Awe and transcendence

ثُمَّ قَسَتۡ قُلُوبُكُم مِّنۢ بَعۡدِ ذَٰلِكَ فَهِيَ كَٱلۡحِجَارَةِ أَوۡ أَشَدُّ قَسۡوَةࣰۚ وَإِنَّ مِنَ ٱلۡحِجَارَةِ لَمَا يَتَفَجَّرُ مِنۡهُ ٱلۡأَنۡهَٰرُۚ وَإِنَّ مِنۡهَا لَمَا يَشَّقَّقُ فَيَخۡرُجُ مِنۡهُ ٱلۡمَآءُۚ وَإِنَّ مِنۡهَا لَمَا يَهۡبِطُ مِنۡ خَشۡيَةِ ٱللَّهِۗ وَمَا ٱللَّهُ بِغَٰفِلٍ عَمَّا تَعۡمَلُونَ

Even after that, your hearts became as hard as rocks, or even harder, for there are rocks from which streams spring out, and some from which water comes when they split open, and others which fall down in awe of God: He is not unaware of what you do

إِنَّ ٱلَّذِينَ هُم مِّنۡ خَشۡيَةِ رَبِّهِم مُّشۡفِقُونَ

Those who stand in awe of their Lord

لَوۡ أَنزَلۡنَا هَٰذَا ٱلۡقُرۡءَانَ عَلَىٰ جَبَلࣲ لَّرَأَيۡتَهُۥ خَٰشِعࣰ ا مُّتَصَدِّعࣰ ا مِّنۡ خَشۡيَةِ ٱللَّهِۚ وَتِلۡكَ ٱلۡأَمۡثَٰلُ نَضۡرِبُهَا لِلنَّاسِ لَعَلَّهُمۡ يَتَفَكَّرُونَ

If We had sent this Quran down to a mountain, you [Prophet] would have seen it humbled and split apart in its awe of God: We offer people such illustrations so that they may reflect

وَلَمَّا سَكَتَ عَن مُّوسَى ٱلۡغَضَبُ أَخَذَ ٱلۡأَلۡوَاحَۖ وَفِي نُسۡخَتِهَا هُدࣰ ى وَرَحۡمَةࣱ لِّلَّذِينَ هُمۡ لِرَبِّهِمۡ يَرۡهَبُونَ

When Moses’ anger abated, he picked up the Tablets, on which were inscribed guidance and mercy for those who stood in awe of their Lord

وَٱذۡكُر رَّبَّكَ فِي نَفۡسِكَ تَضَرُّعࣰ ا وَخِيفَةࣰ وَدُونَ ٱلۡجَهۡرِ مِنَ ٱلۡقَوۡلِ بِٱلۡغُدُوِّ وَٱلۡأٓصَالِ وَلَا تَكُن مِّنَ ٱلۡغَٰفِلِينَ

[Prophet], remember your Lord inwardly, in all humility and awe, without raising your voice, in the mornings and in the evenings- do not be one of the heedless

إِنَّمَا ٱلۡمُؤۡمِنُونَ ٱلَّذِينَ إِذَا ذُكِرَ ٱللَّهُ وَجِلَتۡ قُلُوبُهُمۡ وَإِذَا تُلِيَتۡ عَلَيۡهِمۡ ءَايَٰتُهُۥ زَادَتۡهُمۡ إِيمَٰنࣰ ا وَعَلَىٰ رَبِّهِمۡ يَتَوَكَّلُونَ

true believers are those whose hearts tremble with awe when God is mentioned, whose faith increases when His revelations are recited to them, who put their trust in their Lord

Then your hearts became hardened after that, so they were like stones or even harder. And there are stones from which rivers come gushing, and among them are those that split and water comes forth from them, and among them are those that fall down in fear of God. In the case of the ignorant, the hardening of the heart is unkindness, lack of mercy, and distance from the path of the Real. In the case of the recognizers, the purifiers, and the limpid, hardening is the strength of the heart, the state of stability, the perfection of knowledge, and the state of limpid- ness. Abū Bakr used to show it from himself. Whenever he saw that someone was weeping and twisting in himself because of listening to the Qur'an, he would say, “I was like that until the hearts became hardened.” This hardening is an allusion to the perfection of the state of the recognizers and the majesty of the level of the s

Surely those who tremble in fear of their Lord… it is they who hurry to good deeds. When an intelligent man ponders the meaning of these verses, he will come to know that the obedi- ent are more fearful in their obedience than the disobedient are fearful in their disobedience. Just as the disobedient need His curtaining, so also the obedient need His curtaining. The Real says, “And repent all together to God, O you who have faith! [24:31]. O faithful, you who are obedient and you who are disobedient! All of you return to Our threshold with the attribute of pleading! In the state of poverty and brokenness ask for Our forgiveness, so that We may cover you with the curtain of Our mercy.” I wonder at the empty-headed Qur'an-reciter who makes two cycles of prayer at night and the next day knits the knot of self-seeing on his brow and places the favor of his own being on heaven and earth. All

Then your hearts became hardened O you Jews they your hearts became stiffened against acceptance of the truth thereafter that is after what is mentioned of the bringing back to life of the slain man and the other signs before this; and they are like stones in their hardness or even yet harder than these; for there are stones from which rivers come gushing and others split yashshaqqaq the initial tā’ of the root-form yatashaqqaq has been assimilated with the shīn so that water issues from them; and others come down from on high in fear of God while your hearts are unmoved unstirred and not humbled; And God is not heedless of what you do but instead He gives you respite until your time comes ta‘malūna ‘you do’ a variant reading has ya‘malūna ‘they do’ indicating a shift to the third person address.

Surely those who for fear of their Lord are apprehensive are fearful of His chastisement

Had We sent down this Qur’ān upon a mountain and had it the mountain been endowed with a faculty of discernment like man you would have surely seen it humbled rent asunder by the fear of God. And such similitudes as those mentioned — do We strike for mankind that perhaps they may reflect and so become believers.

Had We sent down this Qur'an on a mountain, you would surely have seen it humbling itself and rent asunder by the fear of Allah. Such are the parables which We put forward to mankind that they may reflect (21)He is Allah, beside Whom La ilaha illa Huwa, the All-Knower of the unseen and the seen. He is the Most Gracious, the Most Merciful (22)He is Allah, beside Whom La ilaha illa Huwa, Al-Malik, Al-Quddus, As-Salam, Al-Mu'min, Al-Muhaymin, Al-'Aziz, Al-Jabbar, Al-Mutakabbir. Glory be to Allah! Above all that they associate as partners with Him (23)He is Allah, Al-Khaliq, Al-Bari, Al-Musawwir. To Him belong the Best Names. All that is in the heavens and the earth glorify Him. And He is the Almighty, the All-Wise (24) Asserting the Greatness of the Qur'an Allah the Exalted emphasizes the greatness of the Qur'an, its high status and of being worthy of making hearts humble and rent asunder

حَدَّثَنَا هَدَّابُ بْنُ خَالِدٍ، حَدَّثَنَا حَمَّادُ بْنُ سَلَمَةَ، ح وَحَدَّثَنِي زُهَيْرُ بْنُ حَرْبٍ، حَدَّثَنَا مُعَاذُ بْنُ مُعَاذٍ الْعَنْبَرِيُّ، ح وَحَدَّثَنِي مُحَمَّدُ بْنُ عَبْدِ الأَعْلَى، حَدَّثَنَا الْمُعْتَمِرُ، ح وَحَدَّثَنَا إِسْحَاقُ، بْنُ إِبْرَاهِيمَ أَخْبَرَنَا جَرِيرٌ، كُلُّهُمْ عَنْ سُلَيْمَانَ التَّيْمِيِّ، ح وَحَدَّثَنَا أَبُو كَامِلٍ، فُضَيْلُ بْنُ حُسَيْنٍ - وَاللَّفْظُ لَهُ - حَدَّثَنَا يَزِيدُ بْنُ زُرَيْعٍ، حَدَّثَنَا التَّيْمِيُّ، عَنْ أَبِي عُثْمَانَ، عَنْ أُسَامَةَ بْنِ زَيْدٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ قُمْتُ عَلَى بَابِ الْجَنَّةِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا الْمَسَاكِينُ وَإِذَا أَصْحَابُ الْجَدِّ مَحْبُوسُونَ إِلاَّ أَصْحَابَ النَّارِ فَقَدْ أُمِرَ بِهِمْ إِلَى النَّارِ وَقُمْتُ عَلَى بَابِ النَّارِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا النِّسَاءُ ‏"‏ ‏.‏

Usama b. Zaid reported that Allah's Messenger (way peace be upon him) said:I stood at the door of Paradise and I found that the overwhelming majority of those who entered therein was that of poor persons and the wealthy persons were detained to get into that. The denizens of Hell were commanded to get into Hell, and I stood upon the door of Fire and the majority amongst them who entered there was that of women

حَدَّثَنَا أَبُو كُرَيْبٍ، حَدَّثَنَا أَبُو أُسَامَةَ، عَنْ سَعِيدِ بْنِ أَبِي عَرُوبَةَ، سَمِعَ أَبَا رَجَاءٍ، عَنِ ابْنِ عَبَّاسٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ مِثْلَهُ ‏.‏

This hadith is narrated likewise through another chain of transmitters

حَدَّثَنَا مُحَمَّدُ بْنُ كَثِيرٍ، أَخْبَرَنَا سُفْيَانُ، عَنْ جَامِعِ بْنِ شَدَّادٍ، عَنْ صَفْوَانَ بْنِ مُحْرِزٍ، عَنْ عِمْرَانَ بْنِ حُصَيْنٍ ـ رضى الله عنهما ـ قَالَ جَاءَ نَفَرٌ مِنْ بَنِي تَمِيمٍ إِلَى النَّبِيِّ صلى الله عليه وسلم فَقَالَ ‏"‏ يَا بَنِي تَمِيمٍ، أَبْشِرُوا ‏"‏‏.‏ قَالُوا بَشَّرْتَنَا فَأَعْطِنَا‏.‏ فَتَغَيَّرَ وَجْهُهُ، فَجَاءَهُ أَهْلُ الْيَمَنِ، فَقَالَ ‏"‏ يَا أَهْلَ الْيَمَنِ، اقْبَلُوا الْبُشْرَى إِذْ لَمْ يَقْبَلْهَا بَنُو تَمِيمٍ ‏"‏‏.‏ قَالُوا قَبِلْنَا‏.‏ فَأَخَذَ النَّبِيُّ صلى الله عليه وسلم يُحَدِّثُ بَدْءَ الْخَلْقِ وَالْعَرْشِ، فَجَاءَ رَجُلٌ فَقَالَ يَا عِمْرَانُ، رَاحِلَتُكَ تَفَلَّتَتْ، لَيْتَنِي لَمْ أَقُمْ‏.‏

Narrated `Imran bin Husain:Some people of Bani Tamim came to the Prophet (ﷺ) and he said (to them), "O Bani Tamim! rejoice with glad tidings." They said, "You have given us glad tidings, now give us something." On hearing that the color of his face changed then the people of Yemen came to him and he said, "O people of Yemen ! Accept the good tidings, as Bani Tamim has refused them." The Yemenites said, "We accept them. Then the Prophet (ﷺ) started taking about the beginning of creation and about Allah's Throne. In the mean time a man came saying, "O `Imran! Your she-camel has run away!'' (I got up and went away), but I wish I had not left that place (for I missed what Allah's Messenger (ﷺ) had said

وَرَوَى عِيسَى، عَنْ رَقَبَةَ، عَنْ قَيْسِ بْنِ مُسْلِمٍ، عَنْ طَارِقِ بْنِ شِهَابٍ، قَالَ سَمِعْتُ عُمَرَ ـ رضى الله عنه ـ يَقُولُ قَامَ فِينَا النَّبِيُّ صلى الله عليه وسلم مَقَامًا، فَأَخْبَرَنَا عَنْ بَدْءِ الْخَلْقِ حَتَّى دَخَلَ أَهْلُ الْجَنَّةِ مَنَازِلَهُمْ، وَأَهْلُ النَّارِ مَنَازِلَهُمْ، حَفِظَ ذَلِكَ مَنْ حَفِظَهُ، وَنَسِيَهُ مَنْ نَسِيَهُ‏.‏

Narrated 'Umar:One day the Prophet (ﷺ) stood up amongst us for a long period and informed us about the beginning of creation (and talked about everything in detail) till he mentioned how the people of Paradise will enter their places and the people of Hell will enter their places. Some remembered what he had said, and some forgot it

حَدَّثَنَا الْمَكِّيُّ بْنُ إِبْرَاهِيمَ، أَخْبَرَنَا عَبْدُ اللَّهِ بْنُ سَعِيدٍ ـ هُوَ ابْنُ أَبِي هِنْدٍ ـ عَنْ أَبِيهِ، عَنِ ابْنِ عَبَّاسٍ ـ رضى الله عنهما ـ قَالَ قَالَ النَّبِيُّ صلى الله عليه وسلم ‏ "‏ نِعْمَتَانِ مَغْبُونٌ فِيهِمَا كَثِيرٌ مِنَ النَّاسِ، الصِّحَّةُ وَالْفَرَاغُ ‏"‏‏.‏ قَالَ عَبَّاسٌ الْعَنْبَرِيُّ حَدَّثَنَا صَفْوَانُ بْنُ عِيسَى، عَنْ عَبْدِ اللَّهِ بْنِ سَعِيدِ بْنِ أَبِي هِنْدٍ، عَنْ أَبِيهِ، سَمِعْتُ ابْنَ عَبَّاسٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم مِثْلَهُ‏.‏

Narrated Ibn `Abbas:The Prophet (ﷺ) said: "There are two blessings that many people are deceived into losing: health and free time

حَدَّثَنِي أَحْمَدُ بْنُ الْمِقْدَامِ، حَدَّثَنَا الْفُضَيْلُ بْنُ سُلَيْمَانَ، حَدَّثَنَا أَبُو حَازِمٍ، حَدَّثَنَا سَهْلُ بْنُ سَعْدٍ السَّاعِدِيُّ، كُنَّا مَعَ رَسُولِ اللَّهِ صلى الله عليه وسلم فِي الْخَنْدَقِ وَهْوَ يَحْفِرُ وَنَحْنُ نَنْقُلُ التُّرَابَ وَيَمُرُّ بِنَا فَقَالَ ‏ "‏ اللَّهُمَّ لاَ عَيْشَ إِلاَّ عَيْشُ الآخِرَهْ، فَاغْفِرْ لِلأَنْصَارِ وَالْمُهَاجِرَهْ ‏"‏‏.‏ تَابَعَهُ سَهْلُ بْنُ سَعْدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مِثْلَهُ‏.‏

Narrated Sahl bin Sa`d As-Sa`idi:We were in the company of Allah's Messenger (ﷺ) in (the battle of) Al-Khandaq, and he was digging the trench while we were carrying the earth away. He looked at us and said, "O Allah! There is no life worth living except the life of the Hereafter, so (please) forgive the Ansar and the Emigrants

ومن فهم ذلك فجدير بأن يكون حاله الخشية والحزن ولذلك قال الحسن والله ما أصبح اليوم عبد يتلو القرآن يؤمن به إلا كثر حزنه وقل فرحه وكثر بكاؤه وقل ضحكه وكثر نصبه وشغله وقلت راحته وبطالته

وقال بعضهم إنما العلم الخشية لقوله تعالى إنما يخشى الله من عباده العلماء وكأنه أشار إلى أخص ثمرات العلم

فإن الخشية ثمرة العلم فتكون كالمجاز لغير تلك الغريزة ولكن ليس الغرض البحث عن اللغة

فالطمأنينة والاقشعرار والخشية ولين القلب كل ذلك وجد

والإنابة جامعة لمقام المحبة والخشية لا يكون العبد منيبا إلا باجتماعهما

ومقام المراقبة جامع للمعرفة مع الخشية فبحسبهما يصح مقام المراقبة

App-based mindfulness training supported eudaimonic wellbeing during the COVID19 pandemic.: A randomized-controlled-trial study (N = 219) tested two pre-registered hypotheses that mobile-phone app-based mindfulness training improves wellbeing and increases self-transcendent emotions: gratitude, self-compassion, and awe. Latent change score modeling with a robust maximum likelihood estimator was used to test how those changes are associated in the training versus the waiting-list group. The training increased wellbeing and all self-transcendent emotions regardless of interindividual var

Self-transcendence among adults 65 years and older: A meta-analysis.: Introduction: Self-transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health-promoting resource among adults ≥65 years. Therefore, the objectives of this meta-analysis were to determine the mean score of self-transcendence based on place of residence and gender, and to evaluate the correlations of self-transcendence with meaning, sense of coherence, resilience and depression. Methods: Based on inclusion criteria, 13 studies were included. Orwi

Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis.: Objective: The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. Method: A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlatio

Systematic Literature Review of the Impact of Islamic Psychotherapy on Adolescent Spiritual Well-Being.: Islamic psychotherapy has been widely utilized in various fields, particularly in psychology, focusing on aspects of aqidah, worship, and morality, which can significantly contribute to individuals' spiritual well-being. Despite the abundance of studies on Islamic psychotherapy, systematic literature reviews on this topic remain scarce. This article aims to review the literature on the impact of Islamic psychotherapy on adolescent spiritual well-being. A qualitative research methodology was empl

Experimental elicitations of awe: a meta-analysis.: A meta-analytic review of studies that experimentally elicited awe and compared the emotion to other conditions (84; 487 effects; 17,801 participants) examined the degree to which experimentally elicited awe (1) affects outcomes relative to other positive emotions (2) affects experience, judgment, behaviour, and physiology, and (3) differs in its effects if the awe state was elicited through positive or threatening contexts. The efficacy of methods that have been used to experimentally elicit aw

Religiosity and spirituality in the prevention and management of depression and anxiety in young people: a systematic review and meta-analysis.: Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to positive mental health outcomes in adults, their role during the developmental context of adolescence, and the mechanisms through which such beliefs might operate, is less well understood. Moreover, there is some evidence that negative aspects of religiosity are associated with poor mental health outcomes. Guided by lived experien

Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.

Importance: Previous studies report associations between medical utilization at the end-of-life (EoL) and religious coping and spiritual support from the medical team. However, the influence of clergy and religious communities on EoL outcomes is unclear. Objective: To determine whether spiritual support from religious communities influences terminally ill patients' medical care and quality of life (QoL) near death. Design, setting, and participants: A US-based, multisite cohort study of 343 patients with advanced cancer enrolled from September 2002 through August 2008 and followed up (median duration, 116 days) until death. Baseline interviews assessed support of patients' spiritual needs by religious communities. End-of-life medical care in the final week included the following: hospice, aggressive EoL measures (care in an intensive care unit [ICU], resuscitation, or ventilation), and I…

matched on Spirituality (mesh)

The spiritual needs and resources of hospitalized primary care patients.

Previous studies have recognized the importance of hospitalized primary care patients' spiritual issues and needs. The sources patients consult to address these spiritual issues, including the role of their attending physician, have been largely unstudied. We sought to study patients' internal and external resources for addressing spiritual questions, while also exploring the physician's role in providing spiritual care. Our multicenter observational study evaluated 326 inpatients admitted to primary care physicians in four midwestern hospitals. We assessed how frequently these patients identified spiritual concerns during their hospitalization, the manner in which spiritual questions were addressed, patients' desires for spiritual interaction, and patient outcome measures associated with spiritual care. Nearly 30% of respondents (referred to as "R/S respondents") reported religious stru…

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Spirituality and religion: intertwined protective factors for substance use among urban American Indian youth.

Background and objective: This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth. Methods: Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis. Results: Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use. Conclusions and scientific significance: Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.

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The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy.

Objectives: National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients' religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the relationships of these variables to quality of life (QOL); and assess patients' perceptions of spiritual care in the cancer care setting. Methods: This is a multisite, cross-sectional survey of 69 patients with advanced cancer (response rate = 73%) receiving palliative RT. Scripted interviews assessed patient spirituality, religiousness, religious coping, QOL (McGill QOL Questionnaire), and perceptions of the importance of attention to spiritual needs by health providers. Multivariable models asse…

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Religion, spirituality and mental health in the West and the Middle East.

Research on religion, spirituality and mental health has been rapidly accumulating from Western countries and now increasingly from the Middle East. We review here the latest research on this topic from these two areas of the world, one largely Christian and the other largely Muslim, after discussing similarities and differences in these faith traditions. Contrary to popular thought, there is considerable overlap between these religious groups in beliefs, practices of worship, moral beliefs and values, and emphasis on family life (although also some distinct differences). Because of the similarity in belief and practice, it is not surprising that research on mental health and devout religious involvement in both these religious traditions has tended to produce similar results. Religious psychotherapies within these faith traditions have been developed and are now being refined and used i…

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Clinical correlates of suicidal thoughts in patients with advanced cancer.

Objective: : Cancer patients are at heightened risk of suicide. Clinical correlates of suicidal ideation in advanced cancer patients were examined to identify those at risk and to inform the development of interventions to reduce suicidal ideation in this vulnerable group. Methods: : Coping with Cancer (CwC) is an NCI- and NIMH-funded multiinstitutional investigation examining psychosocial influences on the quality of life and care of advanced cancer patients. Baseline face-to-face interviews that assessed mental and physical functioning, coping, spirituality, and use of mental health services were conducted with 700 advanced cancer patients. Results: : Compared with patients without suicidal ideation, the 8.9% of patients who reported suicidal thoughts were more likely to be white and report no affiliation with an organized religion (p < 0.05). Adjusted analyses revealed that cancer pat…

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Impact of death and dying on the personal lives and practices of palliative and hospice care professionals.

Background Working within the landscape of death and dying, professionals in palliative and hospice care provide insight into the nature of mortality that may be of benefit to individuals facing the end of life. Much less is known about how these professionals incorporate these experiences into their personal lives and clinical practices. Methods This ethnographic inquiry used semi-structured interviews and participant observation to elicit an in-depth understanding of the impact of death and dying on the personal lives of national key leaders (n = 6) and frontline clinicians (n = 24) involved in end-of-life care in Canada. Analysis of findings occurred in the field through constant comparative method and member checking, with more formal levels of analysis occurring after the data-collection phase. Results Eleven specific themes, organized under three overarching categories (past, prese…

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The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5.

Background: There is considerable debate about the cross-cultural applicability of the posttraumatic stress disorder (PTSD) category as currently specified. Concerns include the possible status of PTSD as a Western culture-bound disorder and the validity of individual items and criteria thresholds. This review examines various types of cross-cultural validity of the PTSD criteria as defined in DSM-IV-TR, and presents options and preliminary recommendations to be considered for DSM-5. Methods: Searches were conducted of the mental health literature, particularly since 1994, regarding cultural-, race-, or ethnicity-related factors that might limit the universal applicability of the diagnostic criteria of PTSD in DSM-IV-TR and the possible criteria for DSM-5. Results: Substantial evidence of the cross-cultural validity of PTSD was found. However, evidence of cross-cultural variability in ce…

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Support of cancer patients' spiritual needs and associations with medical care costs at the end of life.

Background: Although spiritual care is associated with less aggressive medical care at the end of life (EOL), it remains infrequent. It is unclear if the omission of spiritual care impacts EOL costs. Methods: A prospective, multisite study of 339 advanced cancer patients accrued subjects from September 2002 to August 2007 from an outpatient setting and followed them until death. Spiritual care was measured by patients' reports that the health care team supported their religious/spiritual needs. EOL costs in the last week were compared among patients reporting that their spiritual needs were inadequately supported versus those who reported that their needs were well supported. Analyses were adjusted for confounders (eg, EOL discussions). Results: Patients reporting that their religious/spiritual needs were inadequately supported by clinic staff were less likely to receive a week or more o…

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Health index, sense of coherence scale, brief religious coping scale and spiritual perspective scale: psychometric properties.

Aim: This paper is a report of a study to translate one Swedish and three English instruments into the Persian language, and to estimate their validity and reliability. Background: The Sense of Coherence Scale, Health Index, Brief Religious Coping Scale and Spiritual Perspective Scale are all well tested instruments for use in nursing research. Since there was no Persian translation of these instruments, they had to be translated and cross-culturally adapted for nursing research in the Iranian culture. Method: After the translation process, sampling for psychometric tests was done. A sample of healthy Iranian people (n = 375) was selected to response to the instruments in 2006, at baseline and 1 month later. Findings: Cronbach's alpha values and intra-class correlations were high (>0·70). Tests of criterion-related validity showed that six of the ten hypotheses were confirmed, and the fo…

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Spiritual, religious, and personal beliefs are important and distinctive to assessing quality of life in health: a comparison of theoretical models.

Objectives: The study investigates theoretical debates on the contribution of spiritual, religious, and personal beliefs (SRPB) to quality of life (QoL) in health, by examining contrasting models. Design and method: The WHOQOL-SRPB assesses QoL relating to SRPB where 33 QoL facets are scored in 6 domains, of which SRPB is one. The measure was completed by a heterogeneous sample of 285 sick and well people representing a cross-section of religious, agnostic, and atheist beliefs in UK, and structured for gender (52% female) and age (mean 47 years). Results: No evidence was found to support the model of spiritual QoL as a concept that overarches every other QoL domain. Confirmatory factor analysis showed that SRPB is an integral concept to overall QoL, with a very good fit (comparative fit index=.99). Spiritual QoL made a significant, relatively independent contribution, similar to the othe…

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Spiritual needs of patients with chronic pain diseases and cancer - validation of the spiritual needs questionnaire.

Purpose: For many patients confronted with chronic diseases, spirituality/religiosity is a relevant resource to cope. While most studies on patients' spiritual needs refer to the care of patients at the end of life, our intention was to develop an instrument to measure spiritual, existential and psychosocial need of patients with chronic diseases. Methods: In an anonymous cross-sectional survey, we applied the Spiritual Needs Questionnaire (SpNQ version 1.2.) to 210 patients (75% women, mean age 54 +/- 12 years) with chronic pain conditions (67%), cancer (28%), other chronic conditions (5%). Patients were recruited at the Community Hospital Herdecke, the Institute for Complementary Medicine (University of Bern), and at a conference of a cancer support group in Herten. Results: Factor analysis of the 19-item instrument (Cronbach's alpha +/- .93) pointed to 4 factors which explain 67% of v…

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Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer.

Context: Patients frequently rely on religious faith to cope with cancer, but little is known about the associations between religious coping and the use of intensive life-prolonging care at the end of life. Objective: To determine the way religious coping relates to the use of intensive life-prolonging end-of-life care among patients with advanced cancer. Design, setting, and participants: A US multisite, prospective, longitudinal cohort of 345 patients with advanced cancer, who were enrolled between January 1, 2003, and August 31, 2007. The Brief RCOPE assessed positive religious coping. Baseline interviews assessed psychosocial and religious/spiritual measures, advance care planning, and end-of-life treatment preferences. Patients were followed up until death, a median of 122 days after baseline assessment. Main outcome measures: Intensive life-prolonging care, defined as receipt of m…

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Psychosocial adjustment among cancer survivors: findings from a national survey of health and well-being.

Objective: The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated. Design: Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995-1996 and 2004-2006. Main outcome measures: Outcomes including self-report measures of mental health and mood, psychological well-being, social well-being, and spirituality. Results: Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well…

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Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients.

Background: A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer. Objective: We examined the relative need for palliative care in the two conditions by comparing symptom burden, psychological well-being, and spiritual well-being in heart failure and cancer patients. Design: This was a cross-sectional study. Participants: Sixty outpatients with symptomatic heart failure and 30 outpatients with advanced lung or pancreatic cancer. Measurements: Symptom burden (Memorial Symptom Assessment Scale-Short Form), depression symptoms (Geriatric Depression Scale-Short Form), and spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale). Main results: Overall, the heart failure patients and the cancer patients had similar numbers of physical symptoms (9.1 vs. 8.6, p = 0.79), depression scor…

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Are spirituality and religiosity resources for patients with chronic pain conditions?

Objective: We studied whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of "Spiritual and Religious Attitudes in Dealing with Illness"), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of "Adaptive Coping with Disease"), life satisfaction, and appraisal dimensions. Patients: In a multicenter cross-sectional study, 580 patients with chronic pain conditions were enrolled. Results: We found that the patients relied on both external powerful sources of disease control and on internal powers and virtues, while Trust in Higher Source (intrinsic religiosity) or Illness as Chance (reappraisal) were valued moderately; S…

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The validity and reliability of an instrument to assess nursing competencies in spiritual care.

Aim: This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses' competencies in providing spiritual care. Background: Measuring these competencies and their development is important and the construction of a reliable and valid instrument is recommended in the literature. Design: Survey. Method: The participants were students from Bachelor-level nursing schools in the Netherlands (n = 197) participating in a cross-sectional study. The items in the instrument were hypothesised from a competency profile regarding spiritual care. Construct validity was evaluated by factor analysis and internal consistency was estimated with Cronbach's alpha and the average inter-item correlation. In addition, the test-retest reliability of the instrument was determined at a two-week interval between baseline and follow…

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A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients.

Goals of work: The aim of this study was to compare a mindfulness-based stress reduction (MBSR) program and a healing through the creative arts (HA) program on measures of post-traumatic growth (PTGI-R), spirituality (FACIT-Sp), stress (SOSI), and mood disturbance (POMS) in cancer patients. Materials and methods: A sample of cancer outpatients (MBSR, n = 60; HA, n = 44) with a variety of diagnoses chose to attend either an 8-week MBSR program or a 6-week HA program and were assessed pre- and post-intervention. The majority of participants were female, married, and had breast cancer. Main results: Repeated measures analysis of variance indicated that participants in both groups improved significantly over time on overall post-traumatic growth (p = 0.015). Participants in the MBSR group improved on measures of spirituality more than those in the HA group (p = 0.029). Participants in the MB…

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Assessment of spirituality and its relevance to addiction treatment.

The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspec…

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The assessment of spirituality and religiousness in schizophrenia.

To assess religious coping in schizophrenia, we developed and tested a clinical grid, as no validated questionnaire exists for this population. One hundred fifteen outpatients were interviewed. Results obtained by 2 clinicians were compared. Religion was central in the lives of 45% of patients, 60% used religion extensively to cope with their illness. Religion is a multifaceted construct. Principal component analysis elicited 4 factors: subjective dimension, collective dimension, synergy with psychiatric treatment, and ease of talking about religion with psychiatrist. Different associations were found between these factors and psychopathology, substance abuse, and psychosocial adaptation. The high prevalence of spirituality and religious coping clearly indicates the necessity of addressing spirituality in patient care. Our clinical grid is suitable for this purpose. It proved its applica…

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Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life.

Purpose: Religion and spirituality play a role in coping with illness for many cancer patients. This study examined religiousness and spiritual support in advanced cancer patients of diverse racial/ethnic backgrounds and associations with quality of life (QOL), treatment preferences, and advance care planning. Methods: The Coping With Cancer study is a federally funded, multi-institutional investigation examining factors associated with advanced cancer patient and caregiver well-being. Patients with an advanced cancer diagnosis and failure of first-line chemotherapy were interviewed at baseline regarding religiousness, spiritual support, QOL, treatment preferences, and advance care planning. Results: Most (88%) of the study population (N = 230) considered religion to be at least somewhat important. Nearly half (47%) reported that their spiritual needs were minimally or not at all support…

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Spirituality and religious practices among outpatients with schizophrenia and their clinicians.

Objectives: Religious issues may be neglected by clinicians who are treating psychotic patients, even when religion constitutes an important means of coping. This study examined the spirituality and religious practices of outpatients with schizophrenia compared with their clinicians. Clinicians' knowledge of patients' religious involvement and spirituality was investigated. Methods: The study sample included 100 patients of public psychiatric outpatient facilities in Geneva, Switzerland, with a diagnosis of nonaffective psychosis. Audiotaped interviews were conducted with use of a semistructured interview about spirituality and religious coping. The patients' clinicians (N=34) were asked about their own beliefs and religious activities as well as their patients' religious and clinical characteristics. Results: Sixteen patients (16 percent) had positive psychotic symptoms reflecting aspec…

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Perspectives on spirituality at the end of life: a meta-summary.

Objective: A meta-summary of the qualitative literature on spiritual perspectives of adults who are at the end of life was undertaken to summarily analyze the research to date and identify areas for future research on the relationship of spirituality with physical, functional, and psychosocial outcomes in the health care setting. Methods: Included were all English language reports from 1966 to the present catalogued in PubMed, Medline, PsycInfo, and CINAHL, identifiable as qualitative investigations of the spiritual perspectives of adults at the end of life. The final sample includes 11 articles, collectively representing data from 217 adults. Results: The preponderance of participants had a diagnosis of cancer; those with HIV/AIDS, cardiovascular disease, and ALS were also represented. Approximately half the studies were conducted in the United States; others were performed in Australia…

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Positive emotional change: mediating effects of forgiveness and spirituality.

We evaluated the efficacy of an emotional education program that seeks to reduce the intergenerational transmission of negative interaction patterns by increasing forgiveness and spirituality. We examined both reduction of psychological symptoms and increase in positive psychological outcomes over the course of a year, as well as the mediators of this change. At baseline, the sample consisted of 99 participants and 47 waiting list controls. Comparisons of scores from baseline (Time 1) to one week after the Hoffman Quadrinity Process (Time 2) showed large declines in negative affect (depressive symptoms) and increases in both positive outcomes (mastery, empathy, emotional intelligence, life satisfaction, forgiveness, and spiritual experience) and health and well-being. Over the course of a year, most of these gains were sustained, in comparison with the control group. Further, increases i…

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"Are you at peace?": one item to probe spiritual concerns at the end of life.

Background: Physicians may question their role in probing patients' spiritual distress and the practicality of addressing such issues in the time-limited clinical encounter. Yet, patients' spirituality often influences treatment choices during a course of serious illness. A practical, evidence-based approach to discussing spiritual concerns in a scope suitable to a physician-patient relationship may improve the quality of the clinical encounter. Methods: Analysis of the construct of being "at peace" using a sample of patients with advanced cancer, congestive heart failure, or chronic obstructive pulmonary disease. Descriptive statistics were used to compare response distributions among patient subgroups. Construct validity of the concept of being "at peace" was evaluated by examining Spearman rank correlations between the item and existing spirituality and quality-of-life subscales. Resu…

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