Spirit and Matter – Faith, Love and Health. Being studied and published. Who is reading?

Dr. Weeks’ Comment:   In psycho-neuro-immunology, we have studied the role of prayer and various emotions for decades, we have published and precious few are reading.  Here is a brief update of interesting articles.

Divine love and deep connections: a long-term followup of patients surviving cardiac surgery

Notes:

• The authors examined experiencing divine love as an indicator of affective spiritual growth in a prospective cohort of 200 patients surviving cardiac surgery. These patients previously completed two-wave preoperative interviews when standardized cardiac surgery data were also collected. The information included left ventricular ejection fraction, New York Heart Association Classification, baseline health (physical and mental), optimism, hope, religiousness, prayer coping, religious/spiritual coping, and demographics. The authors then measured divine love at 900 days postoperatively. Hierarchical linear regression indicated the direct effect of positive religious coping on experiences of divine love, controlling for other key variables. Postoperatively perceived spiritual support was entered at the final step as an explanatory factor, which appeared to mediate the coping effect. None of the other faith factors predicted divine love. Further research regarding divine love and spiritual support may eventually guide clinical attempts to support patients’ spiritual growth as an independently relevant outcome of cardiac surgery.

Spiritual struggle related to plasma interleukin-6 prior to cardiac surgery.

• Spiritual struggle appeared consistently to predict poor health outcomes, including mortality. Despite surging interest in the health benefits of religion and spirituality, the health hassle of existential conflicts and proinflammatory cytokines as a potential physiological mechanism has been overlooked. Based on psychological and theological assumptions, we argue for the universal nature of spiritual struggle, a crisis-related existential conflict, and for investigating its physiological influence as essential to understanding human nature. Increased levels of inflammatory cytokines such as interleukin-6 (IL-6) have been linked with adverse health outcomes and negative emotions. This study thus examined spiritual struggle related to plasma IL-6 in 235 adult patients undergoing cardiac surgery, along with positive religious coping, general coping, and optimism, controlling for standardized clinical medical indicators. Multiple regression analysis, following a preplanned sequence, showed that spiritual struggle (p = .011), behavioral coping (p = .013) were positively associated with excess plasma IL-6, controlling for medical correlates (e.g., left ventricular ejection fraction). We conclude that spiritual struggle, indicating the crisis in an existential relation, and behavioral coping strategies are associated with elevated pre-operative plasma IL-6. The interdisciplinary implications are discussed.

Private prayer and quality of life in cardiac patients: Pathways of cognitive coping and social support.

Notes:

• Despite the growing evidence linking faith with health and well-being, national leaders noted the need to explore the mechanism underlying these linkages. The goal of this prospective study was to investigate the psychosocial mechanisms involved in the preoperative use of private prayer for coping and the effects of such act on short-term quality of life (SPQOL) in 294 patients following open-heart surgery. Using established instruments, three interviews were conducted with middle-aged and older patients (average age 62) at two weeks and two days preoperatively, then 36 days postoperatively. The endpoints were assessed with levels of distress (e.g., depression and anxiety) and fatigue symptoms. Structural equation modeling was used to test a theoretical model. The final model showed the indirect influence of using prayer for coping on SPQOL through the mediation of cognitive coping and perceived social support. However, this mediation was not observed for behavioral, anger, and avoidant coping. Psychosocial factors may explain the potential role of using prayer for coping on short-term postoperative quality of life.

Pathways to postoperative hostility in cardiac patients: mediation of coping, spiritual struggle and interleukin-6

Notes:

• Using structural equation modeling, we estimated major pathways from preoperative distress, indicated by anxiety and other factors, to postoperative hostility in cardiac patients. Sequential interviews were conducted before and after surgery. Standardized medical and surgical indices were selected from a national database. Results showed that preoperative spiritual struggle mediated indirect effects of anxiety and anger coping on Interleukin-6 (IL-6) immediately before surgery. The link between spiritual struggle and IL-6 further mediated the indirect effects of anxiety and anger coping on postoperative hostility. Anger coping mediated the harmful influence of anxiety and counteracted the protection of positive religious coping on adjustment.

Prayer and reverence in naturalistic, aesthetic, and socio-moral contexts predicted fewer complications following coronary artery bypass.

Notes:

• This prospective study explores prayer, reverence, and other aspects of faith in postoperative complications and hospital length of stay of patients undergoing coronary artery bypass graft surgery.Alongside traditional religiousness measures, we examined sense of reverence in religious and secular contexts. Face-to-face interviews were conducted with 177 patients 2 weeks before surgery at a medical center. Medical variables were retrieved from the national Society of Thoracic Surgeons’ Database.Logistic and multiple regression models were performed to predict outcomes. Prayer frequencies were associated with reduced complications but not hospitalization. Sense of reverence in secular contexts predicted fewer complications and shorter hospitalization. Controlling for complications reduced the initial influence of reverence on hospitalization, suggesting the potential mediation of complications. No interaction between demographics and faith factors was evident. The role of faith in medicine is complex and context-dependent. Future studies are needed on mediating factors

Long-term Adjustment After Surviving Open Heart Surgery: The Effect of Using Prayer for Coping Replicated in a Prospective Design

Notes:

• A study examines multifaceted effects of religious factors on long-term postoperative adjustment, extending author’s previous findings concerning prayer and coping with cardiac disease.

“If God wanted me yesterday, I wouldn’t be here today”: religious and spiritual themes in patients’ experiences of advanced cancer

Notes:

• This study sought to inductively derive core themes of religion and/or spirituality (R/S) active in patients’ experiences of advanced cancer to inform the development of spiritual care interventions in the terminally ill cancer setting. The authors concluded that R/S plays a variety of important and inter-related roles for most advanced cancer patients. Future research is needed to determine how spiritual care can incorporate these five themes and address R/S concerns.