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Nov 2, 2010 - Religion – How does it help to cope? "I don't dwell on the pain. Some people are sick and have pain and
Religion, Spirituality & Medicine Research and Clinical Implications Harold G. Koenig, MD Departments of Psychiatry and Medicine Duke University Medical Center Director, Center for Spirituality, Theology & Health

Overview •

Definitions



Religion and mental health



Religion and health behaviors



Religion, disease detection, treatment compliance



Religion, physical health and recovery



Clinical applications



Further resources

12:15-1:30

Definitions

Religion vs. Spirituality vs. Humanism Religion – beliefs, practices, a creed with do’s and don’ts, community-oriented, responsibility-oriented, divisive and unpopular, but easier to define and measure Spirituality – quest for sacred, relationship to the transcendent, personal, individual-focused, inclusive, popular, but difficult to define and quantify Secular Humanism – human experiences that lack a connection to the transcendent, to a higher power, or to ultimate truth; focus is on the human self and human community as the ultimate source of power and meaning Most of the research has been done on religion.

Many persons in the USA are religious and turn to religion for comfort, support, and hope when they become sick

How common is religious coping in medical patients?

Self-Rated Religious Coping Moderate to Large Extent 5.0-7.4

Small to Moderate 0.1-4.9

22.7% Large Extent or More 7.5-9.9

5.0% 27.3%

5.0%

None 0

40.1%

10 The Most Important Factor

Responses by 337 consecutively admitted patients to Duke Hospital (Koenig 1998)

Religious Coping is Not Just for the Sick

America’s Coping Response to Sept 11th: 1. 2. 3. 4. 5. 6.

Talking with others (98%) Turning to religion (90%) Checked safety of family/friends (75%) Participating in group activities (60%) Avoiding reminders (watching TV) (39%) Making donations (36%)

Based on a random-digit dialing survey of the U.S. on Sept 14-16 New England Journal of Medicine 2001; 345:1507-1512

Example of Religious Coping (JAMA 2002; 288 (4): 487-493)

1. 83 years old 2. Multiple serious medical problems 3. Chronic, progressive, unrelenting pain 4. Traditional medical treatments ineffective 5. Alternative medical treatments ineffective 6. Limited material resources – lives alone 7. But, doing well psychologically 8. Positive, hopeful and optimistic 9. Functioning independently- without assist 10. Concerned with meeting others’ needs 11. How does she do it? Religion, she says

Religion – How does it help to cope? "I don’t dwell on the pain. Some people are sick and have pain and it gets the best of them. Not me. I pray a lot…. I believe in God, and I give my whole heart, body, and soul over to him… Sometimes I pray and I'm in deep serious prayer and all of a sudden, my pain gets easy. It slackens up and I drop off to sleep, and wake up and I can do things for myself. So prayer helps me a lot – I give God my heart and soul – and you don’t have to worry about nothing. He leads you and directs you, and he takes care of you. And I believe in that. That is my belief."

The Research (systematic review 1806-2010)

The following research is documented in the Handbook of Religion and Health (Oxford University Press, 1st ed (2001), and 2nd ed (2011, forthcoming)

Religion and Mental Health Well-being and happiness Depression Anxiety Substance use Suicide Meaning, purpose, and hope Forgiveness, altruism, gratitude, compassion Social support

Well-being and Happiness (systematic review)

Religious involvement is related to: Greater well-being and happiness (256 of 326 studies) (79%) [82% of best] Lower well-being or happiness (