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Spirituality in Nursing

Spirituality’s Impact on Health Behaviors

Published January 29, 2016 12:54 PM by Mark Darby
Nursing is focused on Evidenced Based Practice. More so now than in any other time in our history, we look to research and the scientific method. You may think these methods fail us when we study spirituality. Can you imagine being a peer reviewer and being assigned an article entitled "God and Cholesterol: An underused intervention" I can just see the description of the research protocol. "A group of volunteers were randomly assigned to two groups--God and Not-God. The God group was exposed to God twice a day for 15 minutes with the Not-God group receiving general counseling only with all contact with God blocked. In a 6 week follow up the God group had a 15.7% lowering of LDL (p <0.013) and a rising of HDL 4.5% (p < 0.01) than control." Nah, I don't think so.

It would be a big error to think that religion and spirituality are completely separate from research. There are research methods that can be used to examine religion and spirituality and guide its use in health care. Harold Koenig, MD from Duke University, has done some excellent work in this area. In a 2012 review article in Psychiatry he searched databases for articles researching the connection between religion/spirituality and health. In the 128 years between 1872 and 2000 he found 1200 articles. In the next 10 years he found 2100 studies--almost double the number of articles. He grouped these articles together according to their effects on mental health, health behaviors and physical health.

A majority of articles showed that religion and spirituality had positive influences on mental health including positive influences on depression, stress reduction, coping with adversity, sense of purpose, and happiness. Religion and spirituality also had positive influences not only on health behaviors such as cigarette smoking, exercise and healthy diet but also on physical health such coronary disease, cerebral vascular functioning, cancer and mortality.

I would encourage you to read this article (Koenig HG. (2012) Religion, spirituality, and health: the research and clinical implications. <> Psychiatry Dec 16;2012:278730. doi: 10.5402/2012/278730) though his other work is well worth reading. In this article, in his conclusion section, Koenig acts only as an objective scientist. He states that the effects of spirituality and religion can be measured using normal scientific methods and explained using normal psychological and physiological processes WITHOUT resorting to supernatural explanations. In other words, the effects of religion and spirituality do not rely on the existence of a supreme being.

Depending on your own personal beliefs, this may confirm to you that belief in a supreme being is superfluous or you may see this as an attack on your beliefs. I have neither reaction. Rather, the effects of spirituality and religion are independent of my own beliefs and will continue long after I have shed this mortal coil but until that time, it is important for health care professionals to look at spirituality and religion as a way to help our patients. In the next column, I will discuss how my clinic integrates spirituality into its weight loss program.



Paul (In regard to Feb 16 post from Paul Kraus)

Thanks Paul.  I will look up Dr Battey's work.  


Mark Darby, , Diirector NOAH Clinic February 25, 2016 9:44 AM

Derek (In regard to Feb 22, post from Derek Hanson)

Thanks for your comments. The specific passage I refer to is on page 13 of the Koenig article  specifically "...this research says nothing about the existence of supernatural or transcendent forces (which is a matter of faith) but rather asks whether belief in such forces ...has an effect on health. (Koenig, H. (2015) Religion, Spirituality and Health: The Research and Clinical Implications.  ISRN Psychiatry Vol 2102, Article ID 278730. )

The point I draw from this is not about whether or not God exists but how do I (We) as health professionals learn to accept and address the spiritual needs or our patients.   This is very important to all clinicians, regardless of our own beliefs, to accept for the simple reason- our patient's need spirituality.  

Thanks for reading the article and your work with our patients.

Mark Darby, Director February 25, 2016 9:41 AM
Omaha NE

Thanks Annmarie.  

Mark Darby, Nursing - Director, NOAH Clinic February 25, 2016 9:14 AM
Omaha NE

Love this article Mark. Thank you!

Annemarie, Orthopedics - Clinical Nurse Specialist, TJUH February 23, 2016 6:24 PM


Thank you for bringing this to the forefront. I would encourage you to contact Dr. Koenig before jumping to your conclusions about his conclusion (that sounds redundant!). I understand Dr. Koenig as trying to provide 'hard' evidence to accept what has been regarded as 'soft' evidence for the fact that spiritual care makes a difference. The 'hard' evidence certainly infers something more... God, supernatural.

Derek Hansen, Chaplaincy - Director of Chaplaincy Services February 22, 2016 1:56 PM

Thank you for this introduction to a much needed discussion.

Broadly I see the sense in Medicine being both a science and an art .... for too long we have focussed on the science, and kind of let the art 'tag' along ....for me, spirituality is the basis of the 'art' ....its the canvas on which we individually creatively express our personal way of seeing 'life, dis-ease, death, loss, grief, mourning' etc...the full spectrum of this human experience. To try and separate the art from the science is to put blinkers on and limit our experience of the patient, including what we can learn from them (-someone said "our patients are our best teachers"..)and just focus on the mechanical aspect of the body. ..just my thoughts.

Carol, Palliative Care - Prof Nurse, Hospice February 19, 2016 4:06 AM
Cape Town

Mark, thanks for the positive introduction and bringing up good aspects to this component of care and nursing research.   Have you done any delving into what Faith Community Nurses do in their congregations-parishes?  The ANA recognizes our specialty and it would be interesting to view it with your write up on Koenig's article.  

Karen Harlow, Private Practice - Faith Community Nurse February 17, 2016 5:21 PM
Penn Laird VA

Hi Mark,

Thank you for your positive article on spirituality and health. I work with Dr. Bonnie Battey who has published material on this subject especially "spirituality in nursing". Dr. Harold Koenig has endorsed her work.

Thank you for bringing this to our attention.


Dr. Paul D. Kraus

Faculty at Seminary of the Southwest and Austin Presbyterian Theological Seminary, Austin, Texas

Paul Kraus, Pastoral Care - Professor/Chaplain, Seminaries/Healthcare February 16, 2016 9:59 AM
Austin TX

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