Spirituality, religion, and health: over the last 15 years of field research (1999-2013)

Thematic Evolution and Scholarly Contributions: A Study of the Top 100 Most Cited Papers in the Journal of Religion and Health

The Journal of Religion and Health (JORH) has significantly contributed to the intersection of spirituality and healthcare since its inception in 1961. We analyzed the top 100 most cited papers published in JORH, which may provide insights into authorship patterns, institutional affiliations, and publication dynamics. The data was retrieved from the Scopus database. Details about the annual growth rate of publications, citation metrics, authorship trends, and collaboration patterns among authors, universities, and countries are provided. A total of 3,359 papers were published in JORH. The top 100 most cited papers exhibited an annual growth rate of 3.14%. The average age of these documents was 12.8 years, with each paper receiving an average of 88.87 citations. The analysis identified 289 authors contributing to these highly cited works, of which 11 authors produced single-authored documents, resulting in 12 single-authored papers. The co-authorship rate averaged 3.27 authors per document, with an international collaboration rate of 16%, indicating moderate global engagement. The authors were affiliated with 141 universities across 21 countries. Performance metrics, including the number of papers, citations, h-index, g-index, m-index, HG composite, and q2 index, highlighted the contributions of top authors. The analysis also included a focus on the thematic evolution of papers through unigram, bigram, and trigram analyses. This bibliometric study of the top 100 most cited papers in JORH may underscore the journal's role in fostering interdisciplinary dialogue and highlight areas for future research.

Judaism, Women's Health and COVID-19

This issue commences with a review of the top 100 most cited papers in the Journal of Religion and Health. This is followed by Part 2 of a series examining Judaism and health related research, which is subsequently followed by an extensive collection of research specifically connected to women's health. Finally, research continues to present the unique and ongoing effects of COVID-19.

Religiosity and Health Outcomes in a Cohort of Romanian Patients Hospitalized for COVID-19

There is a growing body of evidence for the interrelation between health status and religious beliefs. Our aim was to evaluate the level of religiosity in patients hospitalized for COVID-19 and to assess the link between religiosity and measurable health outcomes. This was an observational, single-center study which included patients with moderate-to-severe forms of COVID-19. A total of 112 patients were enrolled in the study, of whom 77 were highly religious (CRS-15 score ≥ 4) and 35 non-highly religious (CRS-15 score < 4). There was no difference in demographics or prevalence of comorbidities between the two groups. Furthermore, we found no difference between groups in radiological extension of lung lesions, length of hospital stays, or ICU need; however, in-hospital mortality rate was significantly lower in highly religious group (1% vs. 14%, p = 0.005). Serum ferritin level at admission was significantly lower (p = 0.03) and prevalence of post-COVID-19 pulmonary sequelae significantly higher in highly religious group (p = 0.02).

Spirituality and mental health - investigating the association between spiritual attitudes and psychosomatic treatment outcomes

Background

The relationship between spirituality and mental health has garnered attention, fostering overall well-being. Spirituality, posited as a protective factor, may enhance resilience and provide meaning, thus benefiting mental health. This study aims to identify spirituality-associated factors influencing clinical outcomes in psychosomatic inpatients and validate the Transpersonal Spirituality Inventory (TSI).

Methods

The study involved 4952 psychosomatic inpatients completing the Transpersonales Vertrauen (TPV) and 7739 patients completing the TSI, with assessments conducted at admission and discharge. Additional instruments included the ISR for symptom rating and the LK-18 for life skills. Factor analysis and Spearman's rank correlation were used to evaluate the validity of TSI and the relationship between spirituality and clinical outcomes.

Results

Factor analysis confirmed the TSI's two-factor structure: "centered connectedness" (F1) and "transcendent orientation" (F2), with satisfactory internal consistency (Cronbach's α = 0.824 for F1 and 0.644 for F2). Higher spirituality levels, particularly in transpersonal trust and centered connectedness, correlated with lower depression and psychosomatic symptoms (ISR). Although these correlations were generally weak, significant associations were found between spirituality and life competences, particularly in meaning, belief, and values (r = .595 for TPV and .598 for TSI F1).

Conclusion

Despite correlations between psychosomatic health and spirituality as measured with TPV and TSI were rather small several spirituality items could be identified which seem to have a prominent connection to the diagnosis and development of psychosomatic health. Specific spiritual attitudes, such as access to inner stillness and connection to a greater whole, were linked to positive treatment responses and reduced symptom burden. These findings suggest potential benefits in incorporating spirituality into psychosomatic treatments, though its complex and multifaceted nature warrants further investigation.

Religion, Religiosity, and Smoking Among Older Adults: Results from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 2019-2021

Religion and religiosity have long been associated with various health outcomes and behaviors. This study explored the relationship between religion/religiosity and smoking among 8,703 participants enrolled in The Brazilian Longitudinal Study of Aging (ELSI-Brazil). The logistic regression model was used to test this association, which was then adjusted for sociodemographic factors, health indicators, and alcohol consumption. The results evidenced a negative association between smoking and religious affiliation, as well as the frequency of religious attendance. These results suggest that incorporating religious and spiritual considerations into health care strategies could be beneficial in reducing smoking rates among the elderly population, potentially improving overall health outcomes within this group.

Poland, Public Health, Chaplains, Clergy, Mindfulness and Prayer

This issue commences with a bibliometric analysis of the top 100 most cited articles on religion. It then presents the first of a two-part series relating to research from Poland and progresses to examine the relevance of religion and spirituality to public health. Finally, this issue revisits the long-established and productive discipline of healthcare chaplaincy and various factors relating to parish clergy. A new theme of mindfulness and prayer is also introduced.

Quantitative and Qualitative Research in the Field of 'Spirituality and Health': An Introductory How-to-Guide from a Brazilian Perspective

The present article aims to describe the different steps on how to design, develop and conduct quantitative and qualitative Spirituality and Health (S/H) studies from a Brazilian perspective, discussing definitions and instruments, and proposing a "how-to guide" for those interested in this field of research. A narrative review of the literature has been conducted by experts in the field of S/H aiming to develop a "how-to-guide". Spirituality is a very complex concept that has several challenges in the current scientific literature, including the lack of consensus in the definitions, the numerous dimensions assessed, the diverse instruments for measurement, the criticisms from other scholars, the great diversity of religious and cultural traditions and the growing number of "spiritual but not religious" individuals. This review supports that S/H studies may follow the high scientific standards, using consolidated research procedures and solid methods for both qualitative and quantitative research. Some peculiarities of the research methods for this field are discussed. S/H research is still under development, and there are several future directions for S/H studies, aiming to minimize previous criticisms and generating stronger evidence.

The Relationship between Distress Tolerance and Spiritual Well-Being towards ARV Therapy Adherence in People Living with HIV/AIDS

A crucial factor in the success of treatment for patients with Human Immunodeficiency Virus (HIV) is adherence to antiretroviral (ARV) therapy among People Living with HIV/AIDS (PLWHA). Adherence issues remain a persisting problem with multifaceted causes. There are many studies on variables related to ARV therapy adherence, but no study has been found on spiritual well-being and distress tolerance in ARV therapy adherence. This study aims to determine the relationship between distress tolerance and spiritual well-being on adherence to ARV therapy in PLWHA. This research used a quantitative approach with a cross-sectional design. The sample collection process followed a consecutive sampling technique, with data gathered from 129 participants at the South Lampung Regional General Hospital located in Indonesia. Data collection was conducted using three questionnaires administered by the interviewer, which assessed distress tolerance using the Miller-Smith Rating Scale For Stress Tolerance (MSRS-ST), evaluated spiritual Well-Being using the Spiritual Well-Being Scale (SWBS), and gauged ARV therapy adherence using the Medication Adherence Rating Scale (MARS). Data analysis using a simple logistic regression with a 95% confidence interval (CI) showed a significant relationship between distress tolerance (p-value 0.002) and spiritual well-being (p-value 0.036) towards ARV therapy adherence in PLWHA. The results of multiple logistic regression yielded distress tolerance as the most dominant and influential variable in this research. Distress tolerance and spiritual well-being impact adherence to ARV therapy in PLWHA. Suggestions for healthcare services should consider these factors to decrease the risk of non-adherence to therapy and inadvertently heighten mortality risk.

The effectiveness of spiritual care training on medical students' self-reported competencies: A quasi-experimental study

OBJECTIVES

To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies.

METHODS

This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n = 64) who received spiritual care training and sixth-year students (n = 51) who did not receive this training - control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported.

RESULTS

Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d = 0.99), "Improvement of care" (d = 0.69), "Counseling (d = 0.88)," "Referral" (d = 0.75), and "Total Spiritual Care" (d = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032.

SIGNIFICANCE OF RESULTS

Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools.

Comparison of the Role of Different Levels of Religiousness and Spirituality in Controversial Ethical Issues and Clinical Practice among Brazilian Resident Physicians: Results from the Multicenter SBRAMER Study

This study compares clinical practice and objections to controversial ethical issues among 836 Brazilian resident physicians according to levels of religiousness/spirituality. Residents with low religiousness/spirituality (s/r) believed less in the influence of spirituality on clinical practice, were less comfortable addressing this issue, tended to listen less carefully and try to change the subject more than other groups. Residents with high spirituality and low religiousness (S/r) inquired more about religious/spiritual issues, while those with high religiousness/spirituality (S/R) were more supportive and reported fewer barriers to addressing these issues. Concerning ethical issues (e.g., physician-assisted suicide, withdrawal of life support, abortion), S/R had more objections than others.

Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches

Background

Cardiovascular disease is the leading cause of death in the United States, and Black populations are disproportionately affected. Black populations also have high rates of religiosity, which may be an important health motivator, but mechanisms are unclear.

Objective

We examined the relationship between perceived religious influence on health and cardiovascular health behaviors, risk factors, and confidence participating in medical care in Black church congregants.

Methods

We surveyed 302 members of 13 churches with predominantly Black congregations in New Orleans, Louisiana. Participants reported if religious beliefs had an influence on their health and if they avoided harmful behaviors because of religion. Fruit and vegetable intake, physical activity, smoking status, confidence asking questions to health care providers, understanding treatment plans and self-reported hypertension, hypercholesterolemia, and diabetes were assessed. Logistic regression was used adjusting for age, sex, and education.

Results

Survey respondents were 77% female with a median age of 66 years, and 72%, 56%, and 37% reported hypertension, hypercholesterolemia, and diabetes, respectively. Perceived religious influence on health was positively associated with fruit and vegetable intake, physical activity, and confidence asking questions to health care providers. Avoiding harmful behaviors because of religion was positively associated with physical activity. There was no association between perceived religious influence on health and smoking, hypertension, hypercholesterolemia, or diabetes.

Conclusion

Perceived religious influence on health was associated with beneficial cardiovascular health behaviors and confidence participating in medical care. These findings can inform the design and delivery of interventions to reduce cardiovascular disease among Black religious communities.

Identifying the Leading Global Contributors to Scholarship in Religion Journals: A Bibliometric Study

This study identified the 100 most impactful global contributors to religion journals and mapped their respective disciplinary affiliations. To conduct this investigation, we performed a secondary data analysis of a Scopus-derived database featuring the world's leading scientists. The mean contributor published 51.93 papers, had an h-index of 13.57, and an hm-index 11.50. Most contributors were located in the USA with the most common disciplinary affiliations being religion, non-specialized (n = 22), sociology, non-specialized (n = 21), sociology of religion (n = 20), and theology (n = 11). The results reveal that religion discourse is populated by some of the leading scholars in the world. Leveraging their expertise can help advance the field's knowledge development.

Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals

OBJECTIVES

To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic.

METHODS

A qualitative investigation was carried out using in-depth interviews.

SETTING

Emergency and emergency and ICU health professionals from different regions of Spain.

FINDINGS

The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: "the experience with spirituality in clinical practice"; "resources and barriers to provide spiritual care"; "the COVID pandemic and spiritual care" and "training in spiritual care". In addition, two subdeliveries were also obtained: "ethical dilemma" and "rituals of death".

CONCLUSIONS

The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients' spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic.

IMPLICATIONS FOR CLINICAL PRACTICE

Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

The current status of "spirituality and health" teaching in Brazilian medical schools: a nationwide survey

BACKGROUND

Recent data on the teaching of "spirituality and health" (S/H) in medical schools are needed. In this study, we aimed to investigate the current status of S/H teaching in Brazilian medical schools, the opinions of medical directors/deans on this topic and the factors associated with its incorporation into the curriculum.

METHODS

A nationwide cross-sectional survey was carried out in 2021. Information concerning the S/H content in the curricula of medical schools was obtained through medical school representatives and other sources. Medical school representatives were asked about their opinions of and barriers to S/H teaching. Regression models were used to evaluate the factors associated with the incorporation of such content into the curriculum.

RESULTS

Information on the incorporation of S/H content in medical curricula was retrieved from different sources for all 342 (100%) Brazilian medical schools. Among the representatives, 150 (43.9%) completed the online form. An increase in the S/H content in Brazilian medical schools was observed (from 40% to 2011 to 65.5% in 2021). Most medical school representatives agreed that this issue is important in medical training and that more space in the curriculum is needed. However, they also observed several barriers, such as a lack of knowledge of medical teachers/faculty, a lack of time, and the topic not being included in teaching plans. The most important factors that influenced the incorporation of S/H teaching in medical schools and representatives' opinions were a lack of time and knowledge, professor preparedness and standardized national competency requirements.

CONCLUSION

These results could help medical educators rethink the incorporation of S/H content into their curricula.

A Bibliometric Analysis of the Journal of Religion and Health: Sixty Years of Publication (1961-2021)

In 1961, the Journal of Religion and Health (JORH) commenced publishing articles that examined modern religious and spiritual philosophy in relation to psychology and health. The year 2021 marked the 60th anniversary of the founding of JORH. This research paper retrospectively analyses the journal's content. It provides insight into JORH's publication trends, citation records, prominent themes, authors' collaboration and its aggregate contribution to the field of religion and health. Over time, the number of publications, citations and downloads of JORH articles have substantially increased, as has the journals prominence and diverse contributions to the study of religion, spirituality and health.

"More Spiritual Health Professionals Provide Different Care": A Qualitative Study in the Field of Mental Health

In recent years, there has been an exponential increase in studies demonstrating the positive effects of the religiosity/spirituality (R/S) approach on patients' physical and mental health. In mental health units, patients want professionals to be sensitive to their spiritual and/or religious needs, which is a fundamental aspect of a holistic approach to patients. Qualitative research with an exploratory and descriptive design with an ethnographic-phenomenological approach through in-depth interviews with sixteen professionals from Spanish mental health units. There is no consensus on the definition of spirituality; however, all of them believe that R/S has a positive influence on the health of patients in coping with illness. They believe that their own R/S may interfere with the professional-patient relationship and their attention to spiritual needs. Few professionals address these needs, citing limitations such as lack of time and lack of specific training in spiritual care. More research is needed on the spiritual care of mental health professionals to define the framework, professional training, and associated challenges in the spiritual care of patients.

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.

Deconstructing type 2 diabetes self-management of Australian Pacific Islander women: Using a community participatory research and talanoa approach

Community-based participatory research using culturally appropriate talanoa approaches provided the framework to explore diabetes self-management of Australian Pacific Islander (API) women living with type 2 diabetes in South-East Queensland. Data collection included interviews with key informants (21), in-depth interviews with API women with diabetes (10), talanoa group discussions (7) and monthly steering committee meetings. Using an interpretive-constructionist lens and the interpretations of community members, four cultural constructs in diabetes self-management emerged: self-identity, spirituality, stigma and denial, and structural factors. Self-identity connected the women to their Pacific heritage that framed their collective roles as primary caregivers in the community. This gave the women a strong sense of belonging and helped maintain cultural, family and relational connections which were important for their day-to-day management of diabetes. Although spirituality through religion supported the women to cope with their diabetes a total reliance on God resulted in disengagement with self-care. Shame associated with disclosure also prevented effective self-management. Finally, structural factors such as access to healthcare, poor health literacy and cultural barriers associated with obesogenic environments impeded women from seeking appropriate diabetes care. However, family and community were critical in ensuring women were supported with their diabetes self-management. The findings highlight the importance of engaging families in healthcare planning decisions in the development of culturally responsive models of diabetes support care for API women with type 2 diabetes.

Religiosity/Spirituality and Cardiovascular Health: The American Heart Association Life's Simple 7 in African Americans of the Jackson Heart Study

Background

Religiosity/spirituality is a major coping mechanism for African Americans, but no prior studies have analyzed its association with the American Heart Association Life's Simple 7 (LS7) indicators in this group.

Methods and Results

This cross‐sectional study using Jackson Heart Study (JHS) data examined relationships between religiosity (religious attendance, private prayer, religious coping) and spirituality (theistic, nontheistic, total) with LS7 individual components (eg, physical activity, diet, smoking, blood pressure) and composite score among African Americans. Multivariable logistic regression assessed the odds of achieving intermediate/ideal (versus poor) LS7 levels adjusted for sociodemographic, behavioral, and biomedical factors. Among the 2967 participants (mean [SD] age=54.0 [12.3] years; 65.7% women), higher religious attendance was associated with increased likelihood (reported as odds ratio [95% CI]) of achieving intermediate/ideal levels of physical activity (1.16 [1.06–1.26]), diet (1.10 [1.01–1.20]), smoking (1.50 [1.34–1.68]), blood pressure (1.12 [1.01–1.24]), and LS7 composite score (1.15 [1.06–1.26]). Private prayer was associated with increased odds of achieving intermediate/ideal levels for diet (1.12 [1.03–1.22]) and smoking (1.24 [1.12–1.39]). Religious coping was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.18 [1.08–1.28]), diet (1.10 [1.01–1.20]), smoking (1.32 [1.18–1.48]), and LS7 composite score (1.14 [1.04–1.24]). Total spirituality was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.11 [1.02–1.21]) and smoking (1.36 [1.21–1.53]).

Conclusions

Higher levels of religiosity/spirituality were associated with intermediate/ideal cardiovascular health across multiple LS7 indicators. Reinforcement of religiosity/spirituality in lifestyle interventions may decrease overall cardiovascular disease risk among African Americans.

Health and Chinese Beliefs: A Scientometric Analysis of Health Literature Related to Taoism and Confucianism

Taoism and Confucianism both exited simultaneously as philosophies of living in dynastic China. Although there has been an increasing popularity in scientometric studies, religion and health (R&H) literature lacks a holistic evaluation investigating articles relevant to Taoism and Confucianism. All publications produced in Taoism and Confucianism literature and indexed in Web of Science (WoS) databases between 1975 and 2018 were included in this study. Database search on health and Taoism literature retrieved 199 documents from WoS databases. Main research areas were Psychology, Religion and Behavioral Sciences (24.121, 21.608 and 20.603, respectively). The USA ranked first with 38 papers followed China, Taiwan and the UK (n = 35, 20 and 6 documents, respectively). Hong Kong Polytechnic University from China was the most contributor institution in health and Taoism literature. A total of 448 documents were published in health and Confucianism literature between 1975 and 2018, and original articles covered 93.08% of all literature. China was leading country with 126 articles followed by the USA, South Korea and Taiwan (n = 97, 35 and 35 items, respectively). The most productive institutions were City University of Hong Kong (China), Karolinska Institute (Sweden) and University of Hong Kong (China). Researchers from developing and least developed countries should be encouraged to carry out novel scientometric studies in R&H literature.

The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature

The pandemic caused by the new coronavirus SARS-CoV-2 has been affecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientific literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our findings revealed the importance of including spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pandemic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

[Influence of spirituality on health status in times of pandemic]

Spirituality is a health protection factor recognised in the scientific literature. However, few studies have evaluated its impact on French-speaking populations, in secularised societies and even fewer in the context of a pandemic. It is therefore interesting to highlight significant relationships between spiritual quality of life and health.

Spirituality/Religiosity as a Therapeutic Resource in Clinical Practice: Conception of Undergraduate Medical Students of the Paulista School of Medicine (Escola Paulista de Medicina) - Federal University of São Paulo (Universidade Federal de São Paulo)

Introduction: The high degree of religious/spiritual involvement that brings meaning and purpose to a patients' life, especially when they are weakened by pain, is among the various reasons to consider the spiritual dimension in clinical practice. This involvement may influence medical decisions and, therefore, should be identified in the medical history of a patient (anamnesis). Objective: To verify the opinion of undergraduate medical students of the Paulista School of Medicine - Federal University of São Paulo regarding the use of a patient's Spirituality/Religiosity as a therapeutic resource in clinical practice. Method: Quantitative approach of the transversal analytical observational type. The sample was composed of academics' medical program, from the first to the sixth year, regularly enrolled in 2017. Data collection was performed with a standardized questionnaire divided into three sections: sociodemographic profile; Duke University Religious Index; Spirituality/Religiosity in the clinical and academic context. Results: Participated in the survey 72% of the enrolled students, of which 61.4% had religious affiliation, 26.2% declared themselves agnostic and 12.4% atheists. All of them proposed to answer questions about the insertion of Spirituality/Religiosity in the patient care process. Through the Duke Religiosity Index, we evaluated the importance of religiosity in the student's personal life and the pertinence of religiosity as a therapeutic insertion for medical treatment. Regarding the clinical and academic context, most participants considered relevant the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient. Conclusion: We conclude, through our research, that the insertion of the Spirituality/Religiosity of the patient as a therapeutic resource in clinical practice is feasible for most undergraduate students in Medicine of the Escola Paulista de Medicina - Universidade Federal de São Paulo (Paulista School of Medicine - Federal University of São Paulo). The result of the research, although it shows only the opinion of medical students at a Brazilian university, indicates that Spirituality/Religiosity is already part of the contemporary medical universe.

Christian Churches and the Prevention of Preadolescent Aggression and Violence in Puerto Rico: Regional Leaders' Perspective

Preadolescents' involvement in religious congregations may serve as a distal protective factor against aggression. Interviews were conducted to explore Puerto Rico (PR) Christian church and faith-based organization (FBO) leaders' knowledge and perceptions about preadolescent violence, and the role of congregations in its prevention. Bullying was perceived as the most common type of aggression among PR preadolescents. Education, positive role modeling, and relationships with pro-social adults are considered important in its prevention. While willing to engage in violence prevention efforts, congregations may possess limited knowledge on the topic and its relevance. Findings can help inform the development of collaborative research and prevention efforts at the family and community levels.

Defining Spirituality in Healthcare: A Systematic Review and Conceptual Framework

Objective: To investigate the definitions of spirituality in the healthcare field, identifying its main dimensions and proposing a framework that operationalizes the understanding of this concept. Methods: This is a systematic review following the PRISMA guideline (PROSPERO: CRD42021262091), searching for spirituality definitions published in scientific journals. Searches were carried out in PubMed (all articles listed up to October 2020) and in the reference lists of the articles found in the database, followed by selection under specific eligibility criteria. Results: From a total of 493 articles, 166 were included in the final analysis, showing that there is a large body of scientific literature proposing and analyzing spirituality definitions. In these articles, 24 spirituality dimensions were found, most commonly related to the connectedness and meaning of life. Spirituality was presented as a human and individual aspect. These findings led us to construct a framework that represents spirituality as a quantifiable construct. Conclusions: Understanding spirituality is an important aspect for healthcare research and clinical practice. This proposed framework may help to better understand the complexity of this topic, where advances are desirable, given the relevance it has acquired for integral health care.

Spiritual care in critically ill patients during COVID-19 pandemic

Introduction

Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic.

Purpose

The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic.

Methods

A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals.

Findings

During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare.

Discussion

These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Religiosity/Spirituality and Mental Health and Quality of Life of Early Pregnant Women

The present study aims to investigate how religious/spiritual (R/S) beliefs are associated with depressive, anxious and stress symptoms and quality of life (QOL) of 160 Brazilian women in early pregnancy. In this cross-sectional study, religiosity/spirituality (DUREL, Daily Spiritual Experiences, Brief-RCOPE), mental health (DASS-21) and quality of life (WHOQOL-Bref) were assessed. Negative R/S coping was associated with higher levels of depressive, anxious and stress symptoms and worse physical and psychological QOL. On the other hand, positive R/S coping, intrinsic religiosity, and spirituality were associated with better psychological QOL, while only spirituality was associated with better social QOL.

The influence of spirituality and religion on critical care nursing: An integrative review

BACKGROUND

Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed.

AIMS AND OBJECTIVES

To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing.

METHODS

An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included.

RESULTS

Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinical practice. Nurses are encouraged to increase their knowledge and awareness towards spiritual issues.

Religiosity as a predictor of mental health in Egyptian teenagers in preparatory and secondary school

BACKGROUND

There have been few studies of religiosity in adolescents and even fewer in Muslim cultures.

AIMS

The present study investigated the associations of religiosity with subjective well-being (WB, and mental and physical health) using samples of Egyptian children and adolescents.

METHOD

Samples of Egyptian preparatory school children and secondary school children were administered questions concerning religiosity, mental and physical health and satisfaction with life.

RESULTS

In study 1, boys obtained significantly higher mean scores than girls did on the self-rating scales of religiosity, mental health, physical health and satisfaction with life. In study 2, boys obtained significantly higher mean scores on the Arabic Scale of Mental Health and the self-rating scales of physical health and happiness. All the Pearson correlation coefficients between religiosity, WB and health were significant and positive in both studies. Predictors of mental health differed for boys and girls, but religiosity played a significant role in the prediction of mental health for the younger boys and for the older girls.

CONCLUSION

Religion plays an important role in the lives of the present two samples of Egyptian adolescents.

The effectiveness of spiritual interventions in the workplace for work-related health outcomes: A systematic review and meta-analysis

AIM

To investigate the effectiveness of spiritual interventions in the workplace for different health outcomes through the use of a meta-analysis of randomized controlled trials.

BACKGROUND

Most studies including spirituality in the workplace investigated it at the organisational/business level, while giving a secondary value to the well-being and quality of life of the workers.

METHODS

Systematic review and meta-analysis carried out on the following databases: SCOPUS, PubMed and Web of Science. Spiritual interventions investigating work-related health outcomes were included. Then, meta-analyses were conducted.

RESULTS

From a total of 2,832 studies, 7 articles were included in the systematic review and 6 in the meta-analysis. Spiritual interventions, as compared to controls, improved the health outcomes of the workers (standard mean difference (SMD), -1.42; 95% CI, -1.98, -0.86; p < .001; I²  = 96%). Subanalyses revealed that yoga was an effective intervention and that stress was reduced by these interventions.

CONCLUSION

Spiritual interventions in the workplace seem to be effective in improving workers' health. Nevertheless, the high heterogeneity and limited number of studies may hinder more robust conclusions at the moment.

IMPLICATIONS FOR NURSING MANAGEMENT

The use of spiritual interventions should be considered in workplaces in order to reduce the stress and other negative outcomes.

Religious Affiliations Influence Health-Related and General Decision Making: A Brazilian Nationwide Survey

Approximately 90% of the world's population is involved in some spiritual/religious practice, and this dimension has a relevant role in life. Many studies demonstrate the associations between spirituality/religiosity (S/R), and physical, mental, and social health. Systematic reviews have indicated positive associations; however, the mechanisms behind religious coping are not fully understood. The present study aimed to examine the role of religious affiliation in general (ordinary) and health-related decisions. A nationwide, population-based, cross-sectional study was conducted in Brazil using a self-administered online survey. How much religious affiliation influences decision making was investigated. A total of 1133 participants were included, who were classified as Catholics (43.9%), Evangelicals (18.7%), spiritualists (12.8%), non-religious (11.9%), and others (12.7%). Most participants (66.5%) believed that their religious affiliations had moderate to high influences on their decisions. Participants rated the influence as high in marriage (62.7%), in donations (60.1%), in volunteering (55%), in friendships (53.9%), and in work (50.5%). Concerning health-related decisions, the influence was rated as high in drug use (45.2%), in accepting medical recommendations (45%), and in smoking (43.2%). The influence of religious affiliation on general decision making was significantly correlated for dietary restrictions (r = 0.462), alcohol consumption (r = 0.458), drug use (r = 0.441), tobacco consumption (r = 0.456), and refusal of medical recommendations (r = 0.314). Improving the understanding of how a patient's beliefs, practices, and experiences affect their health may help healthcare practitioners to take into account religious considerations, not only regarding influences on habits but also regarding adherence to medical treatment advice.

Is there a relationship between spirituality/religiosity and resilience? A systematic review and meta-analysis of observational studies

Resilience is the ability to recover or cope with adverse situations. Spiritual and religious beliefs may be associated with important "resilience resources." To investigate whether there is a relationship between spirituality/religiosity (S/R) and resilience. This is a systematic review (observational studies) with meta-analysis following the PRISMA guidelines. From a total of 2468 articles, 34 observational studies were included. We identified a moderate positive correlation between S/R and resilience (r = 0.40 (95% CI, 0.32-0.48], p < 0.01). When only high-quality articles were included, the results were maintained. Conclusion: A moderate positive correlation was found between S/R and resilience.

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.

Religiosity and Spirituality of Resident Physicians and Implications for Clinical Practice-the SBRAMER Multicenter Study

OBJECTIVES

To assess the attitudes, knowledge, and experiences of Brazilian resident physicians regarding religiosity/spirituality (R/S), factors associated with addressing this issue, and its influence on clinical practice.

METHODS

We report results of the multicenter "Spirituality in Brazilian Medical Residents" (SBRAMER) study involving 7 Brazilian university centers. The Network for Research Spirituality and Health (NERSH) scale (collecting sociodemographic data, opinions about the R/S-health interface, and respondents' R/S characteristics) and the Duke Religion Index were self-administered. Logistic regression models were constructed to determine those factors associated with residents' opinions on spirituality in clinical practice.

RESULTS

The sample comprised 879 resident physicians (53.5% of total) from all years of residency with 71.6% from clinical specialties. In general, the residents considered themselves spiritual and religious, despite not regularly attending religious services. Most participants believed R/S had an important influence on patient health (75.2%) and that it was appropriate to discuss these beliefs in clinical encounters with patients (77.1%), although this was not done in routine clinical practice (14.4%). The main barriers to discussing R/S were maintaining professional neutrality (31.4%), concern about offending patients (29.1%), and insufficient time (26.2%). Factors including female gender, clinical specialty (e.g., internal medicine, family medicine, psychiatry) as opposed to surgical specialty (e.g., surgery, obstetrics/gynecology, orthopedics), having had formal training on R/S, and higher levels of R/S were associated with greater discussion of and more positive opinions about R/S.

CONCLUSION

Brazilian resident physicians held that religious and spiritual beliefs can influence health, and deemed it appropriate for physicians to discuss this issue. However, lack of training was one of the main obstacles to addressing R/S issues in clinical practice. Educators should draw on these data to conduct interventions and produce content on the subject in residency programs.

Spirituality and Religiosity are Associated with Quality of Life in Patients with Lung Disease

Patients were separated into two groups: (1) non-waiting list (NWL) and (2) waiting list (WL) for the lung transplantation. We found greater levels of the faith and spirituality, in those awaiting transplantation. In the NWL group, higher 'meaning' was associated with higher 'vitality,' 'emotional well-being,' and 'mental health'; higher 'peace' was associated with higher 'mental health.' In the WL group, higher 'peace' was associated with and better 'mental health' and 'emotional well-being.' Regardless of whether patients are lung transplantation candidates or not, spirituality/religiosity may help those with lung diseases cope better with their disease and have better quality of life.

The Impact of Spirituality and Religiosity on Mental Health and Quality of Life of Patients with Active Crohn's Disease

We aim to investigate the association among religious/spiritual coping (RSC), quality of life (QOL), and mental health in patients with active Crohn's disease (CD). This cross-sectional study included 102 patients with active CD. Religious and spiritual beliefs were common among patients, being positive RSC higher than negative RSC. Negative coping was associated with mood disorders (depressive or anxiety symptoms) through the Hospital Anxiety and Depression Scale (β = 0.260, p < 0.01) but not with QOL (Inflammatory Bowel Disease Questionnaire) (β = - 0.105, p = NS) after adjustments. Positive coping and other religious/spiritual beliefs and behaviors were not associated with either QOL or mental health. This study suggests that a negative RSC is associated with worse mental health outcomes. This may detrimentally impact adaptations to deal with CD in the active phase, although patients generally tend to use more common positive strategies. These findings may increase the awareness of health professionals while dealing with spiritual beliefs in patients with CD.

The Effect of Religious Beliefs on the Attitude of Aesthetic Surgery Operation in Islam

This study aims to investigate the relationship between individuals' attitudes about acceptance of aesthetic surgery (e.g. rhinoplasty, autoplasty, blepharoplasty, and mammaplasty) and some of the worship practices in Islamic religion such as performing prayer, fasting, and going to pilgrimage. Although many people think that aesthetic surgery is inappropriate in Islamic religion, no studies in the literature were found to have investigated this issue. This study collected data through a questionnaire administered to 96 patients who applied to our Plastic Surgery Clinic and underwent various surgical operations and 96 patients who were recommended plastic surgery but rejected to have one; the questionnaire aimed to identify the participants' frequency of religious worship practices and appropriateness of aesthetic surgery to their beliefs. The participants responded on the frequency of religious worship levels according to the options in the questionnaire. The "Acceptance of Cosmetic Surgery Scale" was utilized in order to identify their attitudes towards aesthetic surgery. Levels of performing prayers, fasting, and going to pilgrimage in the groups that accepted surgery and in the groups that rejected surgery were significantly different (p < 0.001, p = 0.008, p < 0.001). In two different groups, the Acceptance of Aesthetic Surgery Scale scores were significantly different within the prayer groups and fasting groups (p < 0.001, p < 0.001, p = 0.001, p < 0.001). While the group that accepted surgery indicated no significant differences between those who thought about going to pilgrimage and who did not (p = 0.650), there was a significant difference in the group that rejected surgery (p < 0.001). While 14.6% of the participants in the group that accepted surgery considered aesthetic surgery a sin, this proportion was 56.3% in the group that rejected surgery, and this difference was significant (p < 0.001). In both surgery groups, there were differences in the scale scores of those who considered aesthetic surgery a sin and those who did not (p < 0.001, p < 0.001). There was a significant relationship between worship practices, one of the biggest indicators of the level of belief in Islamic religion, and aesthetic surgery attitudes. However, despite the fact that belief levels affect the decision of having an operation in plastic surgery, in case of serious health problems, the decision of having an operation becomes more important religious beliefs.

Destroying God's Temple? Physical Inactivity, Poor Diet, Obesity, and Other "Sin" Behaviors

On average, our participants (N = 112), who self-proclaimed to be Christians, believed that physically inactive lifestyles, unhealthy eating, overeating, and being obese destroy the body, God's temple. However, these beliefs were less definitive, than those of other common "sin" behaviors, such as drug use, smoking, and excessive drinking of alcohol. In addition, destroying the body with physical inactivity or poor diet was not necessarily viewed as sinful. Subsequently, these beliefs did not relate to self-reported physical activity, dietary behavior, or body mass index. It is possible that inactivity, poor dietary habits, and obesity are not internalized into the spiritual perspective as destroying the body, God's temple, in the same way as other "sin" behaviors.

Integration of Spiritual Care in Hospital Care System in Iran

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

Religiosity and Mental Health: A Contribution to Understanding the Heterogeneity of Research Findings

Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in a secular environment, using a nationally representative sample of Czech adults (n = 1795). We measured religious affiliation, conversion experience, non-religious attitudes and the stability of these attitudes, mental health problems, and anxiety levels. Compared to stable non-religious respondents, unstable non-religious and converted respondents who perceived God as distant were more likely to experience anxiety in close relationships, and had higher risks of worse mental health. Our findings support the idea that the heterogeneity of findings in associations between religiosity/spirituality and mental health could be due to measurement problems and variation in the degree of secularity. A shift towards religiosity could be expected to be seen in a substantial part of non-religious respondents in problematic times.

Health and Ancient Beliefs: A Scientometric Analysis of Health Literature Related to Shamanism, Paganism and Spirituality

Scientometrics is a popular statistical application providing data revealing publication trends and patterns in a certain academic field. A quite limited number of studies investigating scientometric features of health and religion literature have been reported in academic literature. The present study aims to present a holistic analysis of health literature related to Shamanism, Paganism and Spirituality. To the best of our knowledge, this is the first study in this field. All data of this analysis were yielded from Web of Science databases. All documents produced between 1975 and 2017 were included. In Shamanism and health field, a total of 157 documents were found, and the USA covering 35.67% of all the literature was the leading country. University of California System (USA) was the most contributor institution. Our search on Paganism and health literature retrieved 51 published documents, and the most productive institution was National Dong Hwa University from Taiwan. A total of 7862 documents were detected in Spirituality and health literature, and the most prolific author in this field was Koenig HG with 82 papers. Journal of Religion and Health was noted to be the predominant academic source in health literature related to ancient beliefs. The number of the publications produced in Spirituality and health literature was greater than total number of all documents published in health literature related to Abrahamic religions, Dharmic religions, Shamanism and Paganism.

Religiously/Spiritually Involved, but in Doubt or Disbelief-Why? Healthy?

The question of why atheists and agnostic theists attend religious services and pray (and what that might mean for their health) is examined through (1) a thematic analysis of commentaries, perspective pieces, and news articles from the popular literature, and (2) a critical review of scholarly research involving comparisons between religious and nonreligious individuals on a variety of health-related outcomes. Findings suggest that atheists and agnostic theists can take pleasure in attending religious services, and they may be driven to pray at times. In many cases, this was explained by their efforts to stay connected and avoid or manage conflict with family members. Despite a pattern of friction between nonbelievers and believers across the dataset, they predominantly agreed on the whys and wherefores of religious service attendance and the prospect that congregants could "bridge the worlds of belief and nonbelief." The themes identified are intended to inform the development of qualitative interview protocols and survey instruments. Although health was not among the most salient themes in the narratives analyzed here, many of the reasons cited for religious service attendance and prayer can be tied to existing literature that has relevance for health. Atheists who experience dissonance between their self-perception and nonbelief in God-and agnostic theists who are prone to existential uncertainty and have only moderate faith-might experience poorer health outcomes. Recommendations focus on the need to (a) supplement secondary analyses of archival survey data with qualitative descriptions of belief systems within groups, and (b) move away from the adversarial stance taken by some of the authors of recently published studies on atheism, nonreligion, and health.

Dharmic Religions and Health: A Holistic Analysis of Global Health Literature Related to Hinduism, Buddhism, Sikhism and Jainism

Bibliometrics and scientometrics are popular and novel disciplines providing information in publication trends in a certain academic field. Although there has been an increasing popularity in bibliometric studies, a limited number of reports have been published in religion and health literature. In this study, to the best of our knowledge we aimed to perform a first bibliometric analysis in the health literature related to Dharmic religions, Hinduism, Buddhism, Sikhism and Jainism. We found a total of 655 health articles related to Dharmic religions as we searched Web of Science databases. The United States of America (USA) ranked first in Health and Hinduism literature with 62 documents followed by India, the UK and Bangladesh (n = 40, 33 and 6, respectively). A detailed keyword analysis revealed that the most used keywords in the field of Hinduism and health were "Hinduism," "religion," "spirituality" and "Islam." The USA was also the leading county in the literature of Buddhism and Health with 159 articles (32.78%) and followed by Thailand, the UK and China (10.72, 6.8 and 6.39%, respectively). The Journal of Religion and Health was noted to be the most prolific source in this field. We found that the developing countries such as India, Thailand, Singapore and Taiwan were found to be included in the most productive countries list on the contrary to previous bibliometric studies in health and religion field.

Assessing spirituality: is there a beneficial role in the management of COPD?

Here,we report on the role of spirituality assessment in the management of chronic obstructive pulmonary disease (COPD). Although a positive effect of addressing spirituality in health care has been proved in a number of chronic diseases, its potential in COPD has received less attention. Although limited, available evidence suggests that spirituality may play an important role in improving quality of life of patients with COPD. The fruitful results in other long-term conditions may lay the foundation for further research on addressing spirituality in COPD. This should focus where the burden of COPD is greatest, including low-resource settings globally. Implementation research should include exploration of an acceptable consultation process to identify patients who would welcome spiritual discussions; how to integrate spiritual approaches into health care professional curricula so that they are aware of its importance and have the confidence to raise it with patients and how to integrate spiritual approaches into holistic COPD care.

The Evolution of Spirituality, Religion and Health Publications: Yesterday, Today and Tomorrow

This research aims to present a bibliometric analysis of the published documents on spirituality, religion and health. Despite the increasing number of publications spirituality, religion and health research in recent years, there is still little information about the effects of these publications in the literature. "Religion," "spirituality," "spiritual," "health" and "medicine" keywords were used to search the Web of Science (WoS) database. Bibliometric analysis was conducted on the articles published between 1975 and 2017. The analysis was presented with network and density maps. The analysis also included the regression analysis to predict a number of publications in 2018. A total number of 1674 publications were found: 818 of these publications were articles. Of the 818 articles, 210 were religion, 198 were Public Environmental Occupational Health, 139 were Psychology, and 77 were performed in the field of Psychiatry. The most productive journal with 107 articles and 1129 citations was the Journal of Religion and Health. The USA (495; 60.5%) was the most productive country on spirituality, religion and health publications. The author who had the highest number of publications and citations was Koenig HG (33 publications; 4.03% and 1617 citations), the document who had the highest number of citations was Ellison CG and Levin JS (633 citations), and the author who had the highest number of citations in the references was Koenig HG, 2001, (126 citations). Duke Univ was the top institution in the number of publication (50 Article). This study will lead the researchers especially in terms of the important journals, active countries, authors, top-cited articles and current topics in spirituality, religion and health research.

Spirituality, Religiosity, Quality of Life and Mental Health Among Pantaneiros: A Study Involving a Vulnerable Population in Pantanal Wetlands, Brazil

This study aims to investigate the relationship between spirituality, religiosity (S/R), mental health and quality of life in a vulnerable population in the Pantanal wetlands of Brazil. A total of 129 individuals were interviewed. We examined mental health (Hospital Anxiety and Depression Scale), quality of life (SF-12), spirituality (self-spirituality rating scale), religiosity (DUREL) and R/S opinions. Individuals had high levels of spirituality, non-organizational and intrinsic religiosity, but low levels of religious attendance. Most participants said they would like to have their faith addressed by a health professional and that this approach would strengthen their trust on the doctors. Higher levels of spirituality were associated with less anxiety (β = - 0.236, p < 0.01) and depressive symptoms (β = - 0.398, p < 0.001); higher levels of non-organizational religiosity were associated with less anxiety (β = - 0.250, p < 0.01) and depressive symptoms (β = - 0.351, p < 0.001); and higher levels of intrinsic religiosity were associated with less depressive symptoms (β = - 0.315, p < 0.001). Quality of life was not associated with any religious/spiritual measures.

Health Behaviors and Preventive Healthcare Utilization Among African-American Attendees at a Faith-Based Public Health Conference: Healthy Churches 2020

Unhealthy eating habits and physical inactivity along with lack of access to quality healthcare contribute to the marked health disparities in chronic diseases among African-Americans. Faith-based public health conferences offer a potential opportunity to improve health literacy and change health behaviors through health promotion within this population, thereby reducing health disparities. This study examined the self-reported health behaviors and preventive healthcare utilization patterns of 77 participants at a predominantly African-American faith-based public health conference, Healthy Churches 2020. A self-administered questionnaire was distributed to a sample of attendees to assess their health behaviors (diet and physical activity), preventive healthcare utilization (annual healthcare provider visits), and health-promoting activities at their places of worship. The results indicate that attendees of a faith-based public health conference have adequate preventive healthcare utilization, but suboptimal healthy behaviors. Our findings support the need for ongoing health-promoting activities with an emphasis on diet and physical activity among this population.