Ethical considerations of complementary and alternative medical therapies in conventional medical settings

Tags:

• Adenocarcinoma
• Carcinoma in Situ
• Complementary Therapies
• Decision Making
• Ethics, Medical
• Female
• Humans
• Middle Aged
• Neoplasm Recurrence, Local
• Ovarian Neoplasms
• Physician-Patient Relations
• Referral and Consultation
• Risk Assessment
• Treatment Refusal
• Truth Disclosure
• Uterine Cervical Neoplasms

Notes:

• Increasing use of complementary and alternative medical (CAM) therapies by patients, health care providers, and institutions has made it imperative that physicians consider their ethical obligations when recommending, tolerating, or proscribing these therapies. The authors present a risk-benefit framework that can be applied to determine the appropriateness of using CAM therapies in various clinical scenarios. The major relevant issues are the severity and acuteness of illness; the curability of the illness by conventional forms of treatment; the degree of invasiveness, associated toxicities, and side effects of the conventional treatment; the availability and quality of evidence of utility and safety of the desired CAM treatment; the level of understanding of risks and benefits of the CAM treatment combined with the patient’s knowing and voluntary acceptance of those risks; and the patient’s persistence of intention to use CAM therapies. Even in the absence of scientific evidence for CAM therapies, by considering these relevant issues, providers can formulate a plan that is clinically sound, ethically appropriate, and targeted to the unique circumstances of individual patients. Physicians are encouraged to remain engaged in problem-solving with their patients and to attempt to elucidate and clarify the patient’s core values and beliefs when counseling about CAM therapies.

Spirituality, healing and medicine

Tags:

• Attitude of Health Personnel
• Attitude to Health
• Complementary Therapies
• Family Practice
• Humans
• Mental Healing
• Professional Practice

Notes:

• The natural science base of modern medicine influences the way in which medicine is delivered and may ignore the spiritual factors associated with illness. The history of spirituality in healing presented here reflects the growth of scientific knowledge, demands for religious renewal, and the shift in the understanding of the concept of health within a broader cultural context. General practitioners have been willing to entertain the idea of spiritual healing and include it in their daily practice, or referral network. Recognizing patients’ beliefs in the face of suffering is an important factor in health care practice.

The 3 H and BMSEST models for spirituality in multicultural whole-person medicine

Tags:

• Cultural Diversity
• Education, Medical
• Holistic Health
• Humans
• Mind-Body Relations (Metaphysics)
• Models, Biological
• Models, Psychological
• Psychophysiology
• Religion and Medicine
• spirituality

Notes:

• Purpose: The explosion of evidence in the last decade supporting the role of spirituality in whole-person patient care has prompted proposals for a move to a biopsychosocial-spiritual model for health. Making this paradigm shift in today’s multicultural societies poses many challenges, however. This article presents 2 theoretical models that provide common ground for further exploration of the role of spirituality in medicine. Methods: The 3 H model (head, heart, hands) and the BMSEST models (body, mind, spirit, environment, social, transcendent) evolved from the author’s 12-year experience with curricula development regarding spirituality and medicine, 16-year experience as an attending family physician and educator, lived experience with both Hinduism and Christianity since childhood, and a lifetime study of the world’s great spiritual traditions. The models were developed, tested with learners, and refined. Results: The 3 H model offers a multidimensional definition of spirituality, applicable across cultures and belief systems, that provides opportunities for a common vocabulary for spirituality. Therapeutic options, from general spiritual care (compassion, presence, and the healing relationship), to specialized spiritual care (eg, by clinical chaplains), to spiritual self-care are discussed. The BMSEST model provides a conceptual framework for the role of spirituality in the larger health care context, useful for patient care, education, and research. Interactions among the 6 BMSEST components, with references to ongoing research, are proposed. Conclusions: Including spirituality in whole-person care is a way of furthering our understanding of the complexities of human health and well-being. The 3 H and BMSEST models suggest a multidimensional and multidisciplinary approach based on universal concepts and a foundation in both the art and science of medicine.

Prayer and healing: A medical and scientific perspective on randomized controlled trials

Notes:

• This article provides a critical analysis of three types of prayer studies on scientific (methodological) and philosophical grounds and concludes that any future research into the effectiveness of prayer in healing will inevitably run up against these problems.

Political bias, moral values, and spirituality in the training of psychotherapists

Tags:

• Humans
• Psychiatry
• Psychotherapy
• Religion and Psychology
• Social Values

Notes:

• Today psychotherapists face a challenge quite different from Karl Menninger’s early efforts to foster an understanding between the new science of psychiatry and traditional religion. Today the mental health sciences are struggling with the contradictions and conflicts about society’s values and spirituality that are currently vexing us all. The challenge today for psychotherapists is how to address values and spirituality professionally, ethically, and usefully in our work. This article looks at the scope of the task of training psychotherapists to work with values and spirituality in today’s climate of amorphous values and culture wars.

The State of Research on Complementary and Alternative Medicine in Pediatric Rheumatology

Tags:

• complementary and alternative medicine
• Juvenile idiopathic arthritis
• Pediatric rheumatology

Why Patients Use Alternative Medicine: Results of a National Study

Notes:

• Context.-- Research both in the United States and abroad suggests that significant numbers of people are involved with various forms of alternative medicine. However, the reasons for such use are, at present, poorly understood. Objective.-- To investigate possible predictors of alternative health care use. Methods.-- Three primary hypotheses were tested. People seek out these alternatives because (1) they are dissatisfied in some way with conventional treatment; (2) they see alternative treatments as offering more personal autonomy and control over health care decisions; and (3) the alternatives are seen as more compatible with the patients’ values, worldview, or beliefs regarding the nature and meaning of health and illness. Additional predictor variables explored included demographics and health status. Design.-- A written survey examining use of alternative health care, health status, values, and attitudes toward conventional medicine. Multiple logistic regression analyses were used in an effort to identify predictors of alternative health care use. Setting and Participants.-- A total of 1035 individuals randomly selected from a panel who had agreed to participate in mail surveys and who live throughout the United States. Main Outcome Measure.-- Use of alternative medicine within the previous year. Results.-- The response rate was 69%.The following variables emerged as predictors of alternative health care use: more education (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.1-1.3); poorer health status (OR, 1.3; 95% CI, 1.1-1.5); a holistic orientation to health (OR, 1.4; 95% CI, 1.1-1.9); having had a transformational experience that changed the person’s worldview (OR, 1.8; 95% CI, 1.3-2.5); any of the following health problems: anxiety (OR, 3.1; 95% CI, 1.6-6.0); back problems (OR, 2.3; 95% CI, 1.7-3.2); chronic pain (OR, 2.0; 95% CI, 1.1-3.5); urinary tract problems (OR, 2.2; 95% CI, 1.3-3.5); and classification in a cultural group identifiable by their commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology (OR, 2.0; 95% CI, 1.4-2.7). Dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies. Conclusion.-- Along with being more educated and reporting poorer health status, the majority of alternative medicine users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.

A review of the incorporation of complementary and alternative medicine by mainstream physicians

Tags:

• Acupuncture Therapy
• Adult
• Attitude of Health Personnel
• Chiropractic
• Complementary Therapies
• Homeopathy
• Humans
• Massage
• Physicians
• Phytotherapy
• Referral and Consultation

Notes:

• Background: Studies suggest that between 30% and 50% of the adult population in industrialized nations use some form of complementary and/or alternative medicine (CAM) to prevent or treat a variety of health-related problems. Method: A comprehensive literature search identified 25 surveys conducted between 1982 and 1995 that examined the practices and beliefs of conventional physicians with regard to 5 of the more prominent CAM therapies: acupuncture, chiropractic, homeopathy, herbal medicine, and massage. Six studies were excluded owing to their methodological limitations. Results: Across surveys, acupuncture had the highest rate of physician referral (43%) among the 5 CAM therapies, followed by chiropractic (40%) and massage (21%). Rates of CAM practice by conventional physicians varied from a low of 9% for homeopathy to a high of 19% for chiropractic and massage therapy. Approximately half of the surveyed physicians believed in the efficacy of acupuncture (51%), chiropractic (53%), and massage (48%), while fewer believed in the value of homeopathy (26%) and herbal approaches (13%). Conclusions: This review suggests that large numbers of physicians are either referring to or practicing some of the more prominent and well-known forms of CAM and that many physicians believe that these therapies are useful or efficacious. These data vary considerably across surveys, most likely because of regional differences and sampling methods, suggesting the need for more rigorous surveys using national, representative samples. Finally, outcomes studies are needed so that physicians can make decisions about the use of CAM based on scientific evidence of efficacy rather than on regional economics and cultural norms.

Mind-Body Medicine: State of the Science, Implications for Practice

Notes:

• Background: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions. Methods: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials. Results: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies. Conclusions: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.

Benefits, barriers, and cues to action of yoga practice: a focus group approach

Tags:

• Adult
• Attitude to Health
• Female
• Focus Groups
• Health Behavior
• Humans
• Male
• Mid-Atlantic Region
• Middle Aged
• Outcome Assessment (Health Care)
• Perception
• Physical Fitness
• Postural Balance
• Qualitative Research
• Stress, Psychological
• yoga

Derivative benefits: exploring the body through complementary and alternative medicine

Tags:

• Acupuncture Therapy
• Adult
• Aged
• Aged, 80 and over
• Attitude to Health
• Complementary Therapies
• Female
• Health Behavior
• Humans
• Internal-External Control
• Interviews as Topic
• Male
• Massage
• Meditation
• Middle Aged
• Patient Acceptance of Health Care
• Patient Satisfaction
• Young Adult

Derivative benefits: exploring the body through complementary and alternative medicine

Tags:

• Acupuncture Therapy
• Adult
• Aged
• Aged, 80 and over
• Attitude to Health
• Complementary Therapies
• Female
• Health Behavior
• Humans
• Internal-External Control
• Interviews as Topic
• Male
• Massage
• Meditation
• Middle Aged
• Patient Acceptance of Health Care
• Patient Satisfaction
• Young Adult

Notes:

• Since the 1960s, in Western societies, there has been a striking growth of consumer interest in complementary or alternative medicine (CAM). In order to make this increased popularity intelligible this paper challenges stereotypical images of users’ motives and the results of clinical studies of CAM by exploring bodily experiences of acupuncture, reflexology treatments, and mindfulness training. The study draws on 138 in-depth interviews with 46 clients, client diaries and observations of 92 clinical treatments in order to identify bodily experiences of health and care: experiences that are contested between forces of mastery, control and resistance. We discuss why clients continue to use CAM even when the treatments do not help or even after they have been relieved of their physiological or mental problems. The encounter between the client and CAM produces derivative benefits such as a fresh and sustained sense of bodily responsibility that induces new health practices.

Complementary medicine in the primary care setting: Results of a survey of gender and cultural patterns in Israel

Tags:

• Adult
• Aged
• Arabs
• Complementary Therapies
• Data Collection
• Female
• Health Knowledge, Attitudes, Practice
• Humans
• Israel
• Jews
• Male
• Middle Aged
• Primary Health Care
• Sex Distribution

Exploring association of spiritual perspectives with complementary medicine use among patients with Type 2 diabetes in Israel.

Tags:

• Alternative medicine
• DIABETES -- Treatment
• DIABETICS -- Treatment
• Integrative medicine
• Israel
• PATIENTS -- Religious life
• spirituality
• TRADITIONAL medicine
• TRANSCULTURAL medical care

Is a biopsychosocial-spiritual approach relevant to cancer treatment? A study of patients and oncology staff members on issues of complementary medicine and spirituality

Tags:

• Adult
• Aged
• Attitude to Health
• Complementary Therapies
• Female
• Health Surveys
• Hospitals, Teaching
• Humans
• Male
• Middle Aged
• Neoplasms
• spirituality

Notes:

• Background: Complementary and alternative medicine (CAM) is increasingly being used by patients with cancer. Objectives Our aim is to compare the attitudes of cancer patients who use CAM to those of nonusers, on issues of CAM, biopsychosocial considerations, and spiritual needs. Methods: Questionnaires were administered to patients and medical care providers in a tertiary teaching hospital with a comprehensive cancer center. Results: Forty-nine percent of the study patients reported integrating CAM into their conventional care. Health care providers considered psychological and spiritual needs as major reasons for CAM use, while patients considered the familial-social aspect to be more important. Conclusions: Cancer patients do not correlate CAM use with spiritual concerns but expect their physicians to attend to spiritual themes. Health care providers involved in oncology cancer care should emphasize spiritual as well as CAM themes. The integration of these themes into a biopsychosocial-spiritual approach may enrich the dialogue between patients and health providers.

Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: a cross-cultural study

Tags:

• Adult
• Arabs
• Chi-Square Distribution
• Community Health Centers
• Complementary Therapies
• Cross-Cultural Comparison
• Delivery of Health Care, Integrated
• Female
• Humans
• Israel
• Jews
• Logistic Models
• Male
• Middle Aged
• Patient Acceptance of Health Care
• Primary Health Care
• Religion and Medicine
• Young Adult

Equity and resource allocation in health care: dialogue between Islam and Christianity

Tags:

• Christianity
• Delivery of Health Care
• Health Care Rationing
• Humans
• ISLAM
• Social Justice
• Social Welfare

Notes:

• Inequities in health and health care are one of the greatest challenges facing the international community today. This problem raises serious questions for health care planners, politicians and ethicists alike. The major world religions can play an important role in this discussion. Therefore, interreligious dialogue on this topic between ethicists and health care professionals is of increasing relevance and urgency. This article gives an overview on the positions of Islam and Christianity on equity and the distribution of resources in health care. It has been written in close collaboration and constant dialogue between the two authors coming from the two religions. Although there is no specific concept for the modern term equity in either of the two religions, several areas of agreement have been identified: All human beings share the same values and status, which constitutes the basis for an equitable distribution of rights and benefits. Special provisions need to be made for the most needy and disadvantaged. The obligation to provide equitable health services extends beyond national and religious boundaries. Several areas require intensified research and further dialogue: the relationship between the individual and the community in terms of rights and responsibilities, how to operationalize the moral duty to decrease global inequalities in health, and the understanding and interpretation of human rights in regard to social services.

The Art of Contemplative and Mindfulness Practice: Incorporating the Findings of Neuroscience into Pastoral Care and Counseling.

Tags:

• ADAPTABILITY (Psychology)
• CONTEMPLATION
• Counseling
• Interpersonal Relations
• NEUROPLASTICITY
• Neurosciences
• Pastoral Care

Zen practice: a training method to enhance the skills of clinical social workers

Tags:

• Adult
• Awareness
• Female
• Humans
• Interviews as Topic
• Male
• Meditation
• Middle Aged
• Professional Competence
• Professional-Patient Relations
• Social Work

Mastery of the mind East and West: excellence in being and doing and everyday happiness

Notes:

• Western psychological research on positive psychology and Buddhism have recently converged in their emphasis on the development of positive states, like states of excellence and everyday happiness. Yet, these traditions differ in their approaches to positive states, with respect to a state-trait and doing-being distinction. Western scientific research on peak performance emphasizes discontinuous, time-limited peak performance states wherein individuals do things extraordinarily well in sports and in the arts. The Eastern spiritual traditions emphasize continuous excellence of being, in the form of traits or character strengths. In both traditions mental imagery is a key ingredient to excellence training. With respect to everyday happiness, Western psychological research has focused on the role of meaning systems in the transformation of flow states into vital engagement in everyday life, while Buddhism stresses the role of meditation training to gain mastery over all levels of mind that leads to everyday happiness. Rorschach and tachistoscopic research on advanced meditators suggests that advance meditators have gained unusual mastery over states of mind not yet documented in the Western psychological research on positive psychology.

Spiritual needs of children with complex healthcare needs in hospital

Tags:

• Child
• Health Services Needs and Demand
• Hospitalization
• Humans
• Scotland
• spirituality
• State Medicine

Notes:

• AIMS: To explore the views of hospitalised school-aged children with complex healthcare needs related to spiritual care. This could help inform national policies and raise awareness of the impact that a stay in an acute paediatric hospital can have on the spiritual needs of some of the children who use the NHS. Method: Pictures used in previous (US) studies were used to facilitate story telling, enabling children to talk about concepts that may not have emerged through direct conversation. A convenience sample of five hospitalised children were presented with the pictures one at a time and asked open-ended questions about each picture. Data analysis involved identifying emerging themes from the transcriptions using a grounded theory approach. Findings: The main themes to emerge from the interview data were: the role of the child’s relationships with family, friends and healthcare professionals; the impact of the hospital environment on the child; coping with invasive procedures; belief--children’s views about their health and belief system. Conclusion: There is a need for all healthcare professionals to recognise that children have spiritual needs that can include religious beliefs, and that it is part of their duty of care to attempt to identify and meet such needs.

Toward a unified field of study: longevity, regeneration, and protection of health through meditation and related practices

Tags:

• Health promotion
• Humans
• Longevity
• Meditation
• yoga

Notes:

• The orientation of this volume and the Longevity and Optimal Health: Integrating Eastern and Western Perspectives conference is that there is abundant evidence in the scientific and medical literatures that the diligent practice of certain yoga-meditational regimens can lead to a spectrum of health enhancements, ranging from modest to profound, and that these can be investigated in a scientifically rigorous fashion. This overview will summarize these possibilities regarding improved human longevity, regeneration, and protection of health and serve to introduce the perspectives of conference participants from all of the traditions represented.

Prayers in the clinic: how pediatric physicians respond

Religion and Spirituality: A Barrier and a Bridge in the Everyday Professional Work of Pediatric Physicians

Religiousness is positively associated with quality of life of ALS caregivers

Evolving Conceptions of Mindfulness in Clinical Settings

Tags:

• Attention
• Mechanisms
• Meditation
• Mindfulness
• Mindfulness-Based Stress Reduction

Notes:

• A number of issues important to the clinical utility of mindfulness require systematic study. These include the most parsimonious definition of mindfulness for clinical purposes, how mindfulness is best described to be most approachable to patients, and the extent to which mindfulness shares common mechanisms with other mind-body programs. The discussion includes a brief review of the transition of mindfulness from traditional into clinical settings as well as the components commonly contained within clinical descriptions of mindfulness. A model based on facility in the use of attention is proposed, and a description of mechanisms by which attentional skill may lead to the recognition of internal associational processes and account for psychological outcomes is given. Using constructs already familiar to patients, an attention-based conception may also be more accessible to patients than more elaborate descriptions and have greater utility in identifying commonalities that mindfulness training may have with other mind-body programs.

The spiritual and religious identities, beliefs, and practices of academic pediatricians in the United States

Tags:

• Academic Medical Centers
• Adult
• Aged
• Faculty, Medical
• Female
• Health Knowledge, Attitudes, Practice
• Humans
• Logistic Models
• Male
• Middle Aged
• Pediatrics
• Philosophy, Medical
• Physician's Practice Patterns
• Pilot Projects
• Questionnaires
• Religion and Medicine
• Social Identification
• spirituality
• United States

Notes:

• Purpose: Physicians’ spiritual and religious identities, beliefs, and practices are beginning to be explored. The objective of this study was to gather descriptive information about personal religion and spirituality from a random sample of academic American pediatricians and to compare this information with similar data from the public. Method: In 2005, a Web-based survey of a random sample of 208 pediatrician faculty from 13 academic centers ranked by the US News & World Report as “honor roll” hospitals was conducted. Surveys elicited information about personal beliefs and practices as well as their influence on decisions about patient care and clinical practice. Multiple questions were replicated from the General Social Survey to enable comparisons with the public. Descriptive statistics were generated, and logistic regression analyses were conducted on relevant variables. Results: Nearly 88% of respondents were raised in a religious tradition, but just 67.2% claimed current religious identification. More than half (52.6%) reported praying privately; additional spiritual practices reported included relaxation techniques (38.8%), meditation (29.3%), sacred readings (26.7%), and yoga (19%). The majority of academic pediatricians (58.6%) believed that personal spiritual or religious beliefs influenced their interactions with patients/colleagues. These odds increased 5.1-fold when academic pediatricians attended religious services monthly or more (P < .05). Conclusions: Compared with the American public, a notably smaller proportion of academic pediatricians reported a personal religious identity. The majority believed spiritual and religious beliefs influenced their practice of pediatrics. Whether secular or faith-based belief systems measurably modify academic pediatric practice is unknown.

Mestizo spirituality: Toward an integrated approach to psychotherapy for Latina/os

A body-mind-spirit model in health: an Eastern approach

Tags:

• Adult
• Breathing Exercises
• Female
• Grief
• Humans
• Medicine, East Asian Traditional
• Mind-Body Relations (Metaphysics)
• Neoplasms
• Social Work

Notes:

• Under the division of labor of Western medicine, the medical physician treats the body of patients, the social worker attends to their emotions and social relations, while the pastoral counselor provides spiritual guidance. Body, mind, cognition, emotion and spirituality are seen as discrete entities. In striking contrast, Eastern philosophies of Buddhism, Taoism and traditional Chinese medicine adopt a holistic conceptualization of an individual and his or her environment. In this view, health is perceived as a harmonious equilibrium that exists between the interplay of ‘yin’ and ‘yang’: the five internal elements (metal, wood, water, fire and earth), the six environmental conditions (dry, wet, hot, cold, wind and flame), other external sources of harm (physical injury, insect bites, poison, overeat and overwork), and the seven emotions (joy, sorrow, anger, worry, panic, anxiety and fear). The authors have adopted a body-mind-spirit integrated model of intervention to promote the health of their Chinese clients. Indeed, research results on these body-mind-spirit groups for cancer patients, bereaved wives and divorced women have shown very positive intervention outcomes. There are significant improvements in their physical health, mental health, sense of control and social support.

Surgeons and the spirit: a study on the relationship of religiosity to clinical practice

Tags:

• Data Collection
• Humans
• Patient Care
• Physicians
• Religion and Medicine
• spirituality

Notes:

• This study aimed to identify the religious practices and beliefs of surgeons and the relationship between surgeons’ locus of control and religiosity. Thirty-five surgeons completed a survey that included items from the Duke University Religion Index, the Salesian Center Intrinsic Religiosity Scale for Clinicians, and Rotter’s Locus of Control Scale. Over 68% of sampled surgeons affirmed that their religious beliefs play a part in their practice, 47% attend religious services at least weekly, and 44% pray daily. There was no correlation between locus of control and religiosity. These results challenge the myth of the egocentric, agnostic surgeon.

Mindfulness in Thailand and the United States: a case of apples versus oranges?

Tags:

• Attention
• Awareness
• Buddhism
• Cross-Cultural Comparison
• Factor Analysis, Statistical
• Female
• Humans
• Male
• Meditation
• Models, Psychological
• Questionnaires
• Self Assessment (Psychology)
• Self Concept
• Thailand
• United States
• Young Adult

Notes:

• The study and practice of mindfulness is rapidly expanding in Western psychology. Recently developed self-report measures of mindfulness were derived from Western operationalizations and cross-cultural validation of many of these measures is lacking, particularly in Buddhist cultures. Therefore, this study examined the measurement equivalence of the Kentucky Inventory of Mindfulness Skills (KIMS) and Mindful Attention Awareness Scale (MAAS) among Thai (n=385) and American (n=365) college students. Multigroup confirmatory factor analysis models fit to the data revealed that the KIMS lacked configural invariance across groups, which precluded subsequent invariance tests, and although the MAAS demonstrated configural, metric, and partial scalar invariance, there was no significant latent mean MAAS difference between Thais and Americans. These findings suggest that Eastern and Western conceptualizations of mindfulness may have important differences.

The Ethics of Alternative Medicine Therapies

The integration of complementary therapies in Australian general practice: results of a national survey

Tags:

• Adult
• Aged
• Attitude of Health Personnel
• Australia
• Complementary Therapies
• Delivery of Health Care, Integrated
• Family Practice
• Female
• Health Services Needs and Demand
• Health Services Research
• Humans
• Male
• Middle Aged
• Physician's Practice Patterns
• Primary Health Care
• Questionnaires

Notes:

• Methods: Australian general practitioners’ (GPs) attitudes toward and use of a range of complementary therapies (CTs) were determined through a self-administered postal survey sent to a random sample of 2000 Australian GPs. The survey canvassed GPs’ opinions as to the harmfulness and effectiveness of CTs; current levels of training and interest in further training; personal use of, and use in practice of, CTs; referrals to CT; practitioners; appropriateness for GPs to practice and for government regulation; perceived patient demand and the need for undergraduate education. Results: The response rate was 33.2%. Based on GPs’ responses, complementary therapies could be classified into: nonmedicinal and nonmanipulative therapies, such as acupuncture, massage, meditation, yoga, and hypnosis, that were seen to be highly effective and safe; medicinal and manipulative therapies, including chiropractic, Chinese herbal medicine, osteopathy, herbal medicine, vitamin and mineral therapy, naturopathy, and homeopathy, which more GPs considered potentially harmful than potentially effective; and esoteric therapies, such as spiritual healing, aromatherapy, and reflexology, which were seen to be relatively safe yet also relatively ineffective. The risks of CTs were seen to mainly arise from incorrect, inadequate, or delayed diagnoses and interactions between complementary medications and pharmaceuticals, rather than the specific risks of the therapies themselves. Conclusions: Nonmedicinal therapies along with chiropractic are widely accepted in Australia and can be considered mainstream. GPs are open to training in complementary therapies, and better communication between patients and GPs about use of CTs is required to minimize the risk of adverse events. There is also a need to prioritize and provide funding for further research into the potential adverse events from these therapies and other therapies currently lacking an evidence base.

Does religious activity improve health outcomes? A critical review of the recent literature

Tags:

• Delphi Technique
• Health Behavior
• Health Status
• Humans
• mental health
• Randomized Controlled Trials as Topic
• religion
• Religion and Medicine
• Treatment Outcome

Notes:

• Objective: Many Americans use religious activity to cope with stressful life events. Our goal was to review systematically the recent medical literature to assess the role of religion in health outcomes. Data sources: We conducted a comprehensive literature search using MEDLINE to identify studies published in the English language between January 1999 and June 2003 describing the effect of religion on health outcomes. The search strategy used the medical subject headings (MeSH) of religion; religion AND medicine; religion OR intercessory prayer; prayer; prayer therapy; religious rites; faith; medicine, traditional; religiosity; religion AND psychology; and religion AND health. Study selection: Religious, but not spiritual, interventions were selected for inclusion. Thus, papers describing interventions such as yoga, meditation, acupuncture, and qigong were excluded. Manuscripts describing randomized controlled trials, clinical trials, and partnerships with faith-based organizations were included. Data extraction: We found five randomized controlled trials, four clinical trials, and seven faith-based partnerships that describe the impact of religious intervention on health outcomes. Papers were analyzed by four reviewers using a modified Delphi technique to reach consensus. Data synthesis: Religious intervention such as intercessory prayer may improve success rates of in vitro fertilization, decrease length of hospital stay and duration of fever in septic patients, increase immune function, improve rheumatoid arthritis, and reduce anxiety. Frequent attendance at religious services likely improves health behaviors. Moreover, prayer may decrease adverse outcomes in patients with cardiac disease. Conclusions: Religious activity may improve health outcomes.

Religion, clinicians, and the integration of complementary and alternative medicines

Religion, clinicians, and the integration of complementary and alternative medicines

Tags:

• Acupuncture
• Attitude of Health Personnel
• Complementary Therapies
• Health Care Surveys
• Health Personnel
• Humans
• Integrative medicine
• Naturopathy
• Physician's Practice Patterns
• Physicians
• Religion and Medicine
• spirituality

Notes:

• Objective: The aim of this study was to compare religious characteristics of general internists, rheumatologists, naturopaths, and acupuncturists, as well as to examine associations between physicians’ religious characteristics and their openness to integrating complementary and alternative medicine (CAM). Design: The design involved a national mail survey. The subjects were internists, rheumatologists, naturopaths, and acupuncturists. Measures: Physician outcome measures were use of and attitudes toward six classes of CAM. Predictors were religious affiliation, intrinsic religiosity, spirituality, and religious traditionalism. Results: There was a 65% response. Naturopaths and acupuncturists were three times as likely as internists and rheumatologists to report no religious affiliation (35% versus 12%, p < 0.001), but were more likely to describe themselves as very spiritual (51% versus 20%, p < 0.001) and to agree they try to carry religious beliefs into life’s dealings (51% versus 44%, p < 0.01). Among physicians, increased spirituality and religiosity coincided with more personal use of CAM and willingness to integrate CAM into a treatment program. Conclusions: Current and future integrative medicine will be shaped in part by religious and spiritual characteristics of providers.

Placing Religion and Spirituality in End-of-Life Care

Notes:

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  In 1995, the SUPPORT (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment) trial stimulated a reexamination of systems of care for seriously ill and dying patients.1 This study has accelerated efforts to improve end-of-life care and has indirectly promoted a rapprochement among religion, spirituality, medicine, and health care.2 The goal of a quality comfortable death is achieved by meeting a patient’s physical needs and by attending to the social, psychological, and the now recognized spiritual and religious dimensions of care.3-4 This perspective is highlighted in a recent consensus statement that includes the assessment and support of spiritual and religious well-being and management of spiritual and religious problems as core principles of professional practice and care at the end of life.5 Yet multiple ethical and pragmatic issues arise. For example, should physicians identify patients’ spiritual and religious needs and intervene in clinical settings? The roles and responsibilities of patients and physicians in this scenario are unclear. An understanding of religion and spirituality within the context of end-of-life care, quality of life, and patient-clinician interactions may illuminate the problems and potentialities for both patients and clinicians.

   

An exploratory study of spiritual care at the end of life

Tags:

• Adult
• Attitude to Death
• Caregivers
• Female
• Humans
• Male
• Middle Aged
• Palliative Care
• Pastoral Care
• Professional-Family Relations
• Professional-Patient Relations
• spirituality
• Terminal Care
• Terminally Ill

Notes:

• Purpose: Although spiritual care is a core element of palliative care, it remains unclear how this care is perceived and delivered at the end of life. We explored how clinicians and other health care workers understand and view spiritual care provided to dying patients and their family members. Methods: Our study was based on qualitative research using key informant interviews and editing analysis with 12 clinicians and other health care workers nominated as spiritual caregivers by dying patients and their family members. Results: Being present was a predominant theme, marked by physical proximity and intentionality, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment. Opening eyes was the process by which caregivers became aware of their patient’s life course and the individualized experience of their patient’s current illness. Participants also described another course of action, which we termed cocreating, that was a mutual and fluid activity between patients, family members, and caregivers. Cocreating began with an affirmation of the patient’s life experience and led to the generation of a wholistic care plan that focused on maintaining the patient’s humanity and dignity. Time was both a facilitator and inhibitor of effective spiritual care. Conclusions: Clinicians and other health care workers consider spiritual care at the end of life as a series of highly fluid interpersonal processes in the context of mutually recognized human values and experiences, rather than a set of prescribed and proscribed roles.

The management of the Muslim dental patient

Tags:

• Culture
• Dental Care
• Fasting
• Female
• Humans
• ISLAM
• Male
• Toothbrushing

Notes:

• There are aspects of the practice of the religion of Islam that have some relevance to receiving dental treatment. This article aims to provide dentists with background knowledge of normal practices which may affect the treatment offered. The author does not attempt to inform the reader about Islam, but to assist the dentist in the management of a Muslim patient. Much of the content of this article describes how to manage a patient who is fasting during the Islamic month of Ramadan. Ramadan takes place this year in early October, lasting for 29 or 30 days. During Ramadan patients may present to dentists with the signs and symptoms described in this article.

Tibetan medicine and regeneration

Tags:

• Cognition
• Complementary Therapies
• Diet
• Emotions
• Female
• Humans
• Immunity
• Male
• Medicine, Tibetan Traditional
• Multiple Sclerosis
• Regeneration
• Sex Factors

Notes:

• An overview of the concept of regeneration in Tibetan medicine is presented with descriptions of detoxification and tonification longevity protocols. The body must be fortified before receiving stronger treatments for regeneration. All disease is brought into balance with understanding of the interplay of the five elements, three humors, and their qualities and locations. The example of multiple sclerosis (MS) is given. The macroscopic three-humor interpretation of MS agrees with the microscopic three-humor description of demyelination, providing a new framework for the understanding and treatment of MS. Treatments for MS and other chronic conditions are based on age, season, time of day, and the individual’s three-humor and hot (excess) and cold (deficiency) balance. Treatments to promote regeneration include nutrition, gentle exercise, herbal formulas, accessory therapies such as herbal baths and oils, and meditation. It is built into the theory of Tibetan medicine to have predictions about outcome and distinguish different disease patterns in patients with MS and other disorders. Taking into account daily and seasonal variations coupled with the changing nature of MS, it is critical to frequently evaluate people with MS and other chronic conditions for monitoring and adjustment of treatment for regeneration.

Integrative Medicine - Medicine of the future or 'Old Wine in New Skins'?

Do religion and spirituality matter in health? A response to the recent article in The Lancet

Tags:

• Complementary Therapies
• Humans
• Religion and Medicine

Religion, infertility and assisted reproductive technology

Tags:

• Female
• Humans
• Infertility, Female
• Pregnancy
• religion
• Reproductive Techniques, Assisted
• Women's Rights

Notes:

• This chapter describes religion in general before discussing the centrality of its concern for family formation. In light of this, the impact of infertility on religious people is considered. Recognizing religion’s cautiously positive attitude towards assisted reproductive technology (ART) as a potential ally in the project of family formation and the relief of infertility, two areas that have caused concern for the religions are discussed: perceived threats to marriage and the sanctity of the human embryo. Throughout the chapter, illustrations are drawn from particular religions, including Christianity, Judaism, Islam, Hinduism and Buddhism. There are striking similarities in their concerns and in the range of their responses to ART. Ways in which medical personnel should take into account the religious dimensions of the experience of infertility in their care for patients are suggested.

Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill?

Tags:

• Adult
• Aged
• Attitude to Death
• Communication
• Female
• Holistic Health
• Humans
• Male
• Middle Aged
• PATIENTS
• Physician-Patient Relations
• Questionnaires
• Religion and Medicine
• Social Values
• spirituality
• Terminal Care
• Trust
• United States

Notes:

• Background: Recognizing that many Americans draw on religious or spiritual beliefs when confronted by serious illness, some medical educators have recommended that physicians routinely ask about spirituality or religion when conducting a medical history. The most appropriate wording for such an inquiry remains unknown. Objective: To examine patient acceptance of including the following question in the medical history of ambulatory outpatients: “Do you have spiritual or religious beliefs that would influence your medical decisions if you become gravely ill?” Methods: Self-administered questionnaires were completed by 177 ambulatory adult patients visiting a pulmonary faculty office practice at a university teaching hospital in 1997 (83% response rate). Results: Fifty-one percent of the study patients described themselves as religious and 90% believe that prayer may sometimes influence recovery from an illness. Forty-five percent reported that religious beliefs would influence their medical decisions if they become gravely ill. Ninety-four percent of individuals with such beliefs agreed or strongly agreed that physicians should ask them whether they have such beliefs if they become gravely ill. Forty-five percent of the respondents who denied having such beliefs also agreed that physicians should ask about them. Altogether, two thirds of the respondents indicated that they would welcome the study question in a medical history, whereas 16% reported that they would not. Only 15% of the study group recalled having been asked whether spiritual or religious beliefs would influence their medical decisions. Conclusion: Many but not all patients surveyed in a pulmonary outpatient practice welcome a carefully worded inquiry about their spiritual or religious beliefs in the event that they become gravely ill.

Complementary and alternative medicine use by psychiatric inpatients

Tags:

• Adult
• Complementary Therapies
• Female
• Hospitalization
• Humans
• Male
• Mental Disorders
• Mental Health Services
• Phytotherapy

Notes:

• 82 psychiatric inpatients hospitalized for acute care were interviewed about their use of complementary and alternative medicine (CAM) modalities. The clinical diagnoses of respondents included Depressive Disorder (61%), Substance Abuse (26%), Schizophrenia (9%), and Anxiety Disorders (5%). Analysis indicated that 63% used at least one CAM modality within the previous 12 mo. The most frequently used modality was herbal therapies (44%), followed by mind-body therapies such as relaxation or mental imagery, hypnosis, meditation, biofeedback (30%), and spiritual healing by another (30%). Physical modalities such as massage, chiropractic treatment, acupuncture, and yoga were used by 21% of respondents. CAM therapies were used for a variety of reasons ranging from treatment of anxiety and depression to weight loss. However, most respondents indicated they did not discuss such use with their psychiatrist or psychotherapist.

Challenges posed by a scientific approach to spiritual issues

Tags:

• Attitude of Health Personnel
• Communication Barriers
• Humans
• Physician-Patient Relations
• Religion and Medicine
• Religion and Science
• spirituality

What do family physicians think about spirituality in clinical practice?

Tags:

• Adult
• Attitude of Health Personnel
• Family Practice
• Female
• Humans
• Male
• Middle Aged
• Missouri
• Physician-Patient Relations
• Physician's Role
• Religion and Medicine
• spirituality

Notes:

• Objectives To describe the context in which physicians address patients’ spiritual concerns, including their attitudes toward this task, cues to discussion, practice patterns, and barriers and facilitators. Study Design: This was a qualitative study using semistructured interviews of 13 family physicians. Population: We selected board-certified Missouri family physicians in a nonrandom fashion to represent a range of demographic factors (age, sex, religious background), practice types (academic/community practice; urban/rural), and opinions and practice regarding physicians’ roles in addressing patients’ spiritual issues. Outcomes measured: We coded and evaluated transcribed interviews for themes. Results: Physicians who reported regularly addressing spiritual issues do so because of the primacy of spirituality in their lives and because of the scientific evidence associating spirituality with health. Respondents noted that patients’ spiritual questions arise from their unique responses to chronic illness, terminal illness, and life stressors. Physicians reported varying approaches to spiritual assessment; affirmed that spiritual discussions should be approached with sensitivity and integrity; and reported physician, patient, mutual physician-patient, and situational barriers. Facilitators of spiritual discussions included physicians’ modeling a life that includes a spiritual focus. Conclusions: These physicians differ in their comfort and practice of addressing spiritual issues with patients but affirm a role for family physicians in responding to patients’ spiritual concerns. Factors that form a context for discussions of spiritual issues with patients include perceived barriers, physicians’ role definition, familiarity with factors likely to prompt spiritual questions, and recognition of principles guiding spiritual discussions.

Patterns of Mind-Body Therapies in Adults with Common Neurological Conditions

Exploring prayer as a spiritual modality

Tags:

• Decision Making
• Humans
• Occupational Therapy
• Professional-Patient Relations
• religion
• spirituality

Notes:

• Background: What does it mean to focus on the spiritual in occupational therapy? What interventions would qualify as spiritual modalities? This paper attempts to define the boundaries of what may be considered legitimate uses of spirituality in occupational therapy by using the example of prayer. Purpose: The purpose of this paper was to provide an in-depth analysis of the use of prayer in practice. Method: Medical and allied health journals were searched using the terms spirituality, spirit, religion, and prayer. Identified articles were synthesized to identify potential advantages and disadvantages of using prayer in therapy. Findings: Prayer can be considered an appropriate occupational therapy intervention so long as four questions can be answered positively. Implications: To answer these questions, guidelines are provided that will lead the therapist through a decision making process to determine the appropriateness of incorporating prayer into any clinical situation.

Staff perceptions of the benefits of religion in health and human services nonprofits: evidence from international development

To what extent are the spiritual needs of hospital patients being met?

Tags:

• Chaplaincy Service, Hospital
• Health Services Needs and Demand
• Hospitalization
• Humans
• Mental Disorders
• spirituality

Notes:

• Although a substantial number of studies have documented the spiritual needs of hospitalized patients, few have examined the prevalence of these needs and even fewer have attempted to measure the extent to which they are being met. Since chaplains are the primary providers of spiritual care, chaplains’ visits to patients would appear to provide a reasonable proxy for the latter. Based on the limited data available, we estimated the proportion of hospitalized patients who are visited by chaplains. Our analyses yielded a point estimate of 20% (+/- 10%), depending on a number of factors.

Meditation in medical practice: a review of the evidence and practice

Medicine, Spirituality, and Patient Care

Notes:

• As a physician and pastoral theologian, and in my role as a teacher of medical, nursing, chaplaincy, and theology students, I am often asked (especially when speaking about the needs of seriously ill and dying patients), “Is spiritual care always an important part of medical care? If yes, who should assess the need for it?” Religion is defined as “the service and worship of God or the supernatural; a personal set or institutionalized system of religious attitudes, beliefs, and practices”; and spirituality is defined as “the quality or state of being spiritual” (with spiritual meaning “of or relating to sacred matters”).1 In most individuals’ estimation, religion tends to be associated with formal practices and rules that connect a person to the sacred. Because spirituality is not usually based on human-made laws of reason or logic, it is often described as the nonlogical or nonrational...

Introducing spirituality into psychiatric care

Rehabilitation nurses' experiences providing spiritual care

Notes:

• The purpose of this phenomenological study was to examine rehabilitation nurses’ experiences providing spiritual care. Rehabilitation nurses provide care for patients and their families after life-threatening events and are in a unique position to meet holistic health care needs. Little is written about rehabilitation nurses’ perceptions of providing spiritual care. Fourteen rehabilitation nurses self-identified as providing spiritual care and agreed to participate in individual interviews. The interviews focused on the nurses’ definition of spiritual care, interventions the nurses perceived as spiritual and their comfort in providing spiritual care. More studies are needed to determine if providing spiritual care improves patient outcomes.

The role and impact of personal faith and religion among genetic service providers

Tags:

• Genetics, Medical
• Humans
• religion

Seeking inspiration: the rediscovery of the spiritual dimension in health and social care in England

Spirituality and the Process of Healing: A Narrative Study

The salvational process in relationships: A view from projective-introjective identification and repetition compulsion

Spirituality and healthcare organizations

Tags:

• Ethics, Institutional
• Health Facility Environment
• Health Services Administration
• Holistic Health
• Humans
• Organizational Culture
• Pastoral Care
• Patient Care
• religion
• Social Values
• United States
• Workplace

Notes:

• In recent years, the place of spirituality in organizations has become increasingly discussed and advocated. On a personal level, this may involve achieving personal fulfillment or spiritual growth in the workplace. In the broader sense, spirituality is considered by many to be essential in an organization’s interactions with employees, customers, and the community. This article describes a possible role for greater spirituality in healthcare organizations, whose cultures in recent decades have largely excluded spirituality or religiousness. This is the consequence of an analytical, scientific perspective on human health; a reductionist paradigm in biomedical research; and the inevitable bureaucratization occurring in large healthcare organizations. However, in recent decades, numerous scientific articles supporting a connection between faith or religiousness and positive health outcomes have been published. Because individuals seek meaning when experiencing severe illnesses, and humans universally respond to compassion and caring, spirituality among healthcare workers and managers appears highly appropriate. The article describes organizational barriers to the greater inclusion of spirituality in healthcare and presents several approaches to developing a more caring organization. These include eliciting extensive input from all staff and clinicians in identifying core or common values, ethics, and a philosophy of caring. Programs should ensure that the views of nonreligious staff and patients are respected and that clear guidelines are established for the extent and nature of affective or spiritual support for patients.

The probable cause of civilization diseases and the structural limits of pleasure

Seeking Security in the New Age: On Attachment and Emotional Compensation

Notes:

• The purpose of the present cross-sectional questionnaire study was to construct a comprehensive and reliable scale to assess new age orientation as a continuous individual difference variable. Given large increases in new age orientation in Sweden in recent years, an additional purpose was to test our emotional compensation hypothesis by studying connections of retrospective parental and adult romantic attachment in relation to new age orientation, emotionally-based religiosity, and socialization-based religiosity, as well as to study links between attachment and several aspects of spiritual change. The study group included 193 participants from upper secondary school classes, Christian youth organizations, and new age establishments in Stockholm, Sweden. The new age orientation scale was shown to be unidimensional according to an exploratory factor analysis, and to possess adequate reliability and construct validity. In line with the emotional compensation predictions, new age orientation was directly linked to attachment insecurity and emotionally-based religiosity and inversely related to socialization-based religiosity. Attachment insecurity was also linked to the experience of spiritual changes, whereas most findings pertaining to characteristics of spiritual change did not support predictions. In general, unlike perceived attachment to parents, adult romantic attachment did not display the predicted pattern of results. It was concluded that attachment theory may make an important contribution by highlighting predisposing factors for new age orientation, as representing one aspect of the emotional compensation profile, but that several methodological improvements are necessary in future studies.

Pediatrician characteristics associated with attention to spirituality and religion in clinical practice

Tags:

• Adult
• Communication
• Humans
• Middle Aged
• Pediatrics
• Professional-Family Relations
• Questionnaires
• Religion and Medicine
• spirituality

Notes:

• Objective: The literature suggests that a majority of pediatricians believe that spirituality and religion are relevant in clinical practice, but only a minority gives them attention. This project explored this disparity by relating personal/professional characteristics of pediatricians to the frequency with which they give attention to spirituality and religion. Methods: Pediatricians (N = 737) associated with 3 academic Midwestern pediatric hospitals responded to a survey that requested information concerning the frequency with which they (1) talked with patients/families about their spiritual and religious concerns and (2) participated with them in spiritual or religious practices (eg, prayer). The associations between these data and 10 personal and professional characteristics were examined. Results: The results demonstrated the disparity, and the analysis identified 9 pediatrician characteristics that were significantly associated with more frequently talking with patients/families about their spiritual and religious concerns. The characteristics included increased age; a Christian religious heritage; self-description as religious; self-description as spiritual; the importance of one’s own spirituality and religion in clinical practice; the belief that the spirituality and religion of patients/families are relevant in clinical practice; formal instruction concerning the role of spirituality and religion in health care; relative comfort asking about beliefs; and relative comfort asking about practices. All of these characteristics except pediatrician age were also significantly associated with the increased frequency of participation in spiritual and religious practices with patients/families. Conclusions: Attention to spiritual and religious concerns and practices are associated with a web of personal and professional pediatrician characteristics. Some characteristics pertain to the physician’s personal investment in spirituality and religion in their own lives, and others include being uncomfortable with spiritual and religious concerns and practices. These associations shed light on the disparity between acknowledged spirituality and religion relevancy and inattention to it in clinical practice.

A theory of alpha/theta neurofeedback, creative performance enhancement, long distance functional connectivity and psychological integration

Tags:

• Alpha Rhythm
• Animals
• Biofeedback, Psychology
• Brain
• Cognition
• Creativeness
• Electroencephalography
• Humans
• Psychomotor Performance
• Theta Rhythm

The Efficacy and Cost Effectiveness of Integrative Medicine: A Review of the Medical and Corporate Literature

Tags:

• cost effectiveness
• Integrative medicine

Providers and types of spiritual care during serious illness

Tags:

• Adaptation, Psychological
• Adult
• Aged
• Aged, 80 and over
• Caregivers
• Critical Illness
• Cross-Sectional Studies
• Female
• Humans
• Male
• Middle Aged
• Palliative Care
• Pastoral Care
• Patient Satisfaction
• Religion and Medicine
• spirituality

Notes:

• Objective: Patients and palliative care experts endorse the importance of spiritual care for seriously ill patients and their families. However, little is known about spiritual care during serious illness, and whether it satisfies patients’ and families’ needs. The objective of this study was to describe spiritual care received by patients and families during serious illness, and test whether the provider and the type of care is associated with satisfaction with care. Methods: Cross-sectional interview with 38 seriously ill patients and 65 family caregivers about spiritual care experiences. Results: The 103 spiritual care recipients identified 237 spiritual care providers; 95 (41%) were family or friends, 38 (17%) were clergy, and 66 (29%) were health care providers. Two-thirds of spiritual care providers shared the recipient’s faith tradition. Recipients identified 21 different types of spiritual care activities. The most common activity was help coping with illness (87%) and the least common intercessory prayer (4%). Half of recipients were very or somewhat satisfied with spiritual care, and half found it very helpful for facilitating inner peace and meaning making. Satisfaction with spiritual care did not differ by provider age, race, gender, role, or frequency of visits. Types of care that helped with understanding or illness coping were associated with greater satisfaction with care. Conclusion: Seriously ill patients and family caregivers experience spiritual care from multiple sources, including health care providers. Satisfaction with this care domain is modest, but approaches that help with understanding and with coping are associated with greater satisfaction.

A religious framework as a lens for understanding the intersection of genetics, health, and disease

Tags:

• African Americans
• European Continental Ancestry Group
• Female
• Genetic Predisposition to Disease
• Health Status
• Humans
• Male
• religion

Patient perspectives on spirituality and the patient-physician relationship

Tags:

• Adult
• Aged
• Attitude
• Communication
• Female
• Focus Groups
• Humans
• Male
• Middle Aged
• PATIENTS
• Physician-Patient Relations
• Spiritualism

Notes:

• Objective: To identify the preferences and concerns of seriously ill patients about discussing religious and spiritual beliefs with physicians. Design: Three focus group discussions with patients who had experienced a recent life-threatening illness. Discussions were audiotaped, transcribed verbatim, and reviewed independently by two investigators to identify discrete comments for grouping into domains. A third investigator adjudicated differences in opinion. Comments were then independently reviewed for relevance and consistency by a health services researcher and a pastoral counselor. Setting: Academic medical center. Patricipants: Referred sample of 22 patients hospitalized with a recent life-threatening illness. Measurements and Main Results: Almost all of the 562 comments could be grouped into one of five broad domains: 1) religiosity/spirituality, 2) prayer, 3) patient-physician relationship, 4) religious/spiritual conversations, and 5) recommendations to physicians. God, prayer, and spiritual beliefs were often mentioned as sources of comfort, support, and healing. All participants stressed the importance of physician empathy. Willingness to participate in spiritual discussions with doctors was closely tied to the patient-physician relationship. Although divided on the proper context, patients agreed that physicians must have strong interpersonal skills for discussions to be fruitful. Physician-initiated conversation without a strong patient-physician relationship was viewed as inappropriate and as implying a poor prognosis. Conclusion: Religion and spirituality are a source of comfort for many patients. Although not necessarily expecting physicians to discuss spirituality, patients want physicians to ask about coping and support mechanisms. This exploratory study suggests that if patients then disclose the importance of spiritual beliefs in their lives, they would like physicians to respect these values.

Spirituality, medicine, and healing

Tags:

• Adaptation, Psychological
• Attitude to Health
• Child
• Ego
• Fear
• Goals
• Holistic Health
• Humans
• Mental Healing
• Mental Processes
• Middle Aged
• Models, Psychological
• Perception
• personality
• Philosophy
• Physical Phenomena
• Physics
• Quality of Life

Notes:

• Contemporary medicine has given little attention to the spiritual dimension of human experience despite its relevance to our fundamental goal of healing. This exploratory work takes the position that this dimension can and should be reintegrated into health care models and practice. After delineating the scope of inquiry and providing some definitions, I draw upon paradigms from psychology and physics to provide a basis for such integration, and then extend the biopsychosocial model to include the spiritual dimension, discussing some ways in which this perspective might affect our thinking about disease and health care.

The place of spirituality in managed care. Attending to spiritual needs can help managed care systems achieve their goals

Tags:

• Health Care Costs
• Holistic Health
• Humans
• Managed Care Programs
• Organizational Objectives
• Patient Satisfaction
• Patient-Centered Care
• Religion and Medicine
• Religion and Psychology
• Social Problems
• social support
• United States

Notes:

• If managed care leaders are able to achieve their goals of enhancing total well-being within a capitated system of care, they must attend to the broad new societal interest in spiritual perspectives and find ways to integrate them into their structure of care. Imaginative and sensitive members of many professions, particularly those who acknowledge the value of spirituality in their own lives and are convinced of its value in healing, will likely spearhead this integrated movement. Promoting individuals’ total well-being necessitates an acknowledgement that everyone has a unique personal spirituality that needs to be addressed at times of crisis, such as illness or hospitalization. Further, attention to the spiritual dimensions of problems that result in high healthcare costs, such as violence, alcoholism, and the fear of death, can help reduce those costs. The process of grief also needs to be addressed in healthcare settings, for professionals as well as patients, to enhance understanding, acceptance, and the quality of care. People recover and retain health through a balanced integration of physical, spiritual, and community aspects of their lives. If professional chaplains who have emphasized crisis and acute care in their ministry styles are to contribute to this integrative healing and its adoption into managed care systems, they may need to explore broader frameworks, holistic concepts of healing processes, motivations for self-care, and a personal holistic balance.

Using spiritual interventions in practice: developing some guidelines from evidence-based practice

Tags:

• Clinical Competence
• Evidence-Based Practice
• Humans
• Professional-Patient Relations
• Social Work
• Spiritual Therapies
• spirituality

Development of a spiritually based educational program to increase colorectal cancer screening among African American men and women

Tags:

• Adult
• African Americans
• Aged
• Aged, 80 and over
• Colorectal Neoplasms
• Female
• Health Education
• Humans
• Male
• Mass Screening
• Middle Aged
• Patient Acceptance of Health Care
• spirituality

Notes:

• This study describes the development of a spiritually based intervention to increase colorectal cancer screening through African American churches by framing the health message with spiritual themes and scripture. The intervention development phase consisted of ideas from an advisory panel and core content identified in focus groups. In the pilot-testing phase, prototypes of the intervention materials were tested for graphic appeal in additional focus groups, and content was tested for acceptability and comprehension in cognitive interviews. Participants preferred materials showing a variety of African Americans in real settings, bright color schemes, and an uplifting message emphasizing prevention and early detection. Spiritual themes such as stewardship over the body, being well to serve God, and using faith to overcome fear, were well received. The materials were then finalized for implementation and will be used by community health advisors to encourage screening.

Considerations and Recommendations for Use of Religiously Based Interventions in a Licensed Setting.

Tags:

• CHURCH work
• COUNSELING -- Religious aspects
• PASTORAL theology
• PSYCHOLOGY & religion
• PSYCHOLOGY, Religious
• Psychotherapy

Personal and Planetary Well-being: Mindfulness Meditation, Pro-environmental Behavior and Personal Quality of Life in a Survey from the Social Justice and Ecological Sustainability Movement

Clinical applications of the relaxation response and mind-body interventions

Tags:

• Cardiovascular Diseases
• Humans
• Internal-External Control
• Mind-Body Relations (Metaphysics)
• Parasympathetic Nervous System
• Relaxation
• Relaxation Therapy
• Stress, Psychological
• Sympathetic Nervous System

Notes:

• Several hundred peer-reviewed studies in the past 20 years have shown that the relaxation response and mind-body interventions are clinically effective in the treatment of many health problems that are caused or made worse by stress. Recent studies show that mind-body interventions may improve prognosis in coronary heart disease and can enhance immune functioning. It is hypothesized that mind-body interventions reduce sympathetic nervous system activation and increase parasympathetic nervous system activity, and thereby restore homeostasis. Researchers have also concluded that cognitive therapy is as effective, and possibly more effective than antidepressant medication in the treatment of major depression. This report provides an overview of some studies that have shown a beneficial role of the relaxation response and cognitive restructuring in the treatment of headaches, insomnia, and cardiovascular disorders. Studies to date suggest that mind-body interventions are effective and can also provide cost savings in patient treatment. It is also clear, however, that mind-body therapies are not panaceas, and should be used in conjunction with standard medical care.

Spirituality, religion and health outcomes research: findings from the Center on Religion and the Professions

Tags:

• Adaptation, Psychological
• Chronic Disease
• Female
• Health Status
• Humans
• Male
• Missouri
• Pilot Projects
• religion
• spirituality

Cultural, ethical, and spiritual competencies of health care providers responding to a catastrophic event

Formulation and treatment: integrating religion and spirituality in clinical practice

Tags:

• Adaptation, Psychological
• Adolescent
• Adult
• Child
• Family Relations
• Family Therapy
• Female
• Humans
• Male
• Marriage
• Mental Disorders
• Parent-Child Relations
• PARENTING
• Religion and Psychology
• Social Values
• spirituality

Notes:

• Several hundred peer-reviewed studies in the past 20 years have shown that the relaxation response and mind-body interventions are clinically effective in the treatment of many health problems that are caused or made worse by stress. Recent studies show that mind-body interventions may improve prognosis in coronary heart disease and can enhance immune functioning. It is hypothesized that mind-body interventions reduce sympathetic nervous system activation and increase parasympathetic nervous system activity, and thereby restore homeostasis. Researchers have also concluded that cognitive therapy is as effective, and possibly more effective than antidepressant medication in the treatment of major depression. This report provides an overview of some studies that have shown a beneficial role of the relaxation response and cognitive restructuring in the treatment of headaches, insomnia, and cardiovascular disorders. Studies to date suggest that mind-body interventions are effective and can also provide cost savings in patient treatment. It is also clear, however, that mind-body therapies are not panaceas, and should be used in conjunction with standard medical care.

Conceptualising spirituality for medical research and health service provision

A multifaith spiritually based intervention for generalized anxiety disorder: a pilot randomized trial

Notes:

• After a multifaith spiritually based intervention was applied to patients suffering generalized anxiety disorder, a reduction in depressive symptoms and improvement in social adjustment was observed.

The brief serenity scale: a psychometric analysis of a measure of spirituality and well-being

Tags:

• Adaptation, Psychological
• Adult
• Aged
• Attitude to Health
• Female
• Holistic Health
• Holistic Nursing
• Humans
• Male
• Middle Aged
• Mind-Body Relations (Metaphysics)
• Nursing Methodology Research
• Personality Assessment
• Psychometrics
• Quality of Life
• spirituality
• United States

Notes:

• Purpose: This article describes a factor analysis of a 22-item version of the Serenity Scale, a tool that measures spirituality and well-being. Method: A sample of 87 participants, enrolled in a National Institutes of Health-funded clinical trial examining the impact of mindfulness-based stress reduction on symptom management post-solid organ transplantation, completed the abbreviated instrument. Findings: Exploratory factor analysis yielded three subscales: acceptance, inner haven, and trust. The Serenity Scale was positively associated with positive affect and mindful awareness and inversely related to negative affect, anxiety, depression, health distress and transplant-related stress. Conclusions: Serenity, a dimension of spirituality that is secular and distinct from religious orientation or religiosity, shows promise as a tool that could be used to measure outcomes of nursing interventions that improve health and well-being. Implications: Spirituality is recognized as being an essential component of holistic nursing practice. As nurses expand their use of spiritual interventions, it is important to document outcomes related to nursing care. The Serenity Scale appears to capture a dimension of spirituality, a state of acceptance, inner haven and trust that is distinct from other spirituality instruments.

Mapping a message for faith leaders: encouraging community health promotion with local health data

Complementary and alternative treatment methods in children with cancer: A population-based retrospective survey on the prevalence of use in Germany

Tags:

• Attitude to Health
• Child
• Child, Preschool
• Complementary Therapies
• Female
• Germany
• Health Care Surveys
• Humans
• Infant
• Infant, Newborn
• Male
• Neoplasms
• Parents
• Retrospective Studies
• Socioeconomic Factors

Notes:

• Introduction: Few studies have been conducted to date on the prevalence of use of complementary and alternative treatment methods (CAMs) in paediatric oncology, and those that have been conducted are often not representative. We therefore decided to study a representative sample of children with cancer in the German population. Patients and Methods: The study took the form of a retrospective survey amongst all parents whose children were first diagnosed with a disease covered by the German Childhood Cancer Registry in 2001. The primary objectives of the survey were to establish the prevalence of use of CAM and the factors related to its use. Results: Of the 1595 questionnaires sent out, 1063 (67%) could be evaluated. 35% of the responders had used CAM. The most frequently used methods were homeopathy, dietary supplements and anthroposophic medicine including mistletoe therapy. Factors which increased the probability of using CAM were the previous use of CAM, higher social status and poor prognosis of the child’s disease. The most frequently named reasons for use of CAM were physical stabilisation, strengthening the immune system and improving the chance of cure. Whilst the sources of information about CAM were in most cases not doctors, 71% of users had nevertheless spoken to a doctor about using CAM. The effects of the CAM perceived by the parents were for the most part positive. 89% of the users reported that they would recommend CAM to other parents. Conclusions: CAMs are administered alongside standard therapy to 35% of children with cancer in Germany, usually by the parents. Prospective studies on the effects and side-effects of the most frequently used methods are urgently needed, and paediatric oncologists should have sufficient knowledge of CAM to enable them to advise parents professionally and competently about these treatments, too.

Should clinicians incorporate positive spirituality into their practices? What does the evidence say?

Tags:

• Cross-Sectional Studies
• Education, Medical, Continuing
• Evidence-Based Medicine
• Health Status
• Humans
• Physician-Patient Relations
• Physician's Practice Patterns
• Religion and Medicine
• social support

Notes:

• Most of the rhetoric decrying the incorporation of basic and positive spiritual care into clinical practice is not based on reliable evidence. We briefly review the current evidence, which demonstrates that (a) there is frequently a positive association between positive spirituality and mental and physical health and well being, (b) most patients desire to be offered basic spiritual care by their clinicians, (c) most patients censure our professions for ignoring their spiritual needs, (d) most clinicians believe that spiritual interventions would help their patients but have little training in providing basic spiritual assessment or care, (e) professional associations and educational institutions are beginning to provide learners and clinicians information on how to incorporate spirituality and practice, and (j) anecdotal evidence indicates that clinicians having received such training find it immediately helpful and do apply it to their practice. We point out the reasons that much more research is needed, especially outcome-based, clinical research on the effects of these spiritual interventions by clinicians. We conclude that the evidence to date demonstrates trained or experienced clinicians should encourage positive spirituality with their patients and that there is no evidence that such therapy is, in general, harmful. Further, unless or until there is evidence of harm from a clinician’s provision of either basic spiritual care or a spiritually sensitive practice, interested clinicians and systems should learn to assess their patients’ spiritual health and to provide indicated and desired spiritual intervention. Clinicians and health care systems should not, without compelling data to the contrary, deprive their patients of the spiritual support and comfort on which their hope, health, and well-being may hinge.

Autonomy, religion and clinical decisions: findings from a national physician survey

Tags:

• Adult
• Attitude of Health Personnel
• Female
• Humans
• Male
• Middle Aged
• Patient Rights
• Personal Autonomy
• Physician-Patient Relations
• Physician's Practice Patterns
• Questionnaires
• Religion and Medicine
• Statistics as Topic

Principles to make a spiritual assessment work in your practice

Tags:

• Adult
• Culture
• Ethics, Medical
• Family Practice
• Female
• Humans
• Male
• Middle Aged
• Models, Theoretical
• Pastoral Care
• Quality of Health Care
• Religion and Medicine
• spirituality
• Time Factors

Spirituality in medicine: What is its role, today and tomorrow?

Restoring the spiritual: reflections on arrogance and myopia-allopathic and holistic

"And let us make us a name": reflections on the future of the religion and health field

Tags:

• Faith Healing
• Forecasting
• Humans
• Religion and Medicine
• Research
• spirituality
• Theology

God, Love, and Health: Findings from a Clinical Study

Notes:

• This study identifies a significant health effect of a loving relationship with God. Based on work by Sorokin, an eight-item scale was developed and validated to assess what he termed religious love: the feeling of loving and being loved by God. Using a sample of 205 family practice outpatients, hierarchical OLS regression was used to investigate the effect of this construct on a standard self-rating of health. Several sets of factors were hypothesized to mediate the relationship between religious love and self-rated health: religious involvement, social resources, psychological resources, objective health status, and sociode-mographic factors. These effects were controlled for in six successive models. In the end, despite controlling for effects of 15 variables and scales that accounted for nearly 40% of the variance in self-rated health, the statistically significant association between religious love and self-rated health at baseline (β =.33, p <.001) remained strong, significant, and only marginally affected (β =.24, p < .05). These findings provide evidence that loving and being loved by God exerts a positive influence on perceptions of health.

Osteopathy and (hatha) yoga

Tags:

• Asana
• Consciousness
• healing
• Physicality
• PRANAYAMA
• Stillness

Optimizing learning and quality of life throughout the lifespan: a global framework for research and application

Tags:

• Aging
• Allostasis
• Brain
• Cognition
• Health promotion
• Humans
• Quality of Life
• Research
• Self Care

Notes:

• This overview surveys the new optimism about the aging mind/brain, focusing on the potential for self-regulation practices to advance research in stress-protection and optimal health. It reviews recent findings and offers a research framework. The review links the age-related biology of stress and regeneration to the variability of mind/brain function found under a range of conditions from trauma to enrichment. The framework maps this variation along a biphasic continuum from atrophic dysfunction to peak performance. It adopts the concept of allostatic load as a measure of the wear-and-tear caused by stress, and environmental enrichment as a measure of the use-dependent enhancement caused by positive reinforcement. It frames the dissociation, aversive affect and stereotyped reactions linked with stress as cognitive, affective and behavioral forms of allostatic drag; and the association, positive affect, and creative responses in enrichment as forms of allostatic lift. It views the human mind/brain as a heterarchy of higher intelligence systems that shift between a conservative, egocentric mode heightening self-preservation and memory and a generative, altruistic mode heightening self-correction and learning. Cultural practices like meditation and psychotherapy work by teaching the self-regulation of shifts from the conservative to the generative mode. This involves a systems shift from allostatic drag to allostatic lift, minimizing wear-and-tear and optimizing plasticity and learning. For cultural practices to speed research and application, a universal typology is needed. This framework includes a typology aligning current brain models of stress and learning with traditional Indo-Tibetan models of meditative stress-cessation and learning enrichment.

Beliefs of primary care residents regarding spirituality and religion in clinical encounters with patients: a study at a midwestern U.S. teaching institution

Tags:

• Adult
• Attitude of Health Personnel
• Female
• Humans
• Internship and Residency
• Male
• Midwestern United States
• Physician-Patient Relations
• Questionnaires
• Specialties, Medical
• spirituality

Notes:

• Purpose: To assess primary care residents’ beliefs regarding the role of spirituality and religion in the clinical encounter with patients. Method: In 2003, at a major midwestern U.S. teaching institution, 247 primary care residents were administered a questionnaire adapted from that used in the Religion and Spirituality in the Medical Encounter Study to assess whether primary care house officers feel they should discuss religious and spiritual issues with patients, pray with patients, or both, and whether personal characteristics of residents, including their own spiritual well-being, religiosity, and tendency to use spiritual and religious coping mechanisms, are related to their sentiments regarding spirituality and religion in health care. Simple descriptive, univariate, and two types of multivariable analyses were performed. Results: Data were collected from 227 residents (92%) in internal medicine, pediatrics, internal medicine/pediatrics, and family medicine. One hundred four (46%) respondents felt that they should play a role in patients’ spiritual or religious lives. In multivariable analysis, this sentiment was associated with greater frequency of participating in organized religious activity (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.20-1.99), a higher level of personal spirituality (OR 1.05, 95% CI 1.02-1.08), and older resident age (OR 1.11, 95% CI 1.02-1.21; C-statistic 0.76). In general, advocating spiritual and religious involvement was most often associated with high personal levels of spiritual and religious coping and with the family medicine training program. Residents were more likely to agree with incorporating spirituality and religion into patient encounters as the gravity of the patient’s condition increased (p < .0001). Conclusions: Approximately half of primary care residents felt that they should play a role in their patients’ spiritual or religious lives. Residents’ agreement with specific spiritual and religious activities depended on both the patient’s condition and the resident’s personal characteristics.

Mindfulness in Medicine

Notes:

• Mindfulness refers to a meditation practice that cultivates present moment awareness. In the past 30 years, interest in the therapeutic uses of mindfulness has increased, with more than 70 scientific articles on the topic published in 2007. Meditation practices, including mindfulness, have come to the attention of neuroscientists investigating consciousness and affect regulation through mental training and to psychotherapists interested in personal development and interpersonal relationships. In this Commentary, we define mindfulness, consider possible mechanisms, explore clinical applications, and identify challenges to the field.

Transformative practices for integrating mind-body-spirit

Tags:

• Attitude to Health
• Controlled Clinical Trials as Topic
• Holistic Health
• Humans
• Mind-Body Relations (Metaphysics)
• Quality Assurance, Health Care
• Quality of Life
• Research Design
• Self Care
• Spiritual Therapies
• spirituality

Notes:

• This paper explores the clinical use of transformative practices that arose from the varied religious traditions of the world. Examples include prayer, meditation, mantra, affirmation, tai chi, and yoga. The purpose of these practices was to lead the practitioner to long term spiritual transformation toward an enhanced awareness of spirit, and a corresponding diminishment of identification with the mental and physical aspects of life. Unfortunately, the vagueness of the definition of transformation demonstrates that it is a broad and diffuse multidimensional concept difficult to quantify and resistant to rigorous research. However, these spiritual practices, offered as interventions separate from their spiritual tradition, have begun to be evaluated to document their effect on psychological and physical well-being. Currently, there are a number of well-designed studies that attest to the health-enhancing and suffering-reducing benefits derived from religiously transformative practices. There also is research, although sporadic and mostly on forgiveness, slowly emerging to show that prosocial positive emotion skills can be taught, and when measured, demonstrate benefit. Randomized trials of transformative practices are needed to help all levels of the health care system focus their attention on the manifestations and effect of the care delivered.

Patient preference for physician discussion and practice of spirituality

Tags:

• African Americans
• Female
• Health Care Surveys
• Humans
• Internal Medicine
• Male
• Middle Aged
• Physician-Patient Relations
• Physician's Role
• Questionnaires
• religion
• spirituality

Notes:

• Objective: To determine patient preferences for addressing religion and spirituality in the medical encounter. Design: Multicenter survey verbally administered by trained research assistants. Survey items included questions on demographics, health status, health care utilization, functional status, spiritual well-being, and patient preference for religious/spiritual involvement in their own medical encounters and in hypothetical medical situations. Setting: Primary care clinics of 6 academic medical centers in 3 states (NC, Fla, Vt). Patients/Patricipants: Patients 18 years of age and older who were systematically selected from the waiting rooms of their primary care physicians. Measurements and main results: Four hundred fifty-six patients participated in the study. One third of patients wanted to be asked about their religious beliefs during a routine office visit. Two thirds felt that physicians should be aware of their religious or spiritual beliefs. Patient agreement with physician spiritual interaction increased strongly with the severity of the illness setting, with 19% patient agreement with physician prayer in a routine office visit, 29% agreement in a hospitalized setting, and 50% agreement in a near-death scenario (P <.001). Patient interest in religious or spiritual interaction decreased when the intensity of the interaction moved from a simple discussion of spiritual issues (33% agree) to physician silent prayer (28% agree) to physician prayer with a patient (19% agree; P <.001). Ten percent of patients were willing to give up time spent on medical issues in an office visit setting to discuss religious/spiritual issues with their physician. After controlling for age, gender, marital status, education, spirituality score, and health care utilization, African-American subjects were more likely to accept this time trade-off (odds ratio, 4.9; confidence interval, 2.1 to 11.7). Conclusion: Physicians should be aware that a substantial minority of patients desire spiritual interaction in routine office visits. When asked about specific prayer behaviors across a range of clinical scenarios, patient desire for spiritual interaction increased with increasing severity of illness setting and decreased when referring to more-intense spiritual interactions. For most patients, the routine office visit may not be the optimal setting for a physician-patient spiritual dialog.

Integrative medicine and patient-centered care

Positive changes, increased spiritual importance, and complementary and alternative medicine (CAM) use among cancer survivors

Mindfulness meditation practise as a healthcare intervention: A systematic review

Tags:

• Healthcare
• Meditation
• Mindfulness
• Systematic Review

Religion and family medicine: a survey of physicians and patients

Notes:

• The purpose of this preliminary study was to investigate the role that religion plays in the practice of family medicine. Both physicians and adult patients without age restrictions were surveyed. The following issues were addressed in both groups: 1. Personal religious beliefs and practices, 2. The physician’s right and responsibility to address religious issues with patients, 3. The importance of religious factors in the establishment and maintenance of the physician-patient relationship, and 4. The circumstances under which physicians should and actually are addressing religious issues with patients. Methods: A cross-sectional sample of the entire (N = 146) active membership of the Vermont Academy of Family Physicians was surveyed using a 31-item self-administered questionnaire, which was distributed by mail. The instrument included dichotomous variables, Likert scales, and narrative responses. Many questions concerning religious beliefs were modeled after those used by national pollsters. [1-5] The questionnaire was piloted, revised, and distributed in two mailings 6 weeks apart with telephone follow-up used to assess nonresponse.

Alternative approaches to epilepsy treatment

Tags:

• Acupuncture
• Animals
• Biofeedback (Psychology)
• Complementary Therapies
• Epilepsy
• Fatty Acids, Omega-3
• Homeopathy
• Humans
• Ketogenic Diet
• Mind-Body Therapies
• Phytotherapy
• Relaxation Therapy
• Therapeutic Touch
• yoga

Notes:

• Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.

Alternative approaches to epilepsy treatment

Tags:

• Acupuncture
• Animals
• Biofeedback (Psychology)
• Complementary Therapies
• Epilepsy
• Fatty Acids, Omega-3
• Homeopathy
• Humans
• Ketogenic Diet
• Mind-Body Therapies
• Phytotherapy
• Relaxation Therapy
• Therapeutic Touch
• yoga

Spirituality and medical practice

Tags:

• Holistic Health
• Humans
• Mental Healing
• Models, Theoretical
• Pastoral Care
• Physician-Patient Relations
• Physicians, Family
• Primary Health Care
• Professional Practice
• Religion and Medicine
• United States

Notes:

• Spirituality is an important aspect of health care that is not often addressed in modern day primary medical practice. Controversy surrounds the role of spiritual issues in medical practice. Some of this stems from confusing spirituality with religion. This paper distinguishes between spiritual and religious issues and reviews the history of these issues in medicine, the growing medical literature in this area, and some practical guidelines for the practicing physician. The authors conclude that, when appropriate, spiritual issues should be addressed in patient care since they may have a positive impact on patient health and behavior, and recommend that the medical model be expanded to a biopsychosocial-spiritual one. The guidelines developed by the American Psychiatric Association provide a useful model for the practicing physician to follow. More research is needed in this area, but the authors conclude that enough is already known to support the inclusion of spiritual issues in medical education.

Medicine and spirituality: a simple path to restore compassion in medicine

Tags:

• Adaptation, Psychological
• Holistic Health
• Humans
• Medical History Taking
• NEEDS assessment
• Pastoral Care
• Physician's Role
• Quality of Life
• Religion and Medicine
• spirituality
• Treatment Outcome

Notes:

• Medical science has achieved impressive accomplishments in the diagnosis and treatment of human disease. However, the emphasis on science and technology has created a generation of physicians who find it difficult to relate to their patients about their suffering. Time constraints and economic pressures also add to the challenge of giving meaningful time to patients. Patients want to talk to their physician about their concerns, but surveys indicate that this is not being accomplished. Medical educators are developing curricula to teach how care can be given compassionately. This article reviews the importance of addressing spiritual care in medicine. Spirituality is defined and the spiritual history is explained. Research on the role of spirituality in health care is also reviewed. The role of the physician as a healer, attending to mind, body and spirit is encouraged.

The importance of spirituality in supportive care

Independent advocacy and the “rise of spirituality”: views from advocates, service users and chaplains

Religious involvement, spirituality, and medicine: implications for clinical practice

Tags:

• Adaptation, Psychological
• Holistic Health
• Humans
• Longevity
• Medical History Taking
• mental health
• NEEDS assessment
• Pastoral Care
• Physician's Role
• Quality of Life
• Religion and Medicine
• Religion and Psychology
• spirituality
• Treatment Outcome

Notes:

• Surveys suggest that most patients have a spiritual life and regard their spiritual health and physical health as equally important. Furthermore, people may have greater spiritual needs during illness. We reviewed published studies, meta-analyses, systematic reviews, and subject reviews that examined the association between religious involvement and spirituality and physical health, mental health, health-related quality of life, and other health outcomes. We also reviewed articles that provided suggestions on how clinicians might assess and support the spiritual needs of patients. Most studies have shown that religious involvement and spirituality are associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness) and less anxiety, depression, and suicide. Several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness. Discerning, acknowledging, and supporting the spiritual needs of patients can be done in a straightforward and noncontroversial manner. Furthermore, many sources of spiritual care (e.g., chaplains) are available to clinicians to address the spiritual needs of patients.

Utilization of Complementary and Alternative Medicine by United States Adults: Results from the 1999 National Health Interview Survey

To measure or not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life

Tags:

• Chronic Disease
• Health Status Indicators
• Humans
• Neoplasms
• Psychometrics
• Qualitative Research
• Quality of Life
• Questionnaires
• religion
• Research Design
• spirituality

Notes:

• Measures of quality of life have not conventionally or routinely included concepts of spirituality, religion, or existential wellbeing. Although spirituality has been seen as irrelevant, or difficult to measure, a growing body of peer-reviewed articles point to a positive and important relationship between spiritual beliefs and other domains of quality of life in health. Following a discussion of current theoretical issues surrounding the inclusion of these generic concepts, we select and review seven quality-of-life assessments in health that provide a spiritual and/or religious dimension, and evaluate each in psychometric terms. Such information could be useful to clinicians working in chronic illness, surgery and terminal care, who seek concept clarification before using an assessment that includes a spiritual domain.

Usage of Complementary and Alternative Medicine (CAM) among Osteoarthritis Patients Attending an Urban Multi-Specialist Hospital in Lagos, Nigeria

The inflammatory reflex and the role of complementary and alternative medical therapies