Wellness Check: Spirituality

Patients may demonstrate a high level of acceptability for discussing spirituality in healthcare

1. In this study, almost all patients approved of the proposed history taking prompts related to patient spirituality, and there was a high level of patient acceptability.

2. Furthermore, conversation prompts which did not have religious connotations and focused on individual values were most effective in eliciting spiritual concerns.

Evidence Rating Level: 2 (Good)

Spirituality is well documented to provide several health benefits, which has led to its incorporation in healthcare settings. In Australia, however, there has been little evidence regarding the preferred way to engage in spiritual discussions and spiritual history-taking which has prevented it from being routine practice. As a result, the objective of the present mixed methods cross sectional study was to identify the preferred wording for discussing spirituality in a hospital setting, and the demographic features of patients in relation to their preferences regarding spiritual history-taking.

Participants were identified and recruited from 6 hospitals across Sydney, Australia and were asked to participate in a survey and a qualitative interview to explain survey responses. The survey included demographic information and questions on spirituality. 897 participants completed the survey (n=422 female) and 41 were interviewed. Quantitative data was analyzed using Fischer’s Exact tests and Crammer’s V. Qualitative data was coded using theoretical thematic analysis.

Results demonstrated that almost all patients approved of the proposed historical history prompts and there was a high level of patient acceptability. Furthermore, conversation prompts which did not have religious connotations and focused on individual values were most effective in eliciting spiritual concerns. Despite these findings, the study was limited by the exclusion of seriously ill patients who may have had different spiritual needs. Nonetheless, this study demonstrated that most patients were happy to be asked about spirituality by clinical staff, and that conversation prompts which focused on individual values were most effective in speaking about spiritual concerns.

Spiritual health promotion may improve happiness scores for medical students in Iran

1. In this study, the relationship between spiritual health and happiness was significant amongst medical students in Iran.

2. Furthermore, the students’ happiness scores were not optimal during the COVID-19 pandemic.

Evidence Rating Level: 3 (Average)

Studies have shown that spiritual health plays an integral part in promoting a satisfactory quality of life through several means, including the reduction of mental distress. Compared to students in other fields, medical students face rising mental health problems. As ongoing solutions are being sought to address this issue, the objective of the present descriptive-analytical study was to investigate the relationship between spiritual health and happiness amongst medical students, more specifically during the COVID-19 outbreak.

The study included 409 medical students (71.3% females, mean age 21.6) using a multistage random sampling method from Rafsanjan University of Medical Sciences in Iran. Students were included if they had completed at least 6 months in medical college. Students were excluded if they had a history of mental health disorders or experienced a serious personal tragedy in the previous month. 3 questionnaires were administered: a demographic questionnaire, the Ellison Spiritual Health Questionnaire, and the Oxford Happiness Questionnaire. Qualitative variables were measured using one-sample t-test, analysis of variance and Pearson correlation. Quantitative data were analyzed using the Pearson correlation coefficient.

Study results demonstrated that the relationship between spiritual health and happiness was significant amongst medical students. However, the students’ happiness scores were not optimal during the COVID-19 pandemic. Despite these results, the present study was limited by the absence of a native tool based on Islamic beliefs to measure spiritual health, which may have impacted accuracy. Nonetheless, this study was significant as this was one of the first to examine the relationship between spiritual health and happiness amongst medical students in COVID-19, which may help future plans for health improvement in students.

Religion and spirituality may benefit the physical health of cancer patients

1. In this study, several religion and spirituality (R/S) variables (e.g. spiritual well-being, religious coping, self-rated R/S, etc) displayed a positive association with the physical health of cancer patients.

2. Furthermore, this study found that occasionally, R/S was negatively associated with, or unrelated to health.

Evidence Rating Level: 2 (Good)

Oncological diseases continue to be one of the leading causes of morbidity and mortality in the world. R/S has been shown in the literature to be beneficial for this patient population; however, a greater understanding of the variables within R/S mediating these relationships have not been well established. As a result, the objective of the present systematic review was to synthesize the main R/S variables affecting the physical health of cancer patients and synthesize the major results from the literature.

Of 442 identified studies, 26 were included in the study from 2015 to March 2022.  Studies were included if they studied R/S variables on the physical health (self-perceived or biomarker derived) of cancer patients and survivors. Studies were excluded if they included only mental health outcomes. The study was conducted using the PRISMA 2020 methodology. Quality was assessed using the McMaster Critical Review Form for Quantitative Studies.

The results demonstrated that several religion and spirituality (R/S) variables (e.g. spiritual well-being, religious coping, self-rated R/S, etc.) displayed a positive association with the physical health of cancer patients. Furthermore, R/S was found to be occasionally negatively associated with or unrelated to health. Despite these results, the study was limited by the design of most included studies being cross-sectional, which may impact inferences of causality. However, the study’s identification of R/S variables in the physical health of cancer patients allows for a greater understanding of this relationship whether positive or negative.

Spirituality may improve outcomes in patients suffering from post-traumatic stress disorder

1. In this study, spirituality significantly improved the individual’s ability to ruminate in a constructive manner, thereby promoting positive outcomes.

2. Furthermore, spirituality showed no relationship with the negative outcomes of trauma (e.g. intrusive rumination).

Evidence Rating Level: 3 (Average)

In the literature, higher levels of spirituality have been shown to be associated with lower levels of distress and can be seen as a source of support and guidance in the face of adversity. Post-traumatic stress disorder (PTSD) is one of many distressing psychiatric conditions that may be mediated by positive psychological changes. In order to further evaluate the benefit of spirituality in PTSD, the objective of the present cross-sectional study was to evaluate the impact of spirituality on promoting adaptive outcomes following exposure to traumatic events (e.g. direct rumination, post-traumatic growth and intrusive rumination).

Of 241 participants who accessed the survey via internal advertisements at the University of Liverpool website, 96 (n=68.8% female) were included in the final analysis. Participants were included if they had experienced a Type I traumatic life event after 16 years old. Participants who experienced a traumatic event within the past 4 months were excluded. The survey comprised of participant demographics, the post-traumatic stress diagnostic scale, the event related rumination inventory, the post traumatic growth inventory-short form, and the revised expressions of spirituality inventory. Data was analyzed using moderation analysis and stepwise hierarchical regression analyses.

Results demonstrated that spirituality significantly improved the individual’s ability to ruminate in a constructive manner, thereby promoting positive outcomes. Furthermore, spirituality showed no relationship with the negative outcomes of trauma (e.g., intrusive rumination). Despite these findings, this study was limited as researchers did not include Type II traumas (which are more complex), thereby limiting generalization of results. Nonetheless, the study findings were significant in suggesting that spiritual beliefs may play an important role in mediating the aftermath of traumatic events.

Image: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.