Alessandra Lamas Granero Lucchetti

Validation of the Duke Religion Index: DUREL (Portuguese version).

The purpose of the current study was to examine the psychometric properties of the Portuguese version of the Duke Religion Index (PDUREL) in a community setting. PDUREL was translated and adapted for administration to 383 individuals from a population-based study of low-income community-dwelling adults. The PDUREL intrinsic subscale and total scores demonstrated high internal consistency (alphas ranging from 0.733 for the total scale score to 0.758 for the intrinsic subscale). Correlations among the DUREL subscales were also examined for evidence of discriminant validity. Correlations were ranging from 0.36 to 0.46, indicating significant overlap between the scales without marked redundancy. PDUREL is a reliable and valid scale. The availability of a comprehensive, but brief measure of religiousness can help to study the role of religiousness in health by researchers from countries that speak the Portuguese language.

Religiousness affects mental health, pain and quality of life in older people in an outpatient rehabilitation setting.

OBJECTIVES To evaluate the relationship between religiousness and mental health, hospitalization, pain, disability and quality of life in older adults from an outpatient rehabilitation setting in Sao Paulo, Brazil. DESIGN Cross-sectional study. SUBJECTS/PATIENTS A total of 110 patients aged 60 years or older were interviewed during attendance at an outpatient rehabilitation service. METHODS Researchers administered a standardized questionnaire that assessed socio-demographic data, religiousness, self-reported quality of life, anxiety, physical activity limitation, depression, pain and cognition. Predictors were included in each model analysis, and a backward conditional method was used for variable selection using logistic regression (categorical outcomes) or linear regression (continuous outcomes). RESULTS Thirty-one patients (28.2%) fulfilled criteria for significant depressive symptoms, 27 (24.5%) for anxiety, and 10 (9.6%) for cognitive impairment. Pain was present in 89 (80.7%) patients. Limited depressive symptoms (as assessed by the Geriatric Depression Scale), and greater self-reported quality of life were related to greater self-reported religiousness, as were scores on the Mini-Mental State Examination (less cognitive impairment), and lower ratings of pain. CONCLUSION Religiousness is related to significantly less depressive symptoms, better quality of life, less cognitive impairment, and less perceived pain. Clinicians should consider taking a spiritual history and ensuring that spiritual needs are addressed among older patients in rehabilitation settings.

Impact of Spirituality/Religiosity on Mortality: Comparison With Other Health Interventions

Scientists have been interested in the influence of religion on mortality for at least 130 years. Since this time, many debates have been held by researchers who believe or do not believe in this association. The objective of this study is to compare the impact of spirituality and religiosity (S/R) with other health interventions on mortality. The authors selected 25 well-known health interventions. Then, a search of online medical databases was performed. Meta-analyses between 1994 and 2009 involving mortality were chosen. The same was done for religiosity and spirituality. The combined hazard ratio was obtained directly by the systematic reviews and the mortality reductions by S/R and other health interventions were compared. Twenty-eight meta-analyses with mortality outcomes were selected (25 health interventions and three dealing with S/R). From these three meta-analyses, considering those with the most conservative results, persons with higher S/R had an 18% reduction in mortality. This result is stronger than 60.0% of the 25 systematic reviews analyzed (similar to consumption of fruits and vegetables for cardiovascular events and stronger than statin therapy). These results suggest that S/R plays a considerable role in mortality rate reductions, comparable to fruit and vegetable consumption and statin therapy.

Spirituality, Religion, and Health: Over the Last 15 Years of Field Research (1999–2013)

Objective: Although several studies have examined the contribution of specific countries, journals, and authors in different scientific disciplines, little is known about the contribution of different world countries, journals, and authors to scientific research in the field of “Spirituality, religion, and health” (S/R). The present study aims to analyze the last 15 years of research in the field of spirituality and religiousness (S/R) through a bibliometric analysis. Methods: Using the Pubmed database, we retrieved all articles related to S/R field for the period 1999–2013. We then estimated the total number of publications, number of articles published per year, articles published per country, journals with most publications in S/R field, most productive authors, and most used keywords. Results: We found a growth of publications in the last years, most from the United States and the United Kingdom and published in the English language. Noteworthy, some developing countries such as India, Brazil, Israel, and Iran are at higher positions in this list. The S/R articles were published in journals embracing all fields of research, including high impact journals. Conclusion: In the present study, we took a closer look at the field of “Spirituality, religion, and health,” showing that this field of research has been constantly growing and consolidating in the scientific community.

Spirituality in Medical Education: Global Reality?

We aim to evaluate studies dealing with the incorporation of spirituality in medical education and to list the most scientific productive countries in this field. A bibliographical review was carried out. The final sample comprised 38 articles, which were divided into sub-topics for a clearer description. From these articles, 31 (81.5%) were provided by US medical schools, 3 (7.8%) by Canadian medical schools and 4 (10.5%) from other countries. The studies in this review indicate a predominance of studies related to health/medicine and spirituality in US and Canadian medical schools. New studies outside North America are needed in order to address what is being taught, whether courses are evaluated and what is the student and faculty opinions regarding this educational topic in multiple cultures.

Spirituality and health in the curricula of medical schools in Brazil

BackgroundAccording to recent surveys, 59% of British medical schools and 90% of US medical schools have courses or content on spirituality and health (S/H). There is little research, however, on the teaching of S/H in medical schools in other countries, such as those in Latin America, Asia, Australia and Africa. The present study seeks to investigate the current status of teaching on S/H in Brazilian medical schools.MethodsAll medical schools in Brazil (private and public) were selected for evaluation, were contacted by email and phone, and were administered a questionnaire. The questionnaire, sent by e-mail, asked medical school directors/deans about any S/H courses that were taught, details about those courses, S/H lectures or seminars, importance of teaching this subject for medical school directors, and medical schools characteristics.ResultsA total of 86 out of 180 (47.7%) medical schools responded. Results indicated that 10.4% of Brazilian Medical Schools have a dedicated S/H courses and 40.5% have courses or content on spirituality and health. Only two medical schools have S/H courses that involve hands-on training and three schools have S/H courses that teach how to conduct a spiritual history. The majority of medical directors (54%) believe that S/H is important to teach in their schools.ConclusionFew Brazilian medical schools have courses dealing specifically with S/H and less than half provide some form of teaching on the subject. Unfortunately, there is no standard curriculum on S/H. Nevertheless, the majority of medical directors believe this issue is an important subject that should be taught.

Taking Spiritual History in Clinical Practice: A Systematic Review of Instruments

BACKGROUND To facilitate the addressing of spirituality in clinical practice, several authors have created instruments for obtaining a spiritual history. However, in only a few studies have authors compared these instruments. The aim of this study was to compare the most commonly used instruments for taking a spiritual history in a clinical setting. METHODS A systematic review of spiritual history assessment was conducted in five stages: identification of instruments used in the literature (databases searching); relevant articles from title and initial abstract review; exclusion and Inclusion criteria; full text retrieval and final analysis of each instrument. RESULTS A total of 2,641 articles were retrieved and after the analysis, 25 instruments were included. The authors independently evaluated each instrument on 16 different aspects. The instruments with the greatest scores in the final analysis were FICA, SPIRITual History, FAITH, HOPE, and the Royal College of Psychiatrists. Concerning all 25 instruments, 20 of 25 inquire about the influence of spirituality on a persons life and 17 address religious coping. Nevertheless, only four inquire about medical practices not allowed, six deal with terminal events, nine have mnemonics to facilitate their use, and five were validated. CONCLUSIONS FICA, SPIRITual History, FAITH, HOPE, and Royal College of Psychiatrists scored higher in our analysis. The use of each instrument must be individualized, according to the professional reality, time available, patient profile, and settings.

Religiousness, mental health, and quality of life in Brazilian dialysis patients

Patients with chronic kidney disease often use religion as a coping strategy to relieve suffering and serve as a source of strength. The aim of this study was to identify religious aspects associated with mental health and quality of life in Brazilian dialysis patients. A cross‐sectional study was performed involving two dialysis centers in Brazil. Patients were selected consecutively over three typical dialysis treatment days. The questionnaire was self‐administered and covered the following aspects: socio‐demographic aspects, religiousness (using the Portuguese version of the Private and Social Religious Practice Scale), quality of life (World Health Organization Quality of Life brief Scale Brief Version), depression and anxiety (Beck Inventory), and pain grade. For statistical analysis, the hypothesis that different religious variables are associated (positively or negatively) with depressive/anxiety symptoms and quality of life in these patients was tested using linear regression, controlling for confounding variables. A total of 205 patients were invited to participate and 133 (64.8%) agreed to fill out the questionnaire. On the adjusted model, reading religious literature was found to be inversely associated with depressive symptoms (P < 0.001). In addition, the psychological domain of quality of life was positively associated with an increase in patient religiosity (P = 0.030) and greater religious importance for recovery from their dialysis condition (P = 0.016), whereas the environmental domain was positively associated with greater religious importance for recovery (P = 0.032). No religious aspects were associated with anxiety symptoms. Religiousness is associated with less depressive symptoms and better quality of life in Brazilian dialysis patients. Nephrologists should evaluate the patients spirituality and religion in order to provide more integrative care.

Measuring spirituality and religiosity in clinical research: a systematic review of instruments available in the Portuguese language.

CONTEXT AND OBJECTIVES Despite numerous spirituality and/or religiosity (S/R) measurement tools for use in research worldwide, there is little information on S/R instruments in the Portuguese language. The aim of the present study was to map out the S/R scales available for research in the Portuguese language. DESIGN AND SETTING Systematic review of studies found in databases. METHODS A systematic review was conducted in three phases. Phases 1 and 2: articles in Portuguese, Spanish and English, published up to November 2011, dealing with the Portuguese translation and/or validation of S/R measurement tools for clinical research, were selected from six databases. Phase 3: the instruments were grouped according to authorship, cross-cultural adaptation, internal consistency, concurrent and discriminative validity and test-retest procedures. RESULTS Twenty instruments were found. Forty-five percent of these evaluated religiosity, 40% spirituality, 10% religious/spiritual coping and 5% S/R. Among these, 90% had been produced in (n = 3) or translated to (n = 15) Brazilian Portuguese and two (10%) solely to European Portuguese. Nevertheless, the majority of the instruments had not undergone in-depth psychometric analysis. Only 40% of the instruments presented concurrent validity, 45% discriminative validity and 15% a test-retest procedure. The characteristics of each instrument were analyzed separately, yielding advantages, disadvantages and psychometric properties. CONCLUSION Currently, 20 instruments for measuring S/R are available in the Portuguese language. Most have been translated (n = 15) or developed (n = 3) in Brazil and present good internal consistency. Nevertheless, few instruments have been assessed regarding all their psychometric qualities.

O idoso e sua espiritualidade: impacto sobre diferentes aspectos do envelhecimento

INTRODUCAO: O interesse sobre a espiritualidade e a religiosidade sempre existiu no curso da historia humana, a despeito de diferentes epocas ou culturas. Contudo, apenas recentemente a ciencia tem demonstrado interesse em investigar o tema. Estudos e pesquisas demonstram que a faixa etaria acima dos 65 anos e aquela com mais contato frente a sua espiritualidade e religiosidade. O objetivo do presente estudo e realizar uma revisao da literatura cientifica que norteia essa tematica e investigar qual o impacto da espiritualidade em diferentes aspectos do envelhecimento. METODOLOGIA: Pesquisa nas bases de dados Pubmed/Medline, LILACS e Scielo, nos idiomas ingles e portugues, entre 1966 e 2009, utilizando as palavras-chave aged/idoso e spirituality/espiritualidade. RESULTADOS: Foram incluidos 48 artigos divididos nas seguintes tematicas: envelhecimento bem-sucedido, bem-estar, qualidade de vida, doencas cronico-degenerativas, doencas neuro-psiquiatricas, funcionalidade, mortalidade e impacto no fim da vida. CONCLUSAO: Conclui-se que o envelhecimento possui uma relacao intima com a espiritualidade nos seus mais diferentes aspectos e percebe-se que ha uma escassez de pesquisas sobre espiritualidade/religiosidade em idosos.