Passage meditation improves caregiving self-efficacy among health professionals: a randomized trial and qualitative assessment.

Relational caregiving skills remain seldom studied in health professionals. We evaluated effects on health professional relational caregiving self-efficacy from an eight-week, 16-hour training in self-management tools. Physicians, nurses, chaplains, and other health professionals were randomized after pretest to treatment (n = 30) or waiting list (n = 31). Training used a previously researched program of Easwaran (1991/1978) derived from spiritual wisdom traditions. Changes were measured using a 34-item caregiving self-efficacy scale. Positive effects were observed at posttest, eight- and 19-week follow-up (ds = .38, .47, .37, all ps < .05), and were mediated by adherence to practices and stress reductions (p < .05), findings also obtained in qualitative interviews (n = 24). Evidence suggests this program enhances health professional caregiving self-efficacy, and may merit inclusion in training curricula.

Meditation lowers stress and supports forgiveness among college students: a randomized controlled trial.

OBJECTIVE AND PARTICIPANTS: The authors evaluated the effects on stress, rumination, forgiveness, and hope of two 8-week, 90-min/wk training programs for college undergraduates in meditation-based stress-management tools. METHODS: After a pretest, the authors randomly allocated college undergraduates to training in mindfulness-based stress reduction (MBSR; n = 15), Easwaran's Eight-Point Program (EPP; n = 14), or wait-list control (n = 15). The authors gathered pretest, posttest, and 8-week follow-up data on self-report outcome measures. RESULTS: The authors observed no post-treatment differences between MBSR and EPP or between posttest and 8-week follow-up (p > .10). Compared with controls, treated participants (n = 29) demonstrated significant benefits for stress (p < .05, Cohen's d = -.45) and forgiveness (p < .05, d = .34) and marginal benefits for rumination (p < .10, d = -.34). CONCLUSIONS: Evidence suggests that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Such programs merit further study as potential health-promotion tools for college populations.

Passage meditation reduces perceived stress in health professionals: a randomized, controlled trial.

The authors evaluated an 8-week, 2-hr per week training for physicians, nurses, chaplains, and other health professionals using nonsectarian, spiritually based self-management tools based on passage meditation (E. Easwaran, 1978/1991). Participants were randomized to intervention (n = 27) or waiting list (n = 31). Pretest, posttest, and 8- and 19-week follow-up data were gathered on 8 measures, including perceived stress, burnout, mental health, and psychological well-being. Aggregated across examinations, beneficial treatment effects were observed on stress (p = .0013) and mental health (p = .03). Treatment effects on stress were mediated by adherence to practices (p = .05). Stress reductions remained large at 19 weeks (84% of the pretest standard deviation, p = .006). Evidence suggests this program reduces stress and may enhance mental health.

A qualitative examination of a spiritually-based intervention and self-management in the workplace.

This qualitative study assesses the experience of an intervention that provided spiritually based self-management tools to hospital-based nurses. Drawing on wisdom traditions of the major world religions, the eight point program can be practiced by adherents to any religious faith, or those outside of all traditions. Five of eight program points were perceived as directly useful in improving the nurses' workplace interactions and enhancing fulfillment of compassionate caregiving missions. The findings suggest that this program can be an effective intervention among nurses in dealing with the demands of the healthcare environment and may be a resource for continuing education curricula.

Does writing affect asthma? A randomized trial.

OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written emotional expression improves pulmonary function in patients with asthma compared with writing on neutral topics. METHODS: We conducted a randomized, controlled trial of outpatient asthmatics recruited from hospitals and the community. Of the 137 adult patients with asthma who were randomized, 117 began and 114 completed the study. Patients were randomly assigned to write for 20 minutes, once per week, for 3 weeks about stressful experiences (n = 41), positive experiences (n = 37), or neutral experiences (n = 36; control group). At baseline, postintervention, and 2-month follow up, patients were assessed by spirometry. RESULTS: The mean change from baseline to 2-month follow up in percentage of predicted forced expiratory volume in 1 second (FEV1) was 4.2% in the stress-writing group, 1.3% in the positive-writing group, and 3.0% in the control group. In forced vital capacity (FVC), there was 3.1% improvement in the stress-writing group, 3.6% in the positive-writing group, and 2.4% in the control group. These changes were not statistically or clinically significant. CONCLUSIONS: The present study reduces confidence in the ability of written emotional expression to benefit the disease status of asthma patients.

Volunteering is associated with delayed mortality in older people: analysis of the longitudinal study of aging.

The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (>70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social integration are controlled. We used Cox proportional hazards analyses to assess the unadjusted and adjusted associations between frequency of volunteering and time-to-death (96-month follow-up). Death occurred in 38.3 percent of the sample. After adjusting for covariates, frequent volunteers had significantly reduced mortality compared to non-volunteers. This association was greatest for those who frequently visited with friends or attended religious services.

Spirituality, religion, and health. An emerging research field.

The investigation of spiritual/religious factors in health is clearly warranted and clinically relevant. This special section explores the persistent predictive relationship between religious variables and health, and its implications for future research and practice. The section reviews epidemiological evidence linking religiousness to morbidity and mortality, possible biological pathways linking spirituality/religiousness to health, and advances in the assessment of spiritual/religious variables in research and practice. This introduction provides an overview of this field of research and addresses 3 related methodological issues: definitions of terms, approaches to statistical control, and criteria used to judge the level of supporting evidence for specific hypotheses. The study of spirituality and health is a true frontier for psychology and one with high public interest.

Religion and spirituality. Linkages to physical health.

Evidence is presented that bears on 9 hypotheses about the link between religion or spirituality and mortality, morbidity, disability, or recovery from illness. In healthy participants, there is a strong, consistent, prospective, and often graded reduction in risk of mortality in church/service attenders. This reduction is approximately 25% after adjustment for confounders. Religion or spirituality protects against cardiovascular disease, largely mediated by the healthy lifestyle it encourages. Evidence fails to support a link between depth of religiousness and physical health. In patients, there are consistent failures to support the hypotheses that religion or spirituality slows the progression of cancer or improves recovery from acute illness but some evidence that religion or spirituality impedes recovery from acute illness. The authors conclude that church/service attendance protects healthy people against death. More methodologically sound studies are needed.

'Does religion cause health?': differing interpretations and diverse meanings.

The question, 'Does religion (or spirituality) cause physical health benefits?' may be given at least four diverging interpretations in terms of causal path diagrams. In common usage, the question may be interpreted to indicate that religion causally influences health by: (1) any mechanism, including well-established factors such as social support and improved health behaviors; (2) additional mechanisms, such as enhanced positive psychological states (e.g. faith, hope, inner peace) acting through psychoneuroimmunologic or psychoneuroendocrinologic pathways; (3) offering psychological strength for acquiring or maintaining positive health behaviors; or (4) causally influencing health by distant healing or intercessory prayer. We review historical confusion between these interpretations, arguing that disentangling them is important for collaborative health care, promotion and research.

Cultivating mindfulness: effects on well-being.

There has been great interest in determining if mindfulness can be cultivated and if this cultivation leads to well-being. The current study offers preliminary evidence that at least one aspect of mindfulness, measured by the Mindful Attention and Awareness Scale (MAAS; K. W. Brown & R. M. Ryan, 2003), can be cultivated and does mediate positive outcomes. Further, adherence to the practices taught during the meditation-based interventions predicted positive outcomes. College undergraduates were randomly allocated between training in two distinct meditation-based interventions, Mindfulness Based Stress Reduction (MBSR; J. Kabat-Zinn, 1990; n=15) and E. Easwaran's (1978/1991) Eight Point Program (EPP; n=14), or a waitlist control (n=15). Pretest, posttest, and 8-week follow-up data were gathered on self-report outcome measures. Compared to controls, participants in both treatment groups (n=29) demonstrated increases in mindfulness at 8-week follow-up. Further, increases in mindfulness mediated reductions in perceived stress and rumination. These results suggest that distinct meditation-based practices can increase mindfulness as measured by the MAAS, which may partly mediate benefits. Implications and future directions are discussed.

Effects of a group forgiveness intervention on forgiveness, perceived stress, and trait-anger.

The goal of this study was to evaluate the effects of a 6-week forgiveness intervention on three outcomes: (a) offense-specific forgiveness, (b) forgiveness-likelihood in new situations, and (c) health-related psychosocial variables, such as perceived stress and trait-anger. Participants were 259 adults who had experienced a hurtful interpersonal transgression from which they still felt negative consequences. They were randomized to a forgiveness-training program or a no-treatment control group. The intervention reduced negative thoughts and feelings about the target transgression 2 to 3 times more effectively than the control condition, and it produced significantly greater increases in positive thoughts and feelings toward the transgressor. Significant treatment effects were also found for forgiveness self-efficacy, forgiveness generalized to new situations, perceived stress, and trait-anger.

Spirituality and health: what's the evidence and what's needed?

In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and conclusions. We hope to introduce the dismissing critic to suggestive data that may create tempered doubt and to introduce the uncritical advocate to issues and concerns that will encourage greater modesty in the making of claims and drawing of conclusions. We comment on the following questions: Do specific RS factors influence health outcomes? What possible mechanisms might explain a relation, if one exists? Are there any implications for health professionals at this point in time? Recommendations concern the need to improve research designs and measurement strategies and to clarify conceptualizations of RSfactors. RSfactors appear to be associated with physical and overall health, but the relation appears far more complex and modest than some contend. Which specific RS factors enhance or endanger health and well-being remains unclear.

Correlates of self-perceptions of spirituality in American adults.

To advance knowledge in the study of spirituality and physical health, we examined sociodemographic, behavioral, and attitudinal correlates of self-perceptions of spirituality. Participants were a nationally representative sample of 1,422 adult respondents to the 1998 General Social Survey. They were asked, among other things, to rate themselves on the depth of their spirituality and the depth of their religiousness. Results indicated that, after adjustment for religiousness, self-perceptions of spirituality were positively correlated with being female (r = .07, p < .01), having a higher education (r = .12, p < .001), and having no religion (r = .10, p < .001) and inversely correlated with age (r = -.06, p < .05) and being Catholic (r = -.08, p < .01). After adjustment for these sociodemographic factors, self-perceptions of spirituality were associated with high levels of religious or spiritual activities (range in correlations = .12-.38, all p < .001), low cynical mistrust, and low political conservatism (both r = -.08, p < .01). The population was divided into 4 groups based on their self-perceptions of degree of spirituality and degree of religiousness. The spiritual and religious group had a higherfrequency of attending services, praying, meditating, reading the Bible, and daily spiritual experience than any of the other 3 groups (all differences p < .05) and had less distress and less mistrust than the religious-only group (p < .05 for both). However, they were also more intolerant than either of the nonreligious groups (p < .05 for both) and similar on intolerance to the religious-only group. We conclude that sociodemographicfactors could confound any observed association between spirituality and health and should be controlled. Moreover, individuals who perceive themselves to be both spiritual and religious may be at particularly low risk for morbidity and mortality based on their good psychological status and ongoing restorative activities.