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Abstract
"The existential" is a concept that many people use albeit associated with different meanings. In order to increase research-based insight into the meaning of "the existential," we conducted a questionnaire study in Denmark in 2018 in which we asked 1.106 Danes of various age, gender, educational and geographical background about personal associations linked to "the existential." Factor analysis of the answers resulted in three different groups of meaning: (1) essential meanings of life, (2) spirituality/religiosity and (3) existential thinking. The findings show that "the existential" serves well as an overarching construct potentially including secular, spiritual and religious meaning domains, at least within the European context.
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Affiliation(s)
- Niels Christian Hvidt
- Research Unit of General Practice, University of Southern Denmark, , J. B. Winsløwsvej 9A, 5000, Odense C, Denmark.
| | - Elisabeth Assing Hvidt
- Department for the Study of Culture, University of Southern DenMark & Research Unit of General Practice, Odense, Denmark
| | - Peter la Cour
- Center for Psychology of Religion, Innlandet Hospital Trust, Brumunddal, Norway
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Hvidt NC, Curlin F, Büssing A, Baumann K, Frick E, Søndergaard J, Nielsen JB, Lawrence R, Lucchetti G, Ramakrishnan P, Wermuth I, Hefti R, Lee E, Kørup AK. The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description. J Relig Health 2022; 61:2605-2630. [PMID: 34599478 DOI: 10.1007/s10943-021-01428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!
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Affiliation(s)
- Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
| | - Farr Curlin
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC, USA
| | - Arndt Büssing
- Faculty of Medicine, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University, Freiburg im Breisgau, Germany
| | - Eckhard Frick
- Department of Psychosomatic Medicine and Psychotherapy, Research Centre Spiritual Care, The University Hospital Klinikum Rechts der Isar, Langerstr. 3, 81675, Munich, Germany
- Forschungsstelle Spiritual Care, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Munich School of Philosophy, Kaulbachstr. 31, 80539, Munich, Germany
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ryan Lawrence
- Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Giancarlo Lucchetti
- Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n - Aeroporto, Juiz de Fora, MG, 36038330, Brazil
| | | | - Inga Wermuth
- Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany
| | - René Hefti
- Medical Faculty, University of Bern, Bern, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University Center for Social Cohesion, Daegu Catholic University, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-Si, Gyeongbuk, 38430, Republic of Korea
| | - Alex Kappel Kørup
- Research Unit of General Practice, Department of Mental Health Kolding-Vejle, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Abstract
As the Amish population is growing, researcher and practitioner interest in the Amish health culture is also growing. This is largely due to demand from practitioners for population-specific cultural guidance. Once a small area of study, health-themed publications in Amish studies (n = 246) now account for approximately one-fourth of all peer-reviewed publications, and a sizeable percentage address the health culture, i.e. Amish beliefs, practices, attitudes, decision-making processes, financing, and values. In this article, we provide a first-ever exhaustive narrative review of the Amish health culture literature (addressing Amish health conditions elsewhere). Specifically, we address Amish use of modern medicine, complementary & alternative medicine, cultural norms for birthing and intercourse, support and care for the sick and aged, health knowledge, payment for services, barriers to service access, service provider effectiveness, health programming, and ethical conflicts. Our goal is to organize the literature, synthesize findings, identify orienting perspectives, and clarify research questions and directions. Following our synthesis, we reflect on the current state of Amish health culture research, drawing particular attention to strengths and limitations of the oft-used cultural competency paradigm, and recommending more rigorous social scientific theorization of the Amish health culture.
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Affiliation(s)
- Cory Anderson
- Population Research Institute, Pennsylvania State University, State College, PA, 717-330-1766, USA.
| | - Lindsey Potts
- Truman State University, 100 E. Normal Ave, Kirksville, MO, 63501, USA
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Speedling BB. Celebrating Sabbath as a Holistic Health Practice: The Transformative Power of a Sanctuary in Time. J Relig Health 2019; 58:1382-1400. [PMID: 30972608 DOI: 10.1007/s10943-019-00799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sabbath-keeping has several holistic health benefits when done for intrinsic reasons. Most research on Sabbath-keeping is about individuals where Sabbath-keeping is customary. This organic inquiry describes how a Sabbath promoted transformation for ten women where Sabbath-keeping was not the norm. Six themes emerged: Sabbath-keeping enhanced self-awareness, improved self-care, enriched relationships, developed spirituality, positively affected the rest of a Sabbath-keeper's week, and Sabbath-keeping practices and philosophies also evolved over time. The author argues that reviving the best parts of Sabbath-keeping is an effective, accessible, holistic practice that can contribute to the well-being of individuals, communities, and the earth.
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Affiliation(s)
- Barbara Baker Speedling
- Holistic Health Studies, St. Catherine University, Minneapolis, MN, USA.
- Live Services, RedBrick Health/Virgin Pulse, NBC-HWC, 510 Marquette Avenue, Suite 500, Minneapolis, MN, 55402, USA.
- , 9530 Grand Avenue South, Bloomington, MN, 55420-4221, USA.
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5
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Abstract
Our objective was to assess the acceptability and feasibility of using sermons for health promotion in American Muslim mosque communities by deploying a tailored sermon in two mosque communities. With input from a community advisory board and resident imams, sermons communicated four health-related themes: (i) good health is a grant from Allah, (ii) one's body is trust and must be cared for, (iii) trusting in God's plan does not preclude taking actions to care for oneself, and (iv) community members are caretakers of one another. Self-administered, post-sermon questionnaires asked attendees about the acceptability of the sermon and the sermon-giver, and to identify survey themes. Data analyses involved descriptive statistics and regression modeling to assess variance in acceptability across race/ethnicity and gender. Of the 235 respondents, the majority found the sermon content acceptable and desired to hear health-based sermons more often (72 and 67% respectively). There were no significant differences in acceptability of sermon or sermon-giver by gender or race/ethnicity. Our study demonstrates that theologically-framed health messaging is acceptable within sermons in American Muslim mosque communities. This study underscores the potential utility of mosque sermons for health education programs and for health behavior interventions in American mosques.
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Affiliation(s)
- Aasim I Padela
- Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA. .,Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA. .,Section of Emergency Medicine and General Internal Medicine, The University of Chicago, Chicago, IL, USA.
| | - Sana Malik
- Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Nadia Ahmed
- Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.,Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA
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Padela AI, Malik S, Vu M, Quinn M, Peek M. Developing religiously-tailored health messages for behavioral change: Introducing the reframe, reprioritize, and reform ("3R") model. Soc Sci Med 2018; 204:92-99. [PMID: 29602091 DOI: 10.1016/j.socscimed.2018.03.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 03/06/2018] [Accepted: 03/15/2018] [Indexed: 11/18/2022]
Abstract
RATIONALE As community health interventions advance from being faith-placed to authentically faith-based, greater discussion is needed about the theory, practice, and ethics of delivering health messages embedded within a religious worldview. While there is much potential to leverage religion to promote health behaviors and improve health outcomes, there is also a risk of co-opting religious teachings for strictly biomedical ends. OBJECTIVE To describe the development, implementation, and ethical dimensions of a conceptual model for religiously-tailoring health messages. METHOD We used data from 6 focus groups and 19 interviews with women aged 40 and older sampled from diverse Muslim community organizations to map out how religious beliefs and values impact mammography-related behavioral, normative and control beliefs. These beliefs were further grouped into those that enhance mammography intention (facilitators) and those that impede intention (barriers). In concert with a multi-disciplinary advisory board, and by drawing upon leading theories of health behavior change, we developed the "3R" model for crafting religiously-tailored health messages. RESULTS The 3R model addresses barrier beliefs, which are beliefs that negatively impact adopting a health behavior, by (i) reframing the belief within a relevant religious worldview, (ii) reprioritizing the belief by introducing another religious belief that has greater resonance with participants, and (iii) reforming the belief by uncovering logical flaws and/or theological misinterpretations. These approaches were used to create messages for a peer-led, mosque-based, educational intervention designed to improve mammography intention among Muslim women. CONCLUSIONS There are benefits and potential ethical challenges to using religiously tailored messages to promote health behaviors. Our theoretically driven 3R model aids interventionists in crafting messages that address beliefs that hinder healthy behaviors. It is particularly useful in the context of faith-based interventions for it highlights the ethical choices that must be made when incorporating religious values and beliefs in tailored messages.
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Affiliation(s)
- Aasim I Padela
- Initiative on Islam and Medicine, The University of Chicago, Chicago IL, USA; Section of Emergency Medicine, The University of Chicago, Chicago IL, USA; Comprehensive Cancer Center, The University of Chicago, Chicago IL, USA.
| | - Sana Malik
- Initiative on Islam and Medicine, The University of Chicago, Chicago IL, USA; School of Social Welfare, Stony Brook University, Stony Brook, NY, USA
| | - Milkie Vu
- Initiative on Islam and Medicine, The University of Chicago, Chicago IL, USA
| | - Michael Quinn
- Section of General Internal Medicine, The University of Chicago, Chicago IL, USA
| | - Monica Peek
- Section of General Internal Medicine, The University of Chicago, Chicago IL, USA
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Shih P, Worth H, Travaglia J, Kelly-Hanku A. Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea. Soc Sci Med 2017; 193:51-58. [PMID: 28992541 DOI: 10.1016/j.socscimed.2017.09.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 11/17/2022]
Abstract
In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers' recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers.
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Affiliation(s)
- P Shih
- Australian Institute of Health Innovation, Macquarie University, Australia; School of Public Health and Community Medicine, UNSW Sydney, Australia.
| | - H Worth
- School of Public Health and Community Medicine, UNSW Sydney, Australia
| | - J Travaglia
- Faculty of Health, University of Technology Sydney, Australia
| | - A Kelly-Hanku
- Sexual & Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea; The Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Australia
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Padela AI, Pruitt L, Mallick S. The Types of Trust Involved in American Muslim Healthcare Decisions: An Exploratory Qualitative Study. J Relig Health 2017; 56:1478-1488. [PMID: 28343283 DOI: 10.1007/s10943-017-0387-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Trust in physicians and the healthcare system underlies some disparities noted among minority populations, yet a descriptive typology of different types of trust informing healthcare decisions among minority populations is limited. Using data from 13 focus groups with 102 American Muslims, we identified the types and influence of trust in healthcare decision-making. Participants conveyed four types of trust implicating their health-seeking behaviors-(I) trust in allopathic medicine, (II) trust in God, (III) trust in personal relationships, and (IV) trust in self. Healthcare disparity research can benefit from assessing how these types of trust are associated with health outcomes among minority populations so as to inform intervention programs that seek to enhance trust as a means to improve community health.
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Affiliation(s)
- Aasim I Padela
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA.
- Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA.
- MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA.
| | - Liese Pruitt
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Saleha Mallick
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA
- College of Medicine, University of Illinois, Peoria, IL, USA
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Gonçalves LM, Osório IHS, Oliveira LL, Simonetti LR, Dos Reis E, Lucchetti G. Learning from Listening: Helping Healthcare Students to Understand Spiritual Assessment in Clinical Practice. J Relig Health 2016; 55:986-999. [PMID: 26515368 DOI: 10.1007/s10943-015-0146-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We aim to evaluate the perceptions of healthcare students while taking a spiritual history (SH). Fifty students were trained on how to take a SH, interviewed inpatients and answered a questionnaire concerning their perceptions. A total of 362 patients were interviewed: 60.1% of students felt comfortable taking a SH, 85.1% believed the patient liked the approach, and 72.1% believed more benefits could come with a follow-up. When students felt more comfortable, they tended to believe the patient: liked the approach (p < 0.01), felt better (p < 0.01) and more motivated (p < 0.01). Spirituality/health educational strategies may be a valid strategy to prepare future health professionals to face spiritual issues in health scenarios.
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Affiliation(s)
- Lídia Maria Gonçalves
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil.
| | - Igraíne Helena Scholz Osório
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Luan Leal Oliveira
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Lígia Rodrigues Simonetti
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Edilson Dos Reis
- Hospital Chaplaincy, University Hospital Maria Aparecida Pedrossian, Campo Grande, Brazil
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de For a, Juiz de Fora, Brazil
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Thompson AB, Cragun D, Sumerau JE, Cragun RT, De Gifis V, Trepanier A. "Be Prepared if I Bring It Up:" Patients' Perceptions of the Utility of Religious and Spiritual Discussion During Genetic Counseling. J Genet Couns 2016; 25:945-56. [PMID: 26758255 DOI: 10.1007/s10897-015-9922-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/03/2015] [Indexed: 10/22/2022]
Abstract
As debates continue about the relevance of religion to health care, research is needed to guide decisions about whether genetic counselors (GCs) should routinely address religious and/or spiritual (R/S) issues with their patients. We conducted an online survey to gauge patient perspectives on this issue. Among the 70 respondents, frequencies of closed-ended responses and thematic analyses of open-ended responses revealed multiple patient concerns related to R/S discussions with GCs. Although 60 respondents reported being R/S, only a small minority would want to discuss R/S issues if it meant less time discussing medical information. Most respondents also expressed opinions that: 1) genetic counseling should be about science; 2) GCs are not qualified to discuss R/S issues; 3) other outlets are available to meet the needs of patients who want R/S counseling; and/or 4) R/S discussions are more likely to be acceptable if patients broach the topic or in specific circumstances (e.g., when patients are facing end-of life issues). Overall, responses suggest routine or comprehensive R/S assessments or discussions are not necessary and that GCs would be best equipped to help all their patients if they were prepared to listen, be supportive, and make referrals when R/S issues arise in clinic.
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