Session 2
Religion, Spirituality and Physical Health
Chair: René Hefti
1. Health Practices that Lengthen Life Expectancy among Seventh Day Adventists: the Confusion for Public Health
Pawel Zagozdzon
Background: The health principles from Ellen G. White’s writings contributed to give rise to one of the longest living people groups in the world – The Seventh - day Adventists. The health and longevity of the Adventists has attracted the interest of many public health specialists, who incidentally tend to focus more on the dietary and psychosocial determinants of the Adventist lifestyle, rather than the source from where the knowledge about health preservation among the Adventists arise.
Aim: The principles of health stated by White will be reviewed with respect to their accordance with modern science and proven beneficial health effects when practiced.
Methods: Epidemiological evidence on the effects of health principles advocated by Seventh day Adventists will be reviewed from the perspective of causal association. The attempted use of these epidemiological evidence in public health context will be also analyzed, along with the ethical problems it throws up.
Results: Exercise, vegetarian diet, not smoking, eating nuts and social support have been found to predict longevity in Adventists. Apart from the diet, researchers have also emphasized the psychological function of hope, rest on Sabbath and prayer. They have been interested in finding out whether the good health and longevity of the Seventh - day Adventists results solely from nutrition or its intrinsic combination with spirituality. Some suggested that the Seventh - day Adventists were able to view difficult and stressful situations of daily life as something positive, bringing them closer to God, rather than moan about daily difficulties. The relationship between stress and religion in the context of allostatic load is being assessed in ongoing Biopsychosocial Religion and Health Study.
Conclusion: There is a need for a better understanding of the pathways by which religion might influence health in Adventists. Many health behaviors present among Adventists are already established as elements of healthy lifestyles and are promoted by public health practitioners. There is no sufficient data to determine whether the longevity of Adventists is the result of combined manifestation of beliefs and behaviors or this is the result of specific behaviors only.
PowerPoint slides of the presentation (PDF)
2. The Correlation between Sholat and the Development of Knee Osteoarthritis among Elderly Muslim in Yogyakarta, Indonesia
Muhammad Fauzan Hasby, Iman Permana
Background: Osteoarthritis (OA) is a degenerative joint disease that developed due to cartilage destruction process with specific clinical sign of pain, crepitation, and morning stiffness for less than 30 minutes. The risk factor of knee OA included age, sex, obesity, and physical activity. Sholat is an Islamic ritual with a prescribed movement that included the knee joint lasted for about 5-7 minutes. Thus, it was required for every Muslim to perform Sholat 5 times in a day with different rakaat (a prescribed series of movement and pray); between 2 – 4 rakaat.
Aim: The aim of this study was to seek the correlation between performing sholat against the risk of developing knee OA in subject group of Muslim between 50-75 years.
Method: Osteoarthritis was established according to the American College of Rheumatology classification based on the major symptoms of pain and one of three additional factors: age over 50 years old, crepitation, and morning stiffness. The study utilized observational analytical, cross-sectional method. The sample of this study consisted of 56 elderly Muslim with 17 male and 39 female. Result: The hypothesis, tested with Chi Square Test, was revealing a significant correlation between performing sholat and the occurrence of knee osteoarthritis risk factors among Muslim between 50 – 75 years with p-value of p = 0,019 (p < 0.05).
Summary: Performing sholat was correlated with the development of risk factor of knee OA among 50-75 years old elderly Muslim.
3. A Cross-Sectional Curvey of Perceptions of Health, Not Weight Loss, Focused Programmes (HNWL)
Nazanin Khasteganan, Deborah Lycett, Gill Furze, Andy P. Turner
Background: The benefit of intentional weight loss, particularly in individuals without co-morbidities, and the risk of weight cycling in this population is unclear. Health, not weight loss, focussed programmes (HNWL) engage in a holistic method of promoting healthy behaviour change to reduce obesity risks.
Aim: To identify the attitudes of a working population towards the concept of HNWL focussed programmes.
Methods: All Coventry university staff were invited to participate in a cross-sectional survey using the Bristol Online Survey. The first section included: a demographic questionnaire, the Three-Factor Eating Questionnaire (TFEQ R-21) and questions on religion/spirituality. The second section contained three links relating to HNWL programmes, including the Health at Every Size (HAES) website. After browsing these, they answered a final section about their perceptions of HNWL approaches.
Results: The results of the survey reported that all of the respondents (n=78) of the survey agreed with the HAES approach (ranging between 52.5% and 100%). Most of those who held a positive view of the HNWL programme were female (75.6%), primarily British Caucasian (70.5%) and had a higher level of education beyond an undergraduate degree (62.8%). They were mostly non-religious (64.1%), but if they did follow a religion, they were primarily Christian (46.3%). The final results of the linear stepwise regression models showed that the uncontrolled eating variable was the most significant factor relating to acceptance HNWL approach with a positive significance (p < 0.05).
Discussion: Results of this survey show HNWL programmes are considered as an important approach to obesity by the public. Our plan for future would be seek to test their effectiveness and develop potential ways in which such programmes can be incorporated into the NHS.
4. Spiritual Needs of Patients in Neurology and their Expectation Towards the Therapeutic Setting
Anne Zahn, Carolin Schütz, Arndt Büssing
Background: Although, several patients would like to see their spiritual needs to be addressed, the topic of spirituality is often ignored or not giving importance in acute care hospitals and rehabilitation clinics, but seen as important at least in palliative care.
Aim: According to the results of a previous survey with 248 participants in the department of Psychiatry and Psychotherapy investigating their spiritual and religious attitudes and practices alongside with their spiritual needs and expectations towards the clinic and its staff, we now wanted to do the same with neurological
We intended to analyze the expectations of neurological patients towards the clinic with respect to their faith and spirituality on the one hand, and to analyze their specific spiritual needs on the other hand. Further, do patients who expect support differ with respect to their symptom burden and life satisfaction?
Methods: To address these questions, we performed an anonym cross-sectional survey with standardized instruments (i.e., SpNQ, SpREUK-, SpREUK-P, BMLSS) among 200 patients (45% female, 55% male; mean age 62 ± 15 years) of a neurological rehabilitation clinic in Bad Krotzingen (South-Western Germany). With 100 of those patients we conducted a semi-structured interview by Holzhausen Over the course of 18 months, all new in-patients received a questionnaire at the beginning and at the end of their clinical stay.
Results: Referring to data of 189 patients, 49% are Catholics, 34% Protestants, 6% have other denominations, and 11% none. However, 37% regard themselves as neither religious nor spiritual, 8% as not religious but spiritual, 38% as religious but not spiritual and 17% as religious and spiritual.
Among them, 21% would agree that the topic of faith and spirituality is important to be addressed in the clinic, 55% see it as not so important and 25% definitely not important. Asked with whom they would like to talk about their own faith and spirituality, 38% stated friends and family, 25% pastoral workers, 19% psychotherapist, 10% medical staff, and 6% other patients. Asked how often should this topic be address, 44% stated they would not like to talk about it at all, 12% said monthly, 31% weekly, 9% several times per week, and 4% on a daily level.
Among them, 21% would agree that the topic of faith and spirituality is important to be addressed in the clinic, 55% see it as not so important and 25% definitely not important. Asked with whom they would like to talk about their own faith and spirituality, 38% stated friends and family, 25% pastoral workers, 19% psychotherapist, 10% medical staff, and 6% other patients. Asked how often should this topic be address, 44% stated they would not like to talk about it at all, 12% said monthly, 31% weekly, 9% several times per week, and 4% on a daily level.
Which spiritual needs are raised? Using the standardized Spiritual Needs questionnaire /with ranges from 0 to 3), Religious Needs (0.7 ± 0.8) and Existentialistic Needs (0.8 ± 0.7) scored lowest, while Needs for Giving/Generosityy (1.3 ± 0.9) were of some and Needs of Inner Peace (1.5 ± 0.8) of strongest relevance. Because needs of Inner Peace are only weakly related to patients religious Trust (r=.21; p=.006) but correlated moderately with spiritual Search (r=.31; p<.0001) and Reflection of life concerns and illness (r=.32; p<.0001), these specific needs have to be seen as a more general needs of patients. Only these Inner Peace needs were significantly related to patients´ symptom burden (r=.22; p=.004) and negatively with their life satisfaction (r=-.29; p<.0001), not the other needs. However, those who would or would not agree that the topic of faith and spirituality is important to be addressed in the clinic did not significantly differ with respect to their symptom burden (F=1.2; n.s.) or their life satisfaction (F=1.5; n.s.).
Conclusions: The data suggest that for a majority religious and spiritual issues are not so important, and thus not a major issue to be addressed in the therapeutic setting. Nevertheless, there is a longing for inner peace. Interestingly, whether patients may see themselves as spiritual and/or religious, or whether they would like their faith and spirituality to be addressed in the hospital or not, does not differ from their counterparts with respect to their life satisfaction or symptom burden. Therefore, we also performed semi-structured interview with 100 in-persons over a course of 18 months to get more insight about their needs in respect to their concept of quality of life, inner values and personality features. The data of this evaluation is still in progress.
5. Impact of Religious Coping on Pain Processing in Chronic Pain Patients
René Hefti, Matthias Laun
Background/Aim: Several studies have shown the beneficial effect of religiosity in pain patients. Religious coping is seen as a “key” mechanism in promoting adaptation to chronic pain. The present study seeks to further understand how positive and negative religious coping (RCOPE) interact with psychological mechanisms affecting pain control (FESV) and acceptance of pain (CPAQ).
Method: 183 chronic pain patients admitted to a center for pain medicine in Switzerland were surveyed. All patients completed a series of pain questionnaires (CPAQ, DSF, MPSS, FESV, NRS), the Hospital Anxiety and Depression Scale (HADS) as well as two religious measures (RST, Brief RCOPE). The interaction between religious coping, psychological symptoms and coping with pain was assessed using Pearson and Spearman correlations and linear regression.
Results: Correlations revealed significant relationships between positive religious coping and the cognitive as well as behavioral dimensions of coping with pain ( FESV, German Pain Coping Questionnaire): Action-Oriented Coping (r = .163*), Cognitive Restructuring (r = .312**), Self-Efficacy (r = .304**), Mental Distraction (r = .206**) and Counter-Activities (r = .149*). Using a linear regression model that included age, sex, anxiety, depression, pain intensity and impairment as confounders confirmed an impact of positive religious coping on cognitive restructuring (R2 korr = .132, ß = .280, p = .000) and self-efficacy (R2 korr = .271, ß = .268, p = .000). An inverse relationship was found between negative religious coping and acceptance of chronic pain (r = -.286, p = .000), suggesting that negative religious coping may be maladaptive in chronic pain patients and promote non-acceptance of pain.
Conclusions: Present study confirms the association between religiosity and coping with chronic pain. Positive religious coping had a significant positive impact on cognitive pain processing, mainly on cognitive restructuring and self-efficacy. Negative religious coping was inversely related to cognitive processing of pain, and therefore appears to be maladaptive. Both positive and negative religious coping are relevant for the treatment of chronic pain patients.