Spirituality and Health
The Health Benefits of
Religion
Spirituality and Religion in
Nursing Theory
• As nursing sought to establish itself
as a profession with a legitimate
knowledge base, the concern with
human spirituality was downplayed
and even consciously ignored until
the early 1980s
• To avoid falling into a mentality of
treating patients merely as things,
nursing theorists Betty Newman &
Jean Watson began in the 80s to
advocate that nurses cultivate an
awareness of their client’s beliefs
Koenig and Larson
Study 1988
• Harold Koenig and David Larson
Studied 542 people aged over
sixty, finding that over a year,
those who attended church at
least weekly were hospitalized 56
percent less (43 percent less after
controlling for illness, age, and
depression)
• Also, when hospitalized, those
affiliated with any religion stayed
less than half as long as those
who claimed no religion
Results
• Research is on-going, with many
outstanding concerns regarding
methods
• However, there is growing
evidence from 1000s of studies
that considered aggregately
show: higher degree of religious
& spiritual practice is associated
with lower mortality from all
causes (i.e. it has a generally
positive impact on health)
• Don’t just trust me!—research
paper is opportunity to test this
claim
Spirituality, Health and Care
• Koenig, Mcullough, and Larson (2001)
reviewed more than 1200 studies on
religion and health, 2/3 of which
showed a significant statistical
relationship between religious activity,
better physical health, and lower use of
medical services
• International Council of Nurses has
declared that culturally congruent
health care “is a basic human right, not
a privilege” (ICN, Code for Nurses, 1973)
• International Council of Nurses (2005)
defines health as “Mental, physical,
social and spiritual wellbeing”
Holisitic Care
• An approach to medicine that sees
wellness as a state of harmony
between body, mind, emotions, and
spirit in an ever-changing
environment
• Care of the whole person, including
the mind and spirit, is a professional
nursing responsibility
• Since people’s spiritual beliefs can
conflict, it is important for nurses to
learn about the spiritual beliefs of
others and think about their own
beliefs so they can work an
appropriate approach to responding
to the spiritual needs of others
SPIRITUALITY, HEALTH
AND NURSING PRACTICE:
CNA Position Statement
2010
• Therapeutic communication skills
identified by the CNA as competencies:
– Openness to a range of spiritual
perspectives (or lack thereof ) is part of
ethical nursing practice
– Nurses need not feel they must be
knowledgeable in particular spiritual
traditions, but they are required to be
open to inviting or allowing reflection by
the individual on the spiritual dimension
of his or her experience of illness and
suffering
– Nurses may deem self-reflection on their
own spiritual beliefs to be beneficial to
their practice
http://www.cnaaiic.ca/CNA/documents/pdf/publications/PS111_Spirituality_2010_e.
pdf
Possible Scientific
Explanations
1. Strict moral standards can
obviously can help promote
healthy lifestyle
2. Typical group oriented character
of religion supports our wellunderstood needs for group
acceptance and interaction
3. Salvation beliefs can obviously
effect our sense of security and
well being
4. So-called supernatural effects
might just be examples of the
“placebo effect”
Happiness
• There is now extensive research
suggesting that religious people
are happier and less stressed
(Rudin, Mike. 2006-04-30. "The
science of happiness". BBC)
• Surveys by Gallup, the National
Opinion Research Center and the
Pew Organization conclude that
“spiritually committed” people
are twice as likely to report being
"very happy" than the least
religiously committed people
Financial Worry
• Survey of Canadian, 30% admit to
worrying about their finances
• However, more of the “very
religiously committed” (41%) than
the “Non-Religious” (28%) say
they do not worry, while more
than twice as many of the nonreligious (21%) than the very
committed worry a great deal.
• This despite the fact that the
average house-hold income of the
“very committed” is a bit lower
than that of the non-religious
Depression, Drug Abuse
and Suicide
• An analysis of over 200 social
studies contends that "high
religiousness predicts a lower risk of
depression and drug abuse and
fewer suicide attempts, and more
reports of satisfaction with sex life
and a sense of well-being” (Smith,
Timothy; Michael McCullough, and
Justin Poll (2003). "Religiousness
and Depression: Evidence for a Main
Effect and Moderating Influence of
Stressful Life Events". Psychological
Bulletin 129 (4): 614–36.)
Self-Esteem,
Hypertension
• A review of 498 studies published
in peer-reviewed journals
concluded that a large majority of
them showed a positive
correlation between religious
commitment and higher levels of
perceived well-being and selfesteem and lower levels of
hypertension (David Myers The
Science of Subjective Well-Being
Guilford Press 2007 )
Forgiveness
• A wide range of studies indicate that
forgiving those who hurt you can
improve your mental and physical
wellbeing
– E.g. 2004 study showed that women
who were able to forgive their spouses
and feel benevolent toward them
resolved conflicts more effectively.
– forgiving is a skill you can hone
http://www.health.harvard.edu/press_releases/power_of_forgiveness
– In 1997, a Stanford University study found
that college students trained to forgive
were significantly less angry, more hopeful,
and better able to deal with emotions than
students not trained to forgive.
http://www.umm.edu/altmed/articles/spirituality-000360.htm#ixzz27UdLIj3R
Gratitude
• Robert Emmons at the UC Davis divided
participants into 3 groups keeping daily journals:
1. Group 1: Wrote 5 things they were grateful for
2. Group 2: Described 5 daily hassles
3. Control: Listed 5 events that had affected them
Group 1 reported higher levels of life-satisfaction,
optimism, and fewer health problems
• Hundreds of studies have replicated these results
– E.g. people suffering from neuromuscular diseases
reported getting more sleep, spending less time
awake before falling asleep and feeling more
refreshed after sleep
– University of Connecticut study found that
gratitude can have a protective effect against
heart attacks—people who saw benefits and gains
from their experience, experienced a lower risk of
having another heart attack
• “Can prayer increase gratitude?” Lambert,
Fincham, Braithwaite, Graham & Beach,
Psychology of Religion and Spirituality, 1(3), 2009,
139-149. doi: 10.1037/a0016731—Yes
Longevity in the United
States
University Of Colorado At Boulder (1999, May 17).
Research Shows Religion Plays A Major Role
In Health, Longevity. ScienceDaily.
4 Types of Influence
Studied
1. Health Behaviors that influence
health risks (Eg. Smoking, drinking,
religious activities such as fasting,
etc)
2. Adjustment to Illness (Eg.
Psychosocial and Psychodynamic
effects)
3. Physiological functioning and
disease progression (Eg. Healing
effects of meditation, prayer,
fasting, or manipulation of superempirical forces, such as “Chi”)
4. Effects of “spiritual care” by health
care professionals
1. Health Behaviors
• Lower rates of coronary disease,
emphysema, cirrhosis & suicide
(Comstock & Partriidge 1972)
• Lower blood pressure (Larson,
Koenig & Kaplan, 1989)
• Lower rates of heart attack
(Madalie, Kahn & Neufeld 1973)
2. Adjustment to Illness
• Improved functioning, compliance,
self esteem & lower anxiety 1 year
after heart transplant (R.C. Harris et.
al. 1995)
• Reduced levels of pain in cancer
patients (Yates, Chalmers, St James,
et. al. 1981)
• Better perceived health and less
medical service utilization (Frankel
& Hewitt, 1994)
• Decreased disability among nursing
home dwellers (Idler & Kasl, 1992,
1997)
3. Disease Progression Meditation
• Alexander, Langer, Newman and
Chandler (1989) compared
impact on short-term mortality of
73 nursing home residents of
Transcendental Meditation,
Mindfulness Meditation,
Relaxation Training and a control
group. At 3 years TM group had a
100% survival rate, 87.5% for the
MM group, 65% for the RT group
and 62.5 for the control.
3. Disease Progression Intercessory Prayer
• Byrd (1988), Sicher, Targ, Moore
& Smith (1998), W.S. Harris (1999)
conducted double blind studies
on effects of prayer on mortality
after heart attack. Patients
prayed for
– used 7% fewer antibiotics
– 6% less need for intubation
– 6% less pulmonary edema
– 6% less congestive heart failure
– 5% less heart attack
4. Effects of “Spiritual
Care”
• A few studies have documented a
positive relationship between
care-giver attitudes towards
spiritual care-giving and selfreported feelings of spiritual wellbeing (Millison & Dudley, 1990;
Highfield, Taylor & Amenta, 2000)
• Still much controversy over
whether “spiritual care” helps
improve health outcomes (Sloan
et. al 2000, VandeCreek, 1999 vs.
Weaver et. all., 2002)
The Placebo Effect
• A placebo is a sham medical
intervention
• In one common placebo procedure,
a patient is given an inert sugar pill,
told that it may improve his/her
condition, but not told that it is in
fact inert
• Such an intervention may cause the
patient to believe the treatment will
change his/her condition; and such
belief sometimes seems to have a
therapeutic effect, causing the
patient's condition to improve
• This phenomenon is known as the
placebo effect