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OBJECTIVES: To identify and map spiritual care interventions to address spiritual needs and alleviate suffering of patients in the context of palliative care. METHODS: A scoping review using the PRISMA ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was conducted according to the JBI (Joanna Briggs Institute) guidelines. The search was conducted from October 2022 to January 2023 using 9 electronic databases and gray literature. Studies on spiritual care interventions in palliative care were included. Disagreements between the 2 reviewers were resolved by discussion or a third reviewer. RESULTS: A total of 47 studies were included in this review. All selected articles were published between 2003 and 2022. In total, 8 types of spiritual care interventions were identified to assess spiritual needs and/or alleviate suffering: conversations between the patient and a team member, religious practice interventions, therapeutic presence, guided music therapy, multidisciplinary interventions, guided meditation, art therapy, and combined interventions with multiple components such as music, art, integrative therapy, and reflection. SIGNIFICANCE OF RESULTS: Our study identified few spiritual care interventions in palliative care worldwide. Although this review noted a gradual increase in studies, there is a need to improve the reporting quality of spiritual care interventions, so they can be replicated in other contexts. The different interventions identified in this review can be a contribution to palliative care teams as they provide a basis for what is currently being done internationally to alleviate suffering in palliative care and what can be improved. No patient or public contribution was required to design or undertake this methodological research.

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The present article aims to describe the different steps on how to design, develop and conduct quantitative and qualitative Spirituality and Health (S/H) studies from a Brazilian perspective, discussing definitions and instruments, and proposing a "how-to guide" for those interested in this field of research. A narrative review of the literature has been conducted by experts in the field of S/H aiming to develop a "how-to-guide". Spirituality is a very complex concept that has several challenges in the current scientific literature, including the lack of consensus in the definitions, the numerous dimensions assessed, the diverse instruments for measurement, the criticisms from other scholars, the great diversity of religious and cultural traditions and the growing number of "spiritual but not religious" individuals. This review supports that S/H studies may follow the high scientific standards, using consolidated research procedures and solid methods for both qualitative and quantitative research. Some peculiarities of the research methods for this field are discussed. S/H research is still under development, and there are several future directions for S/H studies, aiming to minimize previous criticisms and generating stronger evidence.

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BACKGROUND: Spirituality has religious and nonreligious dimensions and is often linked to well-being, positive emotions, connection and meaning in life. Both empathy and resilience are important in medical training and future professional practice since they are considered core skills related to professionalism and patient care. Our study aimed to understand the relationships among spirituality, resilience, and empathy in medical students. We also aimed to determine whether there are differences by gender and between medical students in different years of a medical program. METHODS: Medical students (n = 1370) of the first to fourth years of a six-year medical program, from six medical schools, completed questionnaires to assess empathy (Jefferson Empathy Scale and Davis Multidimensional Interpersonal Reactivity Scale) and resilience (Wagnild & Young Scale) and to rate their spirituality. RESULTS: Medical students with high spirituality showed higher scores for both resilience and empathy (p < 0.001). In addition, we observed higher levels of both spirituality and empathy, but not resilience, in female medical students than in male medical students. In contrast, we did not detect significant differences in spirituality, empathy, or resilience between students in different years of medical school. CONCLUSION: Medical students with high levels of spirituality have also higher scores for both empathy and resilience. Spirituality, empathy and resilience have similar values for students in different years of a medical program.

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No published studies have investigated the correlation between religiosity, spirituality, mental health, and idiopathic inflammatory myopathy (IIM) or systemic autoimmune myopathy. Therefore, we aimed to evaluate the association between religiosity/spirituality, sociodemographic factors, and the mental health of IIM patients. This is a multicenter case-control study that included 151 patients with IIMs and 95 individuals without autoimmune diseases (controls), held between August 2022 and April 2023. This study used a semi-structured questionnaire that included sociodemographic information and the juxtaposition of the following questionnaires: the Attitudes Related to Spirituality Scale (ARES); the Duke University Religion Index (DUKE), which is composed of the organizational religious affiliation (ORA), non-organizational religious affiliation (NORA), and intrinsic religiosity (IR) domains; and the General Health Questionnaire-12 (GHQ-12). Data were analyzed using Epi Info software 7.2.5 (Centers for Disease Control and Prevention, Atlanta, GA, USA). A comparison between the mean values of the ARES, DUKE, and GHQ-12 scales was made using the Wilcoxon-Mann-Whitney and Kruskal-Wallis tests. A logistic regression test was used with the variables whose difference was statistically significant in the univariate analysis. Correlation analysis was performed using the Spearman rho coefficient. A higher prevalence of evangelicals and a lower prevalence of Catholics (p < 0.050) were seen in the IIM group compared to controls. Positive association was demonstrated between IIMs and the pardo ethnicity (OR = 2.26, 95% CI = 1.20-4.25, p = 0.011), highest ORA (OR = 2.81, 95% CI = 1.53-5.15, p < 0.001), NORA (OR = 3.99, 95% CI = 1.94-8·18, p < 0.001), IR (OR = 5.27, 95% CI = 2.32-11.97, p < 0.001), and ARES values (OR = 1.08, 95% CI = 1.04-1.13, p < 0.001). Mental health levels were compared between the groups (p > 0.999). Therefore, higher levels of religiosity and spirituality were observed in the IIM group than in the control group, but there was a similar distribution of mental health levels. The following can be cited as advantages of the present study: (i) the large sample for a rare disease with the presence of a control group; (ii) the multicenter characteristic with participation from three regions of Brazil; (iii) being the first study to map aspects of religiosity, spirituality, and mental health in IIMs.

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The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes. METHODS: Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index - Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire - Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques. RESULTS: The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes. CONCLUSIONS: The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients' lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.

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Objetivo: O estudo visa analisar como a espiritualidade/religiosidade são importantes recursos de enfrentamento no processo de adoecimento e reabilitação em pessoas que recebem cuidados oncológicos. Visa-se descrever a percepção do papel desses recursos para as pessoas que recebem esses cuidados e investigar como ocorre a integração da fé na abordagem recebida por parte dos profissionais de saúde. Métodos: Trata-se de uma pesquisa de campo, descritiva e de cunho qualitativo, por meio de entrevistas com pessoas com doença oncológica assistidas pelo Instituto de prevenção do câncer Joel Magalhães-IJOMA nos meses de agosto/ setembro de 2021 e foram utilizados como instrumentos para a coleta de dados os questionários de caracterização e o questionário FICA. Resultados: Percebeu-se a importância de agregar a temática da espiritualidade/religiosidade no cuidado da pessoa com doença oncológica. Através das falas, identificou-se como a rede de apoio, os instrumentos para enfrentamento e a abordagem adequada do profissional são importantes recursos no decorrer do cuidado. Conclusão: É necessário ampliar a percepção dos profissionais de saúde acerca do cuidado holístico que abrange também a dimensão espiritual. Bem como propor uma intervenção consciente nos cuidados, ampliando os aspectos sociais e espirituais da pessoa, sem desprezar as práticas de Enfermagem e Ciência atuais. (AU)

Objective: The study aims to analyze how spirituality/religiosity are important coping resources in the process of illness and rehabilitation in people receiving cancer care. The aim is to describe the perception of the role of these resources for people who receive this care and investigate how the integration of faith in the approach received by health professionals occurs. Methods: This is a field research, descriptive and qualitative, through interviews with people with oncological disease assisted by the Joel Magalhães-IJOMA Cancer Prevention Institute in August/September 2021 and were used as instruments for data collection, the characterization questionnaires and the FICA questionnaire. Results: It was noticed the importance of adding the theme of religiosity/spirituality in the care of people with cancer. Through the speeches, it was identified as the support network, the coping instruments and the appropriate approach of the professional are important resources in the course of care. Conclusion: It is necessary to expand the perception of health professionals about holistic care that also encompasses the spiritual dimension. As well as proposing a conscious intervention in care, expanding the person's social and spiritual aspects, without neglecting current Nursing and Science practices. (AU)

Objetivo: El estudio tiene como objetivo analizar cómo la espiritualidad/religiosidad son importantes recursos de afrontamiento en el proceso de enfermedad y rehabilitación en personas que reciben atención oncológica. El objetivo es describir la percepción del papel de estos recursos para las personas que reciben este cuidado e investigar cómo se da la integración de la fe en el enfoque recibido por los profesionales de la salud. Métodos: Se trata de una investigación de campo, descriptiva y cualitativa, a través de entrevistas a personas con enfermedad oncológica asistidas por el Instituto de Prevención del Cáncer Joel Magalhães-IJOMA en agosto / septiembre de 2021 y se utilizaron como instrumentos para la recolección de datos, los cuestionarios de caracterización y el cuestionario FICA. Resultados: Se notó la importancia de incorporar el tema de la espiritualidad/religiosidad en la atención de las personas con cáncer. A través de los discursos, se identificó como la red de apoyo, los instrumentos de afrontamiento y el adecuado abordaje del profesional son recursos importantes en el curso de la atención. Conclusion: Es necesario ampliar la percepción de los profesionales de la salud sobre el cuidado holístico que englobe también la dimensión espiritual. Además de proponer una intervención consciente en el cuidado, ampliando los aspectos sociales y espirituales de la persona, sin descuidar las prácticas actuales de Enfermería y Ciencia. (AU)

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This prospective study examined the primary, secondary and complex conceptual models of religious/spiritual struggles with 18 indicators of whole person functioning across five domains: psychological well-being, psychological distress, social well-being, physical well-being and character. We used three waves of longitudinal data (Wave 1: August/September 2021, Wave 2: October/November 2021, Wave 3: February 2022) from Colombian university students (N = 2878, Mage = 20.88 ± 4.05 years). Adjusting for covariates assessed in Wave 1, our primary analysis applied the analytic templates for outcome-wide and lagged exposure-wide designs to estimate two sets of lagged linear regression models. Religious/spiritual struggles in Wave 2 were associated with a small-to-medium-sized decline in subsequent functioning on 17/18 indicators in Wave 3, and worse functioning on 16/18 indicators in Wave 2 was associated with very small-to-medium-sized increases in subsequent religious/spiritual struggles in Wave 3. The results provided evidence in favour of the complex conceptual model for 16/18 indicators of whole person functioning. Our findings extend existing evidence on the reciprocal association between religious/spiritual struggles and individual functioning to a wide range of indicators, reinforcing the need for practitioners to consider the dynamic interplay between religious/spiritual struggles and individual functioning as they work with younger populations.

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BACKGROUND: Health professionals in Colombian and many parts of the world, in some cases, work in precarious conditions and intend to migrate to other countries in search of better living conditions for themselves and their families, which results in inadequate distribution worldwide and in the quality of care throughout the health system, which can ultimately influence the quality of life of patients in their health-disease processes. PURPOSE: Describe in depth what quality of life at work is like for the health workforce in adult critical care (ACC). METHODS: This is an investigation of convergent parallel mixed methods approach that are integrated by means of a matrix in terms of convergence, divergence, and complementarity. Two methods are used: a transversal analytical method in which three instruments were applied to 209 participants to study the relationship between Quality of Life at Work, exposure to psychosocial risks, compassion fatigue and the intention to rotate; other than from the experiences narrated by 10 Human Talent in Health explore organizational practices in critical care. RESULTS: The dimension of quality of work life with the greatest dissatisfied was the management of free time (77%), the most compromised psychosocial risk was the pace of work (84%). They have high compassion satisfaction (67%) and there is an intention to migrate to another country (66%). The narrative results in discrimination/harassment as normalized practices and faceless spirituality. The integration of mixed methods shows convergence between the use of the instrument that measures quality of life at work and the narratives of the participants, complementarity with the other instruments, and divergence regarding the intention to rotate to another health institution. CONCLUSION: The positive trend that converges with the two approaches is that of safety at work and well-being achieved through work, embodied in the constant updating of technology and care protocols, experience time, balance between salary and work effort, staffing and supplies, and disconnection with work.

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Resumen Objetivo: Evaluar la eficacia de una intervención familiar en duelo complicado por ruptura de pareja. Materiales y método: Investigación con enfoque mixto de intervención en tres etapas (diagnóstica-implementación-evaluación). En la primera se realizó estudio observacional, transversal, descriptivo, con muestra aleatoria simple con remplazo n=99. Se aplicó "Escala de Distrés por Ruptura Amorosa" de Field y APGAR familiar de Smilkstein, previo consentimiento informado. Se incluyeron cinco familias con duelo complicado y disfunción familiar. Se emplearon métodos y técnicas de trabajo con familia. En la tercera etapa se utilizó diseño cuasi experimental con pretest y postest de duelo complicado y APGAR familiar. Para la captura y análisis de datos se empleó el SPSS V25, con estadística descriptiva y analítica con prueba t de student. Resultados. Fueron mujeres 81.8%, con edad Ⱦ=34,19-29 37.4%, bachillerato 37.4%, separados 59.6%, divorciados 49.4%. Con duelo complicado 14%, disfunción familiar 13%. Las familias con duelo complicado fueron disfuncionales 53.8%. Los factores de riesgo: conflicto en subsistema paterno filial, adicciones, economía. Factores protectores: grupos religiosos, artísticos, educativos y médicos. Las acciones se centraron en intervención cognitivo-conductual-emocional. En evaluación pretest/postest, el duelo complicado presentó diferencia de medias de Ⱦ=8.500, ŝ± 8.925, e IC95%: Li: 3.347 Ls:13.653, con t de student=3.564 y gl=13 y valor de p=0.003, estadísticamente significativo, diferencia de medias para Apgar familiar de Ⱦ= 3.357 con ŝ±1.946, IC95%: Li:2.234, Ls:4.481 con t de student=6.456 y gl=13, valor de p=0.001, estadísticamente significativo. Conclusiones: El efecto de la intervención familiar modificó el duelo complicado y mejoró la dinámica y funcionalidad familiar.

Abstract Objective: To evaluate the effectiveness of a family intervention in grief complicated by a couple breakup. Materials and method: Research with a mixed intervention approach in three stages (diagnosis-implementation-evaluation). In the first, an observational, cross-sectional, descriptive study was carried out, with a simple random sample with replacement n=99. Field's "Romantic Breakup Distress Scale" and Smilkstein's family APGAR were applied, with prior informed consent. Five families with complicated grief and family dysfunction were included. Methods and techniques of working with family were used. In the third stage, a quasi-experimental design was used with pretest and posttest of complicated grief and family APGAR. SPSS V25 was used to capture and analyze data, with descriptive and analytical statistics with Student's t test. Results: They were women 81.8%, with age Ⱦ=34.19-29 37.4%, high school 37.4%, separated 59.6%, divorced 49.4%. With complicated grief 14%, family dysfunction 13%. Families with complicated grief were dysfunctional 53.8%. Risk factors: conflict in paternalfilial subsystem, addictions, economy. Protective factors: religious, artistic, educational and medical groups. The actions focused on cognitive-behavioral-emotional intervention. In pretest/posttest evaluation, complicated grief presented a mean difference of Ⱦ=8.500, ŝ± 8.925, and 95% CI: Li: 3.347 Ls:13.653, with student's t=3.564 and df=13 and p value=0.003, statistically significant, mean difference for family Apgar of Ⱦ= 3.357 with ŝ±1.946, 95% CI: Li:2.234, Ls:4.481 with student's t=6.456 and df=13, p value=0.001, statistically significant. Conclusions: The effect of the family intervention modified complicated grief and improved family dynamics and functionality. Conclusions: The effect of the family intervention modified complicated grief and improved family dynamics and functionality.

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INTRODUÇÃO: Por muito tempo os profissionais de saúde seguiram um modelo com uma visão fragmentada do cuidado, focado apenas na doença. Atualmente, esse modelo tem mudado e os profissionais têm adotado uma visão integral do sujeito, ampliando o entendimento de saúde para aspectos biopsicossociais e espiritual no conceito multidimensional de saúde. OBJETIVOS: analisar o processo de formação do profissional de saúde durante a pós-graduação sobre a inclusão da religiosidade e espiritualidade como prática de cuidado em saúde, e identificar as etapas vivenciadas. MÉTODO: Trata-se de uma pesquisa qualitativa, que tem como base metodológica um relato de experiência de março de 2021 a novembro de 2022, a partir da prática de uma residente fisioterapeuta do Programa Multiprofissional em Clínica da Pessoa e da Família. RESULTADOS E DISCUSSÃO: Foram definidos a divisão e o compartilhamento de algumas fases de aprendizado durante a residência: (1) Desconhecimento sobre o tema na graduação, (2) Introdução teórica ao tema da Espiritualidade e (3) Abordagem com os pacientes e os impactos na minha formação. A análise das etapas foi realizada com base nas leituras de artigos científicos realizadas para embasamento do presente estudo. CONSIDERAÇÕES FINAIS: É importante que mais estudos sobre o tema sejam desenvolvidos, com objetivo de incentivar discussões sobre o assunto nas universidades, para que futuros profissionais de saúde tenham uma formação humanizada, ademais, desenvolver métodos eficazes para integração da espiritualidade na prática clínica e construir/validar escalas no Brasil.

INTRODUCTION: For a long time, health professionals followed a model with a fragmented view of care, focused only on the disease. Currently, this model has changed and professionals have adopted an integral view of the subject, expanding the understanding of health to biopsychosocial and spiritual aspects in the multidimensional concept of health. OBJECTIVES: analyze the training process of health professionals during postgraduate studies on the inclusion of religion and spirituality as a health care practice, identifying the stages experienced. METHOD: This is qualitative research and its methodological basis is an experience report from March 2021 to November 2022, based on the practice of a physiotherapist resident of the Multiprofessional Program in Clínica da Pessoa e da Família. RESULTS AND DISCUSSION: It was defined the division and sharing of some learning phases during the residency: (1) Lack of knowledge about the subject in graduation, (2) Theoretical introduction to the theme of Spirituality and (3) Approach with patients and the impacts on my training. The analysis of the stages was carried out based on the readings of scientific articles carried out for the basis of the present study. FINAL CONSIDERATIONS: It is important that more studies on the subject be developed with the aim of encouraging discussions on the subject in universities so that future health professionals have a humanized training, in addition, to develop effective methods for integrating spirituality into clinical practice and to build/validate scales in Brazil.

INTRODUCCIÓN: Durante mucho tiempo, los profesionales de la salud siguieron un modelo con una visión fragmentada del cuidado, centrado únicamente en la enfermedad. Actualmente, ese modelo ha cambiado y los profesionales han adoptado una visión integral del tema, ampliando la comprensión de la salud a aspectos biopsicosociales y espirituales en el concepto multidimensional de la salud. OBJETIVOS: analizar el proceso de formación de los profesionales de la salud durante los estudios de posgrado sobre la inclusión de la religión y la espiritualidad como práctica de atención a la salud, identificando las etapas vividas. MÉTODO: Esta es una investigación cualitativa y su base metodológica es un relato de experiencia de marzo de 2021 a noviembre de 2022, basado en la práctica de un fisioterapeuta residente del Programa Multiprofesional en la Clínica da Pessoa e da Família. RESULTADOS Y DISCUSIÓN: Se definió la división y puesta en común de algunas fases de aprendizaje durante la residencia: (1) Falta de conocimiento sobre el tema en la graduación, (2) Introducción teórica al tema de la Espiritualidad y (3) Acercamiento con los pacientes y los impactos en mi entrenamiento. El análisis de las etapas se realizó a partir de las lecturas de artículos científicos realizadas para la base del presente estudio. CONSIDERACIONES FINALES: Es importante que se desarrollen más estudios sobre el tema con el objetivo de incentivar discusiones sobre el tema en las universidades para que los futuros profesionales de la salud tengan una formación humanizada, además de desarrollar métodos efectivos para integrar la espiritualidad en la práctica clínica y para construir/validar escalas en Brasil.

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Dementia is characterized by the presence of progressive cognitive and behavioral symptoms which affect normal functioning. With the purpose of determining if there are any changes related to patients' religiosity due to dementia, we developed a questionnaire aiming to evaluate changes pre and post diagnostic. In effect, we observed that patients with dementia might experience a reduction of the importance given to religion and its associated practices with the disease progression. However, God's belief did not show any changes despite the diagnosis. Therefore, we point out the relevance of incorporating religiosity as another aspect to take into account in the cognitive rehabilitation treatments.

La demencia se caracteriza por un inicio gradual y un deterioro cognitivo y conductual progresivo, que provoca un significativo impacto en el funcionamiento normal del paciente. Con el objetivo de determinar si hay cambios en la religiosidad de los pacientes con demencia, desarrollamos un cuestionario con el propósito de evaluar cambios en aspectos relacionados con la religiosidad de los pacientes 10 años atrás y en la actualidad. Este formulario fue contestado por familiares y cuidadores. El estudio mostró que los pacientes con demencia podrían experimentar una reducción de la importancia dada a la religión y a sus prácticas asociadas durante el curso de la enfermedad. Sin embargo, la creencia en Dios no se vería modificada a pesar del diagnóstico. Por lo tanto, y dado que se ha visto que la religiosidad puede ayudar en pacientes con demencia, señalamos la relevancia de tener en cuenta dicha variable y de incorporar estrategias para los tratamientos de rehabilitación cognitiva y para la psicoeducación del entorno del paciente.

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OBJECTIVES: To identify the current state of understanding about end-of-life experiences (ELEs) and examine evidence concerning prevalence, the impact on the process of dying and the perceptions/explanations of patients, relatives and healthcare professionals (HCPs) with regard to ELEs. METHODS: Scoping review and mixed-methods systematic review (ScR and MMSR). Nine academic databases were searched for a screening of the available scientific literature (ScR). Articles reporting qualitative, quantitative or mixed-methods studies were selected (MMSR), the quality of which was assessed using the Joanna Briggs Institute (JBI) standardised critical appraisal tools. The quantitative data were synthesised in narrative form while a meta-aggregation approach was adopted for the qualitative results. RESULTS: The ScR identified 115 reports, with 70.4% published after 2010, 55.6% from the USA and the most common terminology for ELE was deathbed visions (29%). The MMSR included 36 papers, describing 35 studies in various settings. The combination of quantitative and qualitative evidence indicated a greater prevalence of ELEs in samples of patients and HCPs compared with relatives. The most common ELEs were visions and dreams of the presence of deceased relatives/friends with references to making ready for a journey. The impact of ELEs was mainly positive, and there was a tendency to interpret them as spiritual experiences inherent to the process of dying. CONCLUSIONS: ELEs are often reported by patients, relatives and HCPs and have a significant, generally positive impact on the process of dying. Guidelines for the furtherance of studies and clinical applications are discussed.

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The diagnosis, treatment, and sequels of cancer are relevant sources of stress, conflicts, and suffering, but spirituality may be a positive coping element. However, studies involving the correlation between prostate cancer patients and spirituality are few and heterogeneous. MEDLINE (PUBMED), SCOPUS, and EMBASE were the databases used for this review with the keywords "spirituality," "religion," and "prostate cancer." The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. About 250 articles were found, and 30 were eligible. Most studies (N = 26; 86.6%) reported the relationship between spirituality and better health findings such as 80% being positively associated with more screening for prostate cancer and better patients' quality of life. More interventional, randomized, and multicentric trials are needed to clarify this relationship.

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OBJECTIVES: To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies. METHODS: This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n = 64) who received spiritual care training and sixth-year students (n = 51) who did not receive this training - control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported. RESULTS: Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d = 0.99), "Improvement of care" (d = 0.69), "Counseling (d = 0.88)," "Referral" (d = 0.75), and "Total Spiritual Care" (d = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032. SIGNIFICANCE OF RESULTS: Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools.

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BACKGROUND: Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS: To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD: This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS: A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION: The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.

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There is robust evidence to support the relationship between spirituality and mental health, but the mechanisms of this association are not well-understood. The existential meaning provided by spirituality may be one of these mechanisms. This was the central theme of Viktor Frankl's psychology, which he explained using the notion of the spiritual unconscious. Thus, we sought to explain how Frankl understands this spiritual unconscious and the two pieces of evidence he presents for its existence: the phenomenological description of responsible action and the analysis of dreams. Lastly, we discuss his contribution to the current understanding of the relationship between having an overarching purpose and/or religious meaning and improvement in mental health.

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RESUMO Introdução: A empatia tende a diminuir ao longo da formação médica. A relação entre espiritualidade e empatia não tem sido amplamente explorada. Objetivo: Este estudo teve como objetivo correlacionar empatia e religiosidade/espiritualismo por meio de questionário voluntário, entre estudantes e residentes de Medicina. Método: Trata-se de um estudo transversal exploratório por meio de um questionário online para preenchimento voluntário entre estudantes de medicina e residentes, composto por: dados sociodemográficos, questionário de empatia e questões sobre religiosidade/espiritualismo. Resultado: De 1.550 convites, 273 participantes voluntários responderam (17,6%). A maioria era católica (103 - 37,7%), seguida de agnósticos (84 - 30,8%), protestantes e kardecistas (27 - 9,9% cada). A Escala de Empatia de Jefferson apresentou pontuação média de 120,4 (de 90 a 140). Não se constatou correlação entre a crença religiosa e o grau de empatia. Ambos os conceitos não indicaram diferença significativa ao longo do período da educação médica. Conclusão: Empatia e religiosidade/espiritualismo não apresentaram correlação entre estudantes e residentes de Medicina.

ABSTRACT Introduction: Empathy tends to decline throughout the course of medical training. The relationship between spirituality and empathy has not been widely explored. Objective: To correlate empathy and religiosity/spiritualism by means of a voluntary questionnaire applied to medical students and residents. Methods: This is an exploratory cross-sectional study using an online questionnaire completed on a voluntary basis by medical students and residents, consisting of: socio-demographic data, an empathy questionnaire and questions about religiosity/spiritualism. Results: From 1,550 invitations, 273 volunteer participants responded (17.6%). Most were Catholic (103 - 37.7%), followed by agnostics (84 - 30.8%), and Protestants and Kardecists (27 - 9.9% each). The Jefferson Empathy Scale had a mean score of 120.4 (from 90 to 140). Religious belief and degree of empathy did not present any correlation. Neither concept presented significant difference over the course of medical training. Conclusion: Empathy and religiosity/spiritualism did not present any correlation among medical students and residents.

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Abstract The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes. Methods Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index - Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire - Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques. Results The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes. Conclusions The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients' lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.

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Resumo A religiosidade e a espiritualidade desempenham papéis cruciais na medicina, especialmente na abordagem centrada no paciente, melhorando a relação médico-paciente. Apesar disso, muitos médicos ainda subutilizam esses recursos, muitas vezes devido a insegurança ao lidar com a esfera pessoal da vida dos pacientes. Para abordar essa questão, conduziu-se pesquisa com 128 médicos, incluindo residentes, em um hospital universitário de Minas Gerais, entre agosto e dezembro de 2021, mediante aplicação dos questionários Inventário de Religiosidade de Duke e Escala Multidimensional de Reatividade Interpessoal, além de questões levantadas em estudos anteriores sobre saúde e espiritualidade. Com isso, buscou-se avaliar de que forma profissionais percebem a importância da religiosidade e da espiritualidade na prática clínica e sua relação com posturas éticas e humanistas. Os resultados revelaram correlação significativa entre as duas escalas, indicando associação positiva entre religiosidade e espiritualidade e empatia.

Abstract Religiosity and spirituality are pivotal in medical practice, particularly in fostering a patient-centered approach that enhances the physician-patient relationship. Despite this, many physicians still underutilize these invaluable resources, often due to feelings of uncertainty when navigating the personal aspects of patients' lives. To address this challenge, a survey involving 128 physicians, including residents, was conducted at a university hospital in Minas Gerais between August and December 2021. Utilizing the Duke Religiosity Inventory and Multidimensional Interpersonal Reactivity Scale questionnaires, alongside inquiries drawn from prior studies on health and spirituality, the goal was to assess professionals' perceptions of the significance of religiosity and spirituality in clinical practice and their interplay with ethical and humanistic attitudes. The findings unveiled a significant correlation between the two scales, underscoring a positive connection between religiosity, spirituality, and empathy.

Resumen La religiosidad y la espiritualidad desempeñan un papel clave en la medicina, especialmente en el enfoque centrado en el paciente al mejorar la relación médico-paciente. Muchos médicos aún no utilizan este recurso, debido a la inseguridad a menudo de enfrentar la vida personal de los pacientes. En este estudio se aplicó a 128 médicos y residentes de un hospital universitario de Minas Gerais (Brasil) los cuestionarios Índice de Religiosidad de Duke y Índice de Reactividad Interpersonal Multidimensional entre agosto y diciembre de 2021, así como preguntas planteadas en estudios anteriores sobre salud y espiritualidad. Se pretendió evaluar la percepción de los profesionales sobre la importancia de la religiosidad y la espiritualidad en la práctica clínica y su relación con las actitudes éticas y humanistas. Los resultados revelaron una correlación significativa entre las dos escalas, lo que indica una asociación positiva entre la religiosidad y espiritualidad y la empatía.

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Resumo O predomínio de teorias formuladas sob inspiração do estilo de vida ocidental no campo da psicologia acabou criando lacunas ao deixar de incluir especificidades de alguns grupos étnicos, religiosos e culturais. Esse cenário impulsionou vários movimentos recentes, que defendem uma psicologia culturalmente sensível que possa incluir as nuances e particularidades desses grupos. Inclui-se nesse contexto o Islã, uma religião que não se restringe somente às crenças, práticas e rituais religiosos, mas que engloba normas e preceitos que influenciam o estilo de vida do indivíduo. Este estudo tem como objetivo delinear uma reflexão teórica a respeito da psicologia islâmica, demarcando possibilidades e limites da integração de epistemologias religiosas como recurso potencial no campo da psicologia da religião. São abordados aspectos conceituais, origens históricas e fundamentos teóricos e metodológicos dessa nova abordagem, que vem ganhando cada vez mais espaço em instituições ao redor do mundo e no campo de pesquisa.

Abstract The psychological theories formulated under inspiration from the Western lifestyle created gaps by failing to include ethnic, religious, and cultural specificities. From this scenario emerged several recent movements which advocate a culturally sensitive psychology that encompass ethnic nuances and particularities. This context includes Islam, a religion that encompasses beliefs, practices, and rituals, as well as norms and precepts that influence the individual's lifestyle. This study outlines a theoretical reflection on Islamic psychology, demarcating the possibilities and limits of integrating religious epistemologies in Psychology of Religion. Conceptual, historical, theoretical, and methodological aspects of this new approach, which has been gaining space in institutions worldwide and in the research field, are addressed in this study.

Resumen El predominio de teorías formuladas bajo la inspiración del estilo de vida occidental en el campo de la Psicología generó vacíos al no incluir especificidades de algunos grupos étnicos, religiosos y culturales. En este escenario surgieron movimientos recientes que abogan por una psicología culturalmente sensible, que incluya las particularidades y matices de estos grupos. Este contexto incluye el Islam, una religión que no solo se limita a creencias, prácticas y rituales religiosos, sino que también abarca normas y preceptos que influyen en el estilo de vida del individuo. El objetivo de este estudio es esbozar una reflexión teórica sobre la psicología islámica, demarcando posibilidades y límites de la integración de epistemologías religiosas como recurso potencial en el campo de la Psicología de la Religión. Se abordan aspectos conceptuales, orígenes históricos y fundamentos teóricos y metodológicos de este enfoque, que ha ganado espacio en instituciones de todo el mundo y en el campo de la investigación.

Résumé Les théories élaborées sous l'inspiration de l'Occident dans la Psychologie a créé des lacunes en omettant d'inclure les spécificités des groupes ethniques, religieux et culturels. Ce scenario donne naissance à plusieurs mouvements récents qui prônent une psychologie douée d'une sensibilité culturelle. Ce contexte inclut l'Islam qui, en plus des croyances et des pratiques, impose des normes et des préceptes qui influencent le mode de vie de l'individu. Cette étude esquisse une réflexion théorique sur la psychologie islamique, soulignant les possibilités et les limites d'intégrer des épistémologies religieuses comme ressource potentielle dans la psychologie de la religion. Les aspects conceptuels, origines historiques et fondements théoriques et méthodologiques de cette nouvelle approche, qui prend de plus en plus de place dans les institutions du monde entier et dans la recherche, sont abordés.

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