2 Minute Medicine is pleased to announce that we are launching Wellness Check, a new series dedicated to exploring new research evidence focused on wellness. Each week, we will report on articles examining different aspects of wellness, including (but not limited to) nutrition, sleep, reproductive health, substance use and mental health. This week, we explore the latest evidence-based updates in spirituality.
Religious attendance may be correlated with cancer screening utilization
1. This study found there was a positive association between religious attendance and cancer screening utilization with no study revealing a negative relationship.
2. There was inconclusive evidence with respect to religious denomination as well as religiosity and cancer screening utilization.
Evidence Rating Level: 2 (Good)
Cancer remains one of the most important health problems in the world; however, there is currently an underuse of cancer screenings in various countries. Through the Andersen model of health care utilization, many factors have been identified in playing a role. However, there is uncertainty on the influence of religion on cancer screening. Therefore, the aim of the present systematic review was to explore the relationship between religion and cancer screening utilization and to determine if there is also a relationship with respect to religious denomination and religiosity.
Of 981 screened records, 27 were included from database inception to June 2020. Studies were included if they were observational studies that reported the association between any kind of religious dimensions, based on Glock’s classification and cancer screening. Studies were excluded if they were non-observational and if they exclusively examined a specific sample (e.g. sects or ethnic minorities). The quality assessment was done using a checklist introduced by Stuhldreher et al. and further improved by Hols et al., as referenced in the manuscript.
Results of the analysis demonstrated that there was a positive association between religious attendance and cancer screening utilization with no study revealing a negative relationship. Furthermore, there was inconclusive evidence with respect to religious denomination as well as religiosity and cancer screening utilization. However, this study was limited by the heterogeneity between studies. Nonetheless, at the time of publication, this was the first systematic review that summarized the evidence pertaining to the influence of religion on the use of cancer screening.
Spirituality-oriented psychological counseling may reduce fear of death among hemodialysis patients
1. In patients receiving the intervention of spirituality-oriented psychological counseling, the fear of death was significantly less compared to the control group.
2. Patients in the control group had no significant difference on their fear of death following the intervention.
Evidence Rating Level: 2 (Good)
Studies have shown that the majority of patients treated with hemodialysis suffer from psychiatric disorders which may have an effect on their spiritual needs. Many of these patients may be preoccupied with the fear of death (FOD) which drastically reduces their quality of life. Little is known with respect to how spirituality-oriented psychological counseling (SOPC) can influence FOD in these patients. As a result, the present single blind randomized controlled trial (RCT) sought to examine the effects of SOPC on FOD among hemodialysis patients in Iran.
The present single blind RCT included 66 patients who were randomly assigned to an intervention group (n=33) or to a control group (n=33) from May 2019 to January 2020. Patients were included if they had been diagnosed with end stage renal disease. Patients were excluded if they used antipsychotic medications. Both groups received routine spiritual care; however, the intervention group received additional psychological counseling (SOPC). FOD was measured using the Collett-Lester Fear of Death Scale (CL-FODS). There was no significant difference between both groups on FOD before the intervention.
The results showed that in patients receiving the intervention of SOPC , the fear of death was significantly less compared to the control group. Furthermore, patients in the control group had no significant difference on their fear of death following the intervention. However, the study was limited by its inclusion of only Shia Muslims which limited the generalizability of the results. Nonetheless, these results present early evidence suggesting that SOPC may help reduce FOD in patients undergoing hemodialysis.
Higher religious adherence may be associated with lower mortality
1. This study found that counties with lower mortality were associated with higher proportions of religion adherents and a greater diversity of adherents and congregations.
2. When controlling for demographic and health factors, religion had less added value; however, the direction of association between religion and mortality remained consistent.
Evidence Rating Level: 3 (Good)
There is considerable evidence that demonstrate the benefit of religion on health on an individual-level. However, the evidence is lacking on a population level and its role as a determinant of population health. As a result, the present study sought to determine the direction and strength of association between religion and mortality when controlling for county demographics in the United States and health factors.
Using data from the 2010 United States Religion Census and from the PHI County Health Rankings & Roadmaps, 3141 counties within the United States were included. From these databases, data pertaining to religion, mortality, demographic, and health factors were included. Religion was measured in terms of adherence, congregation density, and the diversity of adherents and congregation by denominations. Mortality was estimated for each county as the average numerator divided by the average denominator per 100,000 populations. The meta-regression analyses were analyzed as random effects models using the Knapp-Hartung variance estimator.
Results demonstrated that counties with lower mortality were associated with higher proportions of religion adherents and a greater diversity of adherents and congregations. Furthermore, when controlling for demographic and health factors, religion had less added value; however, the direction of association between religion and mortality remained consistent. This study was limited by the fact that mortality is a single measure of population health; therefore, it is difficult for the results of this study to be generalized to other population health measures. Nonetheless, the results of this study suggest that religion merits further consideration as an important population health determinant.
Sensorimotor religious and spiritual traditions may improve mental health outcomes
1. This study demonstrated that both breathwork and chanting reduced levels of anxiety, depression, stress, and symptoms of post-traumatic stress disorder.
2. There were no trials identified which investigated the impact of singing or movements on mental health outcomes.
Evidence Rating Level: 1 (Excellent)
Before the advent of mental health interventions, religious and spiritual (R/S) traditions played an important role in addressing mental health concerns. Among such traditions, there is a paucity of evidence evaluating the role of R/S sensorimotor practices on mental health outcomes. As a result, the present systematic review of randomized controlled trials (RCT) sought to investigate four R/S sensorimotor practices on anxiety, depression, stress, and symptoms of post-traumatic stress disorder (PTSD).
Of 643 screened records, 15 (n=982 participants) were included in the final analysis. Studies were included if they investigated the effects of at least one of four sensorimotor practices (breathwork/chanting/singing/movements) on four mental health outcomes (anxiety, depression, stress, and PTSD symptoms). Studies that measured mental health symptoms using physiological biomarkers were excluded. The quality of the studies was assessed through the PEDro as well as the Cochrane risk of bias tool.
Results demonstrated that both breathwork and chanting reduced levels of anxiety, depression, stress, and symptoms of PTSD. Furthermore, there were no trials identified which investigated the impact of singing or movements on mental health outcomes. However, the study was limited by the exclusion of studies that were non-English and grey literature, therefore some relevant literature may have been overlooked. Nonetheless, the present findings suggest that both breathwork and chanting can potentially be considered as an adjunct to current interventions to improve mental health outcomes.
Image: PD
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