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Table 2 Emerging themes related to relational spirituality and quality of life for the last 10 years

From: Relational spirituality and quality of life 2007 to 2017: an integrative research review

References Domain of QoL & Instrument Meaning of RS & Instrument Main Idea
Idler et al. [62]. Health status and functional ability, family and friendship networks, and psychological well-being
Instrument: 20-item Center for Epidemiological Studies Depression Scale.
The idea of a connection to the sacred through religious rituals or experiences that serve as sources of strength and comfort in the last year of life.
Instrument: Designed variable for ratings of subjective religiosity
QoL in the last year of life is positively related to subjective religiosity due to the social support that is gained in the process of associating with religious believers.
Saffari et al. [63]. Mobility, usual activities, self-care, pain/discomfort and anxiety/depression
Instrument: EQ-5D-3 L (which includes the EQ-5D assessing mobility, self-care, usual activities, pain/discomfort, anxiety/depression; and the Visual Analogue Scale (EQ-VAS) that allows respondents to rate their current health status from 0 to 100.
Intrinsic religiosity and private religious activities that draw a sense of connection to the sacred.
Instrument: Spiritual Coping Strategies (SES) and The Duke University Religion Index (DUREL)
Spiritual resources may contribute to better QoL and health status among haemodialysis patients.
Nagpal et al. [29]. Perceived QoL, behavioural competence, psychological status, and interpersonal environment
Instrument: The Quality of Life -Alzheimer’s Disease Scale (QoL-AD)
Prayer, meditation, and subjective ratings of religiosity
Instrument: Designed variable for subjective ratings of religiosity (How religious or spiritual would you say you are?) answered on a Likert scale from 1 (not at all religious/spiritual) to 4 (very religious/ spiritual).
The religiosity of a caregiver for an individual with Dementia may affect the perception of QoL of the individual they are looking after. In contrast, one’s own perception of spirituality does not guarantee QoL.
Miller et al. [30]. Emotions, confidence, self-esteem, physical health
Instrument: Heart disease specific QOL questionnaire
Prayer or meditation, consequential religiosity for coping with personal problems, theological belief system, experiential religiosity pertaining to feeling of religious comfort.
Instruments: The Spiritual and Religious Concerns (SRC) questionnaire; The Religiosity Measure (RM); Religious coping activities scale.
The distress following a cardiac event may require support from religious behaviour and spiritual beliefs. However, if there is no such support, as shown in the results, the authors argue that lower perceptions of QoL may trigger negative forms of religious coping and put the couples at risk of spiritual distress.
Nguyen et al. [75]. Functional status, physical health, and mental health
Instrument: Assessed indicators of physical HRQoL and mental HRQoL using the MEPS which includes the 12-item of the Medical Outcomes Study questionnaire (SF-12v2)
Instrument: Asked respondents if they used self-prayer as a form of complementary therapy within the past year. Responses to the item were combined to create a dichotomous variable reflecting the prayer and other five complementary therapies recognized by the US National Center of Complementary and Alternative Medicine (NCCAM), including alternative medical systems (i.e., any use of acupuncture, Ayurveda, homeopathy, or naturopathy), biologically based therapies (i.e., any use of chelation therapy, folk medicine, herb use, diet-based therapy, or megavitamin therapy in the past year),, manipulative and body-based methods (i.e., any use of chiropractic and massage in the past year), mind-body medicine (i.e., any use of biofeedback, relaxation techniques such as meditation, hypnosis, movement therapies such as yoga, or healing rituals in the past year),
Prayer and having a sense of connection to the sacred may be a complementary health practice among older adults since it is used more than as any other alternative health therapy. However, this position may change over time since it is not necessarily associated to QoL.
Ai et al. [64]. Psychological functioning (behaviour coping, cognitive coping, levels of distress, anger coping, avoidant coping, depression), physical functioning (fatigue symptoms), social relationships (perceived social support).
Instruments: Short-term postoperative quality-of-life (SPQOL) (levels of distress, fatigue symptoms, levels of coping, and perceived social support) was measured by modifying several scales: 14-item Fatigue Scale, Center for Epidemiologic Studies Depression Scale (CES-D), Multidimensional Coping Scale, and the 12-item Multidimensional Scale of Perceived Social Support
Coping by praying in private
Instrument: 3 items of the Using Private Prayer as a Means of Coping (Ai et al., 2002) was used to assess prayer coping based on its appraisal (“Private prayer is important in my life”), efficacy (“Prayer does not help me to cope with difficulties and stress in my life”), and intention to use (e.g., “I will use private prayer to cope with difficulties and stress associated with my cardiac surgery”)
“Psychosocial factors may explain the potential role of using prayer for coping on short-term postoperative QoL” (p. 471).
Calvo et al. [70]. Physical health and overall QoL (i.e. emotional health, social well-being, and spiritual and financial aspects); psychological functioning (i.e., levels of anxiety, symptoms of depression, life satisfaction)
Instruments: McGill Quality of Life Questionnaire (MQoL); Satisfaction with Life Scale (SWLS); Zung Depression Scale (ZDS); Spielberger ‘s State and Trait Anxiety Inventory (STAI)
Private/subjective religiosity
Instrument: 4-item Idler Index of Religiosity (IIR)
The religiosity of caregivers of patients with ALS can be a helpful coping resource for negotiating their own QoL. Hence, “Health care professionals caring for ALS patients should consider that the needs of the caregivers include religious/spiritual concerns” (p.168).
Kashdan & Nezlek [72]. Psychological well-being, meaning in life, positive affect, self-esteem.
Instrument: Items were adapted from existing scales to assess self-esteem (Rosenberg Self-Esteem Scale), meaning in life (using two items, e.g., “How meaningful did you feel your life was today?” “How much did you feel your life had purpose today?”), and responses to negative (nervous, embarrassed, upset, disappointed, bored, and sad) or positive (enthusiastic, excited, happy, calm, satisfied, and relaxed) affects as the conceptualisation of QoL
Daily spirituality, Personal relationship with a power greater than one’s self, the spiritual part of one’s life.
Instrument: 22-item Spiritual Involvement and Beliefs Scale (SIBS-R) assessing Core Spirituality (e.g., “I have a personal relationship with a power greater than myself”; “I solve my problems without using spiritual resources”)
The study shows that spirituality is used as a coping strategy to deal with negative emotions. This is because the negative emotion experienced on 1 day is likely to predict increases in spirituality on the next day.
Nolan et al. [65]. Physical health, psychological health, social relationships, environmental health.
Instrument: World Health Organization Quality of Life–BREF (WHOQoLBREF)
Religious coping, being connected to God through participating in prayer groups, meetings, and religious activities, meditation, spiritual reading, religious forgiveness, spiritual connection to God, benevolent religious reappraisal
Instrument: 14-item RCOPE consisting of the positive religious coping pattern (e.g., religious forgiveness, seeking spiritual support, collaborative religious coping, spiritual connection, religious purification, and benevolent religious reappraisal) and the negative religious coping pattern (e.g., spiritual discontent, reappraisal of God as punishing, interpersonal religious discontent, reappraisal of demonic powers, and reappraisal of God’s powers).
Spirituality or religious coping in the form of community prayer services and devotion to God is an important factor that may have a major impact on the treatment of patients of African-American origin with Schizophrenia.
Bradshaw & Kent [22]. Psychological Well-Being
Instrument: three measures of psychological well-being: self-esteem, optimism, and life satisfaction
Attachment to God through prayer
Instruments: Attachment to God Scale and frequency of prayer was based on a single item (How often do you pray by yourself?)
A relationship with God makes prayer effective: the impact of prayer on one’s QoL depends on one’s perceived relationship (attachment) with God.
Sorensen et al. [66]. Psychological wellbeing, physical health symptoms, self-image, sexuality
Instrument: Psychological wellbeing in terms of life satisfaction was measured by the item: “Thinking about your life at the moment, would you say that you, by and large, are satisfied with life, or are you mostly dissatisfied?”, with response option dichotomised into ‘Dissatisfied with Life’ and ‘Satisfied with Life’. In addition, physical health was assessed using The EORTC breast cancer module (BR-23), prostate cancer module (PR-25), and colorectal cancer module (CR-29) which cover symptoms, self-image, sexuality, and specific complaints during the previous week.
Seeking God’s Help.
Instrument: A sub-scale of the Instrument of Religious Coping (RCOPE) (e.g., “I seek God’s help when I need strength and solace”) was dichotomized into two response options: ‘Seeking God’s Help’ and ‘Not Seeking God’s Help’.
Cancer patients in Norway are not likely to seek God’s help to negotiate their QoL.
Yun et al. (2012). Physical health, psychological health.
Instrument: European Organization for Research and Treatment of Cancer quality-of-life questionnaire core-30 (EORTC QLQ-C30) instrument
Prayer therapy
Instrument: Investigated participants’ use of mind–body intervention (yoga, meditation, prayer therapy, music/dance therapy, art therapy, and horticultural therapy).
Using mind-body interventions (e.g. prayer) may not be helpful for Korean cancer patients.
Levin [73]. Physical health
Instrument: Activities of Daily Living Scales and variables on indicators of physical health such as self-rated health, long-term health problems, activity limitation, diagnosed chronic diseases, physical symptoms.
Frequency of prayer
Instrument: Designed variables for synagogue activities (e.g., “Have you done any of these activities in the last month? Taken part in a religious organisation [church, synagogue, mosque, etc.])”, prayer (e.g., “Thinking about the present, how often do you pray?”), and religious education (e.g., “Have you been educated religiously by your parents?”)
Religious involvement in the Synagogue is a much stronger predictor of better physical health than prayer, among Jewish people.
Moon & Kim [28] Physical health status, mental health status, social relationships, and the environment.
Instrument: Geriatric quality of life-dementia (GQOL-D)
Subjective religiosity.
Instrument: Duke religion index (DUREL)
Subjective religiosity may account for the difference in QoL based on one’s religious background
Krumrei et al. [74] Physical health
Instrument: Physical Component Summary score of the Short Form Health Survey (SF-12)
Trust/mistrust in God and religious coping
Instrument: Brief Trust/Mistrust in God Scale; Jewish Religious Coping Scale (JCOPE); 2 items of the intrinsic religiosity subscale of the Duke Religion Index
“Beliefs about the Divine activate coping strategies during times of distress, which in turn impact psychological health” (p.327). Highlights spirituality as having a clinical significance in mental health among Jews
Lee, Nezu, & Nezu [27]. Life satisfaction, Health worries, Financial worries, Medication worries, HIV mastery, Disclosure worries, Provider trust, and Sexual functioning
Instrument: The 34-item HIV/AIDS-targeted quality of life (HAT-QoL)
Spiritual connection for religious coping
Instrument: Religious Coping Scale (RCOPE),
Religion is an important resource for people living with HIV/AIDS
Currier et al. [68]. Physical health, psychological health, social and environmental QoL.
Instrument: World Health Organization’s Quality of Life Scale (WHOQOL-bref)
Spiritual functioning in terms of forgiveness of self, others, and God.
Instrument: Brief Multidimensional Measure of Religiousness and Spirituality (BMMRS)
Forgiveness is an important factor to consider when modelling for spirituality and QoL.
Canada et al. [69]. Mental functioning, physical functioning, spiritual functioning.
Instrument: SF-36 Physical and Mental Health Summary Scales
Feelings of comfort and strength
Instrument: Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale
Faith makes an important contribution to the QoL of cancer survivors.
Krause et al. [76]. Physical health
Instrument: Physical health was measured using the Physical Component Summary score of the Short Form Health Survey (SF-12).
Depressive symptoms were also assessed as an aspect of psychological QoL functioning using a short form of the Center for Epidemiologic Studies Depression Scale (CES-D).
God image representations; intrinsic religiosity; trust in God
Instrument: 6-item Brief Trust/Mistrust in God Scale (e.g., “God cares about my deepest concerns”; “God hates me”); 16-item Jewish Religious Coping Scale (JCOPE) (e.g., “I try to see how God may be trying to teach me something,” “I question my religious beliefs, faith and practices,” and “I look for a stronger connection with God”).
Intrinsic religiosity was measured using three items from the Duke Religion Index which are also present in the Religious Orientation Scale and the Hoge Intrinsic Religion Scale (e.g., “My religious beliefs are what really lie behind my whole approach to life,” “In my life, I experience the presence of the Divine (i.e., God),” and “I try hard to carry my religion over in to all other dealings in life”).
Spiritual/social support from fellow members of a church influences one’s perception of God as benevolent and gratitude to God, which in turn leads to better health.
Rohani et al. [71]. Physical health
Instrument: European Organization for Research and Treatment of Cancer QLQ-C30; Sense of Coherence (SOC) scale
Spiritual behaviours and views that are developed through private prayer or meditation
Instrument: Spiritual Perspective Scale; the Brief Religious Coping Scale
Spirituality is not associated with QoL for Iranian women with breast cancer.