Positive and negative religious coping and well-being in women with breast cancer

Heterogeneous associations between early-life religious upbringing and late-life health: Evidence from a machine learning approach

Religious upbringing was common in Europe during the childhood of older adults today. However, studies are still lacking on how early-life religious upbringing is associated with adult health and how this association differs in different population segments. We used cross-national data of 10,346 adults aged 50 or older in Europe. The causal forest approach was applied to capture the complex nonlinear relationships in the data and estimate the average treatment effect (ATE) of early-life religious upbringing on late-life self-rated health and the heterogeneity of this effect across subgroups (early-life circumstances, late-life demographics, and late-life religious involvement) by estimating conditional average treatment effects (CATEs). The results demonstrated that allowing for 19 covariates, early-life religious upbringing was associated with poorer late-life self-rated health with an ATE of -0.10 [95 % confidence interval -0.11, -0.09]. However, the associations varied across different domains of health: religious upbringing was linked to poorer mental health (higher depression levels) and poorer cognitive health (lower numeracy ability) but was associated with better physical health (fewer ADL limitations). CATEs further assess the heterogeneous associations among different subgroups, providing modest evidence that early-life religious upbringing was associated with poorer late-life self-rated health especially among older individuals (65+ years), females, those with low education level, those who were not married or partnered, those who prayed, those who never attended a religious organization, and those with adverse childhood family circumstances. Our results suggest that the association between early-life religious upbringing and late-life health may be modified by both childhood and adulthood social conditions.

Influence of spirituality and religiosity on perceived social stigma among Iranian caregivers of children with autism spectrum disorder

BACKGROUND

The perceived social stigma of caregivers of children with autism spectrum disorder (ASD) may negatively affect caregivers' mental health and, consequently, the quality of care for these children. Religious and spiritual well-being may serve as protective factors against such stigma. This study aimed to examine the relationship between spirituality, religiosity, and perceived social stigma among caregivers of children with ASD.

METHOD

This cross-sectional study was conducted from September 2022 to June 2023 in Qom, Iran. A total of 102 caregivers were recruited from specialized rehabilitation centers through convenience sampling. Participants completed the Multidimensional Inventory for Religious-Spiritual Well-being (MI-RSB 48) and the Stigma Scale for Chronic Illnesses (SSCI-8), along with a demographic questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS

The mean perceived social stigma score was 16.85 ± 6.76, with 45.5% of participants reporting higher-than-average social stigma. All dimensions of spiritual-religious well-being, except belief in the afterlife and the experience of meaning, showed a significant negative correlation with perceived social stigma (P < 0.05). Multiple regression analysis revealed that the child's age (β = 0.401, P = 0.018) and hope transcendent (β = 0.418, P = 0.012) were significant negative predictors of perceived stigma, explaining 59% of the variance.

CONCLUSION

The findings suggest that fostering transcendent hope and spiritual connectedness may mitigate the perceived stigma among caregivers of children with ASD, highlighting the potential of spirituality-based interventions in rehabilitation programs.

An Exploration of the Relationships Between Mental Wellbeing and Religion Amongst Students Attending Post-Primary Schools in Ireland

The current study aimed to explore the relationships between mental wellbeing and religion amongst adolescent students attending post-primary/second-level schools in Ireland. Adolescent student participants (N = 7) attending post-primary schools in Ireland completed online, semi-structured interviews on their perceptions regarding the relationship between mental wellbeing and religion. Reflexive thematic analysis from the critical realist perspective was employed to analyse the qualitative data. The results revealed a positive relationship between mental wellbeing and religion amongst participants. Specifically, aspects of religiosity, such as personal prayer, holding religious beliefs and religious practice were mentioned by participants as being beneficial for their mental wellbeing. Similarly, the practice of positive religious coping methods, such as reading of scripture for strength, having a relationship with God, and interpret negative life events in light of religion, had a positive impact on the mental wellbeing of participants. The findings demonstrate that for the participants in this small-scale study, religion has the potential to positively impact their mental wellbeing. Implications for areas of investigation in future research, curriculum and religious adolescents, as well as the adults who work with them in school and community settings, are discussed.

Spiritual care in outpatient oncology: a qualitative study of focus groups with cancer center chaplains

PURPOSE

To provide a preliminary description of the scope and nature of spiritual care services in outpatient oncology settings.

METHODS

Qualitative thematic analysis of data collected from three focus groups with chaplains representing 13 unique cancer centers.

RESULTS

Eight of 13 chaplain respondents (61.5%) reported that they provided spiritual care exclusively and in a full-time capacity to a cancer center; the remaining 5 (38.5%) had additional inpatient responsibilities. Chaplains visited between 4 and 10 patients per day depending on departmental policies and case acuity. Respondents identified patients for care in a wide variety of ways and described it as a time-intensive aspect of their job. Chaplains noted providing traditional spiritual care and developing innovative strategies/techniques. Most spiritual care relationships were long-term and often focused on medical decision-making. Chaplains commonly faced organizational challenges and identified priorities for strengthening spiritual care integration in outpatient cancer care.

CONCLUSION

The results indicate that the provision of spiritual care in cancer centers differs widely, with chaplains frequently facing challenges with system integration. While chaplains consistently strive to build relationships with clinicians and effectively manage clinic workflows, more collaboration and strategic alignment are needed between chaplains, clinicians, and administrators to develop and advocate for outpatient oncology spiritual care.

Testing items to screen for religious or spiritual distress in adult outpatient cancer care

PURPOSE

The experience of cancer diagnosis and treatment is associated with significant stress. While religion and spirituality (R/S) can provide crucial support, many patients also experience R/S distress. Screening for distress has gained recognition, with tools evolving to address spiritual needs; however, existing screening measures have limitations. This study aims to validate screening items for R/S distress among cancer patients undergoing treatment, using a standardized chaplain assessment as a reference standard.

METHODS

The study involved adult cancer patients undergoing outpatient treatment at Rush Cancer Center. Procedures included researcher-administered screening questions and the ONC-5 spiritual assessment interview with a board-certified chaplain. Data included demographics, illness variables, and R/S measures. Eight single-item and two multi-item screening measures were evaluated against the ONC-5. Analysis entailed descriptive statistics and sensitivity/specificity determination.

RESULTS

Study participants (N = 71) were predominantly female (53.5%) with common cancers (breast, colon/rectum, and lung). R/S distress was evident in 19.7%. Single-item screeners exhibited sensitivities from 14 to 71% and specificities from 72 to 98%. The King 2-question combination showed 71% sensitivity and 63% specificity. The Rush protocol demonstrated 36% sensitivity and 88% specificity. Post hoc analyses of two-item combinations did not enhance sensitivity.

CONCLUSION

This study evaluated R/S distress screening items among outpatient cancer patients. The single-item screener asking whether participants' R/S provided all the strength and comfort needed now performed best with a sensitivity and specificity of 71% and 83%, respectively. Despite limitations, our findings underscore the importance of refining R/S distress screening tools in oncology care.

The association between religiosity, suicidality, psychological distress, and quality of life among breast cancer patients, an example of a Middle Eastern population

The study aimed to explore the relationship between religiosity, psychological distress, and quality of life (QOL) in Saudi breast cancer patients. Utilizing a multi-center cross-sectional design, 277 patients were recruited. Patients completed questionnaires assessing religiosity, depression, anxiety, suicidality, and QOL. Results revealed a high prevalence of depression (35.7%) and anxiety (18.1%), with no significant variations in internal religiosity across different health stages, despite high levels of perceived social support. Suicidal ideation was reported by a small proportion of patients (2.5%). Multivariate analysis identified anxiety, therapy side effects, and breast symptoms as significant predictors of depression, while depression and previous psychiatric treatment predicted anxiety levels. QOL assessments indicated that body image received the highest satisfaction ratings, while sexual function received the lowest. These findings highlight the critical need for integrated mental health support in the treatment regimen of breast cancer patients.

Reviewing the use of the Brief Religious Coping Scale (Brief RCOPE) across diverse cultures and populations

To discern the religious coping methods which individuals employ when confronting life stressors, Pargament devised the Religious Coping Scale (RCOPE) in 1997. Subsequently, in 1998, Pargament et al. formulated an abbreviated iteration, the Brief RCOPE, intended for both research and practical application. The Brief RCOPE has been found to be a reliable and valid measure, however much of the research looking into the psychometric properties of this measure has been conducted in the United States. The aim of the current review was to draw together findings from studies which have investigated the reliability and/or validity of the measure amongst populations outside of the United States. A narrative approach was adopted, involving searches of academic databases using keywords and the application of specific inclusion criteria. It was found that the reliability of the measure has been demonstrated across a number of countries, and across a range of different religions. The measure has also demonstrated good convergent, construct and concurrent validity in diverse cultures. The findings from this review suggest that the Brief RCOPE can be used in a range of diverse religions and cultures. However, more research is needed to ascertain the accuracy of the measure with other religions and cultures and with those in minority groups.

"Religious Coping Fosters Mental Health": Does Psychological Capital Enable Pakistani Engineers to Translate Religious Coping into Mental Wellbeing?

Turning toward religion to make sense of and cope with challenging circumstances is an area of interest for many recent researchers working on wellbeing and mental health. The present study extends this interest by assessing whether psychological capital explains the association between religious coping and mental wellbeing in Pakistani engineers. Psychological capital was assessed from four factors, namely optimism, resilience, hope, and self-efficacy. A sample of 501 Muslim engineers from Pakistan (M age = 33.41, SD = 6.37 years) was assessed on measures of religious coping, psychological capital, and mental wellbeing. Results from correlation and a multimediation model showed that positive religious coping was positively predictive of mental wellbeing and psychological capital; however, negative religious coping remained insignificant for mental wellbeing. Further analysis showed that of four psychological capital factors, only self-efficacy explained the positive association between positive religious coping and mental wellbeing. Implications of the findings along with future directions have been discussed.

Religious Coping and Mental Adjustment to Cancer Among Polish Adolescents

Adults suffering from chronic illnesses are more likely to look to God for support (positive religious coping; PRC) than to fight against God (negative religious coping; NRC). What about when cancer occurs during adolescence-a period of questioning the worldview and values, and at the same time searching for the sacred? Our study aimed to establish the relationships between PRC, NRC, and mental adjustment to cancer among youth and determine support's role in these relationships. The study was conducted in Poland and included 88 adolescent cancer patients who completed the Brief RCOPE and the Mini-MAC. Additionally, general well-being and support were assessed. We found that PRC was positively related to constructive adjustment style (CAS), whereas NCR was related to destructive adjustment style (DAS). Adolescents with cancer were higher in PRC than in NRC and were higher in CAS than in DAS. In young women, CAS was higher than in men. Finally, at a level of received support rated as very high, PRC promoted fighting spirit and well-being.

To what extent do social support and coping strategies mediate the relation between childhood maltreatment and major depressive disorder: A longitudinal community-based cohort

This study aimed to articulate the roles of social support and coping strategies in the relation between childhood maltreatment (CM) and subsequent major depressive disorder (MDD) with a comprehensive exploration of potential factors in a longitudinal community-based cohort. Parallel and serial mediation analyses were applied to estimate the direct effect (DE) (from CM to MDD) and indirect effects (from CM to MDD through social support and coping strategies, simultaneously and sequentially). Sociodemographic characteristics and genetic predispositions of MDD were considered in the modeling process. A total of 902 participants were included in the analyses. CM was significantly associated with MDD (DE coefficient (β) = 0.015, 95% confidence interval (CI) = 0.002∼0.028). This relation was partially mediated by social support (indirect β = 0.004, 95% CI = 0.0001∼0.008) and negative coping (indirect β = 0.013, 95% CI = 0.008∼0.020), respectively. Social support, positive coping, and negative coping also influenced each other and collectively mediated the association between CM and MDD. This study provides robust evidence that although CM has a detrimental effect on later-on MDD, social support and coping strategies could be viable solutions to minimize the risk of MDD. Intervention and prevention programs should primarily focus on weakening negative coping strategies, then strengthening social support and positive coping strategies.

Psychometric Properties of the Spiritual Coping Strategies Scale-Chinese Version (SCSS-C) for Adults in Taiwan

This study examined the psychometric properties of the Spiritual Coping Strategies Scale-Chinese version (SCSS-C) in Taiwanese adults. A convenience sample of 232 participants in Taiwan completed an online survey, and 45 of the 232 participants completed the SCSS-C again over a 2 week interval. The content validity index of the SCSS-C was 0.97. Parallel analysis and exploratory factor analysis results revealed two factors (religious coping and non-religious coping). The internal consistency of the SCSS-C was satisfactory (α = 0.88 to 0.92). Test-retest reliability was satisfactory (r = 0.68 to 0.89). The psychometric properties of the SCSS-C were found to be acceptable for use in Taiwanese adults.

In their own words: a qualitative study of coping mechanisms employed by patients with acute myeloid leukemia

PURPOSE

Positive coping mediates improved outcomes from integrated palliative care in acute myeloid leukemia (AML). We qualitatively explored patients' coping mechanisms to better understand this relationship.

METHODS

We enrolled patients with high-risk AML admitted to Duke Hospital's inpatient hematologic malignancy service for intensive chemotherapy. This study is a secondary analysis of previously collected longitudinal qualitative data, with interviews conducted between February 2014 and August 2015. Interviews were coded in NVivo to identify examples of approach-oriented and avoidant coping.

RESULTS

Patients demonstrated approach-oriented coping in many forms including acceptance, positive reframing, active coping, religious coping, and social coping. Acceptance included accepting their prognosis, the uncertainty of AML, and lifestyle changes due to the disease. Patients exhibited positive reframing by speculating about how their situation could be worse, deriving meaning from their experience, and expressing newfound appreciation for activities previously taken for granted. Social coping involved patients receiving support from their community or care team; however, some expressed guilt for being a "burden" on family. Avoidant coping included denial, behavioral disengagement, and self-blame. Some denied their prognosis, but denial was more commonly demonstrated via patients cognitively distancing themselves from their disease. Much of the behavioral disengagement described by patients was attributed to their symptoms (i.e., lethargy) which prevented patients from maintaining relationships or participating in activities previously enjoyed.

CONCLUSION

These results demonstrate the diverse and nuanced applications of coping mechanisms amid a recent AML diagnosis. Future research should examine coping in the context of novel low-intensity AML therapies.

Spiritual coping strategies: Relationship with physical, anxiety, and depression symptoms of patients with cancer

Introduction

Spirituality is considered an important source against chronic diseases and can promote self-esteem, mental comfort, and hope in patients. Concerning its importance, the present study aims to investigate spiritual coping strategies and its relationship with physical, anxiety, and depression symptoms of patients with cancer who are referred to the oncologic ward.

Method

This was a descriptive-correlative study that 159 patients with cancer participated in the study. Information was collected using a four-part questionnaire including sociodemographic characteristics, Spiritual Coping Strategies Scale, physical symptoms as well as anxiety and depression symptoms. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis, and Spearman correlation coefficient.

Results

Results of the study showed that the mean (±SD) of the application of methods of spiritual coping strategies was 35.69 ± 10.92 and for its subscales the mean (±SD) of the application of religious coping and nonreligious coping strategies were 16.92 ± 5.6 and 18.77 ± 6.24, respectively. Furthermore, physical symptoms perceived by patients were tiredness, drowsiness, and lack of appetite. There was no significant correlation between physical, anxiety, and depression symptoms and spiritual coping strategies (r = -0.12, P = 0.12; r = 0.07, P = 0.41; and r = -0.05, P = 0.5 respectively).

Discussion

Regarding no significant relationship between physical, anxiety and depression symptoms and spiritual (religious and nonreligious) coping strategies in this study, belief towards cancer and cultural aspects of patients may be more essential to their sense of wellness and help them to cope with negative aspects of illness or treatment. Therefore, more study needs to be done in this area.

Assessing the impact of religious resources and struggle on well-being: a report from the American Cancer Society's Study of Cancer Survivors-I

PURPOSE

The current study examined the relationships between religious resources (i.e., certainty of belief in God and attendance at religious services), religious struggle (e.g., belief that cancer is evidence of God's punishment or abandonment), and physical and mental health-related quality of life (HRQoL), including fear of cancer recurrence (FCR), in a large, geographically and clinically diverse sample of long-term survivors of cancer.

METHODS

Participants were 2021 9-year survivors of cancer from the American Cancer Society's Study of Cancer Survivors - I. Religious resources included belief in God and attendance at religious services. Items from the Brief RCOPE and the PROMIS Psychosocial Impact of Illness were combined to assess religious struggle. Survivors also completed the Fear of Cancer Recurrence Inventory, SF-12, and Meaning and Peace subscales of the FACIT-Sp. Regression models were used to predict HRQoL and FCR from religious resources and struggle.

RESULTS

In multivariable models, certain belief in God predicted greater mental HRQoL (B = 1.99, p < .01), and attendance at religious services was associated with greater FCR (B = .80, p < .05) as well as better mental (B = .34, p < .01) and physical (B = .29, p < .05) HRQoL. In addition, religious struggle predicted greater FCR (B = 1.32, p < .001) and poorer mental (B =  - .59, p < .001) and physical (B =  - .29, p < .001) HRQoL. Many of these relationships were mediated through Meaning.

CONCLUSIONS

With the exception of FCR, religious resources predicted better HRQoL outcomes in these long-term survivors of cancer. Conversely, religious struggle consistently predicted poorer HRQoL, including greater FCR.

IMPLICATIONS FOR CANCER SURVIVORS

Given the documented importance of its role in coping with the cancer experience, religion/spirituality should be a consideration in every survivorship care plan. Multidisciplinary assessment and support of religious resources and identification of and referral for religious struggle are needed to ensure the well-being of most long-term survivors of cancer.

Fear of COVID-19, death depression and death anxiety: Religious coping as a mediator

The COVID-19 pandemic has affected the well-being and mental health of populations worldwide. This study sought to examine whether religious coping mediated the relationship between COVID-19-related fear and death distress. We administered an online survey to 390 adult participants (66.15% females; Mage = 30.85 ± 10.19 years) across Turkey. Participants completed a series of questionnaires measuring the fear they had experienced during the COVID-19 pandemic, their levels of religious coping and their levels of death anxiety and depression. Our findings revealed that (a) fear of COVID-19 was associated with positive religious coping, negative religious coping, death anxiety and death distress; (b) negative religious coping was associated with death anxiety and depression and (c) negative religious coping mediated the relationship between fear of COVID-19 and death anxiety and depression. These results highlight the detrimental effect of negative religious coping in increasing the adverse effect of the COVID-19 fear on death depression.

"Faith Is Not Enough?" Ego-Resiliency and Religiosity as Coping Resources with Pandemic Stress-Mediation Study

Based on the concepts of Pargament's adaptational functions of religiosity, Huber's centrality of religiosity, and Block's conceptualisation of ego-resiliency as psychosocial resources, a nonexperimental, moderated mediation project was designed for a group of 175 women and 57 men who voluntarily participated in an online study to determine whether and to what extent religiosity mediated or moderated the relationship between ego-resiliency and the severity of PTSD and depression during the COVID-19 epidemic. The analyses carried out showed that the studied variables, ego-resiliency and centrality of religiosity, were predictors of the intensity of some psychopathological reactions caused by the COVID-19 pandemic but were not connected via a mediation relationship. Therefore, one question remains open: what is the role of ego-resiliency and the nature of the stated immunogenic effect of the centrality of religiosity in dealing with the critical threat to mental health that is the COVID-19 pandemic?

A meta-analytic review of the associations between dimensions of religious coping and psychological symptoms during the first wave of the COVID-19 pandemic

Introduction

In the first wave of the COVID-19 pandemic, the unknown etiology and treatment of the highly transmissible coronavirus posed considerable threats to public mental health. Many people around the globe turned to religion as an attempt to mitigate their heightened psychological distress, but mixed findings have been obtained regarding the association between the use of religious coping and two psychological symptoms-anxiety and depressive symptoms-widely reported in the initial wave.

Objective

The present meta-analysis was conducted to resolve the empirical inconsistency by synthesizing this body of studies and identifying both individual and national-level factors that accounted for the inconsistent findings.

Methods

Following PRISMA guidelines, the literature search and data screening procedures yielded 42 eligible studies, with 25,438 participants (58% females, average age = 36.50 years) from 24 countries spanning seven world regions.

Results

Overall, the results showed that only negative religious coping was positively associated with psychological symptoms (r = 0.2886, p < 0.0001). Although the associations of both general and positive religious coping with psychological symptoms were non-significant (rs = 0.0425 and -0.0240, ps > 0.39), the moderation analysis revealed significant positive associations between positive religious coping and psychological symptoms in two demographic groups who experienced greater pandemic distress than their counterparts: younger participants and female participants.

Discussion

This meta-analysis provides a nuanced understanding of the complex nature of religious coping in the initial wave of the COVID-19 pandemic when the levels of public anxiety and stress were heightened. The exclusive use of religious coping may not be associated with low levels of psychological symptoms, implying the importance of supplementing the deployment of this strategy with an array of other strategies. Therapists of mental health interventions should show their clients how to make good use of positive religious coping together with other strategies, and how to avoid the use of negative religious coping, to handle their psychological problems.

Systematic review registration

https://osf.io/shb32/.

Positive religious coping acts through perception of nature and silence in its association with well-being and life satisfaction among Polish Catholics

Previous studies indicate that perceptions of nature and thought-provoking silence can have positive consequences for individual functioning. The purpose of the present study was to assess the relationships between religious coping (assessed with the Brief RCOPE), perceptions of nature and silence (a subscale of the Perception of Change Questionnaire), well-being (the World Health Organization's five-item Well-Being Index) and life satisfaction (the Brief Multidimensional Life Satisfaction Scale). An online questionnaire was completed between 2021-2022 by 1,010 Polish Catholics ages 18 to 73, 61% of whom were women. Structural equation modeling showed that positive religious coping was positively related to well-being (β = 0.08, p = 0.011) and life satisfaction (β = 0.22, p < 0.001). In contrast, negative religious coping was related to reduced well-being (β = -0.07, p = 0.040) and life satisfaction (β = -0.25). In addition, more frequent perceptions of nature and reflective times of silence partially mediated the associations of positive religious coping with well-being (β = 0.04, p = 0.011) and life satisfaction (β = 0.04, p = 0.008). The data might suggest that interventions that help people develop an ability or awareness for nature as an exceptional encounter and may help to strengthen the ways they can utilize their religiosity as a resource and thus contribute to well-being and life satisfaction among Catholics.

Exploring the mediating effects of negative and positive religious coping between resilience and mental well-being

Background:

The purpose of the study was to examine more thoroughly the relationship between trait resilience and mental well-being. Although research demonstrates that this relationship is partially mediated by stress-related variables, no study has taken into account the mediating role of religious coping. We examined the mediating role of both variants of religious coping, positive and negative, along with specific strategies within the scope of religious coping strategies in a group of practicing Catholics.

Method:

Participants were 317 people aged 19–60 years (M = 24.34; SD = 6.30). The respondents indicated their gender and age, and then completed the RS-14 (trait resilience), RCOPE (religious coping), and WEMWBS (mental well-being) scales.

Results:

The results displayed a significant relationship between resilience and mental well-being (r = 0.67; p &lt; 0.001). The relationship between resilience and positive religious coping was negligible (r = 0.09; p = 0.74), contrary to the relationship between resilience and negative coping that was significant but weak (r = −0.29; p &lt; 0.001). Although the relationships between overall negative and positive religious coping with mental well-being were irrelevant, we found significant relationships between some strategies and mental well-being. The mediation analysis has demonstrated that the general negative religious coping and the strategies of demonic reappraisal, passive religious deferral, and spiritual discontent have enhanced the positive relationship between resilience and mental well-being. Contrary to expectation, positive strategies did not mediate the relationship between resilience and mental well-being, except religious practices (c′path totaled β = 0.66; t = 15.74, p &lt; 0.001). The insignificant mediation effect can stem from the fact that the relationship between positive religious coping and stress is noticeable only in the long term. We controlled age and sex as statistically significant covariates so that the mediation effects obtained were devoid of the influence of those critical variables on the models.

Conclusion:

This is the first study to investigate the role of religious coping as a mediator in the relationship between resilience and mental well-being.

The Effect of Religious Coping on the Satisfaction with Life Among Turkish Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) with life-threatening features due to uncomfortable symptoms such as dyspnea decreases satisfaction with life. This study aims to determine the effect of religious coping methods on satisfaction with life in patients with COPD in Turkey. This descriptive and cross-sectional study was conducted with patients who had COPD for at least a year (n = 149). The positive religious coping levels of the patients were high while their negative religious coping levels were low and their levels of satisfaction with life were below average. A positive correlation was found between the positive religious coping levels and satisfaction with life of the patients (p < 0.05). The patients' age, general health levels, economic status, state of meeting their daily needs and usage of positive religious coping were the factors that significantly affected their levels of satisfaction with life, and these factors explained 38% of the total variance in the patients' satisfaction with life. It is important to evaluate religious coping in increasing the satisfaction with life of COPD patients who receive treatment in health institutions.

The influence of socio-demographics and clinical characteristics on coping strategies in cancer patients: a systematic review

OBJECTIVES

Cancer is a frequent illness and a traumatic experience for both patients and their families. This systematic review aims to analyse studies that examine socio-demographic and clinical characteristics that predict the coping strategies in cancer patients.

METHODS

From January 2000 to March 2021, the database searches were conducted in 7 different databases, using relevant keywords. According to PRISMA Statements, full-text, peer-reviewed articles in English which used socio-demographics as independent variables and coping as dependent variables were included.

RESULTS

Of 1101 abstracts and titles, 30 full-text papers were included. Overall results showed a great influence of socio-demographic characteristics (such as women, younger, in a relationship, with high educational level, with active work status, and high income) on positive coping strategies adopted by cancer patients. Regarding clinical characteristics, no-metastatic patients who have recently been diagnosed, especially in the early stage of cancer, and who know the characteristics of their illness and treatments, more frequently used adaptive coping strategies.

CONCLUSIONS

Both socio-demographics and clinical characteristics showed considerable influence on the coping strategies adopted by patients in most of the investigations. These results supported the assessment of basic patients' information (sociodemographic and clinical characteristics) as fundamental to quickly outline an efficient, supportive, and holistic taking-over, before all the essential and in-depth considerations.

TRIAL REGISTRATION

This systematic review was recorded in PROSPERO with the registration number: CRD42021254776.

Relationship between perceived threat of COVID-19 and burnout among frontline nurses: A mediation analysis

BACKGROUND

Burnout of nurses during the Coronavirus of 2019 pandemic can end up extremely expensive for societies. It is found that positive religious coping (PRC) and a secure God attachment are effective for shielding against the adverse consequences of being exposed to stressful situations.

METHODS

This research explores the relationships among God attachment, religious coping, and burnout among nurses who are confronted with COVID-19 as a perceived threat through a model based on the combination of attachment theory and the Job Demands-Resources model. Analysis was done using SMART-PLS.

RESULTS

The results reveal that perceived threat of COVID-19 (PTC) positively correlates with burnout among nurses and that secure attachment to God and PRC can buffer this relationship, while insecure attachment to God, including anxious and avoidant attachment, along with negative religious coping positively mediates the relationship between PTC and burnout.

CONCLUSION

Finally, this study suggests managerial implications of these findings for healthcare organizations and a recommendation for helping out staff to help them manage such threats and their attachment to God.

The Influence of Parental Religiosity on the Health of Children during Late Adolescence/Early Adulthood: A Test of Mediation

The present study explores whether adolescent religiosity, health-related behaviors, and marital stability mediate the association between parental religiosity and health. Using data from the National Longitudinal Study of Adolescent to Adult (Add) Health, I model potential direct and indirect effects between three measures of parental religiosity (i.e., parental institutional religiosity, parental personal religiosity, and parental religious affiliation); three sets of mediators indicating adolescent religiosity, health-related behaviors, and marital stability; and self-rated health during late adolescence/early adulthood. Overall, I found that parental institutional religiosity has a direct effect on the self-rated health of children during late adolescence/early adulthood, and that it influences self-rated health by reducing adolescent and parental smoking. I also found evidence for deleterious effects of parental institutional religiosity on health as well. Future research should explore variation in the influence of parental religiosity on self-rated health between various sociodemographic groups and between different stages of the life course.

Spiritual Needs, Religious Coping and Mental Wellbeing: A Cross-Sectional Study among Migrants and Refugees in Germany

It has been widely proven that resettlement is associated with negative psychological effects (e.g., increased depression and symptoms of post-traumatic stress disorder) among refugees. Therefore, there is an urgent need to improve the psychosocial functioning of migrants. This study assessed associations between negative dysfunctional appraisal (perceiving experiences as stressful), spiritual needs, religious coping and wellbeing. Data from paper-and-pencil questionnaires were collected from 744 refugees (69.8% male) aged 18–67 years (M = 27.99) with diverse backgrounds (including from Mashreq countries) who were resettled in Germany. Bootstrapping mediation analysis revealed that the relationship of dysfunctional appraisal and wellbeing among refugees is mediated by spiritual needs (i.e., existential and religious needs). Additionally, negative religious coping mediates the relationship between spiritual needs and wellbeing. The data obtained suggest the need for practitioners to focus on psychological interventions that strengthen spiritual needs in order to improve mental health among refugees.

An Analysis of Chaplains' Narrative Chart Notes Describing Spiritual Care Visits with Gender Affirmation Surgical Patients

Purpose

The benefit of spiritual care for patients is well described, but little is known about the role of spiritual care in transgender and nonbinary patients recovering from gender affirming surgeries (GASs).

Methods

A single-center retrospective chart review was performed on patients who underwent GAS in 2017. Demographic information, surgery type, and chaplains' narrative notes were examined.

Results

A total of 145 chaplain visits were identified in 103 inpatient stays among 98 patients at the Mount Sinai Center for Transgender Medicine and Surgery in New York. Analysis was performed on narrative notes authored by a single chaplain, which included 132 visits among 78 transfeminine and 11 transmasculine patients. Fifty-four patients (61%) expressed gratitude for the chaplain visit and/or hospital experience overall. Seven patients (8%) described movement between religious denominations over the course of their lives, and 7 (8%) described supportive belief systems. Fifty-seven patients (64%) had a family member or friend present during the perioperative process, 13 (15%) described support systems, and 9 (10%) described supportive practices, activities, and/or coping methods. Twenty-one patients (24%) expressed concerns about current symptoms or the recovery process, and 32 (36%) received a prayer or blessing from the chaplain. Fifty-two patients (58%) consented to a follow-up call.

Conclusion

Almost 50% of patients expressed gratitude for the chaplain's visit and more than half consented to a follow-up call from the chaplain, suggesting a chaplain can provide a welcome layer of support to postoperative GAS patients. The authors recommend integrating spiritual care into perioperative care.

Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic-A Cross-Sectional Study

Social distancing and the priority given to COVID-19 patients in health services, which caused postponement of appointments and cancer treatment, may have triggered unprecedented levels of distress in cancer patients. The aim of this study was to analyze the prevalence of distress and the levels of spiritual well-being of people initiating chemotherapy during the COVID-19 pandemic, identifying the factors associated with distress, and determining if there is a relationship between distress and spiritual well-being. A cross-sectional study was conducted with 91 Brazilians. Data were collected by applying the Spiritual Well-Being Scale (SWBS) and the Distress Thermometer and Problem List for Patients. The prevalence of distress was 59.5%, and the average score of spiritual well-being was 106.54 (±9.06). Emotional issues were the most reported by patients with distress. The Poisson regression showed that male sex (PR = 0.588; 95% CI 0.392-0.881), age (PR = 0.985; 95% CI 0.973-0.996), and spiritual well-being score were predictors of distress (PR = 0.971; 95% CI 0.946-0.996). These findings indicate that distress relief involves implementation of public health programs capable of integrating spiritual interventions into cancer care.

Top Ten Tips Palliative Care Clinicians Should Know About Spirituality in Serious Illness

Assessment of spiritual suffering and provision of spiritual care are a central component of palliative care (PC). Unfortunately, many PC clinicians, like most medical providers, have received limited or superficial training in spirituality and spiritual distress. This article, written by a group of spiritual care providers, and other PC and hospice clinicians, offers a more in-depth look at religion and spirituality to help to enhance readers' current skills while offering a practical roadmap for screening for spiritual distress and an overview of partnering with colleagues to ensure patients receive values-aligned spiritual care provision.

Religious Coping and Life Satisfaction during the COVID-19 Pandemic among Polish Catholics. The Mediating Effect of Coronavirus Anxiety

Recent data have indicated that people may have experienced fear during the COVID-19 pandemic. This study aims to deepen our understanding of the relationship between religious coping and life satisfaction by analysing the indirect effects of fear of COVID-19.

METHODS

This study included 365 people (75% women) aged 18-78 years. The procedure consisted of completing questionnaires to measure religious coping, COVID-19 anxiety, satisfaction with life, and satisfaction with social support.

RESULTS

Structural equation modelling showed that positive religious coping was related to greater life satisfaction and greater satisfaction with social support during the pandemic. Moreover, fear of COVID-19 mediated the relationship between negative religious coping and life satisfaction and social support satisfaction.

CONCLUSIONS

The data suggest a need for practitioners to focus on interventions that enhance positive religious coping to improve life satisfaction during the spread of infectious diseases.

Randomized Controlled Trial Study of the Impact of a Spiritual Intervention on Hope and Spiritual Well-Being of Persons with Cancer

OBJECTIVES

To determine the impact of spiritual intervention on hope and spiritual well-being of persons with cancer.

METHODS

Randomized controlled trial in which 74 patients with cancer referring to a chemotherapy ward of Shahid Rajaie Hospital in Yasuj city, Iran, were participated. The eligible patients were randomly assigned to either intervention or control group. Spiritual-based intervention was performed based on the protocol in four main fields namely; religious, existence, emotional and social over 5 sessions before chemotherapy. The participants in the control group had received usual cares. Data were collected using Snyder's Hope Scale and Ellison's Scale Spiritual Well-Being Scale on a week before and after intervention.

RESULTS

The total mean scores of the scales of hope and spiritual well-being in both groups did not present statistical differences in the pre-intervention assessment. In contrast, at the post assessment, significant differences (p<0.001) were found in the mean scores between the intervention and control groups on the hope scale (60.9 versus 39.8) and on the spiritual well-being scale (94.3 versus 71.6).

CONCLUSIONS

Spiritual intervention could promote hope and spiritual well-being of persons with cancer.

Validation of a Scale of Religious and Spiritual Coping (RCOPE) for the Portuguese Population

The scale of religious and spiritual coping (RCOPE) is one of the most used measures in the evaluation of coping strategies based on faith. Despite being validated for the Portuguese language in the Brazilian context, there was still no validation for European Portuguese, which seems important considering the cultural differences. We aimed at examining the validity and reliability of the RCOPE with a Portuguese sample. The present study used cross-sectional data from 1103 volunteers that completed the online survey. After randomly splitting the sample (1:1) for cross-validation purposes, an ordinal exploratory factor analysis and confirmatory factor analysis were performed. McDonald's omega, Cronbach's alpha and mean inter-item correlations were used to determine the internal consistency and homogeneity of the RCOPE. The convergent and discriminant validity of the scale was assessed using standardized factor loadings, the average variance extracted and the squared correlation between latent factors, respectively. In the current study, the final structure of the scale included 17 items aggregated into two correlated latent factors. The Portuguese version of the RCOPE showed acceptable psychometric proprieties, which will be an advantageous instrument for the practice and research of psychology in religion and spirituality.

Spirituality, religiousness, and mental health: A review of the current scientific evidence

Research in the field of “Spirituality and Health” has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.

Prevalence, Predictors and Correlates of Religious and Spiritual Struggles in Palliative Cancer Patients

CONTEXT

Religion and spirituality (r/s) are important resources in coping with cancer. However, there are aspects of r/s, such as religious and spiritual struggles, found to be associated with poorer outcomes. A new measure has been adapted from the Religious and Spiritual Struggles Scale (RSS) to assess r/s struggles: the RSS-14. This concise measure allows for the assessment of multiple types of r/s struggles for people from different religious backgrounds or none.

OBJECTIVES

The aim of the present study was to examine the prevalence, predictors and correlates of r/s struggles as measured by the RSS-14 and its subdomains in a cancer population receiving palliative care.

METHODS

Data were collected from six outpatient palliative care services across the US. Inclusion criteria for patients were age 55 or older with a cancer diagnosis. In addition to demographic and r/s characteristics, study measures included the Edmonton Symptom Assessment Scale (ESAS), the Patient Dignity Inventory (PDI) and the Quality of Life at the End of Life (QUAL-E).

RESULTS

The study included 331 participants. Some r/s struggle was reported by 66%, moderate to high struggle for at least one item was reported by 20% of the patients. In bivariate analyses, r/s struggle was associated with greater symptom burden, greater dignity-related problems and poorer quality of life; in multivariable analyses, dignity-related problems remained a predictor of total r/s struggle.

CONCLUSION

R/S struggles may compromise well-being for cancer patients receiving palliative care. Clinicians should consider periodic screening for r/s struggles and referrals for spiritual care if indicated.

Strength of Religious Faith in Peruvian Adolescents and Adults: Psychometric Evidence from the Original and Short Versions of the Santa Clara Strength of Religious Faith Questionnaire in Spanish

The aim of this study was to evaluate the psychometric evidence of the original and short versions of the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ) in Spanish in a sample of 245 Peruvian adolescents and adults (mean age = 21.04 years, SD = 3.07, 47.8% male and 52.2% female), selected by nonprobabilistic convenience sampling. Additionally, the Coronavirus Anxiety Scale and the Satisfaction with Life Scale were applied. Confirmatory Factor Analysis, internal consistency reliability methods, hierarchical sequence of variance models, and a graded response model were used. Results indicate that both versions of the SCSRFQ showed robust psychometric properties: adequate unidimensional structure, adequate difficulty and discrimination parameters, and significant relationships with the measures of fear of COVID-19 and satisfaction with life. The original version of the SCSRFQ showed evidence of strict measurement invariance by sex and age, whereas the short version showed strict invariance by sex and configural invariance by age. Both versions showed acceptable reliability indices. In conclusion, the original and short versions of the SCSRFQ in Spanish show evidence of psychometric indicators that support their use to assess the strength of religious faith.

The Effect of Religious Coping on Hope Level of Cancer Patients Receiving Chemotherapy

Religious coping and hope are among factors that affect the disease, treatment compliance, psychological health and quality of life of cancer patients. The aim of this study was to determine the level of hope and religious coping styles of cancer patients, and to determine the relationship between religious coping and hope. The study was carried out descriptively and cross-sectionally with 133 patients receiving chemotherapy in an oncology center. In the study, the level of hope and positive religious coping of the patients were high and their level of negative religious coping was low. It was determined that there was a positive relationship between positive religious coping style and hope levels of patients, and positive religious coping style was a significant predictor of hope level. While patients are dealing with cancer diagnosis and treatment, it is recommended that health care professionals primarily focus on providing these patients a service with a holistic care approach and developing their hope with practices that will strengthen their positive religious coping styles.

The Influence of Patient and Provider Religious and Spiritual Beliefs on Treatment Decision Making in the Cancer Care Context

BACKGROUND

Providers often underestimate the influence of patient religious and spiritual (R&S) needs. The current study sought to determine the influence of R&S beliefs on treatment decision making among patients and providers in the context of cancer care.

METHODS

We conducted a systematic review of the literature using web-based search engines and discipline-specific databases. Search terms included a combination of the following Medical Subject Headings and key terms: "cancer,""spirituality,""religion," and "decision making." We used Covidence to screen relevant studies and extracted data into Microsoft Excel.

RESULTS

Among 311 screened studies, 32 met inclusion/exclusion criteria. Most studies evaluated the patient perspective (n = 29), while 2 studies evaluated the provider perspective and 1 study examined both. In assessing patient R&S relative to treatment decision making, we thematically characterized articles according to decision-making contexts, including general (n = 11), end-of-life/advance care planning (n = 13), and other: specific (n = 8). Specific contexts included, but were not limited to, clinical trial participation (n = 2) and use of complementary and alternative medicine (n = 4). Within end-of-life/advance care planning, there was a discrepancy regarding how R&S influenced treatment decision making. The influence of R&S on general treatment decision making was both active and passive, with some patients wanting more direct integration of their R&S beliefs in treatment decision making. In contrast, other patients were less aware of indirect R&S influences. Patient perception of the impact of R&S on treatment decision making varied relative to race/ethnicity, being more pronounced among Black patients.

CONCLUSION

Most articles focused on R&S relative to treatment decision making at the end of life, even though R&S appeared important across the care continuum. To improve patient-centered cancer care, providers need to be more aware of the impact of R&S on treatment decision making.

Religion, spirituality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women

Background

Religion and spirituality (R/S) are important resources for coping with stress and are hypothesized to influence health outcomes via modulation of the hypothalamic-pituitary-adrenal (HPA) axis, though this has not been evaluated extensively. In this study, we examined associations between several measures of religiosity or spirituality (R/S) and three HPA axis biomarkers: cortisol, dehydroepiandrosterone (DHEA), and cortisol:DHEA ratio.

Methods

Sample included 216 female postmenopausal Nurses’ Health Study II participants who provided up to five timed saliva samples: immediately upon awakening, 45 min, 4 h, and 10 h after waking, and prior to going to sleep during a single day in 2013. Multivariable-adjusted linear mixed models with piecewise cubic spline functions and adjustment for potential covariates were used to estimate the cross-sectional associations of eight R/S measures with diurnal rhythms of cortisol, DHEA, and the cortisol/DHEA ratio.

Results

There was little evidence of association between the eight R/S measures analyzed and diurnal rhythms of cortisol, DHEA, and the cortisol/DHEA ratio. Women who reported that R/S was very involved in understanding or dealing with stressful situations had slower night rise in cortisol than those who did not. Greater levels of religious struggles were associated with higher cortisol levels throughout the day. Higher non-theistic daily spiritual experiences scores were associated with slower DHEA night rise, and a higher cortisol/DHEA ratio upon waking and at night. However, these associations were significantly attenuated when we excluded women reporting bedtimes at least 30 min later than usual.

Conclusion

Observed associations were driven by those with late sleep schedules, and given the number of comparisons made, could be due to chance. Future research using larger, more diverse samples of individuals is needed to better understand the relationship between R/S and HPA axis biomarkers.

•

We examined the influence of religion and spirituality on HPA-axis diurnal rhythms of cortisol, DHEA, and their ratio.

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Religious coping, religious struggles, and non-theistic DSES were associated with modest alterations in HPA axis rhythms.

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Observed associations were driven by those with late sleep schedules.

“Dies Irae?” The Role of Religiosity in Dealing with Psychological Problems Caused by The COVID-19 Pandemic—Studies on a Polish Sample

Based on Huber’s centrality of religiosity concept, a non-experimental research project was designed in a group of 178 women and 72 men, voluntary participants in online studies, quarantined at home during the first weeks (the first wave) of the pandemic, to determine whether and to what extent religiosity, understood as a multidimensional construct, was a predictor of the worsening of PTSD and depression symptoms in the conditions of the COVID-19 pandemic. The study made use of CRS Huber’s scale to study the centrality of religiosity, Spitzer’s PHQ-9 to determine the severity of depression, and Weiss and Marmar’s IES-R to measure the symptoms of PTSD. Our study, which provided interesting and non-obvious insights into the relationship between the studied variables, did not fully explain the protective nature of religiosity in dealing with pandemic stress. Out of five components of religiosity understood in accordance with Huber’s concept (interest in religious issues, religious beliefs, prayer, religious experience, and cult), two turned out to contribute to modifications in the severity of psychopathological reactions of the respondents to stress caused by the pandemic during its first wave. A protective role was played by prayer, which inhibited the worsening of PTSD symptoms, whereas religious experience aggravated them. This means that in order to interpret the effect of religiosity on the mental functioning of the respondents in a time of crisis (the COVID-19 pandemic), we should not try to explain this effect in a simple and linear way, because religious life may not only bring security and solace, but also be a source of stress and an inner struggle.

The Association Between Positive Religious Coping, Perceived Stress, and Depressive Symptoms During the Spread of Coronavirus (COVID-19) Among a Sample of Adults in Palestine: Across Sectional Study

OBJECTIVES

The current study was designed to investigate the relationship between positive religious coping, perceived stress, and depressive symptoms among Palestinian adults in response to the emergence of coronavirus (COVID-19), and the quarantine system implemented in the city of Tulkarem, Palestine.

METHODS

A correlational study was conducted to examine the relationship between study variables. Participants were 400 Palestinian adults, involving 172 males and 228 females, living in the city of Tulkarem, Palestine, during the spread of coronavirus. Participants were selected using convenience and snowball sampling techniques.

RESULTS

Pearson's correlation coefficient was used to test the relationship between positive religious coping, depressive symptoms, and perceived stress. Findings revealed a statistically significant negative correlation between positive religious coping and depressive symptoms (r = - .17, p < .01). Results also indicated a statistically significant negative correlation between positive religious coping and perceived stress (r = - .15, p < .01). The regression analysis for predicting depressive symptoms found that both positive religious coping (B = - .21, SE = .05, β = - .18) and perceived stress (B = .41, SE = .05, β = .35) were statistically significant toward explaining variance in depressive symptoms.

CONCLUSION

The importance of developing intervention programs that take into consideration religious/spiritual struggles and positive religious strategies may help improve resilience and well-being among affected populations. With the recent spread of COVID-19, findings of this current study have presented important practical implications for improving the mental health and well-being among Palestinians, especially since Palestinian society continues to face different types of stressors, such as illegal occupation. Further studies are recommended to test the relationship between current study variables and other related variables.

Influence of Religiousness and Spirituality on Remission Rate, Mental Health, and Quality of Life of Patients With Active Crohn's Disease: A Longitudinal 2-Year Follow-up Study

BACKGROUND AND AIMS

Studies on inflammatory bowel disease [IBD] have shown that religiousness and spirituality [R/S] were associated with better mental health and quality of life [QOL]. However, longitudinal studies assessing the impact of R/S on long-term clinical outcomes of Crohn's disease [CD] are scarce. The aim of this study was to assess the influence of R/S on the course of CD after a 2-year follow-up and to determine whether these R/S beliefs were associated with mental health and QOL.

METHODS

A longitudinal 2-year follow-up study was conducted at a referral centre for IBD, including patients with moderately to severely active CD. Clinical data, disease activity [Harvey-Bradshaw Index], QOL [Inflammatory Bowel Disease Questionnaire-IBDQ], depression and anxiety [Hospital Anxiety and Depression Scale-HADS], and R/S [Duke Religion Index-DUREL, Spirituality Self-Rating Scale-SSRS, and Spiritual/Religious Coping-SRCOPE scale] were assessed at baseline and at the end of the 2-year follow-up. Linear and logistic regression models were employed.

RESULTS

A total of 90 patients [88.2%] were followed up for 2 years. On logistic regression, baseline levels of spirituality (odds ratio [OR] = 1.309; 95% confidence interval [CI]= 1.104-1.552, p = 0.002) and intrinsic religiousness [OR = 1.682; 95% CI = 1.221-2.317, p = 0.001] were predictors of remission at 2 years. On linear regression, the different dimensions of R/S did not significantly predict IBDQ or anxiety and depression scores after 2 years.

CONCLUSIONS

R/S predicted remission of CD patients after a 2-year follow-up. However, these beliefs failed to predict mental health or QOL. Health professionals who treat CD should be aware of the religious and spiritual beliefs of their patients, given these beliefs may impact on the disease course.

A mixed-methods approach to comparing perceptions of cancer patients' and cancer care providers' religious and spiritual beliefs, behaviours, and attitudes

OBJECTIVES

To compare the perceptions of cancer patients' and cancer care providers' religious and spiritual (R&S) beliefs, behaviours, and attitudes.

METHODS

A concurrent, nested, quantitative dominant, mixed-methods design was utilised. Data were collected from patient and provider groups via online survey. Analyses include chi-square tests of independence and independent t-tests for quantitative data and content analysis for qualitative data.

RESULTS

The final analytic cohort for the study included 576 participants (n_patients  = 236, n_providers  = 340) with an average age of 47.4 years (SD = 15.0). Over half of participants were partnered (n = 386, 70.1%), female (n = 317, 57.3%) and had an advanced degree (n = 284, 51.2%). The most common diagnosis for patients was breast cancer (n = 103, 43.2%). The most common provider role was nurse (n = 220; 64.7%), while a smaller subset included physicians (n = 61; 17.9%) and "other" providers (n = 59; 17.4%). There was no difference between patients and providers in relation to R&S identity (p = 0.49) or behaviour (p = 0.28). Providers more frequently indicated that patients should receive R&S resources in the hospital (n = 281, 89.7% vs. n = 111, 49.6%, p < 0.001). For resource type, patients most frequently endorsed written resources (n = 93, 83.8%) while providers endorsed relational resources (n = 281, 97.9%).

CONCLUSION

Aligning patient and provider expectations of spiritual care will contribute to provision of optimal patient-centred cancer care.

The accuracy of measures in screening adults for spiritual suffering in health care settings: A systematic review

OBJECTIVE

Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence of the accuracy of measures used to screen adults for spiritual suffering.

METHODS

A systematic review of the literature. We searched five scientific databases to identify relevant articles. Two independent reviewers screened, extracted data, and assessed study methodological quality.

RESULTS

We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the two-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82-87%), and the revised Rush protocol had the highest specificity (81-90%). The methodological quality of all included studies was low.

SIGNIFICANCE OF RESULTS

While most of the identified spiritual screening measures are brief (comprised 1 to 12 items), few had sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.

Religious Struggle and Life Satisfaction Among Adult Christians: Self-esteem as a Mediator

The religious dimension of life represents an important source of human strength, meaning, and coping for many people. However, the religious life is not always "smooth and easy" and can be associated with weak personal adjustment, poorer psychological well-being, and lower satisfaction. Yet, besides the direct relationship between these variables, some researchers postulate the existence of an indirect association that has not been fully explained by various psychosocial mediators. The aim of the present study was to verify whether self-esteem could be a potential mediator between religious strain and life satisfaction. The sample consisted of 607 adult Christians (49.6% women) aged between 18 and 79. We used the Religious Comfort and Strain Scale, the Satisfaction with Life Scale, and the Rosenberg Self-Esteem Scale. Consistent with our hypotheses, life satisfaction positively correlated with religious comfort and was negatively associated with fear/guilt, negative emotions toward God, and negative social interactions surrounding religion. The same pattern of results was shown in the case of self-esteem. Moreover, the outcomes obtained from bootstrap sampling (5000) with a 95% confidence interval indicated a significant role of self-esteem as a mediator in all of the relationships between: (1) religious comfort and life satisfaction; (2) fear/guilt and life satisfaction; (3) negative emotions toward God and life satisfaction; and (4) negative social interactions surrounding religion and life satisfaction.

Biopsychosocial and Spiritual Implications of Patients With COVID-19 Dying in Isolation

Critically ill patients with the Coronavirus disease 2019 (COVID-19) are dying in isolation without the comfort of their family or other social support in unprecedented numbers. Recently, healthcare teams at COVID-19 epicenters have been inundated with critically ill patients. Patients isolated for COVID-19 have had no contact with their family or loved ones and may have likely experienced death without closure. This situation highlights concerns about patients’ psychological and spiritual well-being with COVID-19 and their families, as they permanently part ways. While palliative care has advanced to adequately address these patients’ needs, the COVID-19 pandemic presents several barriers that force healthcare teams to deprioritize these essential aspects of patient care. The severe acute respiratory syndrome (SARS) outbreak in 2003 gave us a glimpse of these challenges as these patients were also isolated in hospitals. Here, we discuss the importance of the biopsychosocial spiritual model in end-of-life care and its implications on patients dying with COVID-19. Furthermore, we outline an integrative approach to address the unique and holistic needs of critically ill patients dying with COVID-19. These include intentional and increased coordination with trained palliative care staff, early and frequent goals of care including discussion of end-of-life plans, broader use of technology to improve connectedness, and shared decision making with patients’ families.

Patient Perceptions About the Role of Religion and Spirituality During Cancer Care

We sought to assess the perspectives of cancer patients relative to their spiritual well-being, as well as examine the impact of religion/spirituality during cancer care. A mixed-methods concurrent embedded online survey design was used. While 86% of participants indicated a religious/spiritual belief, respondents also reported lower overall spiritual well-being than population norms (t(73) = - 5.30, p < 0.01). Open-ended responses revealed that 22% of participants desired the healthcare team to address the topic of religion/spirituality, but the majority preferred to discuss with a family member or friend (48%). Religion/spirituality might play a central role for a subset of patients across the cancer journey.

Anxiety and Avoidance in Adults and Childhood Trauma Are Associated with Negative Religious Coping

Religion as a coping strategy is mostly connected with positive health outcomes. Yet, negative religious coping (NRC) has been associated with rather negative outcomes that affect one’s health. The aim of this study was to explore whether insecure adult attachment and childhood trauma are associated with higher NRC. A sample of Czech adults (n = 531, 51.1 ± 17.2 years; 43.5% men) participated in a survey. As measures, the NRC subscale of the Brief RCOPE, the Experiences in Close Relationships-Revised questionnaire, and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used. From the whole sample, 23.7% respondents reported higher NRC. Respondents with higher anxiety in close relationships were more likely to use negative coping strategies, with an odds ratios (OR) of 1.27 (95% confidence interval 1.01–1.59). Similarly, avoidance was associated with negative coping OR = 1.41 (1.13–1.75). Moreover, each subscale of the CTQ-SF revealed a significant association with high summary NRC. Respondents who reported physical neglect scored highest on summary NRC with OR = 1.50 (1.23–1.83) after controlling for sociodemographic variables, but also for anxiety and depression. Our findings support the idea that childhood trauma experience and adult attachment style are associated with higher use of NRC strategies.