Is mindfulness practice "at risk" of increasing spirituality? Systematic review and critical analysis of a claimed effect.

INTRODUCTION: Mindfulness meditation has gained prominence in somatic and psychiatric care in several countries including France. Studies have shown its effectiveness in various conditions, in particular the prevention of depressive relapses. However, there are criticisms and concerns about its potential links to Buddhism and spirituality, raising issues of secularism and sectarianism. This issue is particularly conflicting in France with regard its historical and political relationship with secularism. OBJECTIVES: This study aims to assess quantitative data regarding the impact of mindfulness meditation on spirituality and religiosity using quantitative validated scales. METHODS: A systematic review was conducted. PubMed was searched for relevant studies using keywords related to mindfulness and spirituality/religiosity scales. Four scales assessing spirituality were identified: FACIT-sp, INSPIRIT, DSES, and DUREL. Qualitative analysis determined if scale items pertained to spirituality or other topics considered by opponents to mindfulness as "at risk" for deviances or sectarian aberrations. Quantitative analysis assessed the effect size of changes in scale scores before and after mindfulness meditation interventions. RESULTS: Eighteen studies were analyzed, with varying scales and program durations including 1272 participants. Qualitative analysis showed that most scales contained items related to spirituality as well as "at risk" elements like religion and mysticism. Quantitative analysis revealed that a few studies reported significant increases in spirituality scores following mindfulness meditation, but the clinical relevance of these changes was questioned. In general, control groups had smaller score changes. INTERPRETATION: While some studies suggest a potential increase in spirituality due to mindfulness meditation, the clinical significance of these findings remains uncertain. Moreover, mindfulness meditation's ties to Buddhism are disputed, and its roots are intertwined with various psychotherapy traditions that incorporate spirituality. The role of secularism in psychotherapy is also debated in France, emphasizing the need for proper use and regulation policy rather than prohibition of mindfulness-based approaches. This study highlights the complexity of assessing the impact of mindfulness meditation on spirituality and religiosity. It suggests that a pragmatic approach focusing on risk and harm reduction may be more suitable than labeling the practice as "at risk". Further research is needed to clarify these issues in the specific cultural context of France.

Religion/Spirituality, Mental Health, and the Lifespan: Findings from a Representative Sample of Canadian Adults.

Theories of adult development and aging suggest that older adults turn towards religion and spirituality (R/S) to increase meaning and purpose in life, and to assist in coping with adverse experience. We sought to examine the relationship between R/S and positive mental health and mental illness (i.e., psychological distress) in adulthood, and to determine the potential moderating role of age. Data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), a national population health study, were used. A multivariable linear regression model revealed a significant R/S by age interaction for positive mental health (p = 0.001). Although R/S was associated with positive mental health among all participants, there was a stronger relationship between R/S and positive mental health for older adults. No statistically significant relationship between R/S and psychological distress was observed. Findings highlight the importance of R/S to positive mental health across the adult lifespan. The differential relationships among R/S, positive mental health, and mental illness underscore the utility of using the dual-continua of mental health and mental illness in order to understand their respective determinants.

[Integrating spirituality into care]. / Intégrer la spiritualité dans les soins.

Spiritual care or spirituality in care, spirituality of care or spiritual care. In recent years, it is impossible not to realize that this theme, which is expressed and understood in different ways, covers an increasingly vast field in the field of literature and challenges clinical settings as much as training.

[Development of the concept of positive spirituality in health]. / Élaboration du concept de spiritualité positive en santé.

Positive spirituality has three central attributes: connectedness, meaning of life, and identity. Six factors are likely to contribute to its emergence and it can allow the development of ten positive consequences.

[Influence of spirituality on health status in times of pandemic]. / Influence de la spiritualité sur l'état de santé en temps de pandémie.

Spirituality is a health protection factor recognised in the scientific literature. However, few studies have evaluated its impact on French-speaking populations, in secularised societies and even fewer in the context of a pandemic. It is therefore interesting to highlight significant relationships between spiritual quality of life and health.

[Jewish spirituality in the face of illness, suffering and care]. / La spiritualité juive à l'épreuve de la maladie, de la souffrance et des soins.

Jewish spirituality in its principles, its means and its practice offers the possibilities to cope with sickness, suffering and more broadly with the human condition.

[Spirituality and care in the Muslim tradition]. / La spiritualité et les soins selon la tradition musulmane.

Spirituality in health care in the sense of the Muslim tradition requires inspiration from The Medicine of the Prophet, written by Jalâl ad-Din as-Suyûtî in the 15th century. A work in line with the principles of the Hippocratic oath. It consists in restoring, preserving or promoting health in all its elements, physical and mental, individual and social.

[Spirituality of a Catholic nurse in the encounter with care]. / Spiritualité d'une infirmière catholique à la rencontre du prendre soin.

Working in a palliative care unit raises a number of questions for carers relating to suffering and death. This case study of a Catholic nurse investigates the link between spirituality and caregiving by exploring her subjective relationship to the work of caregiving.

[The art of healing and spirituality, the point of view of a Buddhist doctor]. / Art de soigner et spiritualité, le point de vue d'un médecin bouddhiste.

The spiritual path proposed by Buddhism is based on foundations to be integrated and put into practice. This path and the meditation that integrates it opens up capacities for the caregiver and beneficial effects from a therapeutic point of view for the patient.

[Approach of the spiritual dimension through the nursing care interview in oncohaematology]. / Approche de la dimension spirituelle par l'entretien de relation d'aide infirmière en oncohématologie.

Responding to the existential questions of patients faced with a serious hematological disease does not go without saying for a caregiver not trained for this purpose. It is however essential to accompany them in this tragic moment of their life. The research project here aims to develop a process of relational and spiritual care to best meet their quest.

Vozes do além: uma análise psicopatológica da eclosão de experiências anômalas em médiuns espíritas / Voices from Beyond: A psychopathological analysis of the onset anomalous experiences in spiritists mediums / Les voix de l'au-delà: analyse psychopathologique de l'éclatement d'expériences anormales chez les médiums spirites / Voces del más allá: un análisis psicopatológico del estallido de experiencias anómalas en los médiums espiritistas

As experiências anômalas (EA) são experiências psíquicas inusitadas, não necessariamente patológicas, que ocorrem em contextos espirituais e religiosos. Esse estudo explora o surgimento de EA, suas características e repercussões psíquicas, com base na análise qualitativa do relato autobiográfico de médiuns espíritas. Dez sujeitos foram selecionados e submetidos a um questionário sociodemográfico e a entrevista semiestruturada. As EA surgiram, majoritariamente, na infância e na adolescência dos entrevistados, sendo vagas e associadas a medo, ansiedade e falta de controle, muitas vezes, remetendo à "loucura". Experiências alucinatórias de natureza visual, auditiva e tátil foram descritas de forma marcantemente heterogênea, indicando a importância dos componentes subjetivos e imaginativos, bem como sugerindo que a manifestação de vivências de natureza psicótica ocorra dentro de um campo dimensional complexo.

Anomalous experiences (AE) are unusual psychic events, not necessarily pathological, which occur in religious or spiritual contexts. This study explores the onset of AE in spiritist mediums, their characteristics and psychological effects, based on the qualitative analysis of autobiographical accounts. The ten individuals selected answered a sociodemographic questionnaire and a semi-structured interview. Their AE emerged mainly during childhood or adolescence, being vague and associated with fear, anxiety and lack of control, and often related to "madness." Hallucinatory experiences of visual, auditory and tactile nature were described in a markedly heterogeneous manner, indicating the importance of subjective and imaginative components and suggesting that the manifestation of psychotic-like phenomena takes place within a complex dimensional field.

Les expériences anormales (EA) sont des expériences psychiques inhabituelles, pas forcément pathologiques, qui se produisent dans des contextes spirituels et religieux. Cette étude explore l'éclatement de l'EAs, leurs caractéristiques et leurs répercussions psychiques, à partir de l'analyse qualitative des récits autobiographique de médiums spirites. Les dix individus sélectionnés ont rempli un questionnaire sociodémographique et un entretien semi-structuré. Pour la plupart, les EA sont apparues dans l'enfance et l'adolescence, étant imprécises et associées à la peur, l'anxiété et le manque de contrôle, faisant souvent référence à la "folie". Les expériences hallucinatoires de nature visuelle, auditive et tactile ont été décrites de manière notamment hétérogène, ce qui indique l'importance des composantes subjectives et imaginatives, en suggérant que la manifestation d'expériences de nature psychotique se produit dans un

Las experiencias anómalas (EA) son experiencias psíquicas inusuales, no necesariamente patológicas, que ocurren en contextos espirituales y religiosos. Este estudio explora el advenimiento de las EA, sus características y repercusiones psíquicas, realizando el análisis cualitativo del informe autobiográfico de los médium espiritistas. Diez personas fueron seleccionadas y sometidas a un cuestionario sociodemográfico y a entrevistas semiestructuradas. Las EA se han manifestado, principalmente, en la infancia y la adolescencia de los entrevistados, quienes las consideraban inciertas y las asociaban con el miedo, la ansiedad y la falta de control, a menudo refiriéndose a la "locura". Las experiencias alucinatorias de carácter visual, auditivo y táctil han sido descritas de manera muy heterogénea, lo que indica la importancia de componentes subjetivos e imaginativos, y sugiere que la manifestación de experiencias de naturaleza psicótica ocurre dentro de un campo dimensional complejo.

Spirituality and the quality of life of cancer patients: An antidepressant effect.

OBJECTIVES: Cancer is the second leading cause of mortality in the world, and represents an economic, social and psychological burden. Scientific studies have focused on psychosocial coping mechanisms of patients and on factors improving their quality of life. Thus, the aim of the present study is to analyze the influence that spirituality would have on the quality of life of Lebanese cancer patients and to identify whether the influence on quality of life is mediated through a decreased depression. METHODS: This is a cross-sectional study targeting cancer patients in the hemato-oncology department of the Hôtel-Dieu de France Hospital (Beirut, Lebanon). It is based on a questionnaire composed of three parts: EQ-5D-5L, PHQ-9, and FACIT-Sp-12. Likewise, a control group suffering from chronic diseases and treated in the hospital was questioned. Univariate and multivariate analysis were conducted to assess the relationship between the different questionnaires for controls and for cancer patients. RESULTS: Thirty-nine cancer patients and eight control patients were questioned. In the univariate analysis, there was no relationship between depression and spirituality nor for spirituality and quality of life. After controlling for depression, an inverse correlation between quality of life and spirituality was shown. CONCLUSIONS: Our study is a pilot study which for the first time investigates the implication of depression in a "spirituality-quality of life" association. There is no clear association of spirituality with quality of life. In fact, the physical and psychological burden of chronically ill patients could exceed and render insignificant a possible impact of spirituality on quality of life.

Sentidos de vida e morte: reflexões de pacientes em cuidados paliativos / Sentidos de vida y muerte: reflexiones de pacientes en cuidados paliativos / Sens de la vie et de la mort: réflexions de patients en soins palliatifs / Meanings of life and death: reflections of patients in palliative care

Resumo Cuidados paliativos visam amenizar o sofrimento de pacientes com doenças crônicas e ameaçadoras da vida nas dimensões: física, social, psicológica e espiritual. Na dimensão espiritual, procura-se imbuir de sentido aspectos transcendentais, como vida e morte. Conhecer esses sentidos é o objetivo deste estudo, que se trata de pesquisa qualitativa de caráter exploratório e faz uso de entrevistas semiestruturadas para a coleta de dados e análise do discurso. Foram entrevistados quatro pacientes e identificadas três categorias de significado: recursos de enfrentamento relativos à finitude; sofrimentos relativos à finitude; sentidos atribuídos à vida e à morte. Percebeu-se como maior sofrimento não a finitude em si, mas o que decorre dela, como perda funcional, preocupação com a família e ameaça de valores. A dificuldade em se falar sobre a morte não necessariamente se encontra em si mesma, mas em identificar o sentido que ela tem para a pessoa e os sofrimentos subjacentes.

Resumen Los cuidados paliativos se proponen mitigar el sufrimiento de pacientes con enfermedades crónicas y amenazadoras de vida en cuatro dimensiones: física, social, psicológica y espiritual. En la dimensión espiritural se pretende llenar de sentido con aspectos trascendentales, como vida y muerte. Este estudio tiene como objetivo conocer estos sentidos. Para ello, se utilizó el método cualitativo de carácter exploratorio y aplicó entrevistas semiestructuradas para recopilar los datos y el análisis del discurso. Se entrevistaron a cuatro pacientes, y se identificó tres categorías de significado: recursos de afrontamiento relacionados con la finitud, sufrimientos relacionados con la finitud y sentidos atribuidos a la vida y la muerte. Se observó que el mayor sufrimiento no era la finitud en sí, sino lo que deriva de ella, como la pérdida funcional, la preocupación por la familia y la amenza de valores. La dificultad de hablar acerca de la muerte no reside necesariamente en sí misma, sino en identificar el sentido que tiene para la persona y los sufrimientos subyacentes.

Résumé Les soins palliatifs visent à soulanger les souffrances des patients atteints de maladies chroniques et potentiellement mortelles dans quatre domaines: physique, social, psychologique et spirituel. Ce dernier renvoie au sens que l'on peut donner à des aspects transcendants tels que la vie et la mort. Explorer ces différentes facettes est l'objective de cette étude. Il s'agit d'une recherche qualitative de nature exploratoire, menée à partir d'entretiens semi-directifs pour la collecte de données et l'analyse du discours. Quatre patients ont été interrogés et trois catégories de signification ont été identifiées: les ressources d'adaptation liées à la finitude, la souffrance associées à la finitude, et les sens attribué à la vie et à la mort. Il en ressort que la plus grande souffrance n'est pas l'idée de finitude en soi, mais ce qui en découle, comme la perte d'autonomie fonctionnelle, l'anxiété à l'égard de la famille et la remise en question des valeurs. La difficulté de parler de la mort ne réside cependant pas nécessairement dans le fait de parler de la mort elle-même, mais dans l'identification du sens qu'elle revêt pour la personne concernée et dans l'identification des souffrances sous-jacentes.

Abstract Palliative care seeks to alleviate the suffering of patients with chronic and life-threatening diseases in the physical, social, psychological and spiritual dimensions. In the spiritual dimension, it seeks to imbue transcendental aspects, such as life and death, with meaning. Knowing these senses is the objective of this study, which is a qualitative research of exploratory character, and uses semi-structured interviews for data collection and discourse analysis. Four patients were interviewed and three categories of meaning were identified: finitude coping resources; sufferings related to finitude; meanings attributed to life and death. We noticed the greater suffering was not the finitude itself, but what arises from it, such as functional loss, concern for the family and threat of values. The difficulty in talking about death is not necessarily in itself, but in identifying the meaning it has for the person and the underlying sufferings.

Espiritualidade nos cuidados paliativos de pacientes oncológicos / Spirituality in palliative care of oncological patients / Spiritualité dans les soins palliatifs des patients oncologiques / Espiritualidad en la atención paliativa del paciente oncológico

Resumo A espiritualidade como ferramenta aos cuidados paliativos de pacientes oncológicos vem sendo cada vez mais abordada no contexto acadêmico, como integrante da qualidade de vida. Este estudo analisa de que forma a espiritualidade pode influenciar positivamente no tratamento oncológico e em cuidados paliativos, e contribuir com a melhora da qualidade de vida destes pacientes. Foram selecionados 29 artigos nacionais que evidenciaram a espiritualidade como variável positiva no enfrentamento aos cuidados paliativos, tanto para paciente quanto familiares e equipe multidisciplinar. A espiritualidade é utilizada como ferramenta pela equipe de cuidados paliativos como auxiliadora na compreensão do impacto causado pelo diagnóstico e cuidado integral do paciente, possibilitando ao profissional psicólogo intervir sobre o paciente e sua rede. Ao paciente e sua família, a espiritualidade atua como estratégia de enfrentamento e conforto. Este estudo encontrou limitações acerca de pesquisas com pacientes infantis/adolescestes e sua família.

Abstract The spirituality as a tool in palliative healthcare of oncology patients, has been increasingly studied and approached in the academic context, as an integrant of life quality improvement. The present study aimed to analyze how spirituality can positively influence oncology treatment and palliative care and contribute to the quality of life improvement of these patients. Through this literature review and the inclusion criteria, there had been 29 articles selected. Spirituality is used as a tool by the CP team as an aid to understanding de impact caused by the diagnosis and full-time patient care, it enables the psychologist professional to assist and intervene fully about the patient and its network; on the patient and his family, the spirituality acts as a coping strategy, safety, and comfort. The present study has found limitations around the study in children, adolescents, and their network.

Resumé La spiritualité en tant qu'outil de soins palliatifs des patients atteints de cancer est de plus en plus abordée dans le contexte académique, dans le cadre de la qualité de vie. La présente étude visait à analyser comment la spiritualité peut influencer positivement le traitement du cancer et les soins palliatifs et contribuer à améliorer la qualité de vie de ces patients. Grâce à cette revue de la littérature, 29 articles ont été sélectionnés. La spiritualité est utilisée comme outil par l'équipe de soins palliatifs pour aider à comprendre l'impact provoqué par le diagnostic et la prise en charge globale du patient, permettant au psychologue professionnel d'intervenir sur le patient et son réseau; pour le patient et sa famille, la spiritualité agit comme une stratégie d'adaptation et de confort. La présente étude a révélé des limites concernant la recherche avec des patients enfants / adolescents et leur famille.

Resumen La espiritualidad como herramienta para los cuidados paliativos del paciente oncológico se ha abordado cada vez más en el contexto académico como parte de la calidad de vida. El presente estudio tuvo como objetivo analizar cómo la espiritualidad puede influir positivamente en el tratamiento del cáncer y los cuidados paliativos, así como contribuir a mejorar la calidad de vida de estos pacientes. Se seleccionaron 29 artículos brasileños que abordaron la espiritualidad como una variable positiva en el afrontamiento a los cuidados paliativos tanto para los pacientes como sus familias y el equipo multidisciplinario. La espiritualidad es utilizada por el equipo de cuidados paliativos como herramienta de ayuda en la comprensión del impacto que ocasiona el diagnóstico y la atención integral del paciente, permitiendo al psicólogo profesional intervenir sobre el paciente y su red. Para el paciente y su familia, la espiritualidad actúa como estrategia de afrontamiento y consuelo. El presente estudio encontró limitaciones con respecto a la investigación con pacientes niños/adolescentes y su familia.

[The spiritual dimension in nursing]. / La dimension spirituelle dans les soins infirmiers.

Spirituality refers to that which gives us hope, meaning and purpose. It is naturally part of the holistic nature of the care provided by nurses to people going through life's challenges: health-related accident, serious and incurable illness, chronic disease, end of life, etc. A British advanced practice nurse, who has enriched her training with a doctorate in spirituality in the context of health care, enlightens this dimension, which is less formalized in France than in the United Kingdom, and suggests resources for progressing personally and professionally.

[Meaning of life and mental health: the role of religion]. / Sens de la vie et santé mentale : le rôle de la religion.

Patients suffering from severemental illness often turn to spirituality to help cope with their difficulties, in particular to (re)discover meaning in life.Some thereby try to explain their symptoms through religious causes.Generally, turning to spirituality in this way can be adaptive or on the contrary, detrimental. This question and its therapeutic consequences arediscussed and illustrated through clinical examples.

The Role of Religiosity in Families at High Risk for Depression.

BACKGROUND: About forty years ago we began a study of the offspring of depressed (high-risk) and not depressed (low-risk) parents, matched for age and gender, from the same community. We interviewed all of their biological children, blind to the clinical status of the parents. Over the years, we returned to re-interview the families at baseline, 2, 10, 20, 25 30, and 35 years. As the years went by and the sample grew up, we also interviewed the third generation, the grandchildren. As technology became available, we included measures of electrophysiology and magnetic resonance imaging in order to better understand the mechanisms of risk. At the 10-year follow up, we included measures of religion and spirituality - namely, personal religious/spiritual importance and frequency of religious service attendance. We included these measures in all subsequent waves including a more extensive follow up of religious beliefs at the 35-year follow up. ISSUES OF FOCUS: This paper describes the study design and highlights the key findings of the role of religious/spiritual belief in the transmission and endurance of depression using clinical and biological approaches. METHODS: We describe study findings based on clinical measures, as well as physiological measures that employed electrophysiology and magnetic resonance imaging. RESULTS: Taken together, the findings suggest that religiosity/spirituality is protective against depression in high-risk individuals at both clinical and physiological levels. IMPLICATIONS: The findings suggest religiosity interacts with both culture and biology in its impact on depression.

CONTEXTE: Il y a environ quarante ans, nous avons entrepris une étude sur la progéniture de parents déprimés (à risque élevé) et non déprimés (à faible risque), appariés par âge et par sexe, et de la même communauté. Nous avons interrogé tous leurs enfants biologiques, ignorant l'état clinique des parents. Au fil des ans, nous avons réinterrogé les familles lors des années 2, 10, 20, 25, 30 et 35. Avec le passage des années et la croissance de l'échantillon, nous avons également interrogé la troisième génération, les petits-enfants. Avec l'introduction de nouvelles technologies, nous avons aussi inclus des mesures d'électrophysiologie et d'imagerie par résonance magnétique afin de mieux comprendre les mécanismes de risque. Lors du suivi de 10 ans, nous avons inclus des mesures sur la religion et la spiritualité, c'est-à-dire l'importance personnelle de la religion/spiritualité et la fréquence de présence à des services religieux. Nous avons inclus ces mesures dans tous les suivis ultérieurs, notamment un suivi plus approfondi sur les croyances religieuses au terme de 35 ans. QUESTION PRINCIPALE: Ce document décrit la conception de l'étude et met en évidence les principales conclusions concernant le rôle des croyances religieuses / spirituelles dans la transmission et la persévérance de la dépression à l'aide d'approches cliniques et biologiques. MÉTHODES: Nous décrivons les résultats des études basées sur des mesures cliniques, ainsi que des mesures physiologiques utilisant l'électrophysiologie et l'imagerie par résonance magnétique. RÉSULTATS: L'ensemble des résultats suggère que la religiosité / spiritualité a un effet protecteur contre la dépression chez les individus à haut risque aux niveaux clinique et physiologique. Implications : Les résultats suggèrent que la religiosité interagit avec la culture et la biologie dans son impact sur la dépression.

The Effect of Hajj Pilgrimage on Treatment Compliance in Individuals with Chronic Diseases.

This study was performed in order to determine the effect of Hajj pilgrimage on treatment compliance in individuals with chronic diseases. A total of 168 individuals were included in the prospective and descriptive study. Data were collected in three interviews using a patient identification form and the Religiousness Inclination Scale. When the medicine compliances of the individuals before and after Hajj pilgrimage were compared, a statistically meaningful difference between their regular uses of medicine statuses was found (p = 0.011). However, no difference was detected in the 3-month follow-up (p = 0.094). Additionally, it was found that in individuals with internally driven religiousness inclinations there was no relationship between their statuses regarding having changes in their disease-related complaints after Hajj pilgrimage and their status regarding coping with disease. Hajj pilgrimage was found to negatively affect treatment compliance in the short term in individuals with chronic diseases, while there were no changes in long-term treatment compliance.