion, Spirituality, and Health (ECRSH) (Salzburg, Austria), as well as the inaugural International Moral Injury and Wellbeing Conference (IMIWC), Brisbane, Australia, 2024.

Schizophrenia or Possession? A Rejoinder to Irmak.

In this rejoinder, I comment on Irmak's 2014 article titled "Schizophrenia or Possession?" published in the Journal of Religion and Health  (Irmak, 2014; JORH 53(3):773-777. https://doi.org/10.1007/s10943-012-9673-y ). After providing a brief overview of the article and two commentaries on it, I examine the role that demonic possession may or may not play in the development and course of schizophrenia. While keeping an open mind to the possibility of evil influences on the course of illness in those with or without psychosis, I emphasize that schizophrenia is a neurobiological illness that requires compassionate care and expert psychobiological treatment.

Should Physician-Assisted Suicide or Euthanasia be Legalized in the United States? A Medically Informed Perspective.

There is a pressing debate in the United States concerning the implied physicians' obligation to do no harm and the status of legalizing physician-assisted suicide (PAS). Key issues that underpin the debate are important to consider. These include: (1) foundational medical beginnings; (2) euthanasia's historical and legal background context; and (3) the key arguments held by those for and against legalization of PAS. This paper reviews the major claims made by proponents for the legalization of PAS and the associated complexities and concerns that help underscore the importance of conscience freedoms. Relief of suffering, respect for patient autonomy, and public policy arguments are discussed in these contexts. We argue here that the emphasis by healthcare providers should be on high quality and compassionate care for those at the end of life's journey who are questioning whether to prematurely end their lives. If medicine loses its chief focus on the quality of caring-even when a cure is not possible-it betrays its objective and purpose. In this backdrop, legalization of PAS harms not only healthcare professionals, but also the medical profession's mission itself. Medicine's foundation is grounded in the concept of never intentionally to inflict harm. Inflicting death by any means is not professional or proper, and is not trustworthy medicine.

Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in Switzerland.

OBJECTIVE: The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR). METHODS: In this prospective study, a convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL), and exercise capacity (6-min walk test, cycle ergometer test) were assessed. RESULTS: Social support was significantly associated with less anxiety (p < .01), less depression (p < .01), and better QoL (p < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression (p < .001). Religiosity/spirituality was significantly associated with less depression (p < .05), better QoL (p < .05), and better exercise capacity (p < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant impact of either social support or R/S on the course of CR measured by change in QoL or exercise capacity. CONCLUSION: Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.

Suicide, Moral Injury, Parkinson's Disease, Diabetes and Dialysis.

This issue of JORH presents the first of a two-part series specifically exploring suicide. Research relating to moral injury is also included-a topic which has previously been discussed within earlier editions of JORH and an issue that is increasingly recognised as being associated with suicide. Other topic areas explored within this issue are Parkinson's Disease, Diabetes, and Haemodialysis. Finally, readers are once again reminded of the 9th European Congress on Religion, Spirituality and Health (ECRSH) to be held in May 2024, 16-18th at the Paracelsus Medical University in Salzburg, Austria. We would also like to announce a proposed inaugural International Moral Injury and Wellbeing Conference (IMIWC), 19-20 September 2024, Brisbane Exhibition and Convention Centre, Australia.