Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients.

BACKGROUND: End-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. METHODS: This correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS). RESULTS: The overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p < 0.001). The mean scores of resilience, spiritual health and psychological well-being were 70.59 ± 17.02, 90.09 ± 12.01, and 77.88 ± 11.72, respectively. Spiritual health, psychological well-being, resilience, gender and marital status predicted 54% of the variance of treatment adherence, with psychological well-being being the best predictor (p < 0.001). CONCLUSIONS: Spiritual health, psychological well-being, and resilience are factors that influence treatment adherence of the patients undergoing hemodialysis, with psychological well-being having the greatest contribution to improving patient's treatment adherence. Interventions effective in improving psychological well-being, spiritual health and resilience can improve treatment adherence of patients undergoing hemodialysis. Healthcare workers must pay more attention to the factors affecting treatment adherence of patients undergoing hemodialysis.

Prediction of accident-proneness among a sample of Iranian workers: usefulness of an adjusted version of the Health Belief Model with spiritual health.

BACKGROUND: Workforce health is one of the primary and challenging issues, especially in industrialized countries. The purpose of the present study was to evaluate the ability to predict accident-proneness among Saveh Industry workers in Iran, based on an extended Health Belief Model, that included the construct of spiritual health. METHOD: This descriptive-analytical study was conducted in 2022 on 384 workers in Saveh, Iran. The study aimed to explore relationships between accident proneness behavior, spiritual health, and health beliefs. The accident-proneness questionnaire consisted of two parts: the first part included demographic questions, and the second part comprised 9 sections covering personality traits, workplace harmful factors, miscellaneous factors, musculoskeletal disorders, safety culture, safety attitudes, job stress, organization interest, and degree of risk-taking. The Health Belief Model included 31 questions, while spiritual health was measured with the 20-question Paloutzian and Ellison questionnaire. The collected data were analyzed using SPSS version 26 software. RESULTS: In terms of accident proneness, 229 (59.6%), exhibited high levels, 148 (38.5%) had medium levels, and 7 (1.8%) showed low levels of accident-proneness. Hierarchical multiple regression analysis showed that in the first model, variables of perceived self-efficacy, vulnerability, and severity independently predicted workers accident proneness, explaining a total of 43% of variance in accident proneness behavior. In the second step, perceived self-efficacy (ß = 34%), perceived sensitivity (ß = 27%), spiritual health (ß = 16%), and perceived severity (ß = 12%) were included, respectively, which explained a total of 46% of the variance of accident-prone behavior of workers. CONCLUSION: Given the high rate of accident proneness observed in this study, there is a critical need for policymakers and health planners to design policies aimed at mitigating the risks associated with occupational accidents. Furthermore, the findings highlight the potential of integrating spiritual health into the Health Belief Model, as a conceptual framework for planning effective intervention programs to enhance workplace safety.

Positive Social Mentalities and Quality of Spiritual Living in Old Age: Roles of Social Participation and Life Meaning.

Quality of spiritual living (QSL) in old age is closely related to the health and well-being of older adults. It is necessary to explore the psychosocial factors and mechanisms that affect the QSL of older adults. The researchers investigated 512 older Chinese people using the positive social mentalities scale, social participation scale, sense of life meaning scale, and spiritual living self-assessment questionnaire. (1) Positive social mentalities (PSMs), social participation (SP), and life meaning (LM) had significant positive correlations with QSL of older adults; (2) SP and LM had serial mediating effects between PSMs and QSL. PSMs influenced QSL through the serial mediating effects of SP and LM. It revealed the critical psychosocial factors and the mechanism affecting QSL in old age, which can provide scientific reference for implementing an active aging strategy.

Enhancing training in spiritual and religious competencies in mental health graduate education: Evaluation of an integrated curricular approach.

Despite practice guidelines for multiculturally competent care, including spiritual/religious diversity, most mental health graduate training programs do not formally address spiritual/religious competencies. Thus, we enhanced the Spiritual Competency Training in Mental Health (SCT-MH) course curriculum to train graduate students in foundational attitudes, knowledge, and skills for addressing clients' spirituality and/or religion (S/R). The hybrid (online and in-person) SCT-MH course curriculum was integrated into existing required graduate clinical courses (replacing 15% of a course's curriculum) and taught to 309 students by 20 instructors in 20 different graduate training programs across counseling, psychology, and social work disciplines. Using a multiple baseline waitlist control design in which students served as their own controls, students completed validated assessments at three timepoints evaluating their spiritual/religious competencies for understanding the intersection between S/R and mental health. We also collected qualitative data from the students to evaluate acceptability of the content and format of the training program. Students' scores on all seven measures of spiritual/religious competencies had a statistically significant positive increase after engaging with the SCT-MH curriculum compared to the control period. At the end of the course, 97% of the students envisioned using spiritually integrated therapy techniques with their clients at least some of the time, 92% or more rated the materials as helpful and relevant, and 96% were satisfied with the training modules. Results demonstrate that dedicating a small (i.e., 6 hours of class time; 10 hours outside class time) but intentional amount of course time to teaching spiritual/religious competencies increases students' attitudes, knowledge, and skills for attending to clients' S/R in clinical practice. The SCT-MH hybrid course content is freely available to all graduate programs on our website. https://www.spiritualandreligiouscompetenciesproject.com/resources/sct-mh.

What enhances the quality of death and dying? A perspective from patients with terminal cancer.

AIM: This study aimed to determine which factors improve the quality of dying and death from the point of view of patients with cancer who are nearing the end of their lives. The goal was to find out what they think are necessary conditions for a good death and how they would like to be cared for and supported at the end of their lives. METHODS: This study used an exploratory research approach. Purposive sampling was used to select 21 participants from two hospices in Bengaluru and Hyderabad (Karunashraya and Sparsh), and Karnataka Cancer Hospital in Bangalore, India. Semi-structured interviews were undertaken to obtain data from the patients. Thematic analysis was used to examine the data. RESULTS: Four themes were identified: 1) Spirituality and religiosity, 2) socioemotional support, 3) Breaking silence about the stage of the disease and 4) Preparation for and embracing death. There were distinct sub-themes within some of these that were highlighted using quotes from the participants. CONCLUSIONS: The study provided a comprehensive understanding of end-of-life care, the criteria for a high-quality end of life, strategies for achieving it, and the quality of the dying process and death in advanced cancer patients. Studying patients' experiences will help inform a more robust intervention strategy and action plan to improve the quality of end-of-life care in the Indian community.

Heart Failure Care Facilitators and Barriers in Rural Haiti: A Qualitative Study.

Background: Heart failure (HF) is a leading cause of hospitalizations in Haiti. However, few patients return for outpatient care. The factors contributing to chronic HF care access are poorly understood. Objective: The purpose of this study is to investigate the facilitators and barriers to accessing care for chronic HF from the patients' perspectives. Methods: We conducted a qualitative descriptive study of 13 patients with HF participating in three group interviews and one individual interview. We recruited patients after discharge from a nongovernmental organization-supported academic hospital in rural Haiti. We employed thematic analysis using emergent coding and categorized themes using the socioecological model. Findings: Facilitators of chronic care included participants' knowledge about the importance of treatment for HF and engagement with health systems to manage symptoms. Social support networks helped participants access clinics. Participants reported low cost of care at this subsidized hospital, good medication accessibility, and trust in the healthcare system. Participants expressedstrong spiritual beliefs, with the view that the healthcare system is an extension of God's influence. Barriers to chronic care included misconceptions about the importance of adherence to medications when symptoms improve and remembering follow-up appointments. Unexpectedly, participants believed they should take their HF medications with food and that food insecurity resulted in missed doses. Lack of social support networks limited clinic access. The nonhealthcare costs associated with clinic visits were prohibitive for many participants. Participants expressed low satisfaction regarding the clinic experience. A barrier to healthcare was the belief that heart disease caused by mystical and supernatural spirits is incurable. Conclusions: We identified several facilitators and barriers to chronic HF care with meaningful implications for HF management in rural Haiti. Future interventions to improve chronic HF care should emphasize addressing misconceptions about HF management and fostering patient support systems for visit and medication adherence. Leveraging local spiritual beliefs may also promote care engagement.

CCNP Innovations in Neuropsychopharmacology Award: The psychopharmacology of psychedelics: where the brain meets spirituality.

For 3000 years, psychedelics have been used in religious contexts to enhance spiritual thinking, well-being, and a sense of community. In the last few years, a renaissance in the use of psychedelic drugs for mental disorders has occurred in Western society; consequently, a pressing scientific need to elucidate the intricate mechanisms underlying their actions has arisen. Psychedelics mainly bind to serotonin (5-HT) receptors, particularly 5-HT2A receptors, but may also bind to other receptors. Unlike conventional psychotropic drugs used in psychiatry, psychedelics introduce a distinctive complexity. They not only engage in receptor activation, but also exert influence over specific neural circuits, thereby facilitating transformative cognitive experiences and fostering what many have identified as a spiritual contemplation or mystical experience. This comprehensive review describes clinical studies that have examined the propensity of psychedelics to enhance spiritual, mystical, and transcendent cognitive states. This multifaceted nature, encompassing diverse components and paradigms, necessitates careful consideration during the investigation of psychedelic mechanisms of action to avoid oversimplification. The present review endeavours to elucidate the mechanisms underlying the actions of 2 principal psychedelic substances, psilocybin and lysergic acid diethylamide (LSD), with a focus on monoamine and glutamate receptor mechanisms; molecular aspects, such as neuroplasticity and epigenetics; as well as the impact of psychedelics on brain circuits, including the default mode network and the cortico-striato-thalamo-cortical network. Given their distinctive and intricate mechanisms of action, psychedelics necessitate a novel conceptual framework in psychiatry, offering insight into the treatment of mental health disorders and facilitating the integration of the realms of brain, mind, and spirituality.

Revisiting Louis Fry's spiritual leadership model in confessional school teachers using structural equation modeling (SEM).

This paper examines the construct validity of the spiritual leadership model proposed by (Fry et al. 2005). The analysis focused on examining the relationships proposed by the model through CFA and structural equation modeling (SEM). A confirmatory factor analysis indicated the SL scale provides acceptable reliability and convergent validity indexes; however, it did not achieve discriminant validity. Model convergence was obtained using MLR (Robust Maximum Likelihood) methods. However, when the robustness indices were analyzed, it was found that some obtained acceptable results and others were deficient, so that an acceptable model fit was not achieved. Regarding the relationship between the hypotheses, it was found that they were significant in all cases except for the reciprocal relationship between vision and altruistic love. In light of this finding, alternative models were developed that also failed to yield significant results. The theoretical and methodological discussion focuses on the relationships of Fry's model and addresses the need to review its causal nature, considering recursive and non-recursive aspects.

The relationship between spiritual health, quality of life, stress, anxiety and depression in working women.

Background: While there are benefits to women entering the workforce, there are also drawbacks, such as stress, anxiety, and depression, which can lower quality of life. However, some research indicates that women's spiritual health may be a protective factor in these situations. This study is to explore the relationship between spiritual health and quality of life, stress, anxiety, and depression among a population of women working in health care centers, given the existence of such a relationship among women. Methods: In 2022, 500 women who worked in health centers in Izeh City, Iran, participated in this cross-sectional survey. The clustered census sampling approach was used for the sample. The research participants completed a 12-item quality of life questionnaire on spiritual health, stress, anxiety, and depression as part of the data gathering process. The data were examined using independent t tests, one-way variance, and Pearson correlation after being entered into SPSS-24. Results: Of the participants, 18% were single and 68% were married. In terms of depression, stress, and anxiety, the mean and standard deviation were 8.26 ± 5.78, 11.26 ± 4.89, and 7.91 ± 0.98, respectively. The quality of life had a mean and standard deviation of 30.82 ± 3.56. Women who were unmarried and had more work experience reported a considerably greater quality of life (p < 0.05). The findings indicated that stress and spiritual health (p = 0.001), anxiety and spiritual health (p = 0.032), and depression and spiritual health (p = 0.024) all had a significant and inverse association. Furthermore, a strong and positive correlation was found (p = 0.001) between spiritual health and quality of life. Conclusion: The study's conclusions demonstrated a clear link between spiritual health and life satisfaction, suggesting that working women's quality of life may be raised by treatments that support spiritual health. Furthermore, the findings demonstrated a significant inverse relationship between spiritual health and the psychological variables of stress, anxiety, and depression. This suggests that by understanding the factors influencing mental health and the role of spiritual health moderator, it may be possible to improve the psychological state of employed women.

Exploring emotional well-being, spiritual, religious and personal beliefs and telomere length in chronic pain patients-A pilot study with cross-sectional design.

Living with chronic pain is associated with substantial suffering and high societal costs. Patient reported outcomes (PROM's) and cellular ageing should be considered in pain management. The aim of this study was to explore correlations of PROM's and cellular ageing (telomere length [TL] and telomerase activity [TA]) amongst patients with chronic non-malignant pain. This was an explorative pilot study with cross-sectional design and recruitment was done at two pain rehabilitation facilities in Sweden, with inpatient setting/integrative care and outpatient setting/multimodal care, respectively. Eighty-four patients were enrolled by referral to pain rehabilitation in Sweden. The main outcome measures collected after admission in addition to TL and TA were the following PROMs: Numerical Rating Scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), Hospital Anxiety and Depression Scale (HADS), Five Facets Mindfulness Questionnaire (FFMQ), WHO Quality of Life-Spiritual, Religious and Personal Beliefs (WHOQoL-SRPB) and EuroQol 5 Dimensions (EQ-5D). All the PROM's showed evidence of poor overall health status among the participants. TL correlated negatively with HADS score (r = -.219, p = .047) and positively with WHOQoL-SRPB (r = .224, p = .052). TL did not correlate with any of the pain measures. TA correlated positively with pain spread (r = .222, p = .049). A mediation of the direct effect of spiritual well-being on TL by anxiety and depression could be shown (b = 0.008; p = .045). The correlations between TL and SRPB and anxiety and depression suggest some importance of emotional and SRPB dimensions in pain management, with implications for cellular aging, which may warrant further study. Trial registration: ClinicalTrials.gov Identifier: NCT02459639.

Growth of a Movement Through Spiritual Leadership: Faith Community Nursing in the United States.

ABSTRACT: Faith community nursing often is anchored in a community through local networks that support the development of both the ministry and the faith community nurse. Such local networks are established and sustained through the leadership of faith community nurses (FCNs). A research study interviewed nurses recognized as foundational to the development of FCNs in the United States from 1984 to 2000. The Waterwheel Model of Spiritual Leadership was used as a construct for interviewing 24 FCN leaders discovered through Delphi methodology. An adaptation of Colazzi's method of qualitative analysis was used to analyze data collected in videotaped format. Three predominant themes emerged that may be instrumental to developing future FCN leaders and growth of this specialty nursing practice.

My culture soothes.

In the poignant words of a 12-year-old indigenous girl from the Pijao ethnicity (Tolima, Colombia), who shared her perspective before succumbing to leukaemia, we gain a profound understanding of health from her unique cultural viewpoint. Growing up in El Escobal, indigenus community, with her sister, she experienced the spiritual strength and unity that their culture attributes to twins. For her, health was deeply intertwined with the traditions and rituals of her people, emphasising the healing powers of plants and spiritual harmonisation.She observed a stark contrast between indigenous and Western perspectives on medicine and spirituality. In her reflection, the young girl highlighted the universal language of mutual learning and support that transcends cultural differences. Her message underscores the importance of cultural harmony and the healing power of shared human experiences, advocating for a world where diverse beliefs and practices contribute to collective strength and understanding.This text was her response to the question, "What is health?" as part of one of the methodological exercises in the doctoral research of Pinzón-Segura MC. Teoría del Intersticio Afectivo: Un nuevo enfoque feminista decolonial de análisis de políticas públicas [Internet]. Bogotá: Repositorio virtual de la Universidad Nacional de Colombia; 2024. The thesis, awarded with the distinction of summa cum laude, included various methods such as participant observation, sociological interviews, and discourse analysis of government documents. The question "What is health?" specifically guided 40 creative narrative workshops, which were an integral component of the ethnography and arts-based research design.

Religiosity and Spirituality Development: An Accelerated Longitudinal Design.

BACKGROUND AND OBJECTIVES: The central aim of the present study was to model developmental trends in communal and independent religious practices, spirituality, positive and negative religious/spiritual coping, as well as their confluence, across ages 45-80. RESEARCH DESIGN AND METHODS: Participants derived from the Notre Dame Study of Health & Well-being (NDHWB), a longitudinal study spanning 10 years in an age-heterogeneous sample. Using 2-level multilevel models, we estimated no change, linear change, quadratic change, and cubic change functions across ages 45-80 in each construct. Cohort differences were also tested. RESULTS: Communal and independent practices, spirituality, negative religious/spiritual coping, as well as composite religiosity/spirituality, followed cubic trajectories across mid- to later life. Communal religious practices peaked twice: once at 45 and again around age 70. Independent practices, in contrast, peaked at age 45 and then declined in a stage-like manner until age 80. Spirituality reached its nadir around age 50 and peaked in the early 70s; the reverse was true for negative religious/spiritual coping. The change trajectory in composite religiosity/spirituality most resembled that of independent religious practices. Finally, positive religious/spiritual coping followed a linear trajectory, but a cohort difference precluded its interpretation as developmental change. DISCUSSION AND IMPLICATIONS: Individuals appear to engage with their faith in different ways as they age, meaning extant conclusions about age-related differences and change in global religiosity/spirituality may be distorted.

The landscape of spiritual health and spirituality in Canada: A scoping review protocol.

INTRODUCTION: Currently, literature on spiritual health remains limited. Even more so, literature on spiritual health remains limited in Canada. This is exacerbated by the fact that spiritual health is a term that remains widely contested with no concrete definition. Meanwhile, the semantic connection between "religion" and "spirituality" remains ambiguous in the West and scholars hold different positions. In this paper, we outline our scoping review protocol to describe the current landscape of spiritual health and spirituality (in relation to health) research in Canada, including the meaning and understanding behind these two concepts. METHODS AND ANALYSIS: This protocol for our scoping review is documented in accordance with the PRISMA-P reporting guidelines and adheres to Arksey and O'Malley's scoping review methodology. We will conduct a search strategy across select electronic databases and review the reference lists of chosen papers. Two reviewers, HMB and MM, will independently and blindly screen all title/abstracts and full-text studies for eligibility. Any Canadian-situated studies that centrally mention and focus on "spirituality" or "spiritual health" will be included. Relevant variables will be extracted through an iterative process, with the data charting being continuously reviewed and refined. Findings from this scoping review will support the future of health research and conceptual expansion of health beyond the mental, physical and social. Approval from a research ethics board is not required, nor has it been obtained, as the data is derived from journal articles and academic publications.

Multidisciplinary oncology clinicians' experiences delivering spiritual care to patients with cancer and their care partners.

PURPOSE: To understand multidisciplinary healthcare clinicians' meaningful and challenging experiences providing spiritual care to patients with cancer and their care partners. METHODS: Multidisciplinary clinicians who participated in a communication training program supported by the National Cancer Institute or a palliative care training for nurses (N = 257) responded to two, open-ended questions about meaningful and challenging experiences of providing spiritual care. A thematic analysis of responses using an iterative, inductive approach was conducted until saturation was reached. RESULTS: Participants from nursing (68%), social work (22%), and chaplaincy (10%) responded to open-ended survey questions. Three themes related to meaningful experiences of providing spiritual care emerged: building authentic interpersonal connection with patients and care partners; creating intentional space for patients and care partners to inform spiritual care; and actively supporting patients and care partners in their processes with spirituality. Three themes related to challenging experiences of providing spiritual care emerged: contextual factors and clinical circumstances complicate provision of spiritual care; facing barriers to providing high-quality, patient-centered care; and navigating ethical and logistical issues that affect spiritual and other care. CONCLUSION: Clinicians derive meaning from a range of experiences throughout their provision of spiritual care to patients with cancer. However, they also face many challenges in delivering person-centered spiritual care in cancer settings, with some challenges reflecting significant gaps in spiritual care knowledge and training. Findings can guide future training and educational endeavors for multidisciplinary clinicians in the domain of spiritual care.

The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer.

OBJECTIVE: Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity. METHODS: Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates. RESULTS: Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables. CONCLUSIONS: Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.

Existential Needs in Mental Health - Who Cares? A Mixed Methods Study in Norway.

Mental health care that is open to patients' existential needs requires well-trained professionals who work in teams and use an open conceptualization of spirituality, religion and other meaning-making domains. Using a mixed methods approach, this article explores how professionals (n = 262) in secular Norway perceive obstacles and opportunities in existential care. The results show correlations between age group, personal religiosity, terminology and perceived expertise. Commitment is high, but collaboration with chaplains and team training are neglected.