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"God brought all these churches together": issues in developing religion-health partnerships in an Appalachian community.

This study explored health-related and organizational religious activities in an Appalachian community and identified cultural issues in the development of religion-health partnerships. Partnerships between religious groups and health providers are a channel for health promotion efforts to vulnerable populations and must be approached from the culture of the community. An ethnographic, exploratory study of health-related and organizational activities in nonmainline religious groups yielded the use of prayer requests, anointing, testimonial, and denominational links as potential health resources. Organizational decisions were by congregational consensus and theological interpretation. The communal setting of worship as an informal resource to a community of believers, especially the vulnerable, was a viable model for religion-health partnerships in central Appalachia. Implications for nursing practice, education, and research also are addressed.

Appalachian Region↗

An encounter between psychology and religion: humanistic psychology and the Immaculate Heart of Mary nuns.

In the 1960s, humanistic psychology changed the relationship between psychology and religion by actively asserting the value of individual experience and self-expression. This was particularly evident in the encounter group movement. Beginning in 1967, Carl Rogers conducted a series of encounter groups, in order to promote "self-directed change in an educational system," for the Sisters of the Immaculate Heart of Mary, a religious order in California running an educational system. William Coulson, one of Rogers's associates in the project, later charged that the encounter groups undermined the religious order and played a major contributing part in the breakup of the order in 1970. The article examines these charges, situating the incident within the context of the changes occurring in religious life and in psychology in the 1960s. The article concludes that an already existing conflict the nuns had with the conservative Cardinal McIntyre of Los Angeles led to the departure of some 300 nuns from the order, who began the Immaculate Heart Community, an organization existing today. Nevertheless, encounter groups proved to be a psychological technology that helped to infuse a modern psychological--specifically, a humanistic psychological--perspective into contemporary religious life.

Female↗

Relationships of religion, health status, and socioeconomic status to the quality of life of individuals who are HIV positive.

The present study tested three hypotheses about the quality of life of individuals who are HIV positive. It was hypothesized that quality of life among HIV-positive individuals would be directly related to their (1) health status, (2) religious affiliation, and (3) religious faith. A correlational design was used with a nonrandom sample of 40 subjects (32 males and 8 females) who were HIV positive. Bivariate analyses were conducted to obtain intercorrelational among several independent variables, including two measures of religion (religious affiliation and a composite measure of religious faith), number of symptoms, level of physical functioning, and various demographic measures, including socioeconomic status. Stepwise regression confirmed all three hypotheses, revealing that four independent variables made significant, positive contributions to subjects' scores on the Quality of Life Index (QLI). These were socioeconomic status, religious affiliation (affiliation vs. no affiliation), religious faith, and a combined measure of health status based upon the participants' number of symptoms and Karnofsky Performance Status. The other independent variables (age, ethnicity, and gender) did not make significant contributions to the regression model, accounting for only 2.3% of the variance in the QLI.

Adaptation, Psychological↗

Do people turn to religion in times of stress?: an examination of change in religiousness among elderly, medically ill patients.

This study examined the effect of health-related stress on changes in religiousness in a sample of elderly, medically ill patients. Patients admitted to Duke University Medical Center (N = 745) were interviewed at baseline and 3-month follow-up. Increases in illness severity (from baseline to follow-up) were associated with decreases in both organizational and private religiousness at follow-up. Effect of illness severity on organizational religiousness was statistically mediated by changes in physical activity, while its effect on private religiousness remained significant after controlling for physical activity. These findings encourage further research investigating causal relationships between stress and religion, as well as identifying measures of religiousness that may capture this construct in the medically ill population.

Adaptation, Psychological↗

Two worlds apart: religion and ethics.

In a recent article entitled, Requests "for inappropriate" treatment based on religious beliefs, Orr and Genesen claim that futile treatment should be provided to patients who request it if their request is based on a religious belief. I claim that this implies that we should also accede to requests for harmful or cost-ineffective treatments based on religious beliefs. This special treatment of religious requests is an example of special pleading on the part of theists and morally objectionable discrimination against atheists. It also provides an excellent illustration of how different the practices of religion and ethics are.

Cultural Diversity↗

Medicine, ethics and religion: rational or irrational?

Savulescu maintains that our paper, which encourages clinicians to honour requests for "inappropriate treatment" is prejudicial to his atheistic beliefs, and therefore wrong. In this paper we clarify and expand on our ideas, and respond to his assertion that medicine, ethics and atheism are objective, rational and true, while religion is irrational and false.

Cultural Diversity↗

Nuclear death: an unprecedented challenge to psychiatry and religion.

The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed "pride" by theologians and "narcissism" by psychiatrists. For the first time, humans have power to exterminate themselves and death threatens all ages equally. Pride of power causes leaders to exaggerate their ability to control nuclear weapons; moral pride leads to demonizing enemies. The author considers implications for psychiatrists and clergy, with special reference to preventing a nuclear holocaust.

Attitude of Health Personnel↗

The meaning and function of ritual in psychiatric disorder, religion and everyday behaviour.

OBJECTIVE: Ritual is a central feature of obsessive-compulsive disorder (OCD) and is found in other psychiatric conditions. Defined in a general sense, it is seen in the everyday behaviour of animals and of humans, in secular ceremonies, and in religion. This paper examines the various types of ritual. It considers the common features and differences. METHOD: Material from psychiatric, biological, sociological, anthropological and religious studies literature is reviewed and discussed. RESULTS: The term 'ritual' describes a wide variety of phenomena. These include the rituals of OCD and range from relatively simple animal signals to profoundly meaningful human behaviour. A common feature is stereotyped physical activity which conveys information. Some clinical, developmental, evolutionary and religious/historical evidence suggests that stereotyped motor behaviour may be the primary phenomenon. CONCLUSIONS: The study of ritual in all its manifestations provides insight into the basis of important human behaviours. Obsessive-compulsive disorder is a likely paradigm for this study. Psychiatry, with its clinical orientation and biopsychosocial perspective, is a discipline within which the study might occur.

Adult↗

Adolescent pregnancy: effects of family support, education, and religion on the decision to carry or terminate among Puerto Rican teenagers.

Why do some pregnant teenagers decide to carry to term while others terminate their pregnancy? This study examined the influence of family relationships and support, religion, and education on the decision to carry or to abort. A nonrandom sample of 43 pregnant Puerto Rican teenagers (21 who carried and 22 who aborted) were interviewed in 1982 using a 34-item interview schedule. It was found that girls in the carry group were more significantly influenced and supported by family and friends than were those in the abort group. Fathers were the least influential persons in both carry and abort groups, while mothers were the most influential in the carry group, and sisters in the abort group. Brothers, boyfriends, and best friends were more influential for carry girls than for abort girls. Contrary to expectations, girls in the abort group reported a greater degree of religiosity than did those in the carry group. Further, girls who received strong support from family and friends reported a higher degree of satisfaction with their decision than did those who received less support. Finally, girls in the abort group were more likely to continue their education than were those in the carry group. Overall, the findings of this study have immediate implications for research and counseling services. Practitioners should focus on the girls in conjunction with their families in order to achieve better results in both treatment and preventive services.

Abortion, Induced↗

Religion, spirituality, and acute care hospitalization and long-term care use by older patients.

BACKGROUND: The impact of religion and spirituality on acute care hospitalization (ACH) and long-term care (LTC) in older patients before, during, and after ACH is not well known. METHODS: Patients 50 years or older consecutively admitted to the general medical service at Duke University Medical Center were interviewed shortly after admission (N = 811). Measures of religiosity were organized religious activity (ORA), nonorganizational religious activity (NORA), religiosity through religious radio and/or television (RTV), intrinsic religiosity, and self-rated religiousness. Measures of spirituality included self-rated spirituality and daily spiritual experiences (DSE). Primary outcome was number of ACH days during an average 21-month observation period. Secondary outcomes were times hospitalized and number of days spent in a nursing home or rehabilitation setting (collectively, long-term care: LTC). Race and sex interactions were examined. RESULTS: In the cross-sectional analysis, ORA was the only religious variable related to fewer ACH days and fewer hospitalizations, an effect that is fully explained by physical health status and that disappeared when examined prospectively. The number of LTC days was inversely related to NORA, RTV, and DSE, effects that were partially explained by social support but not by severity of medical illness. Interactions with race and sex were notable but reached statistical significance only among African Americans and women. In those groups, religious and/or spiritual characteristics also predicted future LTC use independent of physical health and baseline LTC status. CONCLUSIONS: Relationships with ACH were weak, were confined to ORA only, and disappeared in prospective analyses. However, robust and persistent effects were documented for religiousness and/or spirituality in the use of LTC among African Americans and women.

Black or African American↗

Religion and end of life treatment preferences among geriatric patients.

The purpose of this study was to determine if religious preference and religiosity influenced choosing end of life treatments in medically ill geriatric patients. The sample consisted of 374 males 60 years of age or older, hospitalized on the acute medical service at the Baltimore Veterans Affairs Medical Center. Choices for end of life treatment preferences were CPR, medical ventilation, tube feeding and IV fluids within six different illness scenarios. Patients indicated how often they attended religious services, how much strength and comfort they got from religion and how religious they would describe themselves. Analyses of variance were performed using as the dependent variables the summation scores across the six scenarios of a willingness to undergo each of the four life saving procedures. The religious preference, race and religiosity scores served as the independent variables. Only tube feeding showed a significant (p<0.05) relationship, with Catholics less willing to undergo this procedure than other Christians. The same trend was found for the other life saving procedures, but was not statistically significant.

Aged↗

Research on religion and serious mental illness.

According to this review, religion plays a largely positive role in mental health; future research on severe mental disorders should include religious factors more directly.

Adaptation, Psychological↗

The place of spirituality and religion in mental health services.

Mental health professionals have raised concerns about the role of spirituality and religion in services for people with severe mental disorders, but this chapter offers compelling reasons for increased attention to spiritual issues in service delivery.

Attitude of Health Personnel↗

The effect of religion on suicide ideation.

Work on the impact of religion on suicide has not yielded consistent results. Classic Durkheimian models stressing religious affiliation (Catholic vs Protestant) have been questioned in recent years and some authors have argued for a model based on the alternative conception of religious commitment (e.g. religiosity per se) as a prophylactic against suicide. Almost all of this work has been based on highly aggregated data where it is not known if nonreligious people account for the suicides. The present study tests both models with national data on 1,687 respondents. No support is found for the Durkheimian model at the individual level, but some is found for the religious commitment model: the greater the church attendance the lower the approval of suicide. The effect of religiosity on suicide ideation is independent of education, gender, marital status, and age.

Humans↗

Religion, medical ethics, and transplants.

This article describes the exclusion of public expressions of religion from the history of bioethics during recent decades. It offers a proposal to include the public church for the purpose of gaining donations of vital organs for transplantation. I also include a brief discussion of theological support and practical suggestions for such a program.

Black or African American↗