Keynote speakers in alphabetical order
C&V Senior Care Services, Williamsville, USA
SPIRITUALITY IN NURSING CARE
This lecture will focus on the significance of the researcher’s and caregiver’s own spirituality. The arguments and conclusions are especially based on a study from 1979. This research evaluated the impact of prayer on a sample of chronic psychiatric patients at Spring Grove State Hospital, Maryland, USA.
Research and experience confirm that the behavior of the researcher/teacher, clinician and caregiver has the potential to serve as a powerful role model for those with whom he or she interacts. In other words, the researcher or caregiver needs to be spiritually healthy. Dealing with others in a loving way is more than the impact of one person but it has the potential to touch so many others. Teaching about spirituality through research not only helps others to become at ease with the topic but gives others permission to address a theme that for many is taboo.
Therefore this presentation will identify some qualities that are necessary for the researcher/teacher, clinician or caregiver that addresses spirituality. There is a need to recognize that our interactions with others must reflect the best of spiritual well-being including compassion, respect and dignity for all involved in the research and the clinical practice. Finally will be named spiritual antidotes that protect against a "publish or perish" culture.
References: Carson, V. & Huss, K. (1979). Prayer: An effective therapeutic and teaching tool. Journal of Psychiatric Nursing and Mental Health Services. 3, 34-37.
Durham University, Durham and Queen Mary University London, UK
SPIRITUALITY IN MENTAL HEALTH CARE - TESTING THE EFFICACY OF PRAYER
Prayer is probably the most common religious practice but is there any evidence that it is effective from the biomedical point of view? The past decade has seen several studies devoted to both distant intercessory prayer and of proximal intercessory prayer. These studies demonstrate mixed results and raise interesting philosophical and theological issues concerning prayer. I will discuss recent work on prayer in Pentecostalism.
Aim of this lecture is to assess the efficacy of prayer, based on a critical literature review which includes a thematic analysis of data. There is no evidence that intercessory prayer is effective in the biomedical sense but prayer may have significant psychotherapeutic benefits. The implications of this will be discussed.
Prof. Dr. Julie Exline
Department of Psychological Sciences, Case Western Reserve University, Cleveland, USA
RELIGIOUS STRUGGLES AND SPIRITUAL DISTRESS
Background: Although many people view religion and spirituality as sources of comfort, strength, and hope, it is also common for people to experience struggles around religious/spiritual issues. Most measures of religious/spiritual struggle focus on a small range of struggles, usually involving negative thoughts or feelings about God. For research and clinical purposes, it would be helpful to have a broad-based measure of religious/spiritual struggle that is still relatively brief.
Aim: This presentation will provide a brief overview of the topic of religious and spiritual struggle. A major aim will be to describe several common domains of religious/spiritual struggle (divine, demonic, interpersonal, moral, ultimate meaning, and doubt) and recent attempts to measure these struggles. The presentation will also highlight major correlates of religious/spiritual struggle, along with the possibility that such struggles may provide the potential for personal growth.
Methods: The presentation will discuss the development of a new measure, the Religious and Spiritual Struggles Scale (RSS), and will briefly summarize results from studies using this measure. The presentation will also summarize highlights from a research program on anger toward God.
Results: Results from various studies suggest that the RSS can be a helpful tool for assessing religious/spiritual struggles among religious believers (e.g., Christians, Jews, Muslims) and nonbelievers. Many people experience religious/spiritual struggles in daily life, although usually at low levels of intensity. Religious/spiritual struggles have been linked with many indicators of emotional distress. People may be reluctant to admit their religious/spiritual struggles, and sometimes they receive negative responses when they disclose such struggles to others. In terms of predicting whether religious/spiritual struggle predicts growth, it is important to assess how people appraise the struggle, how they cope with the struggle, and the responses of people to whom they disclose the struggle.
Conclusions: Religious/spiritual struggles are common in daily life, even among people who also experience religion and spirituality as a source of strength. The RSS provides one effective screening tool for the assessment of these struggles. Although there is no one single remedy for religious/spiritual struggle, it is helpful to be able to normalize such struggles to help diffuse the stigma and secrecy that often surround them.
Division of Psychiatry, University College London, UK
RELIGION AND MENTAL HEALTH - EMPIRICAL FINDINGS IN EUROPEBackground: It is claimed that religious and spiritual people have better mental and physical health. However research is often poorly conducted, there is confusion between the concepts of religious and spiritual, and research findings vary with geography and the culture of the populations studied.
Aim: To review research conducted in Europe on the links between religion, spirituality and mental health and to integrate these findings with clinical practice.
Methods: Examples of epidemiological and clinical research, as well as systematic reviews, will be presented in order to reach a consensus on the evidence for associations between spirituality, religion and mental health.
Conclusions: Although there is evidence that religious involvement is better for mental and physical health, people holding spiritual beliefs in the absence of religious involvemen
t may be at greater risk of mental disorder. Research findings differ between Europe and North America.
Duke University Medical Center, Durham, NC, USA
BREAKING NEWS FROM RSH-RESEARCH
Background: There is much new research appearing regularly in the scientific literature on the relationship between religion, spirituality and health.
Aim: The purpose of this talk is to review the latest research published since 2014 on the relationship between religion, spirituality and health at academic medical research centers around the world, and discuss new research being planned or in progress at Duke University.
Methods: Selective review of published research in peer-reviewed journals, and discussion of research not yet published
Results: Research on depression, importance of religion/spirituality, and brain structure (structural MRI); relationship between religious involvement and telomere length in stressed caregivers; effects of religious cognitive behavioral therapy on depression outcomes, including influence of genetic polymorphisms and effects on biomarkers; effects of Qur’an recitation on anxiety symptoms and depressive symptoms in dialysis patients; and other research findings will be discussed. New research examining the effects of spiritually-oriented cognitive processing therapy for moral injury in post-traumatic stress disorder in active duty military and veterans will also be examined, as will a project integrating spirituality into patient care through the use of spiritual care teams in the Adventist Health System.
Conclusions: More and more research is being published on religion, spirituality and health demonstrating links that have important clinical implications. Exciting new research programs are now in progress or being planned for the future. There is every reason for optimism with regard to the future for this ever-growing research field.
Institute for Ethics in Medicine, University of Vienna, A
THEOLOGICAL PERSPECTIVES ON THE INTERGRATION OF RELIGION AND SPIRITUALITY INTO HEALTH CARE
Background: Modern medicine makes use of the natural sciences and their methods, which forgo the “God hypothesis”, explaining sickness and health „etsi Deus non daretur“. Yet, at the moment there is renewed interest on the part of medical science in the religious dimension of sickness and health. The concept of “spirituality” is readily used today to refer to the positive, life-serving aspects of religion. That the word has its origins in Christianity is often completely overlooked.
Aim: A plea for dealing critically with the concept of spirituality in general, and in medicine in particular.
Methods: First, references to the history and Christian content of the concept are given. This is followed by remarks on the relationship of religion, culture and medicine in the context of a multicultural society. These lead, in a further step of the examination, to the discussion of the term and concepts of Spiritual Care. Next, alongside the positive aspects of religion and spirituality, their ambivalences and possible dangers are explored. In conclusion, in the form of 6 theses, an expanded concept of spirituality in medicine will be presented for discussion.
Results: The topic of “spirituality, religion and culture on the sickbed” is located on three levels: the personal level, or respectively, the level of interactional relationships, e.g. between doctor and patient; the structural or institutional level, on which e.g. the hospital or the whole healthcare system as systems or organizations come into view; and finally the cultural level, on which mindsets and values (i.e. also basic world-view or religious orientations) are located. Just as much as the individual patient should occupy the center of medical proceedings and helping actions, the concrete locations of helping and healing action, the institutional and organizational parameters, must also be born in mind. In the discussion of the term and concept of Spiritual Care, and its relationship to classical, clinical pastoral care, there is still an array of unanswered questions. For this reason, the theoretical debate should be continued.
Conclusions: Despite all the actual overlaps, a distinction is to be made between spirituality, religiosity and religion, since otherwise unclarity remains regarding the objects of possible knowledge and the determination of different task-areas and competences in the area of healthcare.
Indiana University, South Bend, USA
EMPLACEMENT, EMBODIMENT AND EMPOWERMENT - CONSIDERING THE ROLE OF PRAYER IN HEALTH CARE SETTINGSAcross a variety of literatures, there is substantial agreement that “spaces” are of great significance in the creation and maintenance of identity at multiple levels. Likewise, disciplines show cohesion around the notion that the physicality of the body influences personal experiences in unique ways. The spiritual discipline of prayer is one specific domain in which space and body are interwoven with regard to how individuals and groups differentiate and unite. This confluence of emplacement and embodiment has the potential to augment or diminish the moment of prayer in both content and expression, so people singly and together select spaces of prayer and train their bodies in preparation. When healthcare issues arise, the ability of people to choose “spaces” often is restricted and the ability to depend on their bodies is called into question. What becomes of prayer at these times when emplacement and embodiment are altered radically? Taking this inquiry as a central theme, this presentation draws from a variety of literatures to identify how prayers can be both discouraging and empowering events in the instance of healthcare settings. Practical suggestions are offered concerning how to address the challenges and expand on the benefits of prayer in this particular context.
University of Lausanne, CH
SPIRITUALITY IN GERIATRIC CARE - FROM SPIRITUAL DISTRESS TO PUBLIC HEALTH CHALLENGES
Background: Multiple studies have documented a significant association between spirituality and health. Although spirituality is usually considered as a positive resource for coping with illness, spirituality might also influence negatively health outcomes. Spiritual distress has been associated with increased mortality, more severe depression, and desire of hastened death, suggesting a potentially harmful effect on patients’ prognosis and quality of life. These observations supported the growing interest toward implementing spiritual interventions into usual care.
Method: Our research group worked since more than 10 years to develop a structured approach to integrate spiritual care into rehabilitation care for elderly persons and to improve patient’ spiritual state. The first objective of this research was to conceptualize the spiritual dimension and to develop an instrument to assess spiritual distress in hospitalized older patients (development and validation of the Spiritual Distress Assessment Tool). The second objective was to determine spiritual distress prevalence in different populations of older adults and to investigate its relationship with health-related outcomes.
Results: This conference will present the spiritual intervention concept, fully integrated into elderly rehabilitation care, and aimed at addressing spiritual distress and improving patient’ spiritual state. This intervention is based on a structured assessment that identifies patients’ unmet spiritual needs. Results of this assessment, including the degree to which spiritual needs remains unmet, are transmitted by the chaplain to health professionals. The chaplain suggests follow-up discussions, as well as possible interventions to address identified unmet spiritual needs. These propositions include interventions carried out by the chaplain directly with the patient and/or indirectly trough health professionals counseling. Health professionals reported a positive appraisal toward spiritual care implementation as well as chaplain integration into the interdisciplinary rehab team. In particular, health professionals perceived specific benefits in enhancing patient centered care.
Overall, prevalence of spiritual distress was found to be high in different older patients population (around 60%) and was associated with different outcomes such as depression and wish to die.
Conclusion: In addition of these results, and in a broader perspective, some challenges related to the integration spirituality into usual geriatric care will be discussed.Ethical issues of integrating spirituality into routine care will be raised, as well as questions of skills and training of both chaplain and health professionals.
Institute of Psychology, University of Gdansk, PL
THREEFOLD NATURE OF SPIRITUALITY (TNS) MODEL - THREE PERSPECTIVES OF UNDERSTANDING PATIENTS AND DOCTORS
Background: Recognition of patient’s spiritual condition plays key role in a psychological and medical care. But not only - doctors, nurses, chaplains are the most important caregivers for patients, so their spiritual condition and well-being is crucial in this context. The first step in this process should be creation of appropriate theoretical background.
Aim: To explain that from medical and psychological point of view recognizing and defining the nature of spirituality among these groups is indispensable.
Methods: Integrative research - metaanalysis of relevant publications in a field of psychology of religion and spirituality and their conclusions (Emmons 1999, Piedmont 1999, MacDonald 2000, Ozorak 2005, Koenig 2008, Park 2010 etc.). Examples of author’s and others quantitative analyses which were led within last 16 years.
Results: Threefold Nature of Spirituality (TNS) model (Skrzypińska, 2014) proposes description and explanation of spirituality’s mechanisms. This theory presents the three components of spiritual sphere: cognitive schemata, emotional, and behavioural which are indispensable in improving patient’s condition. Proposed solution presents a nature of spirituality from the three perspectives: 1/ cognitive, 2/ individual, and 3/ attitudinal. Spirituality is created on a cognitive basis thanks personality’s motivation, and then it influences attitudes and behavior of individual.
Conclusion: Medical and psychological treatment should be conducted systematically and taking into consideration complexity of human spiritual sphere. Moreover – all caregivers’ condition is important factor for patient’s health also.
PowerPoint slides of the presentation (PDF)
Department of Pastoral Theology and Pastoral Psychology, University Ecclesiastical Academy of Athens, GR
RELIGION AND MENTAL HEALTH - REVISITING THE CONCEPTSIn this lecture I attempt to revisit the two concepts with the purpose of shedding more light at their relationships. Religion is examined in terms of its qualitative characteristics that have the ability to either promote or undermine mental health, while mental health is being distinguished from existential ‘symptomatology’ and thus not reduced to a ‘DSM type’. Besides, the interaction of the two notions is elaborated at the level of culture, with a paradox of American society being a working example. The goal is to show how cultural values associate with both religion and mental health and how they mediate their mutual influence.