Long-term Care Residents' Views About the Contributions of Christian-based Volunteers in Taiwan: A Pilot Study

This pilot study explored the view from six long-term care residents on the contributions of religious volunteers. The findings suggest that religious volunteers may contribute to long-term care residents’ religious or spiritual health more than non-religious volunteers. However, since religious volunteers lack professional training and competence to attend to patients’ religious needs, they may not afford in-depth spiritual and religious services. Under certain conditions when qualified chaplains are not available, inadequate religious services performed by religious volunteers are still better than no such care at all. However, in order to provide this important aspect of holistic care, we propose that health care policy makers should pay more attention to this topic.     

Exploring the Role of Religiosity and Spirituality in Amniocentesis Decision-Making Among Latinas

Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas’ spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas’ daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God’s will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.     

The Impact of a Breast Cancer Diagnosis on Religious/Spiritual Beliefs and Practices in the UK

The use of religious/spiritual resources may increase when dealing with the stress of a cancer diagnosis. However, there has been very little research conducted into changes in religious/spiritual beliefs and practices as a result of a cancer diagnosis outside the USA. The aim of this study was to examine the impact of a breast cancer diagnosis on patients’ religious/spiritual beliefs and practices in the UK where religious practice is different. The study used two methods. One compared the religious/spiritual beliefs and practices of 202 patients newly diagnosed with breast cancer with those of a control group of healthy women (n = 110). The other examined patients’ perceived change in religious/spiritual beliefs and practices at the time of surgery with those in the year prior to surgery. The aspects of religiousness/spirituality assessed were: levels of religiosity/spirituality, strength of faith, belief in God as well as private and public practices. Patient’s perceived their belief in God, strength of faith and private religious/spiritual practices to have significantly increased shortly after surgery compared with the year prior to surgery. However, there were no significant differences in religious/spiritual beliefs and practices between patients and healthy participants. Change scores demonstrated both a reduction and an increase in religious/spiritual beliefs and practices. Although belief in God, strength of faith and private religious/spiritual practices were perceived by patients to be significantly higher after their cancer diagnosis, no significant differences in religious/spiritual beliefs and practices were found between the cancer group at the time of surgery and the control group. Different methodologies appear to produce different results and may explain contradictions in past US studies. Limitations of this study are discussed and suggestions for future research are made.     

Do Spiritual Struggles Predict Poorer Physical/Mental Health Among Jews?

Although spirituality and religion are generally associated with higher levels of physical and mental well-being, spiritual struggles, which involve tension in regard to spiritual issues, have been identified as a risk factor for poorer physical and mental health, especially among individuals with greater levels of personal religiousness. However, studies in this area have utilized predominantly Christian samples and the importance of spiritual struggles to Jews is not known. We proposed and tested two competing models in an adult Jewish community sample: (a) the Universal Effects model in which spiritual struggles were proposed to be associated with decreased levels of physical/mental health, and more problematic for more religious Jews, and (b) the Differential Effects model in which spiritual struggles were proposed to be generally unrelated to the physical/mental health of Jews, and even less impactful on religious Jews. We found some support for both models. Spiritual struggles were modestly associated with lower levels of physical/mental health in the sample as a whole, even after controlling for demographic covariates. However, at the highest levels of spiritual struggle, Orthodox Jews exhibited an increase in physical and mental health whereas non-Orthodox Jews' health continued to decrease.     

“Heart Trouble” and Religious Involvement among Older White Men and Women

Objective Few studies examine how older adults’ health status affects spiritual and religious involvement. This study examined the effects of gender and poor cardiac health on older adults’ ends, means, and quest religious motivations and frequency of private devotion. Method Longitudinal data (12 months between the T₁ and T₂ interviews) with 182 older adults sampled from a Northeast city were used to examine in a multivariate analysis of covariance whether gender and the existence of cardiac health problems at T₁ affected older adults’ spiritual and religious involvement at T₂. Findings A gender and cardiac health condition interaction showed older men with heart trouble had more changes in religious involvement—they engaged in more religious doubt, prayed less, and were not as intrinsically oriented at T₂. Discussion The findings strongly suggest that older men with heart trouble may maintain a masculine style and shun seeking divine help.     

Rehabilitative Beit Midrash as a means for advancing the community integration of Ultra Orthodox Jewish persons with severe mental illness

ABSTRACT

Religious Jews with severe mental illness often encounter barriers to involvement in religious activities in their community affecting their ability to become integrated into their community. Therefore, a study was conducted in Israel examining the contribution to community integration through a programme providing religious persons with mental illness an opportunity to participate in religious studies. An A-B research design was implemented among 42 Ultra-Orthodox Jewish persons with severe mental illness utilising a culturally-oriented structured instrument. The study showed that the opportunity for involvement in religious studies could advance the participants’ sense of social interaction in their community as well as their sense of psychological integration with other religious people. It also strengthened their confidence in their ability to further get involved in religious studies in the community. Rehabilitation services providing persons with severe mental illness an opportunity for involvement in religious studies can act as a springboard for advancing their community integration.     

The Daily Spiritual Experiences Scale and Well-Being: Demographic Comparisons and Scale Validation with Older Jewish Adults and a Diverse Internet Sample

A substantive literature connects spirituality to positive physical, social, and mental health. In this study, the Daily Spiritual Experiences Scale (DSES) was administered to 410 subjects who participated in a community study and to 87 residents at the Hebrew Home for the Aged at Riverdale (HHAR), the latter sample consisting primarily of older Jewish respondents. Internal consistency of the DSES in both samples was high and exploratory factor analyses revealed one dominant factor and a second factor, which included 14 and 2 items, respectively, consistent with the scale’s original validation (Underwood and Teresi 2002). Demographic subgroup comparison among religious groups revealed significantly fewer daily spiritual experiences among Jews, and lowest scores among those respondents endorsing no religious affiliation. Women exhibited more frequent daily experience than men, and attainment of higher levels of education was associated with less frequent daily spiritual experience. All but one of the outcome measures of physical and psychologic well-being were found to be positively associated with the DSES so that more frequent daily spiritual experience correlated with less psychopathology, more close friendships, and better self-rated health. Directions for future research, study interpretation and limitations, and clinical implications for use of the DSES are discussed.     

Hospitable Hospitals in a Diverse Society: From Chaplains to Spiritual Care Providers

The chaplain’s role in health care services has changed profoundly within the contexts of managerial and fiscal constraints, and increasingly pluralistic and secularized societies. Drawing from a larger study that examined religious and spiritual plurality in health care, we present findings regarding the contributions of chaplains or spiritual care providers (SCPs) as they are referred to more recently, in Canadian institutional health care contexts. Qualitative analyses of interviews with 14 employed SCPs and 7 volunteers provided insights about legitimizing and crafting the role of SPCs, becoming part of the health care team, and brokering diversity. Implications are discussed in relation to role clarification and policy development for truly hospitable health care.     

Anger, Spiritual Meaning and Support from the Religious Community in Dementia Caregiving

This study explores the relationships between spiritual meaning and social support from the religious community and problem behaviors, anger and depression in 128 dementia caregivers. The results suggest a mediating role of anger in the relationship between the appraisal of problem behaviors and depression. Support from the religious community is directly and negatively associated with anger, but the relationship between spiritual meaning and anger is mediated by caregivers’ appraisals of problem behaviors, suggesting that spiritual beliefs might help caregivers to find meaning in caregiving experiences and thus appraise care recipients’ behavioral problems as less stressful.     

Children as Mystics, Activists, Sages, and Holy Fools: Understanding the Spirituality of Children and Its Significance for Clinical Work

This article explores children's spirituality and its significance for health care providers seeking to provide “spiritually competent care” of children amidst religious and spiritual diversity. Four metaphors of different spiritualities evidenced among children are explored: mystics, activists, sages, and holy fools. The article addresses issues clinicians face such as the problem of defining spirituality in relation to religion, and countertransference around religious and spiritual matters. Current research shows that spiritual and religious involvements constitute positive factors promoting resiliency and health in children. James W. Fowler's theory of faith development facilitates an exploration of questions concerning how children develop a belief system, leading to a view of children's spirituality as multidimensional. This article preserves the less formal conversational style of an earlier version's presentation in Grand Rounds at the UCLA Medical Center's Neuropsychiatric Hospital on December 10, 2003.     

Psychological Distress Among Religious Nonbelievers: A Systematic Review

Studies of religious belief and psychological health are on the rise, but most overlook atheists and agnostics. We review 14 articles that examine differences between nonbelievers and believers in levels of psychological distress, and potential sources of distress among nonbelievers. Various forms of psychological distress are experienced by nonbelievers, and greater certainty in one’s belief system is associated with greater psychological health. We found one well-documented source of distress for nonbelievers: negative perceptions by others. We provide recommendations for improving research on nonbelievers and suggest a model analogous to Pargament’s tripartite spiritual struggle to understand the stresses of nonbelief.     

Bridging Science and Religion: How Health‐Care Workers as Storytellers Construct Spiritual Meanings

Contrary to the notion that medical science has supplanted religious understandings of human suffering, recent research suggests that health‐care workers like nurses can still portray their confrontations with illness and death in spiritual terms through storytelling. However, scholars have yet to systematically analyze the rhetorical devices used to construct spiritual meanings. Drawing on a symbolic interactionist perspective, we theorize that front‐line health professionals can deploy various rhetorical devices to infuse their workplace interactions with a spiritual significance. We also propose novel fuzzy set analysis techniques for determining which configurations of devices are most important in developing spiritual meanings. This approach was illustrated by examining 173 stories elicited from nurses at a nonsectarian, teaching hospital about encounters at work that significantly impacted their understanding of spirituality. Consistent with our expectations, the way in which nurses tell stories about their experiences not only shapes whether they attach spiritual significance to them, but whether they perceive spirituality and medicine to be compatible. We discuss the implications of our findings for future research on lived religion, conflicting identities, and institutional boundaries.     

Integration of Spiritual Care in Hospital Care System in Iran

There is a growing body of evidence on the positive effects of religion and spirituality on recovery from cancer and the ability to cope with it. Most spiritual interventions carried out in Iranian research are based on care and support models that have been developed in the West. With the unique cultural and religious features of the Iranian context, a more refined look at spiritual care in the hospital care system of Iran is called for. This paper examines how to implement the spiritual care of cancer patients in hospitals and oncology wards in Iran. A consensus panel of experts was used to develop guidelines for spiritually integrated care consisting of 18 primary areas, which are described in detail in this report. Health care policy makers and managers of health care in Iran and possibly other areas of the Middle East should consider implementing these guidelines. Using indigenous models and programs specific to the religion and the cultural of a region should be considered when providing spiritual care for cancer patients.

     

Spiritual Disposition and Understanding Illness

Although Dull and Skokan (1995) proposed a cognitive model of the effect of religion on health, they neglected to clearly identify the multi-dimensional nature of religion as a cognitive schema. The present paper identifies various aspects of spiritual disposition (defined as personality and beliefs) that can play a role in an individual’s adaptation to illness. Specifically, this paper reviews the factors of religious doctrine and affiliation, spiritual beliefs, religious orientation, God locus of control, faith and hope as aspects of a spiritual disposition and explores how they can function as resources and/or negative factors in the process of adjustment to illness. Implications for clinical health care (e.g., pastoral counsellors) are drawn from this review.     

Developing and Testing a Spiritual Care Questionnaire in the Iranian Context

As most research exploring nurses?? perceptions on the topic of spiritual care was conducted in Western countries, these findings may not be applicable in Iran because of cultural and health system differences. Therefore, a new survey instrument was developed for the Iranian context. The study was conducted in two steps: (1) development and validation of items for perception scale and (2) distribution of the questionnaire among nursing students to determine scale reliability and construct validity. The preliminary scale consisted of 50 items designed to measure the participants?? perception of spiritual care. Construct validity of the scale was examined on the remaining 33 items. On interpretation of the items, the following four components were identified: (1) meeting patient as a being in meaning and hope, (2) meeting patient as a being in relationship, (3) meeting patient as a religious being, and (4) meeting patients as a being with autonomy. The results in this paper showed that preserving dignity in the nurses?? practice meant getting involved in interpersonal caring relationships, with respect for the involved peoples?? religious beliefs and their autonomy. Proper education and professionally led supervision with reflection on past and recent experiences may develop student nurses?? and nurses?? perceptions as well as their attitudes toward spiritual care and to achieve a realistic view of the profession.     

Determining Relationships Between Physical Health and Spiritual Experience,Religious Practices,and Congregational Support in a Heterogeneous Medical Sample

Previous research indicates that increased religiosity/spirituality is related to better health, but the specific nature of these relationships is unclear. The purpose of this study was to determine the relationships between physical health and spiritual belief, religious practices, and congregational support using the Brief Multidimensional Measure of Religiousness/Spirituality and the Medical Outcomes Scale Shortform-36. A total of 168 participants were surveyed with the following medical disorders: Cancer, Spinal Cord Injury, Traumatic Brain Injury, and Stroke, plus a healthy sample from a primary care setting. The results show that individuals with chronic medical conditions do not automatically turn to religious and spiritual resources following onset of their disorder. Physical health is positively related to frequency of attendance at religious services, which may be related to better health leading to increased ability to attend services. In addition, spiritual belief in a loving, higher power, and a positive worldview are associated with better health, consistent with psychoneuroimmunological models of health. Practical implications for health care providers are discussed.     

Coming out of the Hasidic closet: Jiří Mordechai Langer (1894–1943) and the fashioning of homosexual-Jewish identity

This essay inaugurates the historical study of the modern homosexual Jewish experience before Stonewall. I begin with a historiographic introduction to the emerging subfield of gay Jewish history. I then turn to reintroduce Jiri Langer, a homosexual and Hasidic writer affiliated with the interwar "Prague circle" (and friend of Franz Kafka and Max Brod) into the purview of modern Jewish Studies. I take up two questions: first, how Langer reconciled his homosexual and Orthodox religious identity; and second, why Langer"s homosexuality became exigent as a Jewish question at this particular historical moment. In his key text, Die Erotik der Kabbala, Langer engages with the dominant interwar debates on homosexuality, but most directly with the work of Hans Blüher, the major theoretician of the German Wandervogelbewegung. In the course of correcting Blüher's antisemitic claims about Jews and homosexuality, Langer managed to delineate a specifically homosexual Jewish identity by renegotiating the relationship between homosexuality and Judaism and by adumbrating a history of "gay" Jews. I contextualize this long-neglected text within Langer's fascinating biography; the debates in the early homosexual rights movement; the particular cultural features of the "Prague circle" in which Langer wrote; and the dislocation and devastation of Langer's beloved eastern-European Hasidic communities caused by World War I—communities that Langer experienced as deeply homoerotic.     

The Meanings and Manifestations of Religion and Spirituality among Lesbian, Gay, Bisexual, and Transgender Adults

The present study employed a mixed method approach in the effort to explore religious and spiritual practices among lesbian, gay, bisexual, and transgender (LGBT) individuals, as well as the meanings ascribed to the terms religiosity and spirituality by LGBT adults. Data were collected via a cross-sectional survey consisting of open- and close-ended items among 498 LGBT (lesbian, gay, bisexual, transgender) identified individuals attending an annual Pride event in a large northeastern city. Both quantitative and qualitative findings suggested that consistent with other studies, spirituality was defined largely in relational terms (e.g., in terms of one’s relationship with God and with self). Religion, in contrast, was defined largely in terms of communal worship and in terms of its negative influences in the lives of individuals and communities. For this sample of LGBT persons, spiritual identities were more pronounced than religious ones, and this pattern may be explained by their understanding of the spiritual self in relation to prosocial engagement and interconnectedness with others, the world around them, and the universe. Further, religious affiliation and practices were explained, in part, by the religion in which the individual was raised, level of educational attainment, as well as the developmental stage in which the person is currently situated. The findings highlight the reality that a substantial number of LGBT individuals may remain committed to religious and spiritual life, which may be related to a motivation to make sense of one’s place in the world especially in light of societal misunderstandings and intolerance to LGBT individuals.     

What is the Place of Clinicians’ Religious or Spiritual Commitments in Psychotherapy? A Virtues-Based Perspective

Value neutrality in psychotherapy is widely acknowledged to be a myth, and a majority of US physicians report that their religious faith influences their practice. Most attention to therapists’ religious and spiritual commitments has focused on ethical boundaries, transference/countertransference dynamics and questions about how to relate religious and psychological truth. No consensus exists about the legitimate place in psychotherapy of clinicians’ differing value commitments. Therapists’ virtues are vitally important in psychotherapy, not least in the relational and aspirational process by which the patient identifies with the therapist as they engage together in confronting obstacles which the patient has been unable to surmount alone. Among the individual and cultural factors that shape a therapist’s virtues are spiritual traditions, which encourage preferred or characteristic virtues. Arguably, these include for Jews, communal responsibility and critical thought; for Christians, love and grace; for Muslims, reverence and obedience; for Buddhists, equanimity and compassion; for Hindus, appreciation of Dharma and Karma; and for secularists, respect for scientific evidence and intelligibility. These have differing implications for treatment, as illustrated through the use of a hypothetical case. Attention to differing spiritual and religious virtues in a pluralistic culture offers opportunities for creative dialogue, collaborative teaching and interdisciplinary research.