Table 1 Articles related to relational spirituality and quality of life for the last 10 years

***Idler et al. [62].

A prospective study. Interviews (n = 499) from 1982 to 1994 with terminally ill elderly persons in the last year of their lives.

Gender (M = 41%, F = 59%)

Age range: 65 years and over

Mean Age: 74.5

Country: USA

Those who had a sense of religious attachment were more likely to see friends, and they had better QoL, fewer depressive feelings, and were observed by the interviewer to find life more exciting compared with the less religious respondents.

*** Saffari et al. [63].

Cross-sectional survey design (n-362) with Muslim patients undergoing haemodialysis.

Gender (M = 46.1%, F = 53.9%)

Age range: 20 years and older

Mean Age: 57.81 (SD = 9.67)

Country: Iran

Spiritual/religious factors were related to QoL and health status. Regression models revealed that demographics, clinical variables, and especially spiritual/religious factors explained about 40% of variance of QoL and nearly 25% of the variance in health status.

# and #*

Nagpal et al. [29].

Quantitative interviews and cross-sectional design with 111 Individuals With Dementia (IWD) and their family caregivers from two service-based organizations in the San Francisco Bay Area and Cleveland, Ohio.

Age range: 30 to 90+

Mean Age: Caregiver (M = 61.20, SD = 14.00); IWD (M = 76.80, SD = 8.90).

Country: USA

After controlling for care-related stress, one’s own religiosity is not significantly related to individuals’ or caregivers’ perceptions of the QoL of individuals with Dementia. However, when modelled for both the individuals and their caregivers, effects of religiosity on perceptions of QoL, caregivers’ religiosity was positively related to the QoL of individuals with Dementia whereas the religiosity of individuals with Dementia was negatively associated with caregivers’ perceptions of IWDs’ QoL.

# Miller et al. [30].

Cross-sectional survey with 44 (dyads) couples between 49 and 73 years of age following a first-time cardiac event.

Gender: Patient Males (n = 35) and Females (n = 9).

Age range: Patients (49 to 73 years of age); Spouses (47 and 71 years of age).

Mean Age: Spouses (M = 59.1, SD = 12.6); Patients (M = 61.6, SD = 11.8).

The findings suggest that there is no association between dimensions of spirituality and QoL and perception of the patient’s physical self-efficacy following a first-time cardiac event.

# Nguyen et al. [75].

A prospective study. Data was analysed from the 2002 National Health Interview Survey (n = 106,000) that covered responses regarding use of complementary therapies reported by older adults aged 55 to 85 and the association with health outcomes assessed in the 2003 US Medical Expenditure Panel Survey (n = 1683).

Gender: (M = 40.5%, F = 59.5%)

Age range: 55 to 85 years of age.

Mean Age: (M = 68.5, SD = 0.3)

Country: USA.

Even though there was no association between prayer and functional status or QoL, results show that the use of prayer for health was the most common complementary alternative medical therapy reported by those aged 55 to 85 (52.3%), which was more than twice as common as any other category of complementary therapy in term of users of biologically based therapies (20.4%) which predicted better functional status.

***Ai et al. [64].

Quantitative interviews with 294 middle-aged and older patients following open-heart surgery.

Gender: (M = 58%, F = 42%)

Age range: aged 35 to 89 years of age.

Mean Age: (M = 62)

Country: USA.

Results show support for adaptive faith-based coping in patients, suggesting that prayer coping was positively associated with cognitive and behavioural changes, as well as perceived social support from family, friends, and significant others at the time of participant’s surgery.

***Calvo et al. [70].

Quantitative interviews with 75 consecutive Amyotrophic Lateral Sclerosis (ALS) patients and their informal caregivers, using tests evaluating religiosity, QoL, satisfaction with life.

Gender: Caregivers (26 males and 49 females); Patients (40 males and 35 females)

Mean Age: Caregivers (M = 55.8, SD = 12.0); Patients (M = 63.6, SD = 9.2)

Results showed that the QoL of the caregivers of patients with ALS was associated with their private religiousness (i.e. subjective religiosity) whereas their satisfaction with life related to their overall religiosity.

***Kashdan & Nezlek [72].

A 1239 days daily diary study on 87 college students using lagged analysis to examine whether spirituality is causing greater well-being or vice versa.

Gender: (M = 23.5%, F = (76.5%)

Mean Age: (M = 21.62, SD = 2.36)

Country: USA.

There was a significant positive relationship between daily spirituality, self-esteem, meaning in life, and positive affect. Furthermore, present-day spirituality was associated with next day’s meaning in life. There was no evidence shown that supports that meaning in life predicted next day spirituality. Lower positive affect and greater negative emotion on 1 day was associated with greater spirituality on the next day.

***Nolan et al. [65]

Quantitative interviews were conducted with stable outpatients with schizophrenia (n = 63), mostly African-Americans (nearly two-thirds of the sample size) living in south-eastern United States to examine the role of religion in coping with their disorder.

Gender: (M = 52%, F = (48%)

Mean Age: (M = 42.2, SD = 11.6)

Country: USA.

Results show that about 68% of the participants were involved in one form of religious activity that involved their religious others. 64% of the participants indicated that being connected to a faith community was important to them. 91% indicated that they were involved in private religious activities that involve praying at least once a day. These kinds of positive religious coping (i.e., religious forgiveness, seeking spiritual support, collaborative religious coping, spiritual connection, religious purification, and benevolent religious reappraisal) were associated with greater QoL (r = .28, p = .03) and psychological health (b = .72, p = .05) whereas negative religious coping (i.e., spiritual discontent, reappraisal of God as punishing, interpersonal religious discontent, reappraisal of demonic powers, and reappraisal of God’s powers) in the form of feeling abandoned by God was associated with worse QoL (r = .30, p = .02).

#* and #

Bradshaw & Kent [22].

Longitudinal study.

Data collected from nationwide Religion, Aging, and Health Survey from 1024 older Americans.

Gender: (M = 38.3%, F = (61.70%)

Mean Age: 75.15

Country: USA

Prayer is not directly associated with improvements in psychological well-being. However, when moderated by attachment to God there was a relationship between prayer and psychological well-being. This association was only seen in individuals with secure attachments and not with those who are insecurely attached to God.

# Sorensen et al. [66].

A cross-sectional survey from a sample of 2086 cancer patients and 6258 cancer-free controls from the Nord-Trøndelag Health Study in Norway that took place between 2006 and 2008.

Mean Age for cancer patients (Sample), 6.9 years; cancer cases (Sample 2a), 7.7 years; cases of breast, prostate, or colorectal cancer (Sample 2b), 6.3 years.

Country: Norway

Spirituality in terms of ‘seeking God’s help’ was associated with lower levels of sexual QoL in the unadjusted model, but when adjusted for other factors (e.g., gender, age, anxiety, neuroticism, extraversion, follow-up time, daily smoking, infrequent exercise, negative outlook, and positive outlook) it did not remain significant for life satisfaction or to QoL measures. There was a lack of association between ‘Seeking God’s Help’ and Life Satisfaction among patients, nor was ‘Seeking God’s Help’ associated with Disease-Specific QoL in patients with breast, prostate, or colorectal cancer.

**Yun et al. [67].

A prospective cohort study of 481 terminally ill Korean cancer patients. 76% (n = 466) were interviewed till the time of death.

Mean age: Users of complementary alternative medicine (CAM) (58.2 years); Nonusers of CAM (59.0 years).

Gender: Users of CAM (Males = 42%, Females = 58%) Nonusers of CAM (Males = 42%, Females = 58%)

Country: Korea

Those who used mind-body interventions (e.g. meditation, prayer therapy, music therapy, art therapy, yoga, horticultural therapy) experienced a significant decline in their QoL compared to non-users. Participants using prayer therapy showed a significantly worse survival of insomnia.

**Levin [73].

Data collected from a cross-sectional survey of a random national sample of Jewish participants (n = 1287) who are 50 years and older.

Mean age: 64.4 years

Context: Israeli sample in Europe

Frequency of prayer was inversely related to self-rated health, and positively associated with activity limitation, physical symptoms, and poor physical functioning.

***Moon & Kim [28].

A cross-sectional survey with older Koreans (n = 274) 65 and over, living alone in Chuncheon, South Korea.

Mean age: (M = 76.76, SD = 6.18)

Gender: Females = 82.1%, Males = 17.9%.

There were associations between dimensions of depression, QoL, and spirituality. Spirituality explained the variance on depression and QoL amongst Christians, but did not account for the difference in the Buddhist sample.

***Krumrei et al. [74].

A cross-sectional survey with 208 Jewish men and women.

Mean age: M = 42, SD = 12

Gender: 74.5% (Females), 25.5 (Males).

Participants were based in U.S. (83%), Canada (7%), Israel (6%), and other countries (4%)

There was a positive correlation between physical health and trust in God (r.14, p < .05), and inverse relationship with mistrust in God (−.16, p < .05) and negative religious coping (r.14, p < .05). When adjusted for gender and age, correlation with physical health remained significant, especially in trust in God and physical health.

***Lee et al. [27].

A cross sectional study with 198 persons with HIV/AIDS in urban Philadelphia.

Mean age: 44.89 years

Gender: 60.5% male (female = 39.5%)

Country: USA

Results of the multiple hierarchical analyses reveal that negative religious coping was significantly related to low levels of QoL when adjusted for demographic and clinical variables. Positive religious coping was also significantly associated with positive affect and life satisfaction, but not with overall QoL.

***Currier et al. [68].

A cross-sectional data on 678 military Veterans with posttraumatic stress disorder (PTSD).

Mean age: 51.57 years (SD = 9.57

Gender: 94.8% male, 5.2% female

Country: USA

When adjusted for demographic risk factors, combat exposure, and severe PTSD symptoms in the structural equation modelling, results revealed that spirituality was significantly associated with forgiveness and QoL. “Higher levels of spiritual functioning were associated with fewer forgiveness problems among these Veterans, and their propensity to forgive self and others was also concurrently linked with QOL” (p.175).

***Canada et al. [69].

Mediation analyses was conducted on data collected from the American Cancer Society’s Study of Cancer Survivors-II (n = 8405).

Mean age: 63 years

Gender: Female (55.1%), Male (44.9%)

Country: USA

Results show evidence that faith was strongly associated with meaning and peace in uncontrolled analyses. The mediation analyses show that faith had a significant positive effect on mental functioning (when mediated with greater meaning) and physical functioning (when mediated by both meaning and peace).

***Krause et al. [76].

Data were collected from a nationwide survey with adults (n = 1774) from 18 years above.

Mean age: 53.1 years (SD = 18.7 years)

Gender: Males (38%), Females (62%)

Country: USA

The structural equation modelling analyses revealed that those who received spiritual support from members of a faith community experienced stronger benevolent images of God (B = .362, p < .001) which influenced QoL. Results also suggest that those who have gratitude to God had more hope about the future (B = .214, p < .001), and hope was associated with better physical health (B = .330, p < .001)

# Rohani et al. [71].

A cross-sectional survey with Iranian women with breast cancer (n = 162).

Mean age: Breast cancer patients: M = 46.1, SD = 9.8; control group: M = 46.6, SD = 8.4

Country: Iran

Spirituality and positive religious coping was not associated with increases in QoL in Iranian patients.