@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2020;12(4):213-221
ISSN: 2008-2630 Iranian Journal of War & Public Health 2020;12(4):213-221
The Effect of Spiritual Practice along with Routine Medical Care on the Recovery of Patients Hospitalized with Covid-19: a Randomized Clinical Trial
ARTICLE INFO
Article Type
Original ResearchAuthors
Jahangir A. (1)Mousavi B. (*2)
Asgari M. (3)
Karbakhsh M. (4)
(*2) Prevention Department, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(1) Nursing Department, Army University of Medical Sciences, Tehran, Iran
(3) Janbazan Medical and Engineering Research Center (JMERC, Tehran, Iran
(4) Department of Social Medicine, Tehran University of Medical Sciences, Tehran, Iran
Correspondence
Address: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.Phone: +98 (21) 22416699
Fax: +98(21) 22412114
mousavi.b@gmail.com
Article History
Received: October 28, 2020Accepted: November 30, 2020
ePublished: March 9, 2021
ABSTRACT
Aims
This study was conducted to determine the effects of spiritual practice along routine medical care on the recovery of patients admitted with Covid-19.
Materials & Methods In a single-blinded clinical trial study 64 hospitalized patients with Covid-19, were randomly assigned in to two groups of intervention (spiritual practice+ routine treatment) and comparison (routine treatment). The intervention was performed using religious teachings, spiritual practice was taught to the patients in the intervention group with the intention of recovery and comfort. Spiritual practice was reciting Surah "Al-Hamd" and "Ya-Allah". The intervention group accomplished spiritual practice three times a day (21 times in total) for 7 days. Information gathered on demographic characteristics, depression and anxiety score, length of hospital stay, ICU transfer, intubation, and patient death. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used to determine the symptoms of depression and anxiety.
Findings A total of 35 participants in the comparison group and 29 in the intervention group completed the study. After intervention, there was no significant difference between the length of hospitalization days between the intervention group (5.8±1.7) and the comparison (6.7±1.7). The rate of ICU request was significantly higher in the comparison group (40%,n=14) than in the intervention group (3.4%, n=1) (P <0.001). In the intervention group, no cases of intubation and death occurred, in the comparison group, these rates were 40% (n=14) and 45.7% (n=16), respectively, and the difference was significant (P <0.001). The mean difference of anxiety score before and after spiritual practice in the intervention group was 3.1 (±3.6) and the comparison was 0.9 (±2.6) (P = 0.03). The mean difference of depression in the intervention group was 1.5 (2.1) and the comparison was 0.9 (1.8) (P <0.001).
Conclusion Spiritual practice along with routine medical care, can leadto less mortality, ICU transmission, intubation, improved anxiety/depression, as well as, improved recovery among Covid-19 hospitalized patients.
Materials & Methods In a single-blinded clinical trial study 64 hospitalized patients with Covid-19, were randomly assigned in to two groups of intervention (spiritual practice+ routine treatment) and comparison (routine treatment). The intervention was performed using religious teachings, spiritual practice was taught to the patients in the intervention group with the intention of recovery and comfort. Spiritual practice was reciting Surah "Al-Hamd" and "Ya-Allah". The intervention group accomplished spiritual practice three times a day (21 times in total) for 7 days. Information gathered on demographic characteristics, depression and anxiety score, length of hospital stay, ICU transfer, intubation, and patient death. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used to determine the symptoms of depression and anxiety.
Findings A total of 35 participants in the comparison group and 29 in the intervention group completed the study. After intervention, there was no significant difference between the length of hospitalization days between the intervention group (5.8±1.7) and the comparison (6.7±1.7). The rate of ICU request was significantly higher in the comparison group (40%,n=14) than in the intervention group (3.4%, n=1) (P <0.001). In the intervention group, no cases of intubation and death occurred, in the comparison group, these rates were 40% (n=14) and 45.7% (n=16), respectively, and the difference was significant (P <0.001). The mean difference of anxiety score before and after spiritual practice in the intervention group was 3.1 (±3.6) and the comparison was 0.9 (±2.6) (P = 0.03). The mean difference of depression in the intervention group was 1.5 (2.1) and the comparison was 0.9 (1.8) (P <0.001).
Conclusion Spiritual practice along with routine medical care, can leadto less mortality, ICU transmission, intubation, improved anxiety/depression, as well as, improved recovery among Covid-19 hospitalized patients.
CITATION LINKS
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[19]Roman NV, Mthembu TG, Hoosen M. Spiritual care–‘A deeper immunity’–A response to Covid-19 pandemic. African Journal of Primary Health Care & Family Medicine. 2020;12(1).
[20]Del Castillo FA, Biana HT, Joaquin JJ. ChurchInAction: the role of religious interventions in times of COVID-19. Journal of Public Health. 2020 Aug 18;42(3):633-4.
[21]Ribeiro MR, Damiano RF, Marujo R, Nasri F, Lucchetti G. The role of spirituality in the COVID-19 pandemic: a spiritual hotline project. Journal of Public Health. 2020 Dec;42(4):855-6
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[23]Forouhari S, Honarvaran R, Masumi R, Robati M, Hashemzadeh I, Setayesh Y. Investigating the auditory effects of Holy Quranic voice on labor pain. J Quran Med. 2009;1(2):18-22. [Persian]
[24]Jahangir A, Maftoon F. Interpretation of verse 82 of Surah Isra regarding prayer and healing. Interdiscip Quranic Stud. 2008;1(1):39-42. [Persian]
[25]Maftoon F, Jahangir A, Sedighi J, Karbakhsh Davari M, Farzadi F, Khodaei S. Prayer therapy (recitation of Surah Al-Fatihah Al-Kitab and Surah Al-Tawhid) and quality of life in patients with multiple sclerosis (MS). Interdiscip Quranic Stud. 2008;1(1):35-8. [Persian]
[26]Etefagh L, Azma K, Jahangir A. Prayer therapy: application of verses of Fatiha al-Kitab and chapters of Tawhid and Qadr in patients with carpal tunnel syndrome. Interdiscip Quranic Stud. 2009;1(2):27-31. [Persian]
[27]Farzin Ara F, Zare M, Mousavi Garmaroudi SM, Behnam Vashani HR, Talebi S. comparative study of the effect of Allah’s recitation and rhythmic breathing on postoperative pain in orthopedic patients. J Anesthesiol Pain. 2018;9(1):68-78. [Persian]
[28]Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The hospital anxiety and depression scale (HADS): Translation and valid study of the Iranian version. Health Qual Life Outcomes. 2003;1:14.
[29]Abedi H, Asgari M, Kazemi Z, Saffari F, Nasiri M. Religious Care Patients and the barriers. J Teb Tazkieh. 2005;4(53):23-16. [Persian]
[30]Matthews DA, Marlowe SM, Macnutt FS. Effects of intercessory prayer on patienationts with rheumatoid arthritis. South Med J. 2000;93(12):1177-86.
[31]Rafiei GR. The role of prayer on physical and mental health. Qom Univ Med Sci J. 2011;5:66-73. [Persian]
[32]Mohsenzadeh Ledari F, Hoseini Tabaghdehi M. Effect of Quran on the treatment of diseases: Literature review. Islam Health J. 2016;3(1):22-8. [Persian]
[33]Vanderweele TJ. Religious communities and human flourishing. Curr Dir Psychol Sci. 2017;26(5):476-81.
[34]Chida Y, Steptoe A, Powell LH. Religiosity/spirituality and mortality: A systematic quantitative review. Psychother Psychosom. 2009;78(2):81-90.
[35]Hayward RD, Elliott M. Cross-national analysis of the influence of cultural norms and government restrictions on the relationship between religion and well-being. Rev Relig Res. 2014;56:23-43.
[36]Li S, Stamfer MJ, Williams DR, Vanderweele TJ. Association between religious service attendance and mortality among women. JAMA Intern Med. 2016;176(6):777-85.
[37]Vanderweele TJ, Yu J, Cozier YC, Wise L, Argentieri MA, Rosenberg L, et al. Religious service attendance, prayer, religious coping, and religious-spiritual identity as predictors of all-cause mortality in the black women’s health study. Am J Epidemiol. 2017;185(7):515-22.
[38]Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. South Med J. 1988;81(7):826-9.
[39]Benson H, Dusek JA, Sherwood JB, Lam P, Bethea CF, Carpenter W, et al. Study of the therapeutic effects of intercessory prayer (STEP) in cardiac bypass patients: A multicenter randomised trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J. 2006;151(4):934-42.
[40]Masters KS, Spielmans GI, Goodson JT. Are there demonstrable effects of distant intercessory prayer? a meta-analytic review. Ann Behav Med. 2006;32(1):21-6.
[41]Aviles JM, Whelan SE, Hernke DA, Williams BA, Kenny KE, O'Fallon WM, et al. Intercessory prayer and cardiovascular disease progression in a coronary care unit population: A randomized controlled trial. Mayo Clin Proc. 2001;76(12):1192-8.
[42]Leibovici L. Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: Randomized controlled trial. BMJ. 2001;323(7327):1450-1.
[43]Koenig HG. Research on religion, spirituality, and mental health: A review. Can J Psychiatry. 2009;54(5):283-91.
[44]Kleinman EM, Liu RT. Prospective prediction of suicide in a nationally representative sample: Religious service attendance as a protective factor. Br J Psychiatry. 2014;204:262-6.
[45]Li S, Okereke OI, Chang SC, Kawachi I, Vanderweele TJ. Religious service attendance and lower depression among women: A prospective cohort study. Ann Behav Med. 2016;50(6):876-84.
[46]Vanderweele TJ, Li S, Tsai A, Kawachi I. Association between religious service attendance and lower suicide rates among US women. JAMA Psychiatry. 2016;73(8):845-51.
[47]Boelens PA, Reeves RR, Replogle WH, Koenig HG. A randomized trial of the effect of prayer on depression and anxiety. Int J Psychiatry Med. 2009;39(4):377-92.
[48]Tloczynski J, Fritzsch S. Intercessory prayer in psychological well-being: Using a multiple-baseline, across-subjects design. Psychol Rep. 2002;91(3 Pt 1):731-41.
[49]Anderson JW, Nunnelley PA. Private prayer associations with depression, anxiety and other health conditions: An analytical review of clinical studies. Postgrad Med. 2016;128(7):635-41.
[50]Carvalho CC, De Cassia Lopes Chaves E, Iunes DH, Simao TP, Da Silva Marciano Grasselli C, Braga CG. Effectiveness of prayer in reducing anxiety in cancer patients. Rev Esc Enferm USP. 2014;48(4):683-9.
[51]Carmody J, Reed G, Kristeller J, Merriam P. Mindfulness, spirituality, and health-related symptoms. J Psychosom Res. 2008;64(4):393-403.
[52]Sharif Nia SH, Hojjati H, Nazari R, Qorbani M, Akhoondzade G. The effect of prayer on mental health of hemodialysis patients. Iran J Crit Care Nurs. 2012;5(1):29-34. [Persian]
[2]Gorbalenya AE, Baker SC, Baric RS, De Groot RJ, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome-related Coronavirus–the species and its viruses, a statement of the Coronavirus study group. Biorxiv. 2020 Feb:1-15.
[3]Heymann DL, Shindo N. COVID-19: What is next for public health. Lancet. 2020;395(10224):542-5.
[4]Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): A perspective from China. Radiology 2020;296(2):15-25.
[5]Sun P, Qie S, Liu Z, Ren J, Li K, Xi J. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis. J Med Virol. 2020;92(6):612-7.
[6] Joost Wiersinga W, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19)A Review. JAMA. 2020;324(8):782-93.
[7]Wu YC, Chen CS, Chan YJ. Overview of the 2019 novel Coronavirus (2019-Ncov): The pathogen of severe specific contagious pneumonia (SSCP). J Chin Med Assoc. 2020;83(3):1
[8]Rosa SGV, Santos WC. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica. 2020;44:40.
[9]Tavakoli A, Vahdat K, Keshavarz M. Novel Coronavirus disease 2019 (COVID-19): An emerging infectious disease in the 21st century. Iran South Med J. 2020;22(6):432-50. [Persian]
[10]United nations. Report of the world summit for social development: Copenhagen, 6-12 March 1995 [Report]. New York: United Nations; 1996. Report NO.:96IV8.
[11]Pargament KI, Koenig HG, Perez LM. The many methods of religious coping: Development and initial validation of the RCOPE. J Clin Psychol. 2000;56(4):519-43.
[12]Koenig HG. Religion, spirituality, and health: The research and clinical implications. Psychiatry. 2012;2012:278730.
[13]Bormann JE, Gifford AL, Shively M, Smith TL, Redwine L, Kelly A, et al. Effects of spiritual mantram repetition on HIV outcomes: A randomized controlled trial. J Behav Med. 2006;29(4):359-76.
[14]Liao L. Spiritual care in medicine. JAMA. 2017;318(24):2495-6.
[15]Syed IB. Spiritual medicine in the history of Islamic medicine. J Int Soc Hist Islam Med. 2003;2(4):45-9.
[16]Ganguly S, Bakhshi S. Traditional and complementary medicine during COVID‐19 pandemic. Phytother Res. 2020;34(12):3083-4.
[17]Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Evidence map on the contributions of traditional, complementary and integrative medicines for health care in times of COVID-19. Integr Med Res. 2020;9(3):100473
[18]Nandan A, Tiwari S, Sharma V. Exploring alternative medicine options for the prevention or treatment of coronavirus disease 2019 (COVID-19)-A systematic scoping review. medRxiv. 2020 Jan 1.
[19]Roman NV, Mthembu TG, Hoosen M. Spiritual care–‘A deeper immunity’–A response to Covid-19 pandemic. African Journal of Primary Health Care & Family Medicine. 2020;12(1).
[20]Del Castillo FA, Biana HT, Joaquin JJ. ChurchInAction: the role of religious interventions in times of COVID-19. Journal of Public Health. 2020 Aug 18;42(3):633-4.
[21]Ribeiro MR, Damiano RF, Marujo R, Nasri F, Lucchetti G. The role of spirituality in the COVID-19 pandemic: a spiritual hotline project. Journal of Public Health. 2020 Dec;42(4):855-6
[22]World health organization. WHO global report on traditional and complementary medicine 2019 [Internet]. Geneva: World Health Organization; 2019 [Cited Y M D]. Available from: https://apps.who.int/iris/handle/10665/312342.
[23]Forouhari S, Honarvaran R, Masumi R, Robati M, Hashemzadeh I, Setayesh Y. Investigating the auditory effects of Holy Quranic voice on labor pain. J Quran Med. 2009;1(2):18-22. [Persian]
[24]Jahangir A, Maftoon F. Interpretation of verse 82 of Surah Isra regarding prayer and healing. Interdiscip Quranic Stud. 2008;1(1):39-42. [Persian]
[25]Maftoon F, Jahangir A, Sedighi J, Karbakhsh Davari M, Farzadi F, Khodaei S. Prayer therapy (recitation of Surah Al-Fatihah Al-Kitab and Surah Al-Tawhid) and quality of life in patients with multiple sclerosis (MS). Interdiscip Quranic Stud. 2008;1(1):35-8. [Persian]
[26]Etefagh L, Azma K, Jahangir A. Prayer therapy: application of verses of Fatiha al-Kitab and chapters of Tawhid and Qadr in patients with carpal tunnel syndrome. Interdiscip Quranic Stud. 2009;1(2):27-31. [Persian]
[27]Farzin Ara F, Zare M, Mousavi Garmaroudi SM, Behnam Vashani HR, Talebi S. comparative study of the effect of Allah’s recitation and rhythmic breathing on postoperative pain in orthopedic patients. J Anesthesiol Pain. 2018;9(1):68-78. [Persian]
[28]Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The hospital anxiety and depression scale (HADS): Translation and valid study of the Iranian version. Health Qual Life Outcomes. 2003;1:14.
[29]Abedi H, Asgari M, Kazemi Z, Saffari F, Nasiri M. Religious Care Patients and the barriers. J Teb Tazkieh. 2005;4(53):23-16. [Persian]
[30]Matthews DA, Marlowe SM, Macnutt FS. Effects of intercessory prayer on patienationts with rheumatoid arthritis. South Med J. 2000;93(12):1177-86.
[31]Rafiei GR. The role of prayer on physical and mental health. Qom Univ Med Sci J. 2011;5:66-73. [Persian]
[32]Mohsenzadeh Ledari F, Hoseini Tabaghdehi M. Effect of Quran on the treatment of diseases: Literature review. Islam Health J. 2016;3(1):22-8. [Persian]
[33]Vanderweele TJ. Religious communities and human flourishing. Curr Dir Psychol Sci. 2017;26(5):476-81.
[34]Chida Y, Steptoe A, Powell LH. Religiosity/spirituality and mortality: A systematic quantitative review. Psychother Psychosom. 2009;78(2):81-90.
[35]Hayward RD, Elliott M. Cross-national analysis of the influence of cultural norms and government restrictions on the relationship between religion and well-being. Rev Relig Res. 2014;56:23-43.
[36]Li S, Stamfer MJ, Williams DR, Vanderweele TJ. Association between religious service attendance and mortality among women. JAMA Intern Med. 2016;176(6):777-85.
[37]Vanderweele TJ, Yu J, Cozier YC, Wise L, Argentieri MA, Rosenberg L, et al. Religious service attendance, prayer, religious coping, and religious-spiritual identity as predictors of all-cause mortality in the black women’s health study. Am J Epidemiol. 2017;185(7):515-22.
[38]Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. South Med J. 1988;81(7):826-9.
[39]Benson H, Dusek JA, Sherwood JB, Lam P, Bethea CF, Carpenter W, et al. Study of the therapeutic effects of intercessory prayer (STEP) in cardiac bypass patients: A multicenter randomised trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J. 2006;151(4):934-42.
[40]Masters KS, Spielmans GI, Goodson JT. Are there demonstrable effects of distant intercessory prayer? a meta-analytic review. Ann Behav Med. 2006;32(1):21-6.
[41]Aviles JM, Whelan SE, Hernke DA, Williams BA, Kenny KE, O'Fallon WM, et al. Intercessory prayer and cardiovascular disease progression in a coronary care unit population: A randomized controlled trial. Mayo Clin Proc. 2001;76(12):1192-8.
[42]Leibovici L. Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: Randomized controlled trial. BMJ. 2001;323(7327):1450-1.
[43]Koenig HG. Research on religion, spirituality, and mental health: A review. Can J Psychiatry. 2009;54(5):283-91.
[44]Kleinman EM, Liu RT. Prospective prediction of suicide in a nationally representative sample: Religious service attendance as a protective factor. Br J Psychiatry. 2014;204:262-6.
[45]Li S, Okereke OI, Chang SC, Kawachi I, Vanderweele TJ. Religious service attendance and lower depression among women: A prospective cohort study. Ann Behav Med. 2016;50(6):876-84.
[46]Vanderweele TJ, Li S, Tsai A, Kawachi I. Association between religious service attendance and lower suicide rates among US women. JAMA Psychiatry. 2016;73(8):845-51.
[47]Boelens PA, Reeves RR, Replogle WH, Koenig HG. A randomized trial of the effect of prayer on depression and anxiety. Int J Psychiatry Med. 2009;39(4):377-92.
[48]Tloczynski J, Fritzsch S. Intercessory prayer in psychological well-being: Using a multiple-baseline, across-subjects design. Psychol Rep. 2002;91(3 Pt 1):731-41.
[49]Anderson JW, Nunnelley PA. Private prayer associations with depression, anxiety and other health conditions: An analytical review of clinical studies. Postgrad Med. 2016;128(7):635-41.
[50]Carvalho CC, De Cassia Lopes Chaves E, Iunes DH, Simao TP, Da Silva Marciano Grasselli C, Braga CG. Effectiveness of prayer in reducing anxiety in cancer patients. Rev Esc Enferm USP. 2014;48(4):683-9.
[51]Carmody J, Reed G, Kristeller J, Merriam P. Mindfulness, spirituality, and health-related symptoms. J Psychosom Res. 2008;64(4):393-403.
[52]Sharif Nia SH, Hojjati H, Nazari R, Qorbani M, Akhoondzade G. The effect of prayer on mental health of hemodialysis patients. Iran J Crit Care Nurs. 2012;5(1):29-34. [Persian]