The Role of Spiritual Experiences and Activities in the Relationship Between Chronic Illness and Psychological Well-Being

Our research explores the correlates of spiritual experiences over a 2-year period in a sample of older adults (N = 164; mean age 81.9 years) living in a continuing care retirement community. Utilizing responses to the Daily Spiritual Experiences Scale, scores were analyzed for changes over time and for their hypothesized moderating effect in the relationship between chronic illness impact and markers of psychological well-being (as measured by the Geriatric Depression and Life Satisfaction scales). Repeated measures ANOVA indicated a significant decline (P < .01) in the reported spiritual experiences over a 2-year period of time, and t tests showed a significant difference by gender (P < .01) in years 1 and 2, with women reporting higher levels of spiritual experiences than men. Analyses found low spirituality scores associated with low life satisfaction in all years (baseline: r = ?.288, P < .01; year 1: r = ?.209, P < .05; year 2: r = ?.330, P < .001). Only weak associations were detected between low spirituality and the presence of depressive symptoms at baseline (r = .186, P < .05) and year 2 (r = .254, P < .01). Moderation effects of spirituality on the relationship between chronic illness impact and markers of psychological well-being were explored in all years, with a statistically significant effect found only for the presence of depressive symptoms in year 2. Higher impact of chronic illnesses is associated with more depressive symptoms under conditions of low spirituality. Future research may center upon longer-duration evaluation of reliance upon spiritual practices and their impact in care management models.     

Promoting spiritual well-being: a quasi-experimental test of an element of Hay and Nye’s theory of children’s spirituality

This study is one of the first tests of key implicit claims of Hay and Nye’s theory of children’s spirituality and spiritual development. Two quasi-experimental studies tested two claims: that exposure to six conditions posited as fostering relational consciousness in a programme of spiritual formation promotes spiritual well-being; that the effect of the conditions continues after exposure ends. The results for Study One revealed that length of exposure to any of the six conditions was not a significant predictor of spiritual well-being, F(3, 179)?=?1.49, p = 0.22. Study Two results indicated that as the length of time since exposure increased so did spiritual well-being, r(38)?=?0.39, p = 0.01 at the bivariate level, and F(4, 35)?=?2.4, p = 0.06 in the regression. These results reveal a possible relationship between exposure to the six conditions and spiritual well-being.     

The link between stress,well-being,and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.     

Prevalence and Nature of Spiritual Distress Among Palliative Care Patients in India

In palliative care research, little attention has been paid to the empirical study of spirituality in patients in non-Western countries. This study describes the prevalence and nature of spiritual distress among Indian palliative care patients. Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. Spirituality was shaped by the Indian religious and economic context. A latent class analysis resulted in three clusters: trustful patients (46.4 %), spiritually distressed patients (17.4 %), and patients clinging to divine support (36.2 %). After regression, the clusters were found to be associated with pain scores (p < .001), gender (p = .034), and educational level (p < .006). More than half of the patients would benefit from spiritual counselling. More research and education on spirituality in Indian palliative care is urgently required.     

Menopausal Symptoms: Is Spirituality Associated with the Severity of Symptoms?

The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (β = ?.414; p < .001), anxiety (β = ?.308; p < .001), cognitive impairment (β = ?.287; p < .001), aches/pain (β = ?.148; p < .001), vasomotor (β = ?.125; p = .005) and sexual symptoms (β = ?.211; p < .001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.     

Quality of Life of HIV-Infected People Across Different Stages of Infection

Quality of life is an important component in the evaluation of the well-being of HIV-infected patients. In the present study, an attempt has been made to compare HIV-infected patients across the three stages namely, asymptomatic, symptomatic, and AIDS-related conditions. This is a cross-sectional study. For this study, a total number of 90 subjects, 30 each in asymptomatic, symptomatic, and AIDS-related conditions, were taken. The study population consisted of HIV positive individual already enrolled in Voluntary Counseling and Testing Center, Institute of Medical Science, Banaras Hindu University, Varanasi, India. The WHOQOL-HIV BREF was used to assess quality of life across the group of patients. One-way analysis of variance was performed to find out significant difference between the clinical categories. On average AIDS patients experienced significantly poorer quality of life in all the six domains, namely physical (M = 7.87, SD = 1.83), psychological (M = 8.50, SD = 1.54), level of independence (M = 8.57, SD = 1.59), social relation (M = 9.17, SD = 2.59), environment (M = 8.78, SD = 1.50), and spirituality/religion/personal belief (M = 6.93, SD = 1.26) to symptomatic and asymptomatic HIV-infected people (p = .000). Result suggested that there is an inverse relationship between quality of life and different stages of HIV infection.     

Spiritual Well-Being and Psychological Adjustment: Mediated by Interpersonal Needs?

Spiritual well-being has been shown to reduce suicidal behavior, depressive symptoms, and hopelessness. Thwarted interpersonal needs have been shown to increase risk of suicidal behavior. This paper aims to explore the interrelationships among spiritual well-being, thwarted interpersonal needs, and negative outcomes including suicidal ideation, hopelessness, and depressive symptoms among African American women. Sixty-six African American women (M = 36.18; SD = 11.70), from a larger study of women who had experienced interpersonal violence within the past year, completed self-report questionnaires. Mediation analyses revealed that thwarted belongingness, but not perceived burdensomeness, significantly mediated the relations between spiritual well-being and the three outcomes. This study provides the first examination of the role of thwarted interpersonal needs on the link between spiritual well-being and negative psychological outcomes. Spiritual well-being serves a protective role against feelings of social isolation, which may reduce one’s risk of negative psychological outcomes. Treatments that bolster a sense of spirituality and social connectedness may reduce suicidal ideation, hopelessness, and depressive symptoms.     

The role of music in young adults’ spiritual development

Abstract

This article focuses on the role of spiritual music in Finnish young adults’ spirituality formation. The research data consist of interviews (2013, N = 10) and questionnaire answers (2011, N = 278). Spiritual music refers to music that the young adults themselves experienced supportive for their spirituality. The article indicates that the spiritual music enhanced young adults’ spirituality formation as the music was well related to the young adults’ current life questions and to experiences of early life span. According to the data, music offered tools for constructing personal world view and was experienced to strengthen confidence on higher power or life itself. As a mental resource, music had an important role in coping with life. As entertainment, spiritual music enhanced experiencing life as satisfying. As a part of public spiritual life, music advanced spiritual connection with other people. The role of spiritual music in spirituality formation was related to questions of spiritual well-being.     

The Psychological Impact of the Jesus Prayer among Non-Conventional Catholics

This pilot study explored the psychological impact of a 2-month intervention with the Jesus Prayer among a sample taken from a community of middle-aged Catholics in Spain. The study collected quantitative data on psychological symptoms with the Revised Symptom Checklist 90 (SCL-90-R) and on personality traits with the Revised Temperament and Character Inventory (TCI-R) at three different times: baseline, post-intervention, and 5 months after the 2-month intervention. It also collected quantitative data on transient mood states with the Profile of Mood States (POMS) before and after a 25-min intervention with the Jesus Prayer, plus data on adherence 2 years after the inquiry. Statistical analysis found lower scores on Interpersonal Sensitivity (p = .009) and Phobic Anxiety (p = .03) psychological symptoms after the 2-month intervention. Analyses of data also found lower scores and strong effect sizes on Tension (p = .03, d = 1.029) and Fatigue (p = .001, d = 1.390) after a 25-min intervention. The 2-year follow up found that one third of the final sample had completely adhered to a daily practice of the Jesus Prayer. Overall results indicate that the Jesus Prayer may be a relevant practice among Catholics both for well-being and spiritual purposes.     

An Exploratory Study of HIV+ Adolescents’ Spirituality: Will You Pray with Me?

The aims of the study were (1) to determine whether adolescents find it acceptable to have physicians explore their spiritual beliefs as part of their medical care, (2) to characterize the role of spirituality and religious beliefs in adolescents with and without HIV, and (3) to examine associations between spirituality/religion and quality of life. Adolescents receiving their medical care at an urban Adolescent Health Clinic completed a study-specific questionnaire about spiritual inquiry by their physician, the Brief Multidimensional Measurement of Religiousness/Spirituality, and the Pediatric Quality of Life Inventory 4.0. Chi-squared analysis, Fischer’s exact test, and t tests were used to assess associations. A total of 45 participants enrolled: 19 HIV+ (53% vertical transmission) and 26 HIV?; mean age 17.2 years; 80% African American. Four out of 45 (9%) had ever been asked by their doctor about their spiritual/religious beliefs, and only 8 (18%) had ever shared these beliefs with their healthcare provider. Most teens wanted their provider to ask them about their spiritual beliefs during some visits, especially when dealing with death/dying or chronic illness (67%). Those with HIV were more likely to endorse wanting their doctors to pray with them (42% vs. 15%), feeling “God’s presence” (Mean = 3.95 vs. 2.83), being “part of a larger force” (Mean = 2.58 vs. 1.69), and feeling “God had abandoned them” (Mean = 1.63 vs. 1.15). There are certain circumstances in which healthcare providers should include a spiritual history with teenage patients. Few differences emerged in the teens studied with and without HIV.     

Well-Being’s Relation to Religiosity and Spirituality in Children and Adolescents in Zambia

The relations among dimensions of subjective well-being (i.e., happiness and life satisfaction), spirituality and religiousness were assessed in children (aged 7–12, n = 391) and adolescents (aged 13–19, n = 902) in Zambia. These participants were sampled from schools in both urban and rural regions that represented a relatively wide range of affluence. Participants self-reported their happiness using the Faces Scale and the Subjective Happiness Scale, and their life satisfaction using the Student Life Satisfaction Scale. The surveys were available in English as well as two local languages, and were delivered in classroom settings. To assess religiosity, participants were asked about the frequency that they attended church and about the importance of religion in their life. To assess spirituality, participants were asked about whether they considered themselves to be a spiritual person and about the nature domain of spirituality (e.g., “I feel connected to nature”). Results indicated that age, gender, grade and religiosity were not strong predictors of children’s well-being. However, spirituality accounted for 21 % of the variance in life satisfaction beyond these demographic variables and religiosity, but did not account for additional variance in happiness. The results were similar for adolescents except that the demographic variables were weakly predictive of their life satisfaction, and religiosity was a modest predictor of their happiness. Spirituality predicted variance in happiness and life satisfaction more so among adolescents than among children. These results confirm earlier work showing that spirituality, but not necessarily religiosity, is associated with children’s and adolescents’ well-being.     

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students’ Perception of Spiritual Support

Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of “Skill Development Training Program for Spiritual Care of Elderly Individual,” which was carried out with students from elderly care program, on the perception of spirituality support in a pretest–posttest quasi-experimental study design with control group. As the data collection form, “Spiritual Support Perception” (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.     

Effects of cognitive-behavioural therapy on anxiety,depression and condom use in people with HIV in Mexico City: a pilot study

Anxiety and depression in people living with HIV (PLWH) are negatively associated with healthy sexual behaviours. We pilot-tested a Cognitive-Behavioural Therapy (CBT)-based intervention to reduce anxiety and depression, aimed to increase serostatus disclosure to sexual partners, quality of sexual life (QoSL) and condom use. The study had a single-case experimental design (AB) with follow-up measures. Eleven PLWH with moderate/severe anxiety/depression received six-module CBT intervention delivered in ten one-hour individual weekly sessions. Anxiety, depression, consistent/correct condom use and QoSL were measured. Depression and anxiety decreased after the intervention (depression baseline [BL] Mdn = 21, final [F] Mdn = 3, z = -2.934, p = .003; anxiety BL Mdn = 30, F Mdn = 4, z = -2.941, p = .003). QoSL improved (BL Mdn = 28, F Mdn = 13, z = -2.625, p = .009), along with participants’ ability to use condoms (57.14 vs.100, z = -2.937, p = .003). Effect size was large, changes were maintained at follow-up measurements. The CBT intervention had positive effects in reducing anxiety and depression, which could facilitate the acquisition of healthy sexual behaviours. Further studies are important to clarify the benefits of targeting emotional variables to improve wellbeing and prevention behaviours in PLWH.     

Indian Health Care Professionals’ Attitude Towards Spiritual Healing and Its Role in Alleviating Stigma of Psychiatric Services

Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals’ perspectives on patients’ R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers (p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths (p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: ‘spiritual healing is beneficial and complementary to psychiatric care.’ A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant (p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.