Abstract
Experiencing a chronic illness can arouse feelings of helplessness and fear in the face of the progression and incurability of the disease. In seeking to find meaning or support in this experience, many people tend to develop or refine their spirituality. However, we still need to better understand how diseases and their chronicity impact the religious and spiritual beliefs and attitudes of people who are diagnosed with a condition that requires protracted treatment. This article proposes to explore this idea from a review of the literature and an analysis of the reports of 26 healthcare professionals (doctors, nurses, psychologists, and social workers) working in a hospital in Rio de Janeiro, Brazil. Also, the objective is to recommend some guidelines to help professionals deal with the topic. According to reports obtained in semi-structured interviews, religiosity and/or spirituality can have a positive effect on the patient’s life. They can be sources of comfort and hope, showing potential to alleviate suffering from illness, increasing adherence to their treatments, improving the relationship with the health team, and making the patient more resilient to the adversities arising from this situation. Depending on the way patients articulate their religiosity, they may also have negative effects, such as treatment dropout—in the expectation of a divine cure—or practices contrary to hospital asepsis. Understanding these issues helps to establish professional guidelines aimed at making religiosity or spirituality a positive element in the therapeutic process of patients with different forms of chronic illnesses.
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References
Aletti M (2012) A psicologia diante da religião e da espiritualidade: Questões de conteúdo e de método. In: Freitas MH, Paiva JG (eds) Religiosidade e cultura contemporânea. Universa, Brasília, pp 157–190
Amatuzzi MM (2012) Pesquisa fenomenológica em psicologia. In: Bruns MAT, Holanda AF (eds) Psicologia e fenomenologia: reflexões e perspectivas, 2rd edn. Átomo & Alínea, São Paulo, pp 17–25
Benites AC, Neme CMB, Santos MA (2017) Significance of spirituality for patients with cancer receiving palliative care. Estud Psicol 34(2):269–279. https://doi.org/10.1590/1982-02752017000200008
Bentzen JS (2021) In crisis, we pray: religiosity and the COVID-19 pandemic. J Econ Behav Organ 192:541–583. https://doi.org/10.1016/j.jebo.2021.10.014
Bernell S, Howard SW (2016) Use your words carefully: what is a chronic disease? Front Public Health 4:159. https://doi.org/10.3389/fpubh.2016.00159
Best M, Phyllis B, Ian O (2015) Doctors discussing religion and spirituality: a systematic literature review. Palliat Med 30:327–337. https://doi.org/10.1177/0269216315600912
Brasil (2004) HumanizaSUS: Política Nacional de Humanização. A Humanização como Eixo Norteador das Práticas de Atenção e Gestão em Todas as Instâncias do SUS. Brasília: Ministério da Saúde. http://bvsms.saude.gov.br/bvs/publicacoes/humanizasus_2004.pdf. Accessed 22 May 2019
Cai D-Y (2016) A concept analysis of cultural competence. Int J Nurs Sci 3(3):268–273. https://doi.org/10.1016/j.ijnss.2016.08.002
Conversano C (2019) Common psychological factors in chronic diseases. Front Psychol 10:2727. https://doi.org/10.3389/fpsyg.2019.02727
Counted V, Possamai A, Meade T (2018) Relational spirituality and quality of life 2007 to 2017: an integrative research review. Health Qual Life Outcomes 16(75):1–18. https://doi.org/10.1186/s12955-018-0895-x
Curtis E, Jones R, Tipene-Leach D, Walker C, Loring B, Paine S-J, Reid P (2019) Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health 18:1–17. https://doi.org/10.1186/s12939-019-1082-3
Dal-Farra R, Cesar G (2010) Health education and spirituality: methodological propositions. Rev Bras Educ Med 34(4):587–597. https://doi.org/10.1590/S0100-55022010000400015
Danso R (2018) Cultural competence and cultural humility: a critical reflection on key cultural diversity concepts. J Soc Work 18(4):410–430. https://doi.org/10.1177/1468017316654341
Dekkers WJM (2001) Autonomy and dependence: chronic physical illness and decision-making capacity. Med Health Care Philos 4(2):185–192. https://doi.org/10.1023/a:1011497901122
Dillard V, Moss J, Padgett N, Tan X, Kennedy AB (2021) Attitudes, beliefs and behaviors of religiosity, spirituality, and cultural competence in the medical profession: A cross-sectional survey study. PLoS ONE 16(6):e0252750. https://doi.org/10.1371/journal.pone.0252750
Esperandio MR, Zaperlon M, Zorzi P, Silva TD, Marques LF (2015) Religiousness/spirituality (R/E) in health professionals. Interações 10(18):195–209. https://www.redalyc.org/articulo.oa?id=313043585013
Esperandio MRG, Caldeira S (eds) (2022) Espiritualidade e saúde: Fundamentos e práticas em perspectiva luso-brasileira. PUCPRESS, Curitiba (in press)
Evangelista C, Lopes M, Costa S, Batista P, Batista J, Oliveira A (2016) Palliative care and spirituality: an integrative literature review. Rev Bras Enferm 69(3):554–563. https://doi.org/10.1590/0034-7167.2016690324i
Foch GLF, Melina A, Enumo S (2017) Spiritual/Religious Coping: a systematic literature review (2003–2013). Arq Bras Psicol [online] 69(2):53–71. http://pepsic.bvsalud.org/pdf/arbp/v69n2/05.pdf
Freitas MH (2014) Religiousness and health: patient’s experiences and professional’s perceptions. Rev Pistis Prax Teol Pastor 6(1):89–105. https://doi.org/10.7213/revistapistispraxis.06.001.DS05
Freitas MH (2017) Religious psychology, psychology of religion/ spirituality, or psychology and religion/spirituality? Rev Pistis Prax Teol Pastor 9(1):89–107. https://doi.org/10.7213/2175-1838.09.001.DS04
Freitas MH (2020) Religiosity, spirituality and wellbeing in the perception of Brazilian health and mental health professionals. In: Schmidt B, Leonardi J (eds) Spirituality and Wellbeing. Routledge, Oxfordshire, pp 199–224
Freitas MH, Turra V, Zaneti N (2016) Religiosidade, saberes tradicionais e saúde no Brasil. In: Valiengo LE (ed) Na fronteira da Psicologia com os saberes tradicionais: práticas e técnicas, 1rd edn. Conselho Regional de Psicologia de São Paulo, São Paulo, pp 73–77 https://www.crpsp.org/uploads/impresso/107/ima5IVLKnMSn0R6iGfd-Y3HQrYs06ddZ.pdf. Accessed 12 May 2021
Freitas MH, Vilela P (2017) Phenomenological approach of religiosity: implications for psychodiagnostic and psychological clinic praxis. Rev Abordagem Gestalt. [online] 23(1):95–107. http://pepsic.bvsalud.org/pdf/rag/v23n1/v23n1a11.pdf. Accessed 8 May 2019
Fuller J (2018) What are chronic diseases? Synthese 195(7):3197–3220. https://doi.org/10.1007/s11229-017-1368-1
Gallup (2020) The Gallup Report: Religion America. http://www.gallup.com/poll/1690/religion.aspx. Accessed 27 May 2019
Gijsberts MJHE, Liefbroer A, Otten R, Olsman E (2019) Spiritual care in palliative care: a systematic review of the recent european literature. Med Sci 7(2):25. https://doi.org/10.3390/medsci7020022
Giorgi A (2015) The descriptive phenomenological method in psychology: a modified husserlian approach. Duqueste University Press, Pittsburgh
Gobatto C, Araujo TC (2013) Religiosity and spirituality in oncology: health professionals’ conceptions. Psic USP 24(1):11–34. https://doi.org/10.1590/S0103-65642013000100002
Gomes MV, Xavier ASG, Carvalho ES, Cordeiro RC, Ferreira SL, Morbeck AD (2019) “Waiting for a miracle”: spirituality/religiosity in coping with sickle cell disease. Rev Bras Enferm. [online] 72(6):1554–1561. https://doi.org/10.1590/0034-7167-2018-0635
Guay M, Donoso M, Saca J, Rios M, Pastrana T (2019) Spirituality and religiosity and burnout in Latin-American palliative care health care professionals (LAPC) (S818). J Pain Symptom Manag 57(2):490–491. https://doi.org/10.1016/j.jpainsymman.2018.12.271
Hatala AR, Roger K (eds) (2022) Spiritual, religious, and faith-based practices in chronicity: an exploration of mental wellness in global context. Routledge, Oxon/New York
Horenstein A, Potter C, Heimberg R (2018) How does anxiety sensitivity increase risk of chronic medical conditions? Clin Psychol (new York) 25(3):1–22. https://doi.org/10.1111/cpsp.12248
Instituto Brasileiro de Geografia e Estatística, IBGE (2010) Censo Demográfico 2010. Características gerais da população, religião e pessoas com deficiência. Ministério do Planejamento, Orçamento e Gestão, Rio de Janeiro. https://biblioteca.ibge.gov.br/visualizacao/periodicos/94/cd_2010_religiao_deficiencia.pdfAccessed 29 May 2019
Koenig HG (2012) Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry 16(2012):278730. https://doi.org/10.5402/2012/278730
Koenig HG (2015) Religion, spirituality, and health: a review and update. Adv MindBody Med 29(3):19–26. https://www.ncbi.nlm.nih.gov/pubmed/26026153
Lomas T (2019) The dynamics of spirituality: a cross-cultural lexical analysis. Psychol Relig Spiritual 11(2):131–140. https://doi.org/10.1037/rel0000163
Lucchetti G, Granero A, Bassi R, Latorraca R, Nacif S (2010) Spirituality in clinical practice: what should the general practitioner know? Rev Bras Clin Med 8(2):154–158. http://www.files.bvs.br/upload/S/1679-1010/2010/v8n2/a012.pdf. Accessed 20 May 2019
Manso MEG, Góes L (2019) Spirituality and chronic diseases: therapeutic itineraries of people who use health insurance in SP and RJ. Rev Interespe 12:23–39. https://doi.org/10.23925/2179-7498.2019n12p23-39
Marques SMS, Goto TA (2021) O manejo de profissionais da saúde com questões espirituais. Rev. NUFEN 13(1):56–69. http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S2175-25912021000100005&lng=pt&tlng=pt. Accessed 18 May 2021
Mishra SK, Togneri E, Tripathi B, Trikamji, (2017) Spirituality and religiosity and its role in health and diseases. J Relig Health 56:1282–1301. https://doi.org/10.1007/s10943-015-0100-z
Murakami R, Campos C (2012) Religion and mental health: the challenge of integrating religiosity to patient care. Rev Bras Enferm 65(2):361–367. https://doi.org/10.1590/s0034-71672012000200024
National Comprehensive Cancer Network, NCCN (2012) Finding comfort in spirituality. National comprehensive cancer network website. http://www.nccn.com/living-with-cancer/188-cancer-and-spirituality.html. Accessed 20 Mar 2020
Negro-Dellacqua M, Sá-Junior AR, Sousa IF, Lima KM (2019) Panorama on spirituality and health: what scientific literature has pointed out about the topic in the last 5 years?. Res Soc Dev8(7):e10871103. https://doi.org/10.33448/rsd-v8i7.1103
Oman D, Syme L (2018) Weighing the evidence: what is revealed by 100+ meta-analyses and systematic reviews of religion/spirituality and health? In: Oman D (ed) Why religion and spirituality matter for public health: evidence, implications, and resources. Springer, Switzerland, pp 261–281
Pan American Health Organization, PAHO (2019) Health indicators: conceptual and operational considerations. PAHO website. https://www.paho.org/hq/index.php?option=com_content&view=article&id=14401:health-indicators-conceptual-and-operational-considerations-section-1&Itemid=0&limitstart=4&lang=en. Accessed 9 Sep 2019
Pargament KL (1997) The psychology of religion and coping: theory, research and practice. Guilford Press, New York
Ransome Y (2020) Religion, spirituality, and health: new considerations for epidemiology. Am J Epidemiol 189(8):755–758. https://doi.org/10.1093/aje/kwaa022
Richardson P (2014) Spirituality, religion and palliative care. Ann Palliat Med 3(3):150–159. https://doi.org/10.3978/j.issn.2224-5820.2014.07.05
Roger KS, Hatala A (2017) Religion, spirituality & chronic illness: a scoping review and implications for health care practitioners. J Relig Spiritual Soc Work 37(1):24–44. https://doi.org/10.1080/15426432.2017.1386151
Schilbrack K (2022) The concept of religion. In: Zalta EN (ed.) The Stanford Encyclopedia of Philosophy (Summer 2022 Edition). https://plato.stanford.edu/archives/sum2022/entries/concept-religion/ Accessed 2 Aug 2022
Schmidt BE, Leonardi J (eds) (2020) Spirituality and wellbeing: interdisciplinary approach to the study of religious experience and health. Equinox, Sheffield/Bristol
Sena MAB, Damiano RF, Lucchetti G, Peres MFP (2021) Defining spirituality in healthcare: a systematic review and conceptual framework. Front Psychol 12:756080. https://doi.org/10.3389/fpsyg.2021.756080
Sinclair S, Mysak M, Hagen N (2009) What are the core elements of oncology spiritual care programs? Palliat Support Care 7(4):415–422. https://doi.org/10.1017/S1478951509990423
Stanton AL, Revenson T, Tennen H (2007) Health Psychology: psychological adjustment to chronic disease. Annu Rev Psychol 58(1):565–592. https://doi.org/10.1146/annurev.psych.58.110405.085615
Straub RO (2012) Health psychology: a biopsychosocial approach. Worth Publishers, New York
Stroppa A, Moreira-Almeida A (2008) Religiosidade e saúde. In: Salgado MI, Freire G (eds) Saúde e espiritualidade: uma nova visão da medicina. Inede, Belo Horizonte, pp 427–443
Swihart DL, Yarrarapu SNS, Martin RL (2021) Cultural religious competence in clinical Practice. In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493216/. Accessed 22 Jan 2022
Vargas-Escobar LM (2017) Intervención educativa para enfermería: cuidado espiritual durante la enfermedad crónica. Aquichan 17(1):30–41. https://doi.org/10.5294/aqui.2017.17.1.4
Voltmer E, Büssing A, Koenig H, Zaben FA (2014) Religiosity/Spirituality of german doctors in private practice and likelihood of addressing R/S issues with patients. J Relig Health 53(6):1741–1752. https://doi.org/10.1007/s10943-013-9776-0
Williams S (2000) Chronic illness as biographical disruption or biographical disruption as a chronic illness. Sociol Health Illn 22:40–67. https://doi.org/10.1111/1467-9566.00191
Woodhead L (2011) Five concepts of religion. Int Rev Sociol 21(1):121–143. https://doi.org/10.1080/03906701.2011.544192
World Health Organization, WHO (1999) Amendments to the constitution. https://apps.who.int/gb/archive/pdf_files/WHA52/ew24.pdf. Accessed 21 Mar 2020
World Health Organization, WHO (2012) Who definition of palliative care. http://www.who.int/cancer/palliative/definition/en/. Accessed 16 Jun 2021
Acknowledgements
The authors are grateful to the National Council for Scientific and Technological Development (CNPq) for funding the project originally titled “Religiosity and spirituality in the hospital context: perceptions and experiences of multidisciplinary health teams” (“Religiosidade e espiritualidade no contexto hospitalar: percepções e experiências de equipes multiprofissionais em saúde – RESCH”), Call MCTE/CNPq/MEC/CAPES No 43/2013), coordinated by Prof. Dr. Marta Helena de Freitas in national context and vice-coordinated by Prof. Dr. Lilian Maria Borges and Dr. Lúcia Malagris Novaes in regional context (Rio de Janeiro).
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Lilian Maria Borges, Lucia Emmanoel Novaes Malagris, and Marta Helena de Freitas. The first draft of the manuscript was written by Lilian Maria Borges, and all authors commented and added information and specific contribution on previous versions of the manuscript. All authors read and approved the final manuscript.
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The research data collection involved human beings, and, therefore, the project was duly approved by the research ethics committees of the institutions to which the authors were affiliated: Catholic University of Brasília, CAAE 319491 14.0.000.0029 and Federal University of Rio de Janeiro, CAAE 37760614.9.0000.5582. All participants signed an informed consent form.
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Borges, L.M., Malagris, L.E.N. & de Freitas, M.H. Chronic Illness, Religiosity, and Spirituality in Brazil: Health Professionals’ Perceptions and Guidelines. Int J Lat Am Relig 6, 148–170 (2022). https://doi.org/10.1007/s41603-022-00177-3
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DOI: https://doi.org/10.1007/s41603-022-00177-3