Spirituality may promote mental health recovery for people with schizophrenia in Southeast Asia
1. In this systematic review, religion-based spirituality was found to be an important factor in the recovery of people with schizophrenia (PWS) in Southeast Asia.
2. Furthermore, other elements of the Connection, Hope, Identity, Meaning, and Empowerment (CHIME) recovery model, such as identity, stigma, and hope, were found to play a role in mental health recovery for PWS in Southeast Asia.
Evidence Rating Level: 1 (Excellent)
People with schizophrenia (PWS) living in Southeast Asia may recover better from their illness when the focus is placed on elements such as spiritual and culture-specific factors, rather than biomedical factors. Presently, there is limited evidence on mental health recovery of this patient population. As a result, the objective of the present systematic review was to investigate the mental health practices and their alignment with the Connection, Hope, Identity, Meaning, and Empowerment (CHIME) recovery model in PWS living in Southeast Asia.
Of 842 identified records, 31 studies were included from various databases from 2004 to January 2021. Studies were included if they were written in English, conducted on adults in Southeast Asia, and evaluated a response of PWS to their condition during or after treatment. Studies were excluded if they did not focus on patients diagnosed with schizophrenia, or if they were conducted in Singapore, as Singapore is classified as a developed country and is distinct from other Southeast Asian countries. The review was performed using PRISMA guidelines. The Critical Appraisals Skills Programme (CASP) tools were used for quality assessment. The primary outcome was to identify factors associated with mental health recovery in PWS in Southeast Asia and how they align with the CHIME recovery model.
The results demonstrated that overall, religiosity and spirituality aided in mental health recovery. For instance, having a religious affiliation and being part of a religious community lowered distress and was seen as a positive coping mechanism through actions such as prayer, meditation, or reading scripture. Furthermore, other elements such as identity, stigma, and hope were found to play a role in the recovery of PWS in Southeast Asia. Despite these results, the study was limited by the exclusion of languages other than English which may have limited the comprehensiveness of the review. Nonetheless, the present study demonstrated that PWS in Southeast Asia require culturally specific approaches that align with the CHIME recovery model for mental health recovery.
Spirituality, among many other factors, may help promote healthy ageing
1. In this systematic review and synthesis of theoretical models, several intrinsic and extrinsic factors influenced healthy ageing (HA), including cognitive, psychological, physical, social, and environmental dimensions.
2. Furthermore, the influence of spirituality on healthy ageing occurred through its interdependence across other domains as well as its influence across the individual’s lifespan.
Evidence Rating Level: 1 (Excellent)
Healthy ageing (HA) has remained difficult to characterize given a lack of consensus regarding the multitude of concepts and definitions in the literature. To date, studies have not explored and synthesized the theoretical models related to HA, which poses barriers to research in the field. As a result, the objective of the present study was to systematically review the literature on HA, analyze the theoretical models relating to HA, and provide an overview of the dimensions and attributes of HA.
Of 10,741 identified records, 59 (n=65 models/definitions) studies from 16 countries in Europe, Asia, and America were included from various databases from 1960-2022. Studies were included if they had new theoretical definitions or models with a normative description of ageing. Studies were excluded if they were empirical models, operational definitions, or validations, if they investigated HA determinants and risk factors, or if they studied animal models. The review was performed using PRISMA guidelines. The primary outcome was concepts and definitions related to HA.
The results demonstrated that spiritual dimensions were included in 16 of the included frameworks related to HA. Spirituality played a role across the life course and was also related to subjective well-being. In addition to spirituality, HA was found to depend on various factors, with cognitive, psychological, physical, and social dimensions being included in most investigated frameworks. Despite these results, the study was limited by the exclusion of book chapters and non-peer-reviewed articles which may have limited the comprehensiveness of the review. Nonetheless, the present study adds several conceptual terms and dimensions to guide future research in HA.
1. In this systematic review and meta-analysis, palliative care helped alleviate symptom burden and provided greater satisfaction for patients with progressive neurologic diseases and their caregivers.
2. Furthermore, in the studies that included spiritual care, there was a strong association between spiritual care and both lower caregiver burden and lower symptom burden.
Evidence Rating Level: 1 (Excellent)
Individuals with progressive neurologic diseases experience symptom distress that may rival that of terminal cancer. However, there is limited data evaluating the benefit of palliative care in this population As a result, the objective of the present study was to review the literature of the effects of palliative interventions in progressive neurologic diseases on both patient-centered and caregiver-centered outcomes.
Of 23,767 identified records, 27 (n=3431 patients, n=1776 caregivers) studies were included from various databases from database inception to September 2021. Studies were included if they investigated adults with a progressive neurological disease (e.g., Parkinson’s disease, dementia, multiple sclerosis, etc.) who received palliative care. Studies were excluded if >50% of the patients enrolled in the study had a non-progressive neurologic disease. The review was performed using PRISMA guidelines. Risk of bias was assessed using the Cochrane Collaboration risk of bias tool version 2 (RoB2) and risk of bias in nonrandomized studies (ROBINS-I) for quasi-experimental studies. Statistical analysis was performed using random-effects models. The primary outcome was the impact of palliative care interventions on patient-centered and caregiver-centered outcomes.
The results demonstrated that palliative care interventions helped reduce the symptom burden of patients with progressive neurologic disease and improved satisfaction among patients and caregivers. Although few of the investigated studies included spiritual care, those that included spiritual care showed a strong association with both lower caregiver burden and lower symptom burden. Despite these results, the study was limited by study heterogeneity due to clinical and methodological differences. Nonetheless, the present study further supports the importance of palliative care in patients suffering from progressive neurological diseases.
Spirituality may help patients with weight management after bariatric surgery
1. In this cross-sectional study, spiritual practices such as yoga, meditation, and being involved at one’s place of worship were associated with better outcomes after bariatric surgery, including higher percent weight loss (%WL), improved eating adherence, and increased physical activity.
2. In addition, the majority of participants believed that spirituality did or could impact their weight loss after bariatric surgery.
Evidence Rating Level: 2 (Good)
Spirituality has been shown to be correlated with several health-related behaviors including reduced substance use and increased physical activity. However, little is known about the influence of spirituality on weight management. As a result, the objective of the present study was to investigate the role of spirituality on lifestyle changes and weight management in the years following bariatric surgery.
Patients who had recently undergone bariatric surgery at a bariatric center in the United States were contacted. Of 1,129 patients who were contacted, 152 (64.5% Roux-en-Y gastric bypass, 32.9% sleeve gastrectomy) were included between February 2019 and September 2019. A questionnaire was developed to assess participants’ spiritual practices and health-related behaviors following bariatric surgery. In addition, the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) was used to measure spirituality and religiousness related to physical health. Questionnaires were administered 1-2 years postoperatively. Pearson correlations were used to examine associations between spiritual practices and outcome variables. The primary outcomes were percent weight loss (%WL) and percent excess weight loss (%EWL) after bariatric surgery.
The results demonstrated that the majority of bariatric surgery patients believed that spirituality did or could improve weight loss after their surgery. In addition, multiple spiritual practices such as yoga, meditation, and being involved at one’s place of worship were associated with better outcomes after bariatric surgery, including higher %WL, higher %EWL, healthy eating, and physical activity. Despite these results, the study was limited by a sample size derived from a single center which may limit generalizability. Nonetheless, the present study presented evidence of the benefit of spirituality on lifestyle behaviors and weight outcomes following bariatric surgery.
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