May 22-24, 2014University of Malta/Mater Dei Hospital

Malta

European Conference on Religion, Spirituality

and Health

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Contents

Organising Committee

• Dr.med.RenéHefti,chairoftheinternationalcommittee,ResearchInstituteforSpiritualityandHealth&Lecturer,UniversityofBerne,Switzerland

• Dr.phil.StefanRademacher,conferenceoffice,ResearchInstituteforSpiritualityandHealth,Langenthal,Switzerland

• Prof.Dr.DoniaBaldacchino,chairofthelocalcommittee,UniversityofMalta

Scientific Committee

• Prof.Dr.med.ArndtBuessing,chairofthescientificcommittee,ProfessorshipforQualityofLife,Spiritual-ityandCoping,UniversitätWitten/Herdecke,Germany

• Prof.Dr.DoniaBaldacchino,InstituteofHealthCare,FacultyofHealthSciences,UniversityofMalta,Malta• Prof. Dr. theol. Klaus Baumann, Caritaswissenschaft, Albert-Ludwigs-Universität Freiburg, Freiburg/Bg.,

Germany• Prof.Dr.med.ArjanBraam,UniversiteitvoorHumanistiek,Utrecht/Amsterdam,TheNetherlands• Ass.-Prof.Dr.BarbaraHanfstingl, Institut fürUnterrichts-undSchulentwicklung,Alpen-Adria-Universität

Klagenfurt,Austria• Dr.med.RenéHefti,ResearchInstituteforSpiritualityandHealth&LecturerforPsychosocialMedicine,

UniversityofBerne,Switzerland• Prof.Dr.theol.NielsChristianHvidt,UniversityofSouthernDenmark,ResearchUnitofHealth,Manand

Society,Denmark&ProfessorshipforSpiritualCare,Ludwig-Maximilians-UniversitätMünchen,Germany• Dr.des.ConstantinKlein,DepartmentforTheology,UniversitätBielefeld,Germany• Prof.HaroldG.Koenig,MD,DukeUniversityMedicalCenter,Durham,NC,USA&KingAbdulazisUniver-

sity,Jeddah,SaudiArabia• PeterLaCour,PhD,Knowledgecenterforfunctionaldiseases,PsychiatryCopenhagen,Denmark• Ass.Prof.KevinL.Ladd,PhD,DepartmentofPsychology,IndianaUniversitySouthBend,IN,USA• Prof.Dr.TatjanaSchnell,DepartmentofPsychology,UniversitätInnsbruck,Austria• Prof.Dr.JohnSwinton,SchoolofDivinity,HistoryandPhilosophy,King’sCollege,UniversityAberdeen,UK

Organisation

Organisation.............................................................................................................................................. 2Preface......................................................................................................................................................3Schedule....................................................................................................................................................4KeynoteSpeakers...................................................................................................................................... 5KeynoteLectures.......................................................................................................................................8Symposia.................................................................................................................................................14FreeCommunications..............................................................................................................................28Posters..................................................................................................................................................... 47TheConferenceVenue.............................................................................................................................59

Conference Office

Dr. Stefan RademacherResearchInstituteforSpiritualityandHealthWeissensteinstrasse30CH-4900Langenthaloffice@ecrsh.eu

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Preface

Preface

Dr. med. René HeftiIntern.OrganisingCommittee

Dr. Stefan RademacherConferenceOffice

Awarmwelcome to the4th EuropeanConferenceonReligion,SpiritualityandHealthwhich ishostedbytheFacultyofHealthSciencesoftheUniversityofMalta.Abig“thankyou”toDoniaBaldacchinoandherlocalorganisingcommittee.Theconferencewill focuson the integrationof reli-gionandspirituality intoclinicalpracticeandthere-fore on health care professionals. An inspiring pro-grammconsistingofkeynotelectures,symposia,free

communicationsandposterspromotes stateof theartknowledgeandhopefully livelydiscussions.TheMaltaLecturewillbeheldbyProf.HaroldG.Koenig,oneofthegreatexpertsinthefield.The conference also aimes to strengthen the Euro-peanand internationalnetworkamongresearchers,lecturersandcliniciansandtoencourageandequipeyounginvestigatorsinthefield.FinallywewishyouallagreatMaltaexperience!

This conferenceaims toaddress theholisticperspectiveof thepersonandcare.Thecorecomponentofeveryperson is spiritualitywhich in-tegrates the biological, psychological, social, cultural and religious di-mensionsoftheindividual.Spiritualitymotivatesthepersonstolivetheirsufferingmeaningfullyandlivewithapurposeinthisperiodoflifeandalsointheafterlife.Whiletreatingpatientswithmedicalproceduresandwith variousmodesof rehabilitation, caregivers need to acknowledgethehealingimpactoftheirpresenceontheoverallhealthofvulnerablepersonsundertheircare.Caregiversthereforeneedtodiscovertheirownspiritualitywhichmaygeneratemoreeffectivepatientcare.Similarly,patientsneed tobehelped todiscover theirown spiritualityinordertogivemeaningandpurposetotheirsufferingandtheirownlifeandafterlifeholistically.ThiswillbesupportedbyepisodesfromtheHolyBibleandteachingsofPopeFrancisandtheChurchwhichprovideinspirationstotheholisticapproachtopatientcare.

H.G. Mgr Paul Cremona O.P., ArchbishopoftheDioceseofMalta

Dear Participants, dear Colleagues

Prof. Dr. med. Arndt BuessingChairofScientificCommittee

A Holistic Healing Relationship between the Caregiver and the Patient

Prof. Dr. Donia BaldacchinoLocalOrganisingCommittee

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Schedule

Schedule

4th EUROPEAN CONFERENCE ON RELIGION, SPIRITUALITY AND HEALTH

Thursday May 22nd Friday May 23rd Saturday May 24th Sunday

May 25th

9:00

Meeting with the President of Malta

/

Registration (starting around 11:00)

Christina Puchalski: Medical Education in Spirituality & Health: Creating more Compassio-

nate and Whole Person Care

John Swinton: Re-imagining Mental Illness:

Creating Communities That Care

Optional Tour:

A Day

in Gozo

Gozo General Hospital

Tour

Guided Victoria Tour

Discussion Respondents

10:00 Coffee Break Coffee Break

Jacqueline Watts: Role-Models in Health Care: Should Spiritual Care of the Dying be the Concern of Health Professionals?

Christopher Cook: Recommendations for Psychiatrists on Rel. & Spir.: The Royal College of Psychiatrists Position Statement

11:00

Discussion Respondents

Piotr Krakowiak: Who Should Do What? Improving

End-of-Life-Care in Poland

Discussion

12:00

Welcome Lunch

Break

Discussion Arndt Buessing: Spiritual Care for Patients with Chronic Illness: What Do They

Need and How Do They Get It?

Lunch

/ Poster Presentations

/ Meet the Expert

13:00 Opening

Discussion

Closing Session, Awards, Summary, Farewell Donia Baldacchino:

Spiritual Care Education of Health Care Professionals

Optional visit Mater Dei Hospital

Guided Valletta Tour

SAFE JOURNEY HOME!

14:00

Symposia (concurrent sessions)

Discussion

George Fitchett: Assessing Spiritual Needs in a Clinical

Setting

15:00

Discussion

Coffee Break Coffee Break

16:00 Farr Curlin: What has Religion to do with the

Practice of Medicine Free Communication (concurrent sessions)

Discussion

17:00 Ewan Kelly: Rituals in Pastoral and Medical Care:

Bridging the Gap

Discussion

18:00 Break

Social Evening:

Guided Mdina Tour

Prayers for Peace at Mdina Cathedral

Paul Curmi Dancers

Conference Dinner

Musical Performance

19:00 The Malta Lecture: Harold Koenig: Integrating Religion & Spirituality into Clinical Practice: An Overview

20:00 Discussion

Reception

21:00 Committee Meeting

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KeynoteSpeakers

Keynote Speakers (inalphabeticalorder)

UniversityofMalta,MemberoftheResearchEthicsCommitteeandPhDCommit-tee,FacultyofHealthSciencesoftheUniversityofMalta;VisitingProfessor,Univer-sityofSouthWales;AdjunctFacultyMember,JohnsHopkinsUniversity,MD,USA.WorkedintheIntensiveTherapyUnit,RenalUnit,StLuke’sHospital,Malta.Ob-tainedtheCertificateinAdultEducationatGarnettCollege,London(1984).Gradu-atedat:UniversityofMalta(B.Sc.Hons,1992);King’sCollegeUniversityofLondon,UK(M.Sc.Nursing,1993);UniversityofHull,YorkshireUK(Ph.D.Nursing,2002).Publications:SpiritualityinIllnessandCare(2003),SpiritualCare:BeinginDoing(2010)

ProfessorshipforQualityofLife,SpiritualityandCopingattheChair forTheo-ryofMedicine,AnthroposophicalandIntegrativeMedicine,UniversityWitten/Herdecke;ExternalSeniorResearchFellowattheFreiburgInstituteforAdvancedStudies(FRIAS)Freiburg/Bg.,Germany.Researchfocusonqualityoflife,spiritual-ity&coping,andnon-pharmacologicalintegrativemedicineinterventionstotreatpatientswithchronicdiseases.Experiencedindesigningclinicalstudies,surveys,andquestionnairesforresearchwithafocusonintegrativemedicineapproaches.Publications:Spiritualität,KrankheitundHeilung:BedeutungundAusdrucksfor-menderSpiritualitätinderMedizin(2006);Spiritualitättransdisziplinär(2011)

DepartmentofTheologyandReligion,DurhamUniversity,UK.ProfessorChrisCookisProfessorofSpirituality,Theology&HealthintheDepartmentofTheol-ogy&ReligionatDurhamUniversityandanHonoraryConsultantPsychiatristwithTees,Esk&WearValleysNHSFoundationTrust.HetrainedatStGeorge’sHospitalMedical School, London, andworked in thepsychiatry of substancemisuseforover25years.HewasordainedasanAnglicanpriestin2001.HeisDirectoroftheProjectforSpirituality,Theology&HealthatDurhamUniversityandeditorofSpiritualityandPsychiatry(EdsCook,Powell&Sims,RCPsychPress2009)andSpirituality,TheologyandMentalHealth(SCM,2013).

TrentCenterforBioethics,Humanities,&HistoryofMedicine,DukeUniversity,Durham,NC,USA.FarrCurlinisahospiceandpalliativecarephysicianrecentlymovedtoDukeUniversity,wherehewillbecometheTrentProfessorofMedicalHumanities,workingwithcolleaguesintheSchoolofMedicineandTheDivinitySchoolto fosterscholarship,study,andtrainingregardingthe intersectionsofmedicine,ethicsandreligion.BeforemovingtoDuke,FarrfoundedandwasCo-DirectoroftheProgramonMedicineandReligionattheUniversityofChicago.Heisparticularlyconcernedwiththemoralandspiritualdimensionsofmedicalpractice and the doctor-patient relationship, and with themoral and profes-sionalformationofphysicians.

Prof. Dr. Donia Baldacchino

Prof. Dr. med. Arndt Büssing

Rev. Prof. Christopher Cook, MD, PhD

Prof. Farr A. Curlin, MD

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KeynoteSpeakers

DirectorofResearchintheDepartmentofReligion,Health,andHumanValuesand appointment in theDepartment of PreventiveMedicine, RushUniversityMedicalCenter,Chicago,IL,USA.

Certified chaplain and pastoral supervisor; trained in spiritual care and inepidemiology; expert on spiritual assessment. In 1990 he developed his de-partment’s research program. George’s research has examined the rela-tionship between religion and health in a variety of community and clini-cal populations. It has been funded by the National Institutes of Health.Publication:AssessingSpiritualNeeds(AcademicRenewalPress,2002)

NHSEducation forScottland&part-timepositionas senior lecturer forPasto-ralTheologyat theUniversityof Edinburgh,UK.He is a former juniordoctorwhohasspentmostofhisworking lifeasahealthcarechaplainandauniver-sityteacher.Ewan’sexperienceincludeschaplaincyintwolargeacutehospitalsandahospice inScotland.Hisqualitative researchhas involvedexploringthesignificanceof ritual followingbabydeathon thebereavementexperienceofparents.HecurrentlyworksonthestrategicdevelopmentofspiritualcareandhealthcarechaplaincyinNHSScotland.Publications:MarkingShortLives(PeterLang2007),MeaningfulFunerals (Mowbray2008),PersonhoodandPresence(T&TClark2012),SpiritualCareinHealthcare:ReflectionsonPractice(co-author,Radcliffe2011)

Nicolaus Copernicus University, Torun, Poland. Theologian, psychologist andsocialeducator, involved inhospice-palliativecare inPolandsince1990.Stud-ies and internships inhospice-palliative care in Italy and theUS (1994-2000).Conductingresearchregardingvolunteering,spiritualcare,andnon-medicalis-suesoftheend-of-lifecare.Since2011hehasbeeninvolvedasoneofexpertsinEuropeanAcademyofPalliativeCare.Publications:Livingwithachronicallyillpatientinhomecare(Gdansk2011),Socialandeducationalfunctionsofhos-pice-palliativecare(Gdansk2012),Volunteeringinend-of-lifecare(Torun2012),Theartofcommunicationtowardstheend-of-life:Guideforprofessionalsandinformalcareers-familiesandvolunteers(Gdansk2013)

DukeUniversityMedicalCenter,DurhamNC,USA&DistinguishedAdjunctPro-fessorKingAbdulazizUniversity,Jeddah,SaudiArabia.Boardcertifiedingeneralpsychiatry,geriatricpsychiatryandgeriatricmedicineandonthefacultyatDukeUniversityasprofessorofpsychiatryandbehavioralSciences.Co-directoroftheCentreforSpirituality,TheologyandHealthatDukeUniversityMedicalCentre.EditoroftheInternationalJournalofPsychiatryinMedicine,founderandeditor-in-chiefofScienceandTheologyNews.Publications: Isreligiongoodforyourhealth?Theeffectsofreligiononphysicalandmentalhealth(1997);Handbookofreligionandmentalhealth(1998);Handbookofreligionandhealth(co-editor,1sted.2001,2nded.2012)

Prof. George Fitchett, D.Min, PhD

Rev. Dr. Ewan Kelly

Prof. Harold G. Koenig, MD

Dr. Piotr Krakowiak

• SwissAssociationofPsychosomaticandPsychosocialMedicine(SAPPM)• InternationalAssociationofPsychologyofReligion(IAPR)• InternationaleGesellschaftfürGesundheitundSpiritualitäte.V.(IGGS)• FacultyofHealthSciences,UniversityofMalta• TheMinistryofTourism,Malta• AirMalta(www.airmalta.com)• MaypoleCaterers• TheFloralDesigner• ResearchInstituteforSpiritualityandHealthRISH• InternationalSocietyofSpirituality,ReligionandHealth(ISSRH)

Partners and Sponsors

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KeynoteSpeakers

George-Washington-University, Washington, DC, USA. M.D., M.S., FACP, Di-rector of theGeorgeWashington Institute for Spirituality&Health, ProfessorofMedicineandHealthSciencesatGWUSchoolofMedicine,where shehaspioneerednovelandeffectiveeducationalandclinicalstrategiestoaddressthespiritualconcernscommoninpatients.Sheisanactiveclinician,board-certifiedinInternalMedicineandPalliativeCareandhasdemonstratedleadershipinre-searchandeducationintheintegrationofspiritualcareacrossdisciplines.SheisaFellowoftheAmericanCollegeofPhysiciansandservesontheeditorialboardofseveralPalliativeCarejournals.Publications:MakingHealthcareWhole;TimeforListeningandCaring;OxfordTextbookofSpiritualityandHealthcare

King’sCollegeUniversityofAberdeen,Aberdeen,UK.ProfessorinPracticalTheol-ogyandPastoralCareintheSchoolofDivinity,ReligiousStudiesandPhilosophyandhonoraryProfessorofNursingattheUniversity’sCentreforAdvancedStud-ies inNursing.Hehasabackground inmentalhealthnursingandhealthcarechaplaincyandhasresearchedandpublishedwithintheareasofageing,demen-tia,mentalhealthandillness,spiritualityandhumanwell-beingandthetheol-ogyandspiritualityofdisability.Publications:Dementia:LivingintheMemoriesofGod(2012);Spirituality inMentalHealthCare:Rediscoveringa“forgotten”dimension (2001);LivingGently inaViolentWorld:ThePropheticWitnessofWeakness(2008);PracticalTheologyandQualitativeResearchMethods(2006)

FacultyofHealth&SocialCare,TheOpenUniversity,London,UK.DrJacquelineHWattsisSeniorLecturerintheFacultyofHealthandSocialCareattheOpenUniversity,UK.Her researchandwriting interests include feminist theory,gen-deredlabourmarkets,professionsandthesocialcontextofdeathanddying.HerworkhasbeenpublishedinanumberofinternationaljournalsincludingQualita-tiveResearch,GenderWorkandOrganization,WorkEmploymentandSociety,Feminism&Psychology,IllnessCrisis&LossandtheEuropeanJournalofPallia-tiveCare.Publications:DeathDyingandBereavement:IssuesforPractice(2010);GenderHealthandHealthcare-Men’sandWomen’sExperienceofHealthandWorkinginHealthcareRoles(2014)

Prof. Dr. Christina Puchalski

Rev. Prof. John Swinton

Dr. Jacqueline H. Watts

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KeynoteLectures

Keynote Lectures (inchronologicalorder)All Keynote Lectures take place in the Main Auditorium

Spiritual Care Education of Health Care Professionals

Donia BaldacchinoThursdayMay22nd,13:30-14:30

Nursesandhealthcareprofessionalsshouldhaveanactiveroleinmeetingthespiritualneedsofpatientsin collaboration with the family and the chaplain.Literaturecriticizestheimpairedholisticcareasthespiritualdimensionisoftenoverlookedbythehealthcareprofessionals.This couldbedue to feelingsofincompetencedueto lackofeducationonspiritualcare,workoverload, lackoftime,differentcultures,lackofattentiontopersonalspirituality,ethicalissuesorunwillingnesstodeliverspiritualcare.Spiritual care is defined as recognizing, respecting,meetingpatients’spiritualneeds, facilitatingpartici-pation in religious rituals, communicatingby listen-ingandtalkingwithclients,beingwiththepatientby caring, supporting, showing empathy, promot-ing a sense ofwell-being by helping them to findmeaningandpurposeintheirillnessandoveralllife;andreferringthemtootherprofessionals including

thechaplain/pastor.Thispaperoutlines thesystem-aticmodeofintra-professionaltheoreticaleducationonspiritualcareanditsintegrationintotheirclinicalpractice,supportedbyrole-modeling.Exampleswillbegiven from theauthor’s creativeand innovativewaysofteachingspiritualcaretoundergraduateandpost-graduatestudents.Theessenceofspiritualcareisbeing indoingwherebypersonal spiritualityandtherapeutic useof self contribute towards effectiveholisticcare.While taking into consideration the factors whichmay inhibit and enhance the delivery of spiritualcare, recommendationsareproposed to theeduca-tion,management,cliniciansandfurtherresearchtoamelioratepatientholisticcare.

Keywords: spiritual care, holistic care, education,intra-professionalstudents,healthcareprofessionals

The Malta Lecture (public) Integrating Religion/Spirituality into Clinical Practice: An Overview

Harold G. KoenigThursday,May22nd,18:30-20:15Sir Temi Zammit Hall - with Musical Performance and Discussion

Dr. Koenig will begin by defining what “spiritualneeds”are.Hewillthenexaminewhyitisimportantforhealthprofessionals to identify andaddress thespiritual need of patients, and how to accomplishthisinabusy,time-pressuredmedicalsetting.Hewilldiscusswhichhealthprofessionals(physicians,nurses, social workers, or chaplains) should be re-sponsibleforconductingaspiritualhistoryandmobi-lizingresourcestomeetpatients’spiritualneeds.Dr.Koenigwillthenexaminesomeofthebarrierstoad-

dressingpatients’spiritualneeds,includingalackofknowledgeabouthowspiritualneedsrelatetomedi-caloutcomes,lackoftimetoaddressspiritualneeds,andespecially,lackoftrainingonhowtodoso.HewillalsoreviewrecenteffortsbyU.S.healthcaresystemstointegratespiritualityintopatientcare,andtowhatextentthespiritualityofthehealthcarepro-vidermayinfluencetheircapacitytoprovidewholeperson,compassionatecare.

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KeynoteLectures

Assessing Spiritual Needs in a Clinical Setting

George FitchettThursday,May22nd,14:30-16:00

Although a series of patient-centered movementshave brought attention to the influence of cultureandreligiononpatients’experiencesofillness,medi-cinehastendedtothinkofcliniciansasmoreorlessinterchangeable representatives of one biomedicalprofession,trainedtosetasidetheundueinfluenceoftheir“personalvalues.”Inthistalk,FarrCurlinwilldescribea seriesof studies thatchart the influenceofphysicians’religiouscharacteristicsontheirclinicalpractices.Thesestudies,itturnsout,findthatphysi-ciansintheUSaremoreorlessasreligiousastheirpatients,andphysicians’religiousfaithmattersbothfortheirconcretepracticesandforhowtheyunder-standtheirgoalsandresponsibilitiesasphysicians.Dr.Curlinwillthenprovideaframeworktomakesenseoftheseconnectionsbetweenfaithandclinicalprac-tice,andtosuggestthatweshouldnotbesurprised

tofindthatmedicineandreligionaresointertwined.Finally,inlightoftheseconnections,hewillconsiderwhattheprofessionofmedicinemighthopeforfromrenewing and deepening its engagementwith reli-gioustraditionsandpractices.

Participantsinthissessionwillbeableto:- Describe how physicians’ religious characteristicsareassociatedwiththeirpracticesinarangeofclini-caldomains.- Outline a basic framework tomake sense of theconnectionsbetweenreligiousfaithandthepracticeofmedicine.- Describe ways the profession of medicine mightmorefullyengagereligioustraditionsandpracticesasresourcesforunderstandingandpracticinggoodmedicine.

Thepast30yearshaveseenaremarkablegrowthinattention,amongbothresearchersandclinicians,tothe relationship between religion, spirituality, andhealth. This has included the development of nu-merous models for spiritual assessment. It is timeforacriticalreviewofthesediversemodelsinorderto determine anddisseminate best evidence-basedpracticesinspiritualassessment.Mypresentationwillhavethreesections.Iwillbeginwithareviewofexistingmodelsforspiritualassess-mentanddifferentiatetoolsdevelopedforresearchfromthosedevelopedforclinicalpracticeaswellasthreelevelsofinquiryaboutapatient’sreligious/spir-itualneedsandresources:spiritualscreening,spiritu-alhistory-takingandspiritualassessment.NextIwillreview the limited existing research about spiritualassessment.Iwillconcludewithadescriptionofsixissuesthatneedtobeaddressedinacriticalreviewof

modelsforspiritualassessment.Threeoftheseissuesarerelatedtohowwedefinespiritualityandreligion.In addition to our definitions (what are we assess-ing), they include thenormativenatureof spiritualassessment(e.g.,what isspiritualdistress),andthequalificationsnecessarytodevelopamodelforspir-itual assessment or employ one in clinical practice.The remaining three issues focus on the strengthsandweaknessesofcurrentpracticeinspiritualassess-ment.Theseissuesare:1)apreferencefornarrativevsquantitativemodels,2)usingthesamemodelinallclinicalcontexts,and3)using locallydevelopedmodels.To conclude I will ask whether currently there areanyevidence-basedmodels for spiritualassessmentwhichdeservetobewidelydisseminatedinclinicalpractice?Ifnosuchmodelsexistshouldwedevelopthemandifso,howshouldwegoaboutthat?

What has Religion to do with the Practice of Medicine?

Farr A. CurlinThursdayMay22nd,16:00-17:00

Rituals in Pastoral and Medical Care: Bridging the Gap

Ewan KellyThursday,May22nd,17:00-18:00

Ritual is integral to both health and pastoral care.The arts of health and pastoral care involve bothembodied and performative action, including thearticulationandexpressionaswellasthehearingor

observing of individual and collective stories. Ritu-als are social acts which are subjectively and col-lectively interpreted, infused by layers of meaning.Traditionallybothhealthcareandfaithcommunities

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KeynoteLectures

Medical Education in Spirituality and Health: Creating More Com-passionate and Whole Person CareChristina PuchalskiFriday,May23rd,09:00-10:00

Spiritualityhasplayeda role inhealthcare for cen-turies,butby theearly20thcentury, technologicaladvancesindiagnosisandtreatmentovershadowedthemorehumanelementofmedicine. Inresponse,a core group ofmedical academics and practition-ers launched a movement to reclaim medicine’sspiritual roots, defining spirituality beyond religionandethics,aseachperson’ssearchformeaningandpurposeinlife.ThistalkdescribesthehistoryofthefieldofSpiritualityandHealth—itsorigins,itsfurther-ancethroughtheAAMC’sMedicalSchoolObjectivesProject, and its ultimate incorporation into the cur-riculaofover75%ofU.S.medicalschoolsandtheparalleldevelopmentofclinicalcareguidelinesinin-terprofessionalspiritualcare.Thediversityofeffortsindevelopingthisfieldwithinmedicaleducationand

innationalandinternationalorganizationscreatedaneedforacohesiveframework.ThisresultedinthecreationbyaconsensusconferenceofsevenmedicalschoolsoftheNationalCompetenciesinSpiritualityandHealth.Alsodiscussedwillbeanewcurricularprogram called Reflection Rounds, the first applica-tionsofthecompetencies.Therounds,calledGWish-Templeton Reflection Rounds initiative (G-TRR) arecompetency-based.Pilotedineightmedicalschools,G-TRRprovidedclerkshipstudentswiththeopportu-nity through reflectionon their patient encounters,todeveloptheirowninnerresourcestoaddressthesuffering of others. These medical education ini-tiatives inSpiritualityandHealtharehelpingcreatemorecompassionateclinicianswhoaremoreabletoattendtothewholeperson—mind,bodyandspirit.

Thedomainsofmedicineandhealthcarearerepletewithrolemodelsofallkinds–thecaringnurse(usual-lyawoman),theskilledsurgeon(usuallyaman)andtheexpertphysicianaresomeexamplesthatcometomind.SpeakingtoGoffman’sparadigm,theseare‘frontstage’rolemodels;otherslocated‘backstage’might includescientistsandtechnologists,allwork-ingtoadvancehealthanddefeatdisease.This illus-trateshowtheworkofcaring forhealthcomprisesa number of professional subcultures eachwith itsowndemarcationand jurisdictionofpracticeoftendefended in the pursuit of enhancing specialized

knowledge and preserving disciplinary autonomy.Increasingly,however,weareseeingcallsforgreatercross-disciplinary collaboration amongst healthcareprofessionals to provide person-centred care as ac-knowledgementofthemultipleimpactsofillhealthforindividualsandfamilies.Thisparticularlyhasbeenthe case in palliative care philosophy that seeks tooffer integratedphysical, psychosocial and spiritualcareforthoselivingwithterminalillness.Althoughanestablishedmedicalspecialty,palliativecarechallengesthemedicaldomainofcure,promot-ing holistic approaches to patient wellbeing. The

Role-Models in Health Care: Should Spiritual Care of the Dying be the Concern of Health Professionals? Jacqueline WattsFriday,May23rd,10:30-11:30

havedevelopedritualswhichenculturateanddeper-sonalise,yetalsootherswhichprovidemeaning(oranopportunitytosearchformeaning),orderandasenseofbelongingwhicharepotentiallytransforma-tive.Ritualsparticularlymarktimesoftransitionandloss offering a means through which such experi-encemaybegintobetoprocessedand integratedintopersonalandcommunityliving.Themannerbywhichritualisconstructedandperformedinfluencesnotonlythelivedexperienceofparticipantsbuthowthatexperienceisinterpretedandtheimpactithas.Thispresentationwillrefertopastoralorspiritualcare

researchperformedwithbereavedparentsforwhomritualmarkingoftheirbabies’lifeanddeathwassig-nificant. The aim of the presentation is to suggestlearnings from research into ritual performed by ahealthcarechaplainmayhavesomethingworthwhileto say to other healthcare disciplines. HealthcareacrossEuropeisseekingtobeperson-centred;ritualis significant in termsofperson-centredcare for re-cipientsandcare-givers.Participationinperson-cen-tred ritualhashealingand transformativepotentialforallinvolvedinhealthandpastoralcare.

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KeynoteLectures

Who Should Do What? Improving End-of-Life-Care in Poland

Piotr KrakowiakFriday,May23rd,11:30-12:30

ThemodernhospicemovementinPolandhasstartedin1981connectingmedicalandnon-medicalissues,integratingspiritualandreligiouscareintoteamworkpractice.Today inclusionofspiritualcare isastand-ardformosthospice-palliativecareunits.ThesegoodpracticesinPolandbecameinspirationforenlargingmostly sacramental and ritual pastoral service intomoreinclusivespiritualcare.In2011thefirsteditionof postgraduate training for future chaplains andpastoralassistantsinPolandhasbeenlaunched,andafirstgroupofstudentshasgraduated“St.JohnofGodSchool”.ChangingsocietyofPoland,withgreatvalueoftraditionalCatholicismandsacramentalpar-ticipationof a largenumberofpeople,has tocon-sider spiritualneedsofagrowingnumberof thosewhoare far fromthesacramentsandfaithcommu-nities.Thereisnoadequateresearchregardingspir-itual needs of those, who are not fully connectedwith faithcommunities.Religiousneedsofpatientsin Poland aremostly researched by experts of psy-chologyorreligionas it’sdescribedbyM.Jarosz inThepsychologicalmeasurementofreligiosity.Thein-ternational researchproject in spirituality regardingneedsofpatientstowardsend-of-lifeinGermanyandPolandisledbyA.Büssing.ItmeasuresspiritualandreligiousneedsofchronicallyillpatientsandincludesvalidationofthePolishversionoftheSpREUKQues-tionnaire.Since2013anotherexpertofspiritualityinhealthcare,C.M.Puchalski,hasvisitedPolandand

gavelecturesregardingintegrationofspiritualityintopatientcare.ConsequentlyFICAToolforSpiritualAs-sessmenthasbeentranslatedandadaptedtoPolishand will be validated and used among practition-ers.Asetofpublications, followinga lineofabove-mentionedinvestigationsandatextbookregardingspirituality inhealthcare, isduetobepublished inPolish. Initial research regardingunderstanding thedifference between religious and spiritual care hasbeenconductedamongthosewhoworkinpastoralteams inhealthandsocialcareandordainedchap-lains,continuingtraditional,mostlysacramentalandritual care. Results of this initial research in Polandwill be presented during this conference, showingthat cooperation allowsbetter answers for spiritualneedsofpatientsandtheirfamiliesinend-of-lifecare.

ReferencesBornemanT.,FerrellB.,PuchalskiC.M.(2010):Eval-uationoftheFICAToolforSpiritualAssessment,J.ofPainandSymptomManagement40/2:163-173.BüssingA.(2010):SpiritualityasaResourcetoRelyoninChronicIllness:TheSpREUKQuestionnaire,Re-ligions,1:9-17.JaroszM.(ed.)(2011):Psychologicznypomiarreligi-jnosci[Thepsychologicalmeasurementofreligiosity],Lublin.KrakowiakP.(2012):Społeczneiedukacyjnefunkcjeopiekipaliatywno-hospicyjnej[Socialandeducation-

emphasis within thismodel on spiritual aspects ofcarehasraisedchallengesforcliniciansprimarilycon-cernedwithcureofphysicalandpsychologicalmal-function.Spiritualcareofdyingpeoplecontributestoarelationalmodelofillnessanddeath.Incontrasttothemedicalmodel,therelationalmodelhelpstoputthedyingperson‘backtogetheragain’ intheirfullcontext,embeddingtheminapersonalandso-cialhistory.Spiritual care ispart, notonlyofhospice care,butalsoofgeneralnursingpracticethatrecognizestheimportance of spirituality in patient health. Nurs-ing, as a particular role model of professionalizedcare,hascontinuedtostrugglewiththedeliveryofspiritual carewithmuch literature devoted to con-sideringenhancingunderstandingoftheconceptofspiritualityanditsapplicationtonursingpracticeinwaysmeaningful topatients.Given thecomplexityof theexistential realitiesconfrontingdyingpeopleforwhomoftenthefocusisontheirfamilies,unfin-ishedbusinessaswellasaplethoraofother‘legacy’concerns, is it now time to askmore fundamentalquestions about the appropriateness of health pro-

fessionals’involvementinthespiritualcareofthosefacing death? A further question is whether pallia-tivecarethathasreceivedalmostuniversalsocialap-proval,shouldbemorediscriminatinginits‘domains’ofpractice.Inrespondingtothesequestions,thispaperwillar-gueforadifferentapproachbasedonacommunityrolemodel that fosters development of skills of in-dividuals and families in seeing death as a normalpartoflifeandspiritualcareofdyingpeopleaspartofourhumanity.Thesociologist,AllanKellehear,haslong been advocating for a shift in approaches todeliveringspiritualcareawayfromtraditionalprofes-sionalmodels. This paperwill explore some of hisideastogetherwithmyownthatcentreonconnec-tivity through storytelling, faith, reflection, mutualenrichmentandspiritualcareassomethingwegiveto each other and not somethingwe rely on ‘pro-fessionalothers’totakeresponsibilityfor.Whilstformany,spiritualcareisprincipallyamatterofreligiousfaith,inanageofincreasingsecularismthisissuehastakenonnewdimensionsandpossibilities.

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KeynoteLectures

Debateabouttheplaceofspiritualityandreligioninclinicalpractice inpsychiatry intheUK,as inmanyothercountries,hasgeneratedavarietyofopinionsamongst professionals. The course of this debatewillbechartedbrieflybywayofintroductiontothecontextinwhichapolicydocumentwasdevelopedasaguide toclinicalpractice.Thispolicy, adoptedbytheRoyalCollegeofPsychiatristsin2011andre-

visedin2013,providesthefirstdetailedguidanceforpsychiatristsintheUKconcerningtheplacespiritual-ityandreligioninclinicalpractice.Itincludessevenrecommendations, which seek to affirm the placeforaddressingspiritualityandreligion inpsychiatry,whilstalsoprotectingbothpatientsandprofessionalsagainstabuseorpoorpractice.

Recommendations for Psychiatrists on Religion/Spirituality: The Royal College of Psychiatrists Positions Statement

Christopher CookSaturday,May24th,10:30-11:30

Thispresentationwillexplorewaysinwhichwecanre-think mental illness, moving away from the as-sumption that it is a problem to bedealtwith, to-wardsanewandhealingunderstandingwhichper-ceivesitfirstandforemostasawayoflivingintheworldwhichrequirestobeunderstoodandrelatedtoratherthansimplyeradicated.Mental illnessoccurs

inrealpeoplebeforetheybecomediagnoses.Thesepersonalexperiencesshouldnotbeoverlooked.Thepresentationwillexplorethenatureandexperienceofmentalillnessandofferaspiritualperspectivethatcanhelptoregainatrulyholisticapproachtopeoplewhoexperimentpsychologicaldifficulties.

Re-imagining Mental Illness: Creating Communities That Care

John SwintonSaturday,May24th,09:00-10:00

al functionsofhospiceandPalliativecare],Gdansk,summaryinEnglish,169-171.Krakowiak P. (2012):Wolontariatwopieceu kresuzycia [Volunteering in the end of life care], Torun,summaryinEnglish,335-340.Puchalski C.M. (2013): Integrating spirituality intopatientcare:anessentialelementofperson-centeredcare,PolArchMedWewn.123(9):491-497.

Muszala A. et al. (2011): Dolentium Hominum.Duchowni i swieccywobec ludziegocierpienia [Do-lentiumHominum.Clergyandlaitytowardshumansuffering],Kraków.Socha P. (red.) (2000):Duchowy rozwój człowieka[Spiritualhumandevelopment],Kraków.

Spiritual Care for Patients with Chronic Illness: What Do They Need and How Do They Get It?

Arndt BuessingSaturday,May24th,12:15-13:15

Patientssufferingfromchronicillnessorlifethreaten-ing diseases often report unmet spiritual needs. Inmost cases, these needs are neither addressed norrecognizedbyhealthcareprofessionals.Theseneedscan be categorized in terms of Connection, Peace,Meaning/Purpose, and Transcendence, and corre-spondtotheunderlyingcategoriesSocial,Emotional,Existential,andReligious.Althoughitisappropriatethatboard-certifiedchaplainsassesspatients’spiritu-

alneedsandresources,onecannotignorethat,par-ticularly in secular societies,moreandmorehealthprofessionalswithout expertise in spiritual care arerequired be attentive to religious/spiritual issues. Asurvey among German patients with chronic painconditions revealed that 37% preferred talking totheirmedicaldoctorabouttheirspiritualneeds;sur-prisingly,only23%talkedwithachaplain,and20%hadnopartnerwithwhomtodiscusstheirspiritual

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KeynoteLectures

We kindly invite you to participate in our next

European Conference on Religion, Spirituality and Health

needs.Thus,thereseemstobeasubstantialpropor-tion of patients without an adequate partner whohasthenecessarytimeandskillstoaddresstheirspir-itualneeds.Although spiritual needs have been commonly ad-dressed inpalliativepatients,onlya fewstudiesad-dress theseneeds inpatientswith chronicdiseasesthatarenotprimarilyfatal.UsingtheSpiritualNeedsQuestionnaire (SpNQ) we surveyed predominantlysecular German patients with chronic diseases. Re-sultsshowedthatsecularspiritualneedssuchastheneed for InnerPeaceandGiving/Generativitywereof outstanding importance; in contrast, ExistentialNeeds(Reflection/Meaning)orReligiousNeedswerelessimportant.Usingthesameinstrument,predomi-nantlyatheisticpatientsfromShanghaiwerealsosur-veyed.Similarly,Giving/GenerativityandInnerPeaceneeds scored highest, while Religious Needs andthe Reflection/Release Needs scored lower. WhenCatholic Polishpatientswith chronicdiseasesweresurveyed, Inner Peace needs andGiving/Generativ-ity needs along with Religious Needs and Existen-tialNeedswere considered important. Thus,whenunmetspiritualneedsareregardedasanimportanthealthcareissue,thecultural/religiouscontextplaysacrucialrole.

Howarethesefactorsrelatedtovariablesofspiritualwell-beingandlifesatisfaction?InGermanpatients,ReligiousNeedswerepositivelyassociatedwithspir-itualwell-being and life satisfaction.However, Exis-tentialNeedsandInnerPeaceneedswerecorrelatedwithalackofspiritualwell-beingandlifesatisfaction.In contrast, Religious needs did not correlate witheitherhighor low life satisfaction,both inpatientsfrom Poland and Shanghai. Interestingly, amongGerman patients with fibromyalgia, Inner PeaceneedsandExistentialneedscorrelatedwithdifferentdomainsofreducedmentalhealth,particularlywithanxiety,theintentiontoescapefromillness,andpsy-chosocialrestrictions.Thus, spiritual needs among the chronically ill,whetherexpressedactivelyornot,mayimplyalong-ingforpsycho-spiritualwell-being.Thisneedshouldbe supported by health care professionals as a rel-evant,personalresourceforpatients.Thesespecificspiritualneedshavetobeaddressedinclinicalcarein order to identify potential therapeutic avenuestosupportandstabilizepatients’psycho-emotionalsituation.Thisunderlinestheneedforanadequate“spiritual care” as an important task of a modernhealthcaresystem.

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Symposium I: Spirituality in Palliative Care Chair: Prof. Dr. theol. Klaus Baumann

Theaimof this reflectiveaccount isa reflection ‘in’and ‘on’mypersonalworkwith this familywhosechildwasonpalliativecare.Workingasapsychologist,dealingwithchildhoodcancer isoftenexperiencedas a journeywhere thediagnosis of a life-threaten-ingillnessraisesinmekeyquestionsattheinterfaceofmedicine,palliativecareandmyownspirituality.Literaturesuggeststhatthedimensionofspiritualityand theprovision of spiritual care still prove tobestumblingblocksformanyhealthprofessionals.Thiseight-yearoldchildsufferingfromcancerhasbeendiagnosedsincetheageofthreeyears.Inpaediatricpalliativecare,thereisnotonlythechildthatneedssupport,butalsothefamilythatneedsconstantsup-port.ThisreflectionincludeshowtheMaltesecultureof ‘thefamily’ is influencedandhowpalliativecare

isaddressedinhospital.InMalta,95%ofthepopu-lation isaffiliatedwith theRomanCatholic religion.Although,peoplemightnotbepracticingtheir reli-gion,intimesofillness,theymayturntoGodasaconnectiontosomethinggreaterthanthemselvestohelpthemmakesenseoftheirworld.By using the stages of theGibbs (1988) ReflectiveTheory, namely description, feelings, evaluation,analysis,conclusion,andactionplan,Iamunfoldingthe journeyasapsychologistandreflectingonthespiritual impact of this child’s palliative journey onmylife.Myexperienceofspiritualgrowthhasbeenbothonaprofessionalandpersonalbasis.Theper-sonal spiritualgrowthhasgenerateda rippleeffectand is reflectedonmybehavior inmyown familyand onmy relationships with others inmy profes-

Symposia All Symposia on Friday, May 23rd, 14:00 - 15:30

A Model Combining Psychotherapy with Spirituality and Religion in the Area of Palliative Care and Bereavement Dr. Benna ChaseDPsych,ClinicalPsychologistinPalliativeCare,SirPaulBoffaHospital,Malta

This paper presents aModel for working with thedyingandthebereavedwithintheMaltesecontextarising frommy years of practice in oncology andpalliative care. The Model has emerged from mydoctoral work, where, drawing on autoethnogra-phy,which“workstoholdselfandculturetogether,albeit not in equilibrium or stasis” (Holman Jones,2005:764),Ifocusedontheinterplaybetweenselfand culture, seeing that death, dying andbereave-ment are so strongly embedded within culture.The use of self is an important element. Self, fromaGestalt perspective, indicates cohesion over time– Integrity, and openness to change at the contactboundary –Growth (Yontef, 1993), two importantcharacteristics intheModel.The interplaybetweenthe psychotherapeutic and the spiritual and reli-gious is addressed, within a culture where the Ro-manCatholicReligion is adominant tradition.The

Model advocates that, apart from practising pres-ence and inclusion, a practitioner needs to be pre-pared to staywith the client in the long spacebe-tweenWithdrawalandSensation,withitsdearthoffigure-formation. This requires a deep level of con-victionthatsustainsthepractitionerinthe‘between’to allow a natural, positive figure to emerge,withtheresultinggrowthofbothpractitionerandclient.ReferencesHolman Jones, S. (2005): ‘Authoethnography.Mak-ing the personal political’, in N.K. Denzin & Y.S.Lincoln (Eds): TheSagehandbookofqualitative re-search.(3rded.).London:SageYontef,G.M.(1993):Awareness,Dialogueandproc-ess:EssaysonGestalttherapy.NY:TheGestalt Jour-nalPress,Inc.

The Psychologist’s Role in the Spiritual Journey of a Child and Family During Palliative Care: A Case Study in Malta

Marisa GiordimainaMaterDeiHospital,Malta

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The Healing Power of Forgiveness: The Convergence of Education and Clinical Practice from a Personal Stance

Therese BugejaBSc(Hons)(Nurs.Stud.),P.G.Dip.(Educ.),MSc(Hlth.Educ.),P.G.Dip.Psychotherapy,S.R.N.,AssistantLecturerNursing,FacultyofHealthSciences,UniversityofMalta,Malta

Overthepasttenyears,researchonforgivenesshasproliferatedandprovidestangiblereasonsforunbur-deningourselvesofangerandresentment.Actually,forgiveness is themost powerful act that one cando for one’s own health (Luskin, 2002).Mountingevidencerevealsthatthepeoplewhocanforgivearetheoneswhoreceivetherealrewards.Peoplewhoareforgivingtendtohavenotonlylessstressbutalsobetter relationships, fewergeneralhealthproblemsand lower incidencesofthemostserious illnesses—includingdepression,heartdisease, strokeandcan-cer(Worthington,2006).Moreover,recentreviewsoftheliteraturepertainingtoforgivenessandhealthhavearguedthatthephysi-calandmentalhealthbenefitsofforgivenesscanbestartling,regardlessofage,genderoreventhemostunimaginable hurts (Worthington, 2006; WitvlietandMcCullough2007).Thispaper aims tohighlight experiences in forgive-nessencounteredbothwithstudentsasalecturerin

personaldevelopment,andclientsasapsychothera-pist.Eachcontextpresentsbothfailureandsuccesslifestories.Thoughmostpeopleprobablyfeeltheyknowwhatfor-givenessmeans,researchersdifferaboutwhatactual-lyconstitutesforgiveness.Ihavecometobelievethathowwedefineforgivenessusuallydependsoncontext.

ReferencesLuskinF(2002):ForgiveforGood:AProvenPrescrip-tionforHealthandHappiness.NewYork,HarperCol-lins.Witvliet, C.V.O. & McCullough, M.E. (2007): For-givenessandhealth:Areviewandtheoreticalexplo-rationofemotionpathways.InS.G.Post(Ed),Altru-ismandhealth:perspectivesfromempiricalresearch(Pg.259-276).Oxford:OxfordUniversityPress.Worthington E.L. Jr. (2006): Forgiveness and Rec-onciliation: Theory andApplication.NewYork,NY:Brunner-Routledge.

Faith, Hope and Love in the Experience of the Dying Dr. Karin TschanzReformedChurchAargau;DirectoroftraininginPalliativeandSpiritualCare,chaplainHirslandenKlinikAarau,Co-VicePresidentwww.palliative.ch,Switzerland

Spiritual care integrates the physical and psycho-social care to address client’s needs holistically. Re-search suggests various definitions of spiritual carewhich includethe“doing”andthe“being”dimen-sionsofcare.Beingreferstothepersonalspiritualityofthecare-giverswhichenablesthetherapeuticuseof self incarebymeansof theiractivepresencetoclients. Thus, delivery of spiritual care incorporates“beingindoing”.Illnessmayincreasetheindividual’sawarenessoftheirownpersonalspirituality.Theaimofspiritualcareistohelpclientstofindmeaningandpurposeinlifewhichmayleadtospiritualwell-being

even in timesof suffering.Thecare-giver’scommit-menttowardsprovidingactivepresenceincare,mayleaveapositive impactonclient’shealth.Researchshows that when clinical experience is consideredasareflectivejourney,care-giversmayacknowledgethatwhilegivingcaretoclients,theymayalsobeonthereceivingend.ThispaperpresentsresearchandtheclinicalmodelRESPECTofclient’sassessmentofspiritualneeds. Spiritual caremayyield therapeuticandholisticeffectsonboththeclientandthecare-giver.

sionallife.Ithasaffectedmybeliefsandmeaningoflifeandmyvaluesonhowtolookonlifeingeneral.Myreflectionson thecircumstancesofaccompany-ingthischildandthefamily,Ibecameawareoftheimpact this journeyhashadonme,my family,mywork,andothers.

ReferenceGibbs G. (1988) Learning by doing: A guide toteaching and learningmethods. Further EducationUnit,OxfordPolytechnic,Oxford.

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Symposium II: Assessment of Spirituality in a Clinical Setting Chair: Dr. des. Constantin Klein

Aim: The purpose of this study was to develop aframework of competencies (knowledge, skills andattitudes), in spiritual care thatguidesnursingandmidwiferyeducation toensure thatnewrecruits intheprofessionwillbeequippedtomeettheclients’holisticneeds.Background: In spite of the constant call for com-petence in the provision of holistic care as an es-sentialprofessionalskill(WHO,1998;HumanRightsAct2000;NMC2010;QAAHE2001),theareaofac-quiringcompetenceinspiritualcarehaslargelybeenneglected innursingandmidwifery educationandclinicalpractice.Thedevelopmentandvalidationofcompetenciesinspiritualcareisthereforeimportantandrecommended.Method: The study utilized a mixed method ap-proach using an eclectic framework through threemainphases.Thefirstphaseinvolvedtheidentifica-tion and formulation of spiritual care competencyitemsandthedevelopmentoftheresearchtoolfromanindepthliteraturereviewand5focusgroupdis-cussionswithstakeholdersandconsumersofspiritualcare.Thesecondphaseinvolvedaconsensusseekingprocess utilizing themodifiedDelphimethodology.Thegenerated55genericcompetencieswerescruti-nizedbyapanelof‘experts’inspiritualcareusingavarietyofsamplingtechniquesina2-roundModifiedDelphistudy.Responseratesinround1was75.78%(N=318, n=241) and in round 2 85.06% (N=241,n=205). Non respondents equated to 14.93%(n=36). Consensus was determined as having theproportionofexpertswhoratedtheitemwithinthehighestregionofthescaleona7-point‘Likert’formscale(5,6,or7)andequatedtobe75%thresholdorgreater.Thethirdphaseofthestudyinvolvedacon-sultationprocesswithinternationalandlocalexpertsinthefield(N=285,n=107)toobtainapragmaticperspectiveofviewsontheidentifieddomainsandcompetency items in spiritual care, identify whichcompetencies in spiritual care shouldessentiallybeacquiredatPRE-registrationlevel(i.e.atpointofreg-istration),whichcompetenciesshouldessentiallybeleft at POST-registration level (i.e. after graduation

asqualifiedstaff),andwhichcompetenciesarenotessentialateitherlevel.Thematicanalysissoughttoidentify factors thatmay enhance or hinder imple-mentationof the framework ineducation, researchand/orclinicalpractice.Results:The results forphase2of the studywhichwillbepresented.Thesewerebasedontheresponseof241modifiedDelphiparticipants intendifferentgroupsinround1ofthestudyand205participantsin round2 (85.06%).54competency itemsoutofthe55presentedachievedthepre-determined75%levelofconsensusbytheendofround2.Themajor-ity of items (27) scoring above90%and25 itemsscoringabove80%levelofagreement.Cronbach’s Alpha indicated total competency do-mains and competency itemshave reliability coeffi-cientsof0.97andeachofthe7domainsandcom-petencyitemshavecoefficientsofbetween0.79and0.93indicatinggoodtostronginternalconsistency.Spearman’stestindicatedveryhighcorrelations(0.9to1)for23itemsandhighcorrelations(0.7-0.89)for31competencyitems.Onlyoneitemhadamod-eratecorrelationcoefficient(0.5-0.69)(Item35rs=0.554).Results for the exploratory factor analysis showedgoodfitoffivefactormodelofAssessmentandIm-plementationofspiritualcare,ethicalandlegalissuesinspiritualcare,bodyofknowledgeinspiritualcareandInformaticsinspiritualcare.Itemsinthedomainself-awarenessand theuseof self and items in thecommunicationandinterpersonalskillsdomainwerenotdefinedastheseloadedonthevariousotherfac-tors. Itemsrelatingtoreferral tochaplainsandspir-itualleadersloadedasaseparatefactor.Only2items(item8anditem24)crossloadedonanotherfactorwhile5competencyitemsscored<.04rotatedfactorloading.Conclusion:Thedevelopedframeworkofcompeten-ciesinspiritualcareamongthemodifiedDelphi‘ex-perts’ingeneral,demonstratedtobeavalidandreli-abletool.Furthertestingisrecommendedinrelationto theconstructvalidityof the tool inparticular totheuseofconfirmatoryfactoranalysisissuggested.

Framework of Competencies in Spiritual Care for Nurses and Midwives: A Modified Delphi Study Josephine AttardAss.Lecturer,Dep.ofMidwifery,FacultyofHealthSciences,UniversityofMalta,Malta

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Thepapergivesanintroductionintotheassessmentofanindividual’sworldview,inparticularitsreligious/spiritualfacets,withtheFaithDevelopmentInterview(FDI).TheFDI is a semi-structured interviewwhichhas been originally developed in James Fowler’s(1981) researchabout stagesof faithdevelopment.Initsrevisededitions(Fowler,Streib&Keller,2004;Keller&Streib,2013)theFDIhasbeenusedfortheexplorationoffaithbiographiesinnumerousstudiesatBielefeldUniversity(Streib,Hood,Keller,Csöff&Silver,2009;Streib&Hood,inpreparation).Byask-ingquestionswhichexplorethepatient’slifereview,relationships,valuesandcommitments,andreligion/worldview,itoffersspaceforreflectiononone’slifeanditsexistentialfoundations(Keller,Klein,Streib&Hood,2013).

Weregularlymaketheobservationthatresearchpar-ticipants respond to this offer and appreciate it asopportunitytoself-exploration.OurresearchresultsshowthattheFDIpermitstheidentificationofsalu-togenicresourcesaswellasofpathologictendenciesrelatedtoreligion/spirituality.Thegrowingacknowl-edgmentoftheimportanceofreligion/spiritualityformentalhealthsuggestsconsideringtheFDIasadiag-nostictoolinclinicalandpsychotherapeuticcontextsandasanorientationforpastoralcounseling(Keller,Klein&Streib,2013).The potential and limits of the FDI are discussed,drawingonexamplesfromourcurrentresearch.

Keywords: Assessment, Interview, Faith Develop-ment,Biography,Self-Exploration

Assessing Religion/Spirituality with the Faith Development Interview

Prof. Dr. Heinz Streib & Dr. des. Constantin KleinDepartmentofTheology,UniversityofBielefeld,Germany

In recent years numerous studies have deepenedourunderstandingoftherelationofreligion/spiritu-alitywithmentalandphysicalhealth(Koenig,King& Carson, 2012). Several pathways like social sup-port provided by religious communities, a positiverelationship with God, or religious/spiritual copingstrategieswhichcontributetowell-beingandbetterhealthhavebeen identifiedwhiledifferentkindsofreligious/spiritual struggles have been found to af-fecthealthtotheworse(Klein,Silver&Zwingmann,submitted).Themajorityofsuchstudieshaveusedthemethodsofquantitativeempiricalresearch.Thus,thefindingscanbeinterpretedintermsofstatisticalprobabilities.Yet the question remains how such rather abstractresearchresultscanbehelpfulfortheassessmentofa patient’s individual religious/spiritual history andfor dealing with her or his concrete religious/spir-itualneeds intreatment.Toanswerthisquestion itis importanttobeawareofthetypeofmeasureofreligion/spiritualitywhichhasbeenusedinaparticu-larareaoftheempiricalresearchbecauseeachtypeofmeasure relates to an underlying,more generalquestion,e.g.:- How important is the patient’s religion/spiritualityforherorhim?

-Does thepatientholdbeliefswhicharehelpful tofindmeaningorwhichworryherorhim?- Is thepatientmemberof a religious/spiritual com-munity,anddoessheorhereceivesupportfromthiscommunity?-Howdothepatients’religious/spiritualbeliefsinflu-encethesubjectivetheoryofherorhisillness?- Has the patient religious/spiritual needs whichshouldbeconsideredtoimproveherorhiswell-be-ing?(cf.Albani&Klein,2011).Asking questions like these in the communicationwith apatientprovides theopportunity to addressand integrate the patient’s religion/spirituality inclinicalpracticeinawaythatcanbefruitfulbothforthepatient’ssatisfactionwithtreatmentandforthetreatmentoutcome.Thepaper1)givesanoverviewoverthemostimportantlinesofresearchonreligion/spiritualityandhealthand2)illustrateshowthepar-ticularresearchtopicsarerelatedtothemoregeneralquestionswhich could (or should)be addressed inthe direct communicationwith a patient. The pos-sibleconsequencesofsuchanassessmentofreligion/spiritualitywillbediscussed,too.

Keywords: Assessment, Exploration, Measures, Em-piricalFindings

From the Empirical Study of Religion/Spirituality to Practical Assessment in Treatment: Linking Research with Practice

Dr. des. Constantin KleinDepartmentofTheology,UniversityofBielefeld,Germany

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Symposium III: Integrating Religion/Spirituality into Psychotherapy/ Psychiatry/ Neuroscience Chair: Prof. Dr. Arjan Braam

Spirituality and Psychotherapy: A Double-Edged Sword?

Dr. Claudia Psaila CounsellingPsychologist&SocialWorker,Lecturer,UniversityofMalta,FacultyforSocialWellbeing,DepartmentofSocialPolicy&SocialWork,Malta

Itisincreasinglybeingacknowledgedthatspiritualitycannotbeseparatedfrompsychotherapyinthesameway that spirituality cannot be differentiated fromlifesinceitisinterwovenineverydaylife(Pargament,2007). Studies have highlighted a positive relation-shipbetweenspirituality,religionandclientfunction-ingincludingtheirphysicalandpsychologicalhealth(Koenig 2004; Leach 2009). In this presentation, Idiscusstheresultsofarecentqualitativestudyonthespiritual dimension of psychotherapy. The explora-tivestudyfocusedontheexperienceandperceptionofMaltesepsychologistsandpsychotherapistsofthespiritualdimensionofpsychotherapy.Thedatawascollectedthroughusingafocusgroupapproach.Thefindingssuggestthatspiritualityisoftenconsideredtobeanintegraldimensionofaperson’sidentityandexperienceandassuchneeds tobeacknowledgedandaddressed inpsychotherapy.Both religionandspiritualitymay,infact,beconsideredtobesourcesof internal strength and support. However, the op-positeisalsotruesuchthataperson’sspiritualitymayunderliehis/herpsychologicalissues.Attimes,thisislinked to aperson’s understanding and experience

of spiritualityandreligion.Thestudypoints tospir-itualityasaresourcewhilealsobeingpartofthecli-ent’spresentingproblemeitherdirectlyorindirectly.Furthermore, this dualitymay also be truewith re-gardsthetherapist’sunderstandingandexperienceofspiritualityandreligionwithresultantimplicationsforpractice.

ReferencesKoenig,H.G.(2004):Religion,spirituality,andmedi-cine: research findings and implications for clinicalpractice. Southern Medical Journal 97 (12), 1194-1200.Leach,M.M.,Aten,J.D.,Wade,N.G.,&CoudenHer-nandez,B.(2009):Notingtheimportanceofspiritu-alityduringtheclinicalintake.In:J.D.Aten,&M.M.Leach(Eds.),Spiritualityandthetherapeuticprocess:Acomprehensiveresourcefromintaketotermination,Washington,AmericanPsychologicalAssociation.Pargament, K. I. (2007): Spiritually integrated psy-chotherapy: Understanding and addressing the sa-cred,London,TheGuildfordPress.

Spiritual Needs of Patients in Psychiatry and Psychotherapy and their Utilization of Spirituality as Part of a Coping Strategy

Dr. Anne Zahn & Pfr. Franz ReiserUniversitätsklinikumFreiburg,AbteilungfürPsychiatrieundPsychotherapie,Freiburg/Bg.,GermanyPsychologischerPsychotherapeut(BDP,DFT),PsychotherapeutischeBeratungundBegleitungfürBerufederKirche,Freiburg/Bg.,Germany

AclinicalsurveyattheUniversityClinicforPsychiatryand Psychotherapy in Freiburg/Germany investigat-ed psychiatric in-patients’ spiritual and religious at-titudesandpracticesalongwiththeirspiritualneedsandexpectationstowardstheclinicanditsstaff.Overthecourseof18months,allnewin-patientsreceivedaquestionnaireatthebeginningandattheendoftheir clinical stay. Our survey consisted mainly ofmeasuresdevelopedbyA.Büssingetal.(SpREUK-15,Benefit-Scale,SpREUK-P-SF17,SpNQ1.2)aswellassocio-demographicandclinicaldata(e.g.diagnosis,BDI-II,WHOQOL-bref,BMLSS-10).

At admission,248participants tookpart in the sur-vey(60%women,40%men;meanage39.6±13.4years;religiousorientation:77%Christian,8.5%oth-er,14.5%none;self-perception:e.g.46%regardedthemselvesasneither„religious“nor„spiritual“).Our results show that intrinsic religious (Trust inHigherGuidance/Source)andquest-orientedspiritu-alattitudes(SearchforSupport/AccesstoSpirituality/Religiosity)arerelevantforabout20-30%ofpatients.The meaning-making strategy Reflection: PositiveInterpretationofDiseaseisconsideredimportantby47%ofthesample.

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Religious and Spiritual Attitudes of Patients in Neurological Rehabilitation and their own Concept of their Importance in Life

Dr. Anne Zahn & Carolin SchuetzUniversitätsklinikumFreiburg,AbteilungfürPsychiatrieundPsychotherapie,Freiburg/Bg.,Germany

Priorresearchhasshownthatreligiousandspiritualneedsarerelevantforpatientswithchronicdiseases.However, thequestionhowthisshouldbe integrat-ed intherapyornot remains tobe furtherclarifiedWeaskwhetherpatientswithneurologicaldisordershaveaneed that spiritualand religiousaspectsaremetintheirtherapyinhospital.Here,wetestedthehypothesiswhethersubgroupsofpatientswithhighorlowlevelsofspiritualandreligiousneedscanbeidentified based on the relevance of their spiritualandreligiouspracticeinlife.Totestthishypothesis,weuseanadaptedversionofthequestionnairedevelopedbyA.Büssing.Tofurtherunderstandtherelevanceofaddressingtheirspiritu-alityandreligionduringtheirtreatmentepisodewecomparetheresultsgainedinthequestionnairewiththeirvaluestheyhavein lifeandhowcontenttheyarerelatedtothespecificvalue.Thereforeweusea

validated, semi-structured interview (Holzhausen etal.,2010;Holzhausen&Martus,2012).200patientswillbeincluded,100willhavetheinterviewandthequestionnaire;theother100willjusthavetheinter-view.Inordertoseewhethertheadditionalinterviewisneededtounderstandhowreligiousandspiritualneedsmustbetakencareof intheclinicalcontext.Preliminaryfindingsofthestudywillbepresented.

ReferencesHolzhausen,M.,&Martus, P. (2013):Validationofanewpatient-generatedquestionnaireforqualityoflifeinanurbansampleofelderresidents.QualityofLifeResearch22(1),131-135.Holzhausen,M.,Kuhlmey,A.,&Martus,P.(2010):Individualizedmeasurementofqualityoflifeinolderadults:developmentandpilottestingofanewtool.EuropeanJournalofAgeing7(3),201–211.

It seemsthat religionandspiritualityare importantforaconsiderablenumberofpsychiatricin-patients,bothgenerallyandinrelationtotheirdisorder.Sev-eralpatientswould like thesedimensions tobead-dressed intheclinic (thiswouldbe for26%impor-tant)by the clinic staff (35%wishpsychotherapist,18.5%physician,33%chaplain).

ReferencesBüssing,A.(2010):SpiritualityasaResourcetoRelyoninChronicIllness:TheSpREUKQuestionnaire.Re-ligions1(1),S.9–17.DOI:10.3390/rel1010009.Büssing,A.,Balzat,H.-J.,&Heusser,P.(2010):Spirit-ualNeedsofpatientswithchronicpaindiseasesandcancer -Validationof theSpiritualNeedsQuestion-naire.Europ.J.ofMedicalResearch15,266–273.

The Progressive Impact of Burnout on Maltese Nurses

Dr. Michael GaleaLecturer,ClinicalPsychologist,FacultyofHealthSciences,UniversityofMaltaMalta

Nursingprofessionisahighlystressfulvocation.Par-ticipants(N=241),whoworkinthreedifferenthospi-talsinMalta,wereassessedontheimpactofburnouton their holistic wellbeing. Nurses completed theMaslachBurnoutInventory-HumanServices,theSat-isfactionwithLifeScale,theFaithMaturityScale,thePositiveandNegativeAffectScale, theBigFivePer-sonalityInventory,anddemographicvariables.Results from this cross-sectional correlational studyindicatedthat:a)professionalnursesinMaltasuffer

fromhighlevelsofburnout,particularlyfromhighex-haustionanddepersonalizationandlowprofessionalaccomplishment;b)asexpected,burnoutnegativelycorrelatedwithsubjectivewell-being;andc)apathanalysisindicatedtheprogressiveimpactofburnout,first on one’s personality and affective mood, andeventuallyonone’swellbeingandspirituality.The implications and recommendations from theseresultswerediscussed.

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Basichumanquestionsunderliephysicians’respons-estocommonmentalandbehaviorhealthconcerns.ThisstudyusesdatafromanationalsurveyofUnitedStates physicians to assess their self-predicted prac-tices regardingdepression, anxiety,medicallyunex-

plainedsymptoms,andalcoholism,andtodescribetheextenttowhichdifferencesinphysicians’practic-esareaccountedforbydifferencesintheirreligiouscharacteristics. These data suggest that clinicianswho aremore religious tend to interpret common

Religion-Associated Variations in Physicians’ Responses to Basic Mental Health Concerns

Prof. Farr A. Curlin, M.D.TrentCenterforBioethics,Humanities,&HistoryofMedicine,DukeUniversity,Durham,NC,USA

Thisstudyexaminedtheself-assessedreligiosityandspirituality (R/S) of a representative sample of Ger-man physicians in private practice (n = 414) andhowthisrelatedtotheiraddressingR/Sissueswithpatients.Themajorityofphysicians(49.3%)report-ed a Protestant denomination,with the remainderindicatingmainly either Catholic (12.5%) or none(31.9%). A significant proportion perceived them-selvesaseitherreligious(42.8%)orspiritual(29.0%).WomenweremorelikelytoratethemselvesR/Sthandid men. Women (compared to men) were also

somewhat more likely to attend religious services(7.4vs.2.1%at leastonceaweek)andparticipateinprivatereligiousactivities(14.9vs.13.7%atleastdaily), although these differences were not statisti-callysignificant.Themajorityofphysicians(67.2%)never/seldomaddressedR/Sissueswithatypicalpa-tient.Physicianswithhigher self-perceivedR/Sandmore frequent public and private religious activityweremuchmore likely to address R/S issues withpatients.Implicationsforpatientcareandfuturere-searcharediscussed.

Religiosity/Spirituality of German Doctors in Private Practice and Likelihood of Addressing R/S Issues with Patients

PD Dr. med. Edgar VoltmerDepartmentofHealthandBehavioralScience,FriedensauAdventistUniversity,Möckern-Friedensau,Germany(Co-authors:BüssingA,KoenigHG,AlZabenF.)

Doctors’ Beliefs and Medical Practice: Findings from two Swiss Cohorts

Dr. med. René Hefti & Dr. phil. Stefan RademacherResearchInstituteforSpiritualityandHealthRISH,Switzerland

Symposium IV: Doctors’ BeliefsChair: Prof. Dr. Niels Christian Hvidt

Toassessdoctors’beliefsinSwitzerlandweusedanadapted Curlin questionnaire (Curlin et al. 2005)adjusting the religiosity questions to the Religions-monitor(2007).ThisenablesustocomparereligiousprofilesofthephysicianswiththegeneralSwisspop-ulation.We investigated137physiciansof two religiousor-ganisations,theSwissAssociationofProtestantDoc-torsandtheSwissAssociationofCatholicPhysicians.26.0% of the physicians considered themselves asprotestant, 55.7% as evangelical and 18.3% ascatholic.Wewonderedwhether the three denomi-nationalgroupsdifferintheirunderstandingofhow

religion interacts with medicine and how religionshouldbeimplementedintomedicalpractice.Asec-ondsurveywasdoneamongstmedicalstudentsattheUniversityofBernalsousingtheadaptedCurlinquestionnaire. Results of both cohorts will be pre-sentedatthesymposium.

ReferencesCurlinFA,Lantos JD,RoachCJ,SellergrenSA,ChinMH: Religious characteristics of U.S. physicians: anationalsurvey.JGenInternMed.2005.20:629-634.Religionsmonitor 2008, Bertelsmann Foundation,Gütersloh(2007)

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Bymeansofa representative studyofGermanpsy-chiatric staff (e.g. medical and nursing staff), thisstudyaimedtofindout1)towhatextentpsychiatricstaffvaluesreligiosity/spiritualityintheirownlives,2)howpsychiatricstaffreactstoreligious/spiritualissuesintherapeuticprocessand3)howpsychiatricstaff’sownattitudetowardreligiosity/spiritualityinfluencestheirclinicalpractice.FromOctober2010toFebru-ary2011ananonymousstudywasdistributedtothestaffofpsychiatryandpsychotherapydepartmentsatGermanuniversityhospitalsandconfessionalclinics.Theresponseratewas24.43%(N=404of1654).UsingtheDukeUniversityReligionIndex,adegreeofspiritualitym=7.0onascaleof12.0wasshown.OnarevisedversionoftheCurlinetal.questionnaireonReligionandSpiritualityinMedicine:Physicians’Per-spectivespsychiatricstaffindicatedthattheyareopento religiosity/spirituality in the therapeutic setting,ready to listen and discuss religious/spiritual issueswiththeirpatientsandalsocooperatewithchaplains.Moreover,therewassignificantmoderatecorrelationbetweenthestaff’sownspiritualityandtheirattitudetoward religiosity/spirituality in therapeutic setting,

that is:Themore religious/spiritualpsychiatric staffis,themoretheybelievethatreligiosity/spiritualityisappropriateinthetherapeuticprocess.Interestinglychaplainsworkinginpsychiatricclinicsrespondedthatpsychiatricstaffisopentotalkwithpatients about religious/spiritual topics, but psychi-atric staff rated themselves more positively in thisregardthanchaplains.Moreover,chaplainsaffirmedthatthepersonalreligious/spiritualbeliefofpsychiat-ricstaff isan influencingfactorontheirattitudeto-wardreligiosity/spiritualityintheclinicalsetting.

ReferencesLee, E. (2014): Religiosität bzw. Spiritualität in Psy-chiatrieundPsychotherapie.IhreBedeutungfürpsy-chiatrischesWirkenausderSichtdespsychiatrischenPersonalsanhandeinerbundesweitenPersonalbefra-gung.Würzburg:EchterVerlagLee,E,Baumann,K(2013):GermanPsychiatrists’Ob-servationandInterpretationofReligiosity/Spirituality,in: Evidence-BasedComplementary andAlternativeMedicine,http://dx.doi.org/10.1155/2013/280168

Psychiatric Staff´s Religious/Spiritual Belief and its Influence on the Therapeutic Process

Dr. Eunmi LeeDepartmentofCaritasScienceandChristianSocialWelfare,FacultyofTheology,Albert-Ludwig-UniversityFreiburg/Bg.,Germany

The Role of Religion/Spirituality in Medical Management and Decision Making in Obstetrics and Neonatology: A Survey among Medical Professionals

Dr. Inga Wermuth & Prof. Dr. Andreas SchulzePerinatalCentreMunich-Großhadern,DivisionofNeonatology,Munich,Germany

There is evidence that familymembers of criticallyillinfantswishtohavemoreintegrationoftheirR/Sfrommedicalprofessionalsparticularlyduringsharedcritical-decisionmaking. The purpose of our studywastoanalyzetheperspectiveofperinatologists(ob-stetricians,midwifes, neonatologists, neonatal nurs-ingstaff)onR/Sintheirprofessionalenvironment.1500professionalsfrom20Germanperinatalcentersparticipatedinananonymouscrosssectionalsurvey.Thisaccountsfor80%ofallpotentialparticipantsinthesecenters.ThequestionnairewasbasedonCur-lin’sinstrumentandadaptedtosuitperinatalandEu-ropeanspecifics.InourcohortRomanCatholicswereoverrepresented(about45%),whileProtestantsandthosewithoutareligiousdenominationrepresented

aboutonequartereachwithastatisticallynegligiblenumberofallotherreligiousaffiliations.Theageoftheparticipantsrangedfrom22toabove60withthemodelocatedaround30years.AmajorityratedthegeneralimpactofR/Sonpatients’healthassignificantormoderate.Mostofthemfeltthatthisinfluenceispositiveorcouldbepositiveaswellasnegative,whilealmostnonefeltthatitisgen-erallynegative. The vastmajority said thatR/Shasa role in coping during illness and suffering. OnlyaboutonethirdclaimedthatR/Saspectsaresome-times or regularly addressed during a professionalencounterwithfamilies.Lessthan10%saidthatthisneveroccurs.Whilealmostallfelt ittobeappropri-atetoincludeR/Sincounselingwhenparentsbring

mentalandbehaviouralproblemsashavingspiritualdimensions and components, and they tend to en-

couragepatientstomakeuseofspiritualresourcestoaddresssuchproblems.

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Background: Private, personal prayer has beenshown to both positively and negatively influencephysical and mental well-being. Despite inconclu-

siveresultsregardingitsbenefit,prayeriscommonlyusedamongpatientsforhealthpurposes.Therefore,inthisreview,wewereinterestedintwomainques-

Functions and Topics of Prayer in Patients Dealing with Illness - A Systematic Review Karin Jors, M.A.Freiburg/Bg.,Germany

Prayer ismultidimensional andmayhavea theisticor non-theistic orientation. Research provides evi-dence about the efficacy of spirituality and prayerduring stressful situationswhichmay yieldpositiveoutcomesinhealth.Prayermayyieldpositivebeliefsthatmayfostermeaningandpurposeinillnessandlife,particularlywhen facedwith a life threateningillness such as, myocardial Infarction. In contrast,prayer may yield negative outcomes for examplewhenpatientsconsidertheirillnessasapunishmentfromGod.Thispaperpresentspartofalargerdescriptivelongi-tudinalstudyonpatients’experiencesofprayerdur-ingtheonsetofmyocardialinfarction.Thisstudywasguidedbythreetheories:Thenuminousexperience(Otto1950);CognitiveTheoryofStressandCoping(Lazarus& Folkman 1984) and Relational Spiritual-ityandTransformation(Sandage&Shults2007).Atotalof53patientswithfirstacuteMI(34males;19females),meanageof61.9years,affiliatedwiththeRoman Catholic religion, were interviewed retro-spectivelyontheirtransfertothemedicalward.Thequalitativedatawhichunderwentthematicanal-ysisrevealedthatwhilepatientsconsideredthesever-ityoftheirchestpain,theyperceivedthelossoftheirdear ones, experienced the fear of abandonment

from God, and fear of death. Consequently, 53%ofmales(n=18)and84%females(n=16)prayedtoGodthroughtheintercessionofsaintssuchas,SaintMary,PadrePioandSaintGorgPreca.However,47%ofmales(n=16)and16%offemales(n=3)didnotprayduringtheimmediateacutephase.Thetypesofprayerconsistedofintercessoryprayer,thanksgivingtoGod,requestingforgivenessfromGodandeffortsofalignmentwiththewillofGod.Whileconsideringthelimitationsofthisstudy,recommendationsweresetfortheeducation,managementandclinicalsec-torsinordertoamelioratepatientcare.Keywords: prayer, relationship with God, acutephase,myocardialinfarction,impactofheartattack.

ReferencesLazarusR.S.&Folkman(1984)Stress,AppraisalandCoping.SpringerPublishingCompany,NewYork.OttoR(1950)TheIdeaoftheHoly:Aninquiryintothenon-rationalfactorintheideaofthedivineandits relation to the rational. OxfordUniversityPress,London.SandageSJ&ShultsFL(2007)Relationalspiritualityand transformation: A relational integrationmodel.JournalofPsychologyandChristianity26,261-269.

Prayer in the Acute Phase of Myocardial Infarction

Prof. Dr. Donia BaldacchinoPh.D.(Hull),M.Sc.(Lond),B.Sc.(Hons),Cert.Ed.(Lond),R.G.N.,UniversityofMalta,Malta

Symposium V: Integrating Prayer in the Clinical SettingChair: Ass. Prof. Kevin L. Ladd, PhD

such issues up,manyparticipantswerehesitant toactively introduce such themes without a parentalrequest.Abouthalfoftherespondentsindicatedthatspecificbarriersmay impaircommunicationonR/Swithparents.Aprevalentconcernwasthatsuchcon-versationmightbeperceivedasintrusive.Wespecu-latethatthehighsurveyresponserateamonghealth

careprovidersinperinatologymayindicatebyitselfthatcommunicationonR/Sduringtheprofessionalencounterwithparents isgenerallyregardedas im-portant. However, the survey also reveals that thecurrentpracticeofcounseling inperinatologydoesnotreflectthisrating.

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Prayer and Health: Issues for Theology and Psychology of Religion

Mary Rute Gomes Esperandio & Kevin L. Ladd PontifíciaUniversidadeCatólicadoParaná(PUCPR),Curitiba,BrazilIndianaUniversitySouthBend,SouthBend,IN,USA

Quantitative research has been prevalent in thestudies on prayer. Using a qualitative approachbasedoncontentanalysis, this studyexamines therelationshipbetweenprayerandhealth.Datacomefrom 104 recorded interviews of participants fromCatholic,ProtestantandPentecostal traditions.Theanalysisfoundfourcategoriesthatdescribetheuseof prayer: 1. Prayer as a religious coping strategy(62,5%); 2. Prayer as a discipline to keep spiritual-ityalive(15,3%);3.Prayerasatechniqueofmutualempowerment(8,6%);4.Prayerasaturningpointintheexistentialprocess(13,4%).Thetypesofprayercorrespondingtothesecategoriesare:1.Petitionary

andLamentation;2.RestandSacramental;3. Inter-cessoryprayer;4.Conversion;Calling;MovementoftheSpirit.Accordingtothecurrentliterature,prayerprovides inward,outwardandupwardconnectivity.The results indicate an additional connectivity notyetstudied:theEpiphanicconnectivity,whichcomesfromsacredtohumanandmarksaturningpointintheexistentialprocess.Theoutcomessuggestacloserelationshipbetweenprayerandspiritualandmentalhealthbydecreasinganxiety,makingmeaningandpurposeinlife,andpointouttherelevanceandneedforfurtherstudiesontheinterfacebetweentheologyandpsychologyofreligion.

Medicine, Faith, Religion and Science

Prof. Joseph M. Cacciottolo, MD, DSc, FRCPCoordinator,Humanities,Medicine&ScienceProgramme,MedicalSchool,UniversityofMalta,Malta

Thepracticesofmedicineandbeliefinthesupernat-uralhavealwaysbeencloselyassociated,andhistori-cally,medicine has only relatively recently becomeanevidence-basedappliedscience.Despitetheclearseparationofmodernmedicinefromreligion,severalstudieshave shown thatbelief in themetaphysicaland the practice of faith are very important to in-dividuals,especiallywhentheyareconcernedabouttheirhealth,orundergoinglife-changingevents.Anydiscussionoftherelationshipbetweenfaithandmedicine is rendered complex not only becausetheirboundariesareunclear,butalsobecauseofthepersonal and subjectivenatureof faith itself.Ama-

jorconfounding factor in suchdiscourse is the factthatdifferentsystemsofbeliefrelatedissimilarlywithmedical science and practice: Often the only com-mongroundisthesearchfortruth.At a conceptual level, the interface betweenmedi-cineandfaithneedstotakeintoconsiderationmat-tersthatingeneralrelatetoscienceandreligion,aswell as issuesof convergence, hurdles todiscourseanddivergence.At apractical level, faith in the immaterialmayoc-casionally affect individual medical decisions bothfromthepatient’saspect,aswellasfromthephysi-cian’sperspective.Atanindividuallevel,thefaithof

tions:1)whydothepeopleturntoprayerintimesof illness and 2)what are themain topics of theirprayers?Method: We undertook a systematic literature re-viewbysearching thedatabasesPubMed,Medline,PsycINFOandIndexTheologicusforstudiesfocusedonprayerandillness.Thefollowinginclusioncriteriawereused:1)participantsinthestudywerepatientsdealingwithanillness2)studyexaminedtheuseofprivateprayerratherthanintercessoryprayer3)boththefunctionandtopicsofprayerwereinvestigated.Results:Intotal,12articleswereincludedinthefinalreview.Themajorityofthestudiesusedaqualitativedesign, e.g. interviews. Study participants sufferedfromavarietyofdiseasesbutmostoftenfromcancer.

Inall12studies,patientsprayedforimprovementinboth physical andmental well-being.Nine studiesshowedthatpatientsprayedforhelpmanagingtheirdisease,e.g.decision-making.However,patientsalsoprayedforprotection,guidance,strengthandhope.Prayerswerenotonlyself-focusedbutalsoincludedthanksgiving,adorationandprayersforothers.Conclusions:Althoughmostpatientsdoprayforre-lief from their physical andmental suffering, it ap-pearsthattheeffectivenessoftheirprayers(i.e.heal-ing)isnotthemainreasontheypray.Rather,prayercanbeasourceofstrengthandcomfortthatallowspatients to positively transform the experience oftheirillness.

Background: Based on the assumptions of the self-regulation model, the individual being an activeproblemsolverconsciouslyactivateseffortstomod-ulate thoughts, emotions and behaviors when fac-ingillnessorhealththreads.Animportantaspectfordealingwithillnessintermsofcopingandillnessin-terpretationareindividualrepresentationsofdisease.RelyingonDiefenbachand Leventhal (1996) therearetwomaintypesofrepresentations:cognitiveandemotional.Basedonnumerouspreviousstudiescon-cerningtheinfluenceofspiritualityandreligiosityonillnessinterpretationandcoping),thedimensionofspiritualityasathirdimportantdimensionof illnessrepresentation is introduced and discussed. Assum-ingthatspiritualitybeliefsare important factors forindividualcopingstrategiesaswellasbehavioralre-actionsinthecontextofillnessitishypothesizedthatdifferentqualitiesof spirituality (i.e. search for tran-scendence, need for innerpeace, ethical sensitivity,harmony)resultindifferentinterpretationsofillness(i.e.illnessasavalue,asachance,asapunishmentetc.), and thus different coping styles (i.e. helpingothers,self-transcendence,religiousmeaning,escap-ingfromillness).Method: Cross-sectional survey among 275 Polishpatients(meanage56±16;74%women;26%men)withboth fatal andnon-fatal chronicdiseases: can-cer (35%), diabetes mellitus (16%), chronic paindiseases(10%),andotherchronicconditions.Stand-ardized questionnaires were the Interpretation ofIllness Scale; Spiritual needsQuestionnaire (SpNQ),Self-description Questionnaire of Spirituality (SQS),Spirituality/ReligiosityandCoping(SpREUK-15),LifeSatisfaction(BMLSS),andEscapefromIllnessScale.Results:Mostpatientsregardedtheirillnessassome-thingnegative,i.e.,61%interruptionoflife,50%en-emy,20%weakness,8%punishment,13%relieving

break,22%callforhelp;yet,alargefractionalsoassomethingpositive,i.e.,42%challenge,18%value.Compared to patients with cancer, patients withnon-fatalchronicdiseasesregardedtheir illness lessoften as an enemy (F=7.3; p <.01),while all otherinterpretations did not differ significantly betweenthesediseasegroups.Value was strongly associated with religious trust(r=.50),andmoderately(r>.30)withpatients´abilityto reflect their life,with religiousneeds andneedsforgiving/generativity,withSQS´sreligiousattitudesandethicalsensitivity,andothermeasuresofspiritu-ality.However,challengewasonlyweaklyassociatedwithsearch fora spiritual source (r=.21)andreflec-tion (r=.20). Incontrast, anegativediseasepercep-tionsuchasenemywasstronglyassociatedescapefromillness(r=.59),andmoderatelywithexistentialneeds (r=.30); also other negative disease percep-tions such as interruption of life (r=.55) or punish-ment(r=.36)weremoderatelyorstronglyassociatedwithescape.Call forhelpwaspositively correlatedwithescapefromillness(r=.48),andnegativelywithlifesatisfaction(r=-.38).However,weaknessorreliev-ing break is not significantly associatedwithmeas-uresofspirituality.Regressionanalysisbasedonthesecorrelationsshowsignificantimpactofspiritualityoninterpretationstylesofillnessaswellascopingstrate-gies.Conclusion:Datashowthatthetypeofspiritualityisan important predictor for the patients´ interpreta-tionofillnessandcoping.Spiritualattitudesresultinapositiveinterpretationofillnessasbeingsomethingofvalue,indicatingpotentiallythechanceforaspir-itual transformation. Negative interpretations weremainlyrelatedtotheintentiontoescapefromillness,reducedlifesatisfaction,andexistentialneeds.

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Patients´ Interpretation of Illness is associated with their Spiritual Needs, and Specific Forms of Spirituality

Prof. Dr. Janusz Surzykiewicz & Prof. Dr. Arndt Büssing InstituteofSocialPrevention,WarsawUniversity,Poland/ProfessorshipofPastoralTheology&Psychology,CatholicUniversityEichstätt-Ingolstadt,GermanyProfessorshipofQualityofLife,SpiritualityandCoping,FacultyofHealth,UniversityofWitten/Herdecke,Germany

Symposium VI: Spiritual Needs in a Secular SocietyChair: Prof. Dr. Arndt Buessing

persons facingphysical adversity is at times tested,as is belief in intercessional prayer. For physiciansandscientists,itisoftenaverypersonaldecisionto

specifically address faith and its compatibility withscientificevidence.

Toanalysehowagnostic/atheistpatientswithmulti-plesclerosis(MS)copewiththeirillnesscomparedtospiritual/religiouspatientsweperformedaprospec-tive, multi-centre, anonymous study using stand-ardisedquestionnaires. 213patients (75%women;meanage43¬±11years,EDSSScore3.7±1.8)wererecruited fromthreehospitals that specialize in thetreatmentofMS.Among them, 54% rated themselves as neither re-ligious nor spiritual (R-S-), 16% as not religiousbut spiritual (R-S+), 19% as religious but not spir-itual (R+S-), and 20% as both, religious and spirit-ual (R+S+).29%stated that their“faith isa stronghold in difficult times” (52% rejected it, and 19%wereundecided).Havingthisfaithasaresourcewasnotsignificantlyinfluencedbygender,familystatus,educational level,courseofdisease,anditwasalsonotrelatedtopatients´healthstatus,lifesatisfaction,negativemoodstates,orPositiveattitudes. Instead,thisresourcewasassociatedwithMSpatients´ability

to reflect onwhat is essential in life,with the con-victionthatillnessmayhavemeaningandcouldberegardedasachancefordevelopment,andtoappre-ciateandvaluelife.OfinterestwasthefactthattheexperienceofGratitude/Awewas lowest inR-S-pa-tients,andthehighestinR+S+patients.Whenaskedfor their individual sourceofhope,orientationandinspiration in life, 53% of patents had none, 10%stated faith/religion, 22% family/partner/children,18%other(mainlyphilosophicalsources).Thus, religious individualsmayfindhope andholdintheirfaith,andrelatedengagementinindividualformsofreligiosity(i.e.,privateprayers,meditation,rituals) and/or organized forms of religiosity (i.e.church attendance),while R-S- cannot rely on thissource.Onemaysuggestthattheymayhaveeithernospecificinterestorarelesswillingtoreflecttheseissues.Howtheseindividualscouldbesupportedre-quiresfurtherexploration.

Spiritualityispartofthebasicneedsofallhumans,yetoften ignored inhospitalsbecause it is regardedasbeyondprofessionaldutiesofmedicaldoctors,nurs-esorpsychologists.Meanwhilethereisanincreasingbodyofevidence thateven in secular societies,pa-tientswithchronicdiseasesmayhavespecificspirit-ualneeds.However,lessisknownaboutthespiritualneedsofmothersofpretermorsicknewbornchil-dren.Aimofthisstudywasthustoidentifytheneedsofsuchmothers.Sofar,62mothersfromthepaedi-atric intensive careunit of theCommunalHospital

Herdeckemeeting the inclusion / exclusion criteriaresponded to a set of standardized questionnaires,i.e., spiritual needs questionnaire (SpNQ), spiritualwell-being (FACIT-Sp), mood states (ASTS), stressperception(PSS),self-efficacyexpectation(SWE),lifesatisfaction (BMLSS), etc.Wewill present firstdataonmothers´spiritualneedsandspiritualwell-beingduring their strugglewith their new borns´ healthaffections.Bysupportingtheirneedsinhospitalwehopetobeableincreasingmothers´well-beingandbindingtotheirchildren.

The aim of this study was to analyze psychosocialandspiritualneedsamongseniors living in residen-tial/nursinghomesintheSouthofGermanyonone

hand,andtheunderlyingconnectionswiththeirlifesatisfaction,moods,andmeaninginlifeontheotherhand.

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Faith as a Resource in German Patients with Multiple Sclerosis

Anne-Gritli Wirth Witten/HerdeckeUniversity,Witten/Herdecke,Germany(Co-Authors:ArndtBuessing,PeterHeusser)

Spiritual Needs of Mothers of Sick New Born or Preterm Children

Undine WaßermannCommunalHospitalHerdecke,Herdecke&InstituteofIntegrativeMedicine,Witten/HerdeckeUniversity,Germany(Co-Author:ArndtBuessing)

Spiritual Needs of Elderly Living in Residential/Nursing Homes

Jülyet Öven Uslucan ProfessorshipSpiritualCare;ClinicforPalliativeMedicine,UniversityClinicMunich,Munich,Germany(Co-Authors:CarlosIgnacioManGing,EckhardFrick,ArndtBuessing)

112seniors(76%womenand24%menwithameanageof83±7years)wererecruitedin9differentresi-dential /nursinghomes forelderlyandassistedac-commodationhomesinBavaria(predominantlywithaCatholicdenomination).Tomeasurepsychosocialand spiritual needs, we used the Spiritual NeedsQuestionnaire (SpNQ) which differentiates 4 mainfactors,i.e.,ReligiousNeeds,ExistentialNeeds,needforInnerPeace,andneedforGiving/Generativity.WefoundthatReligiousNeedsscoredhighest,whileallotherneedswereofsimilar,yet lowerrelevance.Therewerenosignificantdifferencesbetweenmenandwomen;alsoageandeducationallevelhadnosignificant influence. While there were no particu-

lardifferencesinthemagnitudeofunfulfilledneedswithrespecttoself-careability,thereweresignificantdifferences in terms of elderly living in residentialhomes or residential nursing homes. In fact, thoseliving in residential nursing homes had lower Re-ligiousNeeds, but higher ExistentialNeeds and In-nerPeaceneeds.These resultsclearlydiffer fromasimilarstudyamongelderlyconductedinSchleswig-Holstein(ErichsenandBüssing,2013),locatedintheNorthofGermany(predominantlywithaProtestantdenomination). It couldbeobserved thatReligiousneeds,inwhichprayingforoneselfwasplacedatthefirstplace,was themostpowerful issue.Themoremeaninginlife(SMiLEquestionnaire)theresidents

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Introduction:ThecurrentstudyexaminedthefactorstructureandpsychometricpropertiesofaHebrewversionoftheShalomhealthandspiritualwell-beingquestionnaire (Fisher, 2010). Shalom is one of thefewresearchtoolsthat includeamulti-dimensionalconceptofspiritualityanddifferentiatebetweenspir-itualityandreligiosity.Thequestionnaireisbasedonaspiritualhealthmod-el developed by Fisher and Gomez (2003), whichexamines the quality of relationship people havewith regard to four existing dimensions: personal,communal,environmental,andtranscendental.Thequestionnaireconsistsof20 items;each requestsadoublereference:oneofvalueandtheotherofthedegree of realization this value has in the respond-ent’severydaylife.

Method:1.TheShalomquestionnairewastranslatedintoHebrewaccordingtoacceptedprocedure;2.AresearchquestionnairewasbuiltcontainingShalomandadditionof variables for validity assessment; 3.Thequestionnairewasdistributedanonymouslyon-line,and350questionnaireswerefilledoutbyindi-vidualsfromages19to90.Tools: 1. The structure factor was evaluated usingconfirmatoryfactoranalysis(CFA)withVarimaxrota-tion;2.Constructvaliditywasexaminedbytestingcorrelations between relevant variables; 3. InternalreliabilitywastestedbyCronbach’salphacoefficient.Results:1.Factoranalysis supportedthe four-factorstructureofShalomasreportedbyFisher(2010),2.Constructvaliditywassupportedbynegativecorre-lationwithdeathanxietyanddepression,andposi-

Translation and Validation of Shalom Questionnaire Hebrew Version

Nahum ElhaiDepartmentofPublicHealth,BenGurionUniversityoftheNegev,Israel(Co-authors:SaraCarmel,YaacovG.Bachner)

TheSpiritualCareDepartmentof theClinic forPal-liativeMedicineat the LMUMunichUniversitypre-pared the first study ever designed to observe thesituationof ill anddyingpeople inBavarian Jewishcommunities.Itisanempiricalstudybasedonquali-tativeinterviews.Theparticipants,rabbis,communi-tyleaders,socialworkersetc.areallactivelyinvolved

inJewishcommunitiesandresponsibleforprovidingend of life care. The conducted interviews (21) in-dicatedtheimportanceofmaintainingthemaximallife-quality until the very end in terms of Judaism.Thecommunication regarding the religiousaspectsorquestionsshouldaccordingtotheexperts,bepro-videdbasedonanexplicitwishofthepatient.

Spiritual Care in Bavarian Jewish Communities

Mag. Theol. Michael PeteryClinicforPalliativeMedicine,Ludwig-Maximilians-UniversityMunich,Germany

Symposium VII: Spirituality, Judaism, Health CareChair: Mag. Theol. Michael Petery & Naomi Kalish, B.A., MSW

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tivecorrelationwiththewill to live, lifesatisfaction,andgeneralwell-being,3.Highreliabilitycoefficientswerereceivedfortheoverallscale(0.90),aswellasforeachofthefourfactors(0.80-0.94).Conclusions: The results of this research show thattheHebrewversionof theShalomquestionnaire isvalidandreliableandcanbeusedwithconfidenceinstudiesofspirituality.

ReferencesFisher,J.(2010):DevelopmentandApplicationofaSpiritualWell-BeingQuestionnaire Called SHALOM.Religions,1,105-121.Gomez, R.,& Fisher, J.W. (2003): Domains of spir-itualwell-beinganddevelopmentandvalidationofthe Spiritual Well-Being Questionnaire. PersonalityandIndividualDifferences,35,1975-1991.

Carol Gillligan’s Listening Guide as a Method for Spiritual Assessment

Rabbi Naomi Kalish, ACPE, BCC, MA, CoordinatorPastoralCare&Education,MorganStanleyChildren’sHospital&SloaneHospitalforWomen&UJA-Federation,President,NationalAssociationofJewishChaplains,USA/Israel

Spiritual Care providers and researchers are taskedwithformulatingunderstandingsofthepeopletheyencounter that informs theirprovisionofcare,edu-cational programs, policies, and ongoing research.They must articulate understandings of spiritualityandspiritualcareinordertodosuchassessments.Inthispaper, thepresenterwill introduceparticipantstoatoolforsuchatask:theListeningGuideMethod,developedbyacclaimeddevelopmentalpsychologistCarolGilligan.Inthelatterhalfofthetwentiethcen-turyGilliganpublishedInaDifferentVoice,contribut-ingnotonlynewknowledgeaboutpsychologicalde-velopment,butarevolutionaryapproachtoresearchmethodology.Sincethepublicationofthislandmarkbook, Gilligan’smethod for discovery research hasbeendevelopedandusedbyscholarsinternationallyandacrossdisciplines.Gilligan’scharacterizationofhermethod ‘discoveryresearch’ is especially apropos to emerging fields,suchasspiritualcare,andtocritiquingalreadyestab-lished fields, such as psychology. Thismethod canprovide the crucial, oven over-looked step of ques-tioningofbasicassumptions.Inthispresentationthepresenterwillalsoprovideexamplesofhowresearch-ers can use Gilligan’s Listening GuideMethod canleadtothedevelopmentofspiritualassessmenttools.

Thepresenterwilldemonstratetherelevanceofsucha method for developing and using spiritual caretoolsinculturallyandreligiouslydiversecontexts.Objectives: 1. To learn the history and context ofCarolGilligan’spsychologicaltheoriesandhowtheyinformherresearchmethods;2.TomakethestepsofTheListeningGuideMethod;3.Tomakeanapplica-tionofGilligan’stheoriesandmethodstospiritualas-sessment;4.TorelatetherelevanceofTheListeningGuideMethodtoculturalcompetency

ReferencesGilligan,C.(1982): InaDifferentVoice:Psychologi-calTheoryandWomen’sDevelopment(HarvardUP)Gilligan, C., M. Weinberg, R. Spencer, T. Bertsch(2003):“OntheListeningGuide:AVoice-Centered,RelationalMethod” in: Qualitative Research in Psy-chology: Expanding Perspectives in MethodologyandDesign(APAPress)Hartman,T.(2003):AppropriatelySubversive:Mod-ernMothersinTraditionalReligions(HarvardUP)Loots,G.,K.Coppens,J.Sermijn(2013):“Practisingarhizomaticperspectiveinnarrativeresearch”in:An-drews,M.;SquireC.,Tamboukou,M.DoingNarra-tiveResearch(2nded.),(Sage)

“Quality of Life” vs. “Sanctity of Life” – Traditional Jewish Spiritual Perspectives on Current Trends in Hospice and Palliative Care

Rabbi Jay Yaacov Schwartz, M.A.RamatBeitShemesh,Israel

The Jewish community in theUnited States and Is-raelhasbeengrapplingwiththeprocessofend-of-lifemedicaldecisionmakingaspartofHospitalandHospice for the last twodecades, especially in situ-ationswhen secularmedical ethicsmight seem tobeatoddswith JewishmedicalEthicsandspiritualconsiderations. New Palliative care research initia-tivesarecurrentlystudyinghowtoserveTraditional

JewishpatientsinHospiceandPalliativecaresettingsways thatareconsistentwith serving their spiritualconcernsandculturalorientation.Wewill present actual case studies and the conclu-sionsofthesescientificresearchstudiesconductedinNewYork from2003-2007andexplain theuniqueperspectiveofJudaismontheseissues.

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Session 1: How do Health Care Professionals understand Religion/ Spirituality and Spiritual Care?

Free Communications All Free Communications on Friday, May 23rd, 16:00 - 17:30

Spiritual Care by Hands and Heart

Liv Ødbehr Lecturer,PhDstudent,Norway(Co-Authors:KariKvigne,SolveigHauge,LarsJohanDanbolt)

Aimsandobjectives:Toinvestigatehownursesandcareworkersunderstoodandpracticedspiritualcareamong patients with dementia disease in nursinghomes.Background:Spiritualcareinnursingpracticeisoneaspectintheoverallholisticcareprovidedbynurses.Substantial international empirical studies describetheconceptofspirituality,butfewerstudiesdescribehownursesunderstandandpracticespiritualcareforpatientswithdementiadiseaseinnursinghomes.Design:Qualitativestudywithanexplorativedesign.Methods:Thestudycomprisedeightfocusgroupin-terviewsof31nursesandcareworkersinNorwegiannursinghomes.Datawereanalysedusingaqualita-tiveresearchmethodinaphenomenological–herme-neuticalapproachofinquiry.Results:Initiallythenurseswereunsureofthemean-ing of spiritual care, and whether they performedsuchcareatall.Throughfocusgroupdiscussiontheunderstandingbecamemoreevident.Spiritualcarewasdescribedasi)integratedintheoverallgeneralcare,whichhighlightedpracticaldailycaredescribed

as“workingwithhands”,andnurses’ intuitionandpositive attitudes described as “working with theheart”; ii) togetherness, characterised by presenceandreciprocityandiii)provisionofmeaningintheeveryday life of patients andmeeting patients’ reli-giousneeds.Conclusion: The nurses seemed to lack theoreticalknowledge and concepts that coulddescribe spirit-ualcare.However,throughjointreflectioningroupsthenursesdiscoveredthattheycarriedoutspiritualcare in their everyday practice. Spiritual care wasseenastacitknowledgeinnurses’practicebasedonthenurses’experienceswithdementiapatients.Relevancetoclinicalpractice:Thisstudydemonstratesthenursesneedforarenastodiscussandreflectonwhatspiritualcaretopatientswithdementiadiseasemeans,andhowtopracticeit. Inaddition,thereisalsoaneedforeducationandtheoreticalknowledgeto furtherexplore spiritualneedsand spiritual care.

Keywords: Spiritual care, nursinghomes, dementia,focusgroups,nursingpractice

Religion, Spirituality and Spiritual Care of Nurses in Mental Health Care, Hospital Care and Home Care in The Netherlands

Dr. Annemiek Schep-AkkermanResearcher,Zwolle,TheNetherlands(Co-Author:RRvanLeeuwen)

Background:thereligiousandspiritualaspectoflifeis recognized as having an important part to playinhealth,wellbeingandqualityof life.So,spiritualcareisanimportantpartofthenursesroleandtheexpectationisthatnurseswillbecompetentinthis.Literature shows that thecompetence indeliveringspiritualcaredependsonafewvariables:age,work-ingexperienceandtheimportanceofspiritualityinthenurse’s life.However,therearedifferentsectorsinhealthcare,so,differencesinthesesectorscouldplayaroleaswell.

Researchquestion:howdonursesindifferentsectorsinhealthcare(mentalhealthcare,hospitalcareandhome care) perceive spirituality and spiritual careandhowcompetentdotheythinktheyareindeliv-eringspiritualcare?Nexttothis,whatfactorsappeartocontributetotheseperceptionsandcompetence?Method:nursesinmentalhealthcare,hospitalcareand home care were asked to complete a ques-tionnaire. Parts of the questionnaire: demographiccharacteristics, perceptions of spirituality and spir-itual care (SSCRS), self-assessment of spiritual care

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competence(SCCS)andevaluationownspirituality(SAIL). The answers on thequestionnaire and sum-maryscoreswillbecomparedbetweensectorsanddemographiccharacteristics.Results:160nursesinmentalhealthcare,202nursesin hospital care and 87 nurses in home care havecompleted the questionnaire. Nurses in hospitalcarearetheyoungest,nursesinhomecaredohaveahigherage.53%ofallnursesareChristian,16%saytheyhavenofaithand13%isatheistic/agnostic.Mostnursesdohavearathergeneralperceptionof

spirituality, think they are competent in deliveringspiritualcareandspiritualitydoesplayaroleintheirlives.Similaritiesanddifferencesbetweensectorswillbepresented,nexttofactorsthatseemstobeassoci-atedwithspiritualityandspiritualcare.Discussion:Thereseemstobeassociationsbetweenreligiousness, spirituality, and self-assessed compe-tenceindeliveringspiritualcare.Whatcouldcontrib-utetothediscussionaboutdeliveringspiritualcare:isitnaturalorcaneverybodylearnit?

Meaning-making, Spirituality and Religion: Significance for Patients in Treatment for Substance Use Disorder.

Dr. Torgeir SørensenMFNorwegianSchoolofTheology/CenterforPsychologyofReligion,InlandetHospitalTrust,Oslo,Norway(Co-Authors:LarsLien,AnneLandheim,LarsJ.Danbolt)

Background: Spirituality, religiousness, how peoplecreatemeaninginlifeandthesefactorssignificanceforpatientsinclinicalsettingsareunderexposedsub-jectsintheresearchliterature.InNorwayseveralre-ligiouslymotivatedclinicstreatingaddictionreceivefundingfromthehealthauthorities.Evenso,littleisknownaboutmeaning-making,spirituality,andreli-giousnessamongpeoplewithsubstanceusedisorderandthementionedfactorsfunctionrelatedtotreat-ment.Aim:Thepurposeofthisstudyistoinvestigatehowpatientswithsubstanceabusedisorder relate toac-tivityandexperiencesregardingspirituality,religious-ness,andtomeaning-makingingeneral.Further,wewillinvestigateinwhatwaysuchactivitiesandexpe-riences eventually are of significance for treatmentofsubstanceusedisordersaccordingtopatientsandtherapists.Material andmethods: Data will be collected at aNorwegianreligiouslymotivatedadditctionclinic.Afocus-groupinterviewincludingupto8patientswillbeconducted,hopefullygeneratingrelevantsubjectsforfurtherdatacollection.Next,10-12patientswillbein-depthinterviewed.Thesepatientswillalsofill

intheSoMequestionnairewiththepossibilitytolinkthe questionnaire to each in-depth informant. Thesamequestionnairewill alsobe anonymously filledinbyupto48inpatientsatRiisbyTreatmentCentre.Also,twofocus-groupinterviewsamongtherapistsatthesameinstitutionwillbeperformedtogainknowl-edgeof thetherapists’viewofspirituality, religious-nessandmeaning-makingintreatmentofsubstanceusedisorders.Thislatterinvestigationwillrepresentthemainpartofthepresentationattheconference.Thematerialwillbeanalysedbyqualitativecontentanalyses, and descriptive andmultivariate statistics.Foranoverallanalysisofboththequalitativeandthequantitative material a mixed-methods design willbeutilized.Results and relevance: This study will generate de-tailed knowledge concerning a topic rarely investi-gated.Thefindingswillhaverelevancefortreatmentand care for patientswith substance use disordersand generate important knowledge transferable tomentalhealthcare. Findingsmaybe important fordevelopment of how therapists canmeet and sup-port patients regarding their resilience and copingresources.

Development of the Instrument for Measuring Spiritual Health Scale in Thai University Students

Dr. Preeya KeawpimonLecturer,PrinceofSongklaUniversity,Hatyai,Thailand(Co-authors:SureepornKritcharoen,SopenChunuan,UrairatNayai)

Measuringthespiritualhealthofuniversitystudentsis useful for planning the student’s activities. Thisstudycontributestothedevelopmentofavalidandreliableinstrument,spiritualhealthofuniversitystu-dentscale,asaninstrumenttoassessuniversitystu-dent’sspiritualhealth.Theparticipantswerestudents

fromBachelor-levelof15faculties(N=525),PrinceofSongklaUniversity,Hatyaicampus,Thailand.TheitemsoftheinstrumentwerehypothesizedfromBud-dhistphilosophyregardingspiritualhealth.Contentvaliditywasexaminedbysixexperts(I-CVI=1).Con-struct validitywas evaluatedby factor analysis and

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internalconsistencywasestimatedwithCronbach’salphaandaverageinter-itemcorrelation.Inaddition,Pearson productmoment correlation coefficient ofthe concurrent validitywas test by ThaiHappinessIndicatorwithpositivecorrelation(Pearson’sr=.574).ThereliabilitycoefficientofThaiSpiritualHealthScale(short form with 30 items) was satisfactory value(Cronbach’s=.80).Theinstrumentcomprisesoffour

domainsincluding1)Noblemind(Cronbach’s0.81),2)Moral living (Cronbach’s0.74), 3)Mindfulman-agement (Cronbach’s0.77),and4)Attentive learn-ing (Cronbach’s 0.86). Finding suggests that thedevelopment instrumenthas adequate validity andreliability to investigate the spiritual health of Thaiuniversitystudent.

What Happens when the Patients’ Bell Rings: An Explorative Study in the Field of Palliative Care

Prof. Dr. Niels Christian HvidtUniversityofMunich,Germany(Co-Authors:CécileLoetz,JakobMüller,BeateMayr,YvonnePetersen,PiretPaal,CarlosIgnatioManGin,YousefHelo,EckhardFrick,NielsChristianHvidt)

Background:Besides ringing thebell there are fewpossibilities forpatients inpalliativecaretoactivelyinitiatethecontactwithnurses.Thefollowingstudyexploreswhathappenswhenpatientscallfornursesbyringingthebellinpalliativecaresettings.Aim:Thisexplorativestudyobservedanddescribedthepatient-nurseinteractioninitiatedbybellringing.Specialattentionwaspaidatpatients’distressexperi-ence.Method: The field work lasted one week (24/7).During this period all bell-ringing occasions wererecorded.Dependingon the situation, interactionsinpatientroomswereobservedandcodedusingaparticipantobservationsheet.Subsequently,NCCNDistressthermometerwasusedbothonpatientsandnursestoenquireaboutthereasonsforbellringingandmeasurethedistressinvolved.Results: During the observation period 20 pallia-tivepatientswererecruitedforthisstudy.AllnursesworkinginoneofthelargestpalliativecareunitsinGermany agreed to participate in this study. All inallwerecorded362bell-ringingoccasionsofwhich122interactionswereobserved(33,7%).Theresultsindicate that amajor cause for ringingwas associ-ated with practical (68,0% of n=122 interactions)andphysical(36,9%)needs.Regardingthepractical

needs,patientssoughthelpduringbowelmovement(26,2%).Themostimportantphysicalconcernwaspain (15,6%), whereas only 5,7% expressed emo-tionaland3%spiritualconcerns.Theresultsindicatethatpatientstendtoexpresstheirdistressinextremevalues, then again, physical needs become higher(M=8,15)andpracticalneedslower(M=4,07)stressvalues.Nurseshavethetendencytousethemediumvaluesintheirdistressestimations.Incomparisontoinstructive communication style the inquiring com-municationstyleleadstoahigherparitybetweenpa-tientsandnursesestimations.Duringbasicnursingprocedures and treatments thedistress estimationsfrombothsidesweretogreatextentamenable.Conclusion:This studydescribes situations thatareinitiatedbypalliativepatientsas theycall fornursebyringingthebell.Theresultsofthisstudyreflectonthenursinginterventionsandcommunicationstylesthatoccurduringpatient-nurseinteraction.Thedis-tress estimations pointedout that in particular thepatient’sphysicalneeds are connectedwithhigherdistress,whichshouldnotbeunderratedbynurses.The observation revealed that patients’ emotionaland spiritual needs are not necessarily verbally ex-pressed,butthewordlesscuesmayhaveasignificantrole,whenitcomestodistressanddistressreduction.

What is the Religious Conviction/Spirituality of my Patients? Austrian Medical Students’ Point of View

Dr. med. univ. Anahita Paula Rassoulian PhD-student,UniversityofVienna,Austria

Session 2: Religion & Spirituality in Daily Practice of Health Care Pro-fessionals

Alargenumberofstudieshaveshownthatreligionand spirituality may play an important role in pa-

tients’lifewhiledealingwithseriuosillness.Besidesthebio-psycho-socialconcept there isanotherpart

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of a person, whichwants to be reflected. Patientsreportthattheywanttheirphysiciantotalktothemabouttheirreligiosity/spirituality.Datademonstratedtheexistenceofa“spiritualneed”inpatientsandtheimportanceof addressing spiritual issues inpatient-doctorcommunication.Toreflecttheseneedsdiffer-ent conceptswere developed for taking a spiritualhistoryinaclinicalsetting.What about Austria? Officially 79% of the popula-tionbelongtoareligiousconvictionbuttheroleofpatients’ spiritualityandreligionstill seemstobeataboointhedailyroutineofadoctor.Dowe,asphy-sicians,neglecttheseimportantissues?Arewereadytoconfrontourselveswithourownreligious/spiritualbeliefs and furthermore to open doors for our pa-tients to talk about it?Do physicians of tomorrow,medicalstudents,believethatthe„faithfactor“playsa rolewhile copingwith illness?Do they feel com-fortable to integrate religion/spirituality into theirpatients’scare?To find answers for precisely these questions 1410studentsattheMedicalUniversityofVienna(333at

theirfirst,248attheirsecond,393attheirthirdand426at their fourthyear)participated inaquestion-naire,betweenMarchandJune2013.Thisquestion-naire is assessing the students’ spirituality and re-ligiosity,aswellastheirattitudestowards“spiritualcare”,particularlytoitsrelevanceintheirfuturepro-fession.744menand656women;meanage22,30,SD=2.3,wereaskedwhethertheyhadeverheardofthetermspiritualcare.59,5%ofthestudentshadreflectedtheirownbe-liefconcept,21,9%considerthemselvesasreligious,and20,1%asspiritualindividuals.75,6%ofthestudentsagreedwiththestatementthatreligiousconviction/spiritualitymighthaveaneffectoncancerpatients’coping.85,9%willconsidertalk-ingwiththeirpatientsaboutreligious/spiritualissues,ifpatientswishtodoso.85,9%wouldinvolvechap-lainsiftheyhadthefeelingitisnecessary.Theresultsofthisstudyencouragestheviewthatfu-turedoctorsshouldseethepatientinawiderscopethanthebio-psycho-socialone,byincludingthespir-itualdimension.

Background:Howdophysiciansdealwithincreasingstressandworkburden,whichmayaffect their lifesatisfactionandempathic encounterwithpatients?Is spirituality a resourcewhichhas an influenceonphysicians´ emotions, perceptions and professionalbehaviour?HowdobehavephysicianswithanAn-throposophicbackgroundwithitsspecificfeaturesofspirituality?Methods:Cross-sectionalsurveyamong197medicaldoctorswithanAnthroposophicbackground(meanage53±12;60%men,40%women)usingstandard-izedquestionnaires,i.e.,AspectsofSpirituality(ASP)Questionnaire, Utrecht Work Engagement Scale(UWES), Cool Down Index (CDI), Life Satisfaction(BMLSS),andworkpressure(VAS).Results: In contrast to apredominantly secularnor-mal population, Anthroposophic physicians regardthemselves mostly as both religious and spiritual(80% R+S+) or at least non-religious but spiritual(14%R-S). Also in contrast to aGerman referencepopulation, measures of spirituality (i.e. Religiousorientation: Praying and Trust in God, Search forInsight /Wisdom, Conscious interactions, and Tran-scendenceconviction)scoredveryhigh.Amongthevariousaspectsofspirituality,Consciousinteractions(r=.23) and Search for Insight/Wisdom (r=.20) cor-

relatedweaklywithphysicians´lifesatisfaction,whilenoneofthemeasuresofspiritualitycorrelatedsignifi-cantly(p<.01;Spearmanrho)withtheCoolDownIn-dex.ThisCoolDownIndexwasnegativelyassociatedwithphysicians´ life satisfaction (r= -.39) andworkengagement (r= -.24). However, physicians´ workengagement correlated moderately with Religiousorientation(r=.34),andweaklyalsowithSearchforInsight/Wisdom(r=.25),Transcendenceconviction(r=.23),andConsciousinteractions(r=.19).Stepwiseregressionanalysesrevealedthattheirworkengagementcanbepredictedbest(R2=.29)bylifesatisfaction,with further influencesofReligiousOri-entation,lowCoolDownbehavior,SearchforInsight/Wisdom,andage,whileworkpressure,meditationorgenderwerenotamongthesignificantvariables.Conclusion: Due to their Anthroposophic back-groundwithitsspecificspiritualimplicationsfortheprofessionalwork,physicians´ spiritualitycorrelatedmoderately with their work satisfaction which inturnswasmoderatelyassociatedwithlifesatisfaction(r=.41).Thus,theirspiritualitymightnotbeabufferagainstCoolDownbehavior(i.e.,emotionalexhaus-tionanddepersonalization),butagainstlossofvigoranddedicationintheirmedicalwork.

Influence of Spirituality on Work Engagement in Physicians with an Anthroposophic Background

Prof. Dr. Arndt Buessing & Prof. Dr. Peter Heusser ProfessorshipofQualityofLife,SpiritualityandCoping,FacultyofHealth,UniversityofWitten/Herdecke,Herdecke,GermanyChairforTheoryofMedicine,IntegrativeandAnthroposophicMedicine,InstituteofIntegrativeMedicine,Witten/HerdeckeUniversity,Herdecke,Germany

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Inculturallydiverse communities it isnecessary fortheprofessionaltherapisttobeculturallycompetent(Odawara2005).OccupationalTherapyphilosophysupports a clear link between fulfilled participation(in all and any valued activity) and health & well-being.Thisrequiresanunderstandingofdiverseoc-cupational needs including those related to familyrelationships, gender roles, diet, dress, rites of pas-sageandreligiouspractice.Whilestudiesrelatingtospirituality can be found in Occupational Therapyliterature (Wilson 2010), religious practice, as aneverydayactivity/occupation, is largelyabsent.Thispaperwillreportonaproject(partofaPhDstudy)aimingtoexplorereligiouspracticeasavaluedactiv-ity.Thestudyparticipantsaredrawnfromarangeoffaiths in theUK- (Christian,Muslim, Jewish, Baha’i,Pagan,Buddhist, SikhandHindu).The study takesa Phenomenological approach aiming to explore

themeaningandparticipationneedsofpeoplewhoregularly engage in religious practice. Howeverthe intensely personal nature of religious practiceis challenging and requires a creative approach todatagathering(Eyres2013).Amodifiedphotovoicetechnique termed Participatory Photography Inter-view(Warren2005)hasbeenusedto facilitateper-sonal reflection.Participants tookphotographs thatinsomewayrepresentedtheirreligiouspracticeandindividualinterviewswereheldtorecorddiscussionabouttheimagesproduced.Theanalysisofthisdataisbeingusedtoinformasecondphaseofstudyin-volvingOccupational Therapists and hospital chap-laincystaff,tofurtherexploreandpotentiallyinformthecurrentwaysinwhichoccupationalneedsrelatedtoreligiouspracticearemetwithinclinical/rehabilita-tionsettingsintheUK.

Religious Practice as an Occupational Need

Patricia Eyres, MSc,DipCOT LecturerinOccupationalTherapy,FacultyofHealth&HumanSciences,PlymouthUniversity,Plymouth,UK

Emotion Work Associated with Personal Faith

Bernice TigheSeniorLecturerinDietetics,CoventryUniversity,Coventry,U.K.(Co-Authors:C.Blackburn,A.Slowther)

Introduction: Artificial feeding canbe emotive andcan have deep spiritual and religious meanings1.Method: 16 UK registered dietitians were inter-viewed as part of a qualitative phenomenologicalstudyexploringtheirexperiencesofdecision-makingrelatedtoartificialfeeding.Results:Emotionworkemergedasatheme,andforsomewasrelatedtotheirpersonalbeliefs.Emotionwork is themodificationof emotionswhichhealthcare professionals (HCP) undertake in order to en-able patients to feel cared for and to conform toorganisational rules2.Onedietitian’s experiences ofemotionworkrelatedtoherChristianbeliefsarere-portedhere.Thedietitianreportedfeelingconflictedabout feedingpatients she believedwere dying orsuffering, ‘am I just prolonging somebody’s life anextracoupleofweeksandprolongingtheirpain...fornootherreasonthanI’mfeedingthem?Idostrug-glewith that quite a lot.’ These emotions seemedtoberootedinherviewthatpatientswheresuffer-ing:‘...partofmethinks,“forthequalityoflifetheyhave is it really worth feeding them and keepingthemalive this long?”...I just think that’squite sadreally...Isupposewhatmybeliefwouldbetoletthepatientgotoabetterplace...maybeit’stodowith...mebeingaChristian...’Thisdietitianhadtomodifyheremotionsbecause she feared the repercussionsofexpressingherfaith:‘...obviouslythat’ssomething

youcan’texpresswiththepatient...weliveinaworld...whereyoucansayonethingwrongandthenextthing you’re in the newspapers...or brought up infrontoftheheadofdepartment...’Discussion:Emotionworkcanhavehealthcostsforthepersonundertakingit;itcanincreasestress,andhas been linked to burnout2. High profile cases ofHCPsbeingdisciplinedinfluencedthisparticipanttohideherbeliefssosheneededtoundertakeemotionwork.Adietitian’sfaithmayinfluencedecision-mak-ing3andsonotdisclosingone’sfaithmaynotbebestfortransparentdecision-making.Conclusion:Hidingpersonalreligiousbeliefsduetofearofprofessionalrepercussionscanleadtoemotionwork.References1)Gordon,M.&Alibhai,S.H.(2004)EthicsofPEGtubes-Jewish and Islamicperspectives.Am JGastro-enterol99(6)11942)Zapf,D.(2002)Emotionworkandpsychologicalwell-being:Areviewoftheliteratureandsomecon-ceptualconsiderationsHumResourManageR12(2)237-2683)Taper,L.J.&Hockin,D.(1996)Lifesustainingnu-tritionsupportfortheterminallyillelderly:dietitians’ethicalattitudesandbeliefsJCanDietAssoc57(1)19-24

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ReferencesEyresP(2013):ReligiousPractice:meaningandpar-ticipation: preliminary findings from a photovoicestudy.Sessionno.G.05Stream2.1AnOccupationalScienceConferenceCork2013Occupation -Awak-eningtotheEveryday.UCC,Cork,IrelandOdawara, E (2005): Cultural Competency inOccu-pational Therapy: beyond a cross-cultural view ofpractice:AmericanJournalofOccupationalTherapy,May-June2005,Vol.59(3),p.325(10)

WarrenS (2005):Photographyandvoice incriticalqualitativemanagementresearchAccounting,Audit-ing&AccountabilityJournal,Vol18Iss6p861-882Wilson (2010) Spirituality, occupation and occupa-tional therapy revisited: on-going consideration oftheissuesforoccupationaltherapists.BritishJournalofOccupationalTherapy,Vol.73,No.9

Theconceptsof“AvailabilityandVulnerability”comefrom part of the “Rule of Life” expressed and fol-lowedbymembersandcompanionsofaChristiancommunity (The Northumbria Community). Thepresenter has adapted these concepts throughherdoctoralresearchtosuggestthepossibleintegrationofAvailabilityandVulnerabilityaskeycomponentsofspiritualityinclinicalpractice.“Availability and Vulnerability” is the lens throughwhichIconductedmyresearch.Thisstudyisnearingcompletionandaddressedthe“SpiritualDimensionsof Primary Care Consultations by Advanced NursePractitioners“. A hermeneutic phenomenologicalapproachwas taken throughout the studywith in-terviews conducted with experienced AdvancedNursePractitionersworking inPrimaryCare.Thesepractitionerswere interviewed twice over a periodof2yearsandwereaskedtodiscussvariousthemesincluding“what spiritualitymeant to them”,“how

spiritualityfitsintoclinicalpractice”,“wherearetheboundaries in practice”, “how availability and vul-nerabilitytranslatefortheminpractice”,“whataretheirvaluesinpractice”andanumberofotherissues.These questions were revisited in the second inter-viewsafterthepractitionershadreadandconsideredthe“RuleofLife”.Thispresentationwillexplorethekeyfindingsofmyresearchwitha focusonhow“Availability andVul-nerability” relates to the consultation and spiritual-ity.Timewillbegiventoexploretheboundariesandethical issues associated with “Availability and Vul-nerability”.Considerationwillbegiventohelpclarifyhow“Spirituality”and“AvailabilityandVulnerability”areinterwoven.Finally a conceptual model of Spirituality for Ad-vancedNursePractitionerconsultationswillbepre-sentedtoassistputtingtheconceptof“AvailabilityandVulnerability”intopractice.

“Availability and Vulnerability” in Advanced Nurse Practitioner Consultations: Key Components for integration of Spirituality into Clinical Practice?

Melanie Rogers SeniorLecturer,AdvancedNursePracticioner,Leeds,UK(Co-Authors:A.Topping,J.Hargreaves)

Session 3: Patients’ Needs – Research and Case Studies

The Role of Spirituality in Life Attitude of Individuals with Down Syndrome

Ayse Burcu Goren PhDstudent,Lecturer,Ankara,Turkey(Co-Author:AliceMoscaritolo)

Spirituality has increasingly been recognized as abasichumanneedandisanecessarycomponentofboth mental and physical health. Studies indicatethat spirituality provides meanings, inner strength,peace, and hope for people. However, the impor-tance of the spiritual dimension of life is rarely ac-knowledgedincareofpeoplewholivewithmental

disability.Furthermore,inthefieldofmentaldisabil-ity, spirituality is frequently underused in practice.Therefore,researchisneededtoexplorethedeeperrole of spirituality in living withmental disabilitiesand how to integrate spirituality into the practiceofworkingwith individualswithmental disabilitiesandtheirfamilies.Literatureindicatesthatthereisa

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growingawarenessandinteresttomeetthisneedintheWest.Situationinnon-Westerncountriesappearstobethesame.Thispaperexplorestheroleofspiritualityinthelivesof people with Down syndrome and their parentsin Turkey. For this, 8week-long programwas con-ductedwithsixyoungpeoplewithDownsyndrome,agedbetween16-26yearsold living inAnkara.Re-searcher used her own home for weekly meeting.First, in-depth interviews conducted with mothers.Basic information about their children such as per-sonality, vulnerability, moods, emotionality, dailyroutines, their expectations andwhatmakes themhappy or unhappy collected. Second,weekly pro-

gramplanned.Mainobjectiveofthisprogramwastoaddspiritualactivitiesinthedailyroutinesofchildren.Considering Islamic nature of the local culture, fol-lowingspiritualactivitieswereselected;helpingpoor,visitingnursinghome,talkingaboutfriends,universe,heavenandGod,marbleworkshop (sortof Islamicart)andvisitingworshiphouses.Finally,afterseven-weeklongprogram,motherswerere-interviewedtodetermine what significant changes they observedin the life attitudesandbehaviorsof their children.In addition to report of researcher’s own observa-tion, mothers reported increased happiness, senseofmeaningandbelonging,senseofsubservientness,andincreasedsenseofself-worthintheirchildren.

Religious Needs of Dialysis Patients and their Families

Prof. Barbara A. Elliott PhD, MDiv, BCC FamilyMedicineandCommunityHealth,CenterforBioethics,UniversityofMinnesota,USA(Co-Author:CharlesGessert)

Background: This qualitative study investigated lifeexperiencesandend-of-lifedecisionmakingamongpatients with end-stage renal disease. Analysis re-vealed thatmany of these patients’ and their fam-ilymembers’religiousbeliefsandpracticesprovidedthebasisfortheircopinganddecisionmakingwiththeircircumstancesanddialysistreatment.Methods:Aprospectivequalitativestudyinterviewed31elderlydialysispatientsandtheirfamilymembers;interviews lasted 30-90 minutes. Interviews weretranscribed and coded independently by three in-vestigators. The codeswere collected into content-specific‘‘nodes’’andthemes.Investigatorsidentifiedandreconciledtheir interpretationsbyreturningtothe transcripts to assure that conclusions reflectedparticipants’sentiments.

Results: Five themes pertaining to religious beliefsandpracticesemergedascentraltopatientandfam-ilyexperienceswhilelivingwithdialysis.Twothemeswererelatedtomedicaldecisionmaking:theirfaith-based beliefs and themeaning that emerges fromthesebeliefs.Twothemesdescribedhowtheircop-ing is expressed in their religious experiences: theparticipants’ religious practices and their perceivedsupportfromthechurchcommunity.Theremainingthemedescribedtheparticipants’spiritualdistress.Conclusion: These findings offer insights into thecentralrolereligiousexperiencesplayinthelivesofpeoplelivingwithdialysis.Theresultsidentifytheis-suesthathealthcareandpalliativecareteammem-berscananticipateandbepreparedtoaddressinpa-tientsupportanddecisionmakingindialysissettings.

Spiritual Assessment and Care Plan

Eve Rubli Truchard Centrehospitalieruniversitairevaudois,Lausanne,Switzerland(Co-Authors:RochatE,DürstAV,MonodS)

Background:MrsX,93, isadmittedtohospital suf-fering from presbyoesophagus and cachexy, withoropharyngealdysphagiacausinggreatdifficultiestoeat,and infections.Shesuffers frommildcognitiveimpairment and has no longer her capacity of dis-cernmentconcerningtherapeuticdecisions.Becauseofsevereelectrolyticdisordersrelatedtothedenutri-tion,andwithoutpossiblecurativetreatmentofthepresbyoesophagus, two therapeuticoptionsareop-posed:theplacementofanasogastrictubetofeedthepatientandtogivehertheappropriatemedica-tionvsaccompagnyingthepatientuntilherdeath.

Despiteastructuredmultidisciplinaryapproachwithcomprehensive geriatric assessment (separate spe-cificanamneses)andathoroughdiscussionwiththepatientandherrelatives,theambivalenceofthelat-terleavesthehealthteaminadeadend.Methods:Thetraditionalmodelofmultidimensionalgeriatric assessment and the use of a narrative ap-proach proving insufficient to allow a decision, anintegratedbiopsychosocial and spiritual experimen-tal approach is applied. The chaplain carries out astandardized assessment of the spiritual dimensionwiththeSDAT.Thisassessmentandtheensuingdis-

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cussionwiththehealthteamwillallowtoproposetothepatientandherrelativesanewcareplanmakingsenseforbothpatientandhealthteam.Results: The assessment of the spiritual dimensionwiththeprocedureSDATrevealsthatthepatientsuf-fersfromspiritualdistress.Itallows:1)tobringoutthenecessaryelementsforanethicaldebatebetweenthemembersofthehealthteam,2)tostructurethediscussionwiththepatient.

Thanks to these twotimesof theaction thehealthteamcoulddefineatherapeuticoption:nottoplaceanasogastricprobeand toaccompany thepatientwhowilldieafewdayslater,thisinaccordancewiththepatient’spresumedwill.Conclusion:Aninterdisciplinarymodelofcarearticu-lating thebiopsychosocial and spiritualdimensionsmakesitpossibletoassesstheelderlypatientinherglobality, tothusacquireathoroughknowledgeofthepatientandtodiscuss inamoreadequatewaythegoalsofthecareplan.

The present study examines whether and to whatextentcreativityandspiritualityareused incopinginacross-culturalandcross-denominationalstudentsampleof610participants.Twonew theory-basedinstruments, displaying good internal consistencyand satisfactory levels of content- and constructvalidity, are introduced, the Creative Coping Scale(CCS-19), and the SpiritualCoping Scale (SCS-30).A positive,moderate relationship between creativeand spiritual copingemerged, thus supporting the

theoryof transformativecoping.Thefindingsdem-onstratedthatparticipantsappliedbothcreativeandspiritual coping in their lives in order to dealwithacuteandchronicstress.Associations between creative and spiritual copinganddemographicvariableswereoutlined.Practicalapplicationsforthepromotionofmentalhealthwerediscussed. Future research should seek to replicateandextendthepresentfindings.

The Creativity-Spirituality Construct and its Role in Transformative Coping

Dr. Dagmar A.S. CorryLecturerinPsychology,GlyndwrUniversity,Wrexham,Wales,&TheBamfordCentreforMentalHealthandWellbeing,UniversityofUlster,Derry/Londonderry,NorthernIreland(Co-Authors:JohnMallett,ChristopherA.Lewis,AhmedM.Abdel-Khalek)

Spiritual Distress and Psychological Distress in Elderly Patients: Joint Intervention?

Anne-Véronique DuerstServicedeGériatrieetRéadaptationGériatrique,Centrehospitalieruniversitairevaudois,CHUV,Lausanne,Switzerland(Co-Authors:EtienneRochat,EveRubliTruchard,StéfanieMonod)

Background:MsA, 66-year-old, suffering fromPar-kinson disease since 6 years but fully independent,ishospitalized inageriatric rehabilitationunitafteracomplicatedhipreplacement.Sinceherhusband’sdeath8yearsago,doctorsdisagreeonapsychosisdiagnosis. At her arrival she is fully dependent, hy-poactive, hallucinates and fells several times. AfterdiagnosingaParkinsondiseasedementiaandaper-sistingfluctuatingconfusionalstate,anursinghomeplacementisdecided.MsAissodistressedthathercareiscompromisedMethods: An integrated biopsychosocial and spir-itualapproachisapplied.Achaplainusingthestand-ardizedprocedureSDATandapsychologist respec-tivelyassessthepatient’sspiritualandpsychologicaldimensions.Bothspecialiststhendiscusstheresultstodeterminewhichtypeofinterventionshouldpre-vail:spiritualonly,psychologicalonlyorbothjointly.

Results: The spiritual assessment reveals that : theneedofTranscendenceiscoveredbuttheneedsofSenseandValuesareseverelyunmetandtheneedofIdentitypartiallyunmet.Thepatientisthusdeclaredinseverespiritualdistress.Thepsychologicalassess-mentshowsanadjustmentdisorderwithdepressedmoodandexcludes apsychosis (thehallucinationsbeing linked toParkinsondisease).Being since theoperationfullydependent,unabletowalkbyherself,sufferingofcognitivedisorders,thepatientstrugglestomaintain a senseof identity and tofind the res-sourcestoadapttothesituation.Thusajointspiritu-alandpsychologicalinterventionisputinplace,witha focuson thepsychological dimensionof identityandonthesubdimensionofTranscendence.Specifi-cally,interventionsonapsychologicalweaknessandonaspiritualressourcearecarriedonwhilebothin-tervenantsgivenewoptionstothehealthteamfor

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thepatient’s care.Thanks to this joint intervention,Ms A progressively recovers a sense of identity, ac-ceptsatransferinnursinghomeandcooperatesfullytohercare.Conclusion:Astructuredinterdisciplinarybiopsycho-socialandspiritualmodelofcareintegratingastand-ardized spiritual assessment makes it possible todifferentiate spiritual from psychological distress in

elderlypatients.Thisallowstodesignthemosteffi-cientinterventionandhelpstoproposethecareplanmakingthemostsenseforbothpatientandhealthteam.Whenbothtypesofdistresscoexist,chaplain’sand psychologist’s joint interventions make it pos-sibletoaddresssimultaneouslytheelderlypatient’sneedsandtotreathimasawholeperson.

Session 4: Coping and Quality of Life

The Role of Religious/Spiritual Well-Being in Coping with Dermatological Diseases

Prof. Dr. Elisabeth AbererDept.ofDermatology,MedicalUniversityGraz,Austria(Co-Authors:PilchM,LukanzM,ScharfS,Glawischnig-GoschnikM,WutteN,Fink-PuchesR,UnterrainerH)

Background: Inpreviousresearch,dimensionsofre-ligiosityandspiritualityturnedouttobesignificantlylinked to parameters of subjective well-being andmore adequate stress coping in various clinical aswellasnon-clinicalpopulations.However,studiesfo-cusingontherelevanceofreligious/spiritualissuesinchronic inflammatoryskindiseasesandskintumorsarestillrathersparse.Hence,inthepresentstudyweintendtoaddress thisdeficit inpatientswith lupuserythematosusandsystemicsclerosis,diseaseswithlongtermmorbidityandearlymortalityandpatientsafter the initial diagnosis of melanoma to lay thegroundworkforapproachingdimensionsofreligios-ityandspiritualityintreatment.Methods:Atotalof150dermatologicpatients(age:M=53.52, SD=13.97; 108 females) with lupus ery-thematosus (n=48), systemic sclerosis (n=44) andearly stageofmalignantmelanomawithoutmetas-tasis (n=58) were investigated by means of stand-ardised instruments includingtheMultidimensionalInventory for Religious/Spiritual Well-Being (MI-

RSWB),theBriefSymptomInventory(BSI-18)andashortversionoftheFreiburgerCopingQuestionnaire(FCQ-LIS).Correlationandregressionstatisticswereconductedfordataanalysis.Results: As a main finding the RSWB dimensionsturnedouttoberelevantlyassociatedwitha loweramount of anxiety (p<.01) and depression (p<.01)aswellasamoreactivecopingstyle(p<.05)inall3patientgroups. Furthermore, in comparison to thenormalpopulation,ourpatientswithdermatologicaldiseasesexhibitedanotablyhighamountofRSWBsubdimensionssuchasHopeImmanentorForgive-ness,whichwas paralleled by a better coping out-comeingeneral.Conclusion: In accordance with the existing litera-turethedimensionsofreligiousandspiritualwell-be-ingwereconfirmedasbeingimportantresourcesforpatients copingwith chronic autoimmunediseasesoftheskinanddiagnosedmelanoma.Basedonthesepromising initial results a further religiously/spiritu-allybasedinterventionshouldberecommended.

Religiosity and Health Related Quality of Life of Elderly People: Populational Study in Sao Paulo City, Brazil

Dr. Gina Andrade AbdalaProfessoradoMestradoemPromoçãodaSaúde-UNASPSP,DoutorandaPROESA-EE/USP,SaoPaulo,Brazil(Co-Authors:MiakoKimura,YedaAparecidadeOliveiraDuarte,MariaLúciaLebrão,BernardodosSantos)

Objective:Totestthemediatingeffectofreligiosityonahypotheticalmodelofhealth-relatedqualityoflife (HRQoL)ofelderly throughStructural EquationModeling(SEM).Methodo:Thiswasanobservationalcross-sectionalstudy developed as part of the StudyHealth,Well-being and Aging (SABE). The sample consisted of

911 elderly people from Sao Paulo, Brazil, with aminimal age of 60 years, living in the community.AStructural EquationModeling (SEM)analysiswasperformed in order to verify the mediating effectof religiosity on the relationship between selectedvariablesand theHRQoLofelderly,with separatedmodels for men and women. For these analyses,

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SPSS AMOS program (IBM, 22nd version) was uti-lized.Theindependentvariableswere:age, literacy,family function (APGAR)andmultimorbidity (morethan two diseasesmentioned). The outcome varia-blewasHRQoL,measuredbySF–12,whichcontainstwo components: physical (PC) and mental (MC).The mediators were: organizational religious orien-tation(ORA:churchattendanceorreligiousservice),non-organizationalreligiousorientation(NORA:thepracticeofprivatereligiousactivitiessuchasprayer)andintrinsicreligiosity(IR:meaningandimportanceofreligion).Cronbach’salphawas0.85forPC,MC=0.80,RI=0.89andAPGAR=0.91.Results:HigherlevelsofORAandIRwerepredictorsofbetterphysicalandmentalqualityof life for theelderly, aswell as higher level of education, better

family functioningandfewerdiseases,contributingdirectly to improveperformance inPCandMC, in-dependentlyofORA,NORAandIR.Forwomen,ORAinfluencedasmediatorbetweenageandthephysicalcomponent(β=2.401;p<0.01),aswellasthementalcomponent(β=1.661,p<0.01).Inthesamemanner,IR mediated the relationship between literacy andMCinmen(β=7.158,p<0.01).Conclusion: This study confirms the importance ofreligion, level of education, family functioning andmultimoborbidity as factors influencing theHRQoLofelderly,anddemonstratesthebeneficialeffectoforganizationalandintrinsicreligiosityintherelationofage,educationonphysicalandmentalhealthofelderly.

The Association of Spirituality and Quality of Life in Chronic Kidney Diseases Stage V Patients

Assist. Prof. Dr. Areewan Cheawchanwattana DepartmentofSocialandAdministrativePharmacy.FacultyofPharmaceuticalSciences,KhonKaenUniver-sity,KhonKaen,Thailand(Co-Author:WarapornSaisunantararom)

Objectives:Thedeteriorationofhealth-relatedqual-ityof life (HRQoL)ofchronickidneydisease (CKD)patients was well-established. Though the WorldHealthOrganizationsuggestedthespiritualityasanimportant componentofHRQoL, therewere still alimitnumberof spirituality studies inCKDpatients.The relationshipof spiritualityandHRQoLwasalsoobscure.ThisstudywasaimedtoevaluatespiritualityofCKDpatients,anditsassociationwithHRQoL.Methods:The studywasapprovedby theHospitalEthicCommittee.CKDstageVpatients(N=63)wereaskedforconsentandtheninterviewedofspiritualityandHRQoLusingWorldHealthOrganizationQualityof Life - Spirituality, Religiousness and Personal Be-liefs (WHOQOL-SRPB)Thaiversion,and9-itemThaiHealth status Assessment Instrument (9-THAI), re-spectively.TheassociationofspiritualityandHRQoLwasexaminedbyusingmultiplelinearregressionascontrolling for other contributing factors includinggender,age,maritalstatus(married),glomerularfil-trationrate(GFR),andpersoncharacteristicsofreli-gious,spiritual,andpersonalbeliefs.Thesignificancelevelwassettobe0.05withthe2-sidedtest.

Results: Based on multiple linear regression analy-sis,9-THAImentalhealthscores(9-THAIMHS)weresignificantly associated with WHOQOL-SRPB totalscores(p-value=0.009).Theincrementofonescoreof 9-THAIMHS resulted in the incrementof 0.033scoreofWHOQOL-SRPBtotalscore(95%CI;0.008to0.057),andthisindicatedthatbettermentalHR-QoLwasassociatedwithbetter spirituality. In termof physical HRQOL, 9-THAI physical health scores(9-THAIPHS)werenon-significantlyassociatedwithWHOQOL-SRPBtotalscores,eventhoughthebetterphysicalHRQoLalsoresultedinthebetterspirituality(p-value=0.142).Theanalysiswascontrolledforthecontributing factors as mentioned. Apart from HR-QOL,femalegender,morereligiousandpersonalbe-liefcharacteristicssignificantlyassociatedwithhigherspirituality(p-value<0.05).Conclusions:ThepositiveassociationofmentalHR-QoLandspiritualitywasfoundedinthisstudy.ThiscalledforfutureresearchthatexaminedwhethertheinterventionimprovingspiritualitymightleadtothebettermentalHRQoLinthesepatientsornot.

A Survey Study on the Use of Religious Coping among Cancer Patients in Sweden

Prof. Dr. Fereshteh Ahmadi UniversityofGävle,DepartmentofSocialWorkandPsychology,Gävle,Sweden(Co-Author:NaderAhmadi)

In thisarticlebasedontheresultofasurveystudyinSwedenamong2355peoplewhohitbycancer,

wediscusstheroleofreligionincoping.Thesurveystudywasbasedonthefindingsofaqualitativestudy

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among cancer patients in Sweden (Ahmadi 2006).The aimof the surveywas to examine towhat ex-tenttheresultsobtainedinthequalitativestudywereapplicabletoawiderpopulationofcancerpatientsinSweden. Inaddition toquestions relatingto theformerqualitativestudyithadalsousedtheRCOPEquestionnaire - designed by Kenneth I Pargamentinthedesignofthenewquantitativestudy.ResultofthequantitativestudyindicatesthatSelf-directedReligiousCopingisthemostprevalentreligiouscop-ingmethodamongcancerpatientsinSweden.Thestudyshowsthatfewinformantsusedprayingorvis-itingthechurchascopingmethods.ThefactorthatSelf-directedwasrankedinfourthplace,havingthefourthhighestaverage(2.3).Halfofrespondents(49percent)answeredthatthisfactorhelpedalotorto

quitea largeextent to themfeelbetterwhentheyfeltstressed,sad,ordepressedduringoraftertheirillness.The factor “Topray toGod tomake thingsbetter” is in thirteenth place (mean = 1.7).Nearlythree infive (58percent)chose theoption“notatall”. Innineteenthplace (mean=1.5)was the fac-tor“Togotochurch”.Nearlytwointhree(64per-cent)chosetheoption“notatall”.ThisresultmaybepartlybecauseofthedominanceofsecularisminSwedish society and the strong position individual-ismplaysinSwedishculture,whichfosterstheideathat individuals have the responsibility of tacklingtheirownproblems.Key words: Religious coping, RCOPE, Self-directedreligiouscoping,Cancer,Sweden

Understanding the Relationship between Religion and Well-Being: a Mixed Methods Investigation into Religious Maturity and Psychological Well-being

Dr. Julian Caruana Malta

Background:Despitearecentresurgenceofinterestin the field of religion andwell-being, the psycho-logical understanding of the relationship betweenthese2phenomenaremainslimited.Areviewofrel-evantliteratureindicatedthatfocusingonthepoten-tial relationshipbetweenreligiousmaturity (RM)asconceptualizedbyAllport(1950)andamultidimen-sionalconceptualisationofpsychologicalwell-being(PWB)mightrepresentafruitfulwayforward.Methodology:Thisresearchadoptedamixedparalleldesigncomposedofaquantitativestrand(Study-1)investigatingtheextenttowhichRMpredictedPWBandthemediatingimpactofself-actualisation,mean-ing in life and self-esteem and a qualitative strand(Study-2) exploring the hypothesized relationshipand possible intermediary mechanisms and proc-essesinamoreopen-endedmanner.Methods:Asampleof138adultUKresidentsfromaCatholicorProtestantreligiousbackgroundwerere-cruitedforStudy-1’spurposeswhile,usingmaximum

variationsampling,4intervieweeswereselectedforStudy-2fromtheinitialpoolofparticipants.Results: Study-1’s findings indicated that, althoughRMwas not a significant predictor of PWB, higherlevels of master-motive predicted higher levels ofPWBmainly throughmeaning in life,while higherlevels of openness predicted lower levels of PWBmainlythroughself-esteem.Study-2yieldedatheo-reticalmodelpostulatinga setofdiverse religiosityfacetsimpactingwell-beingthroughaseriesofinter-mediaryprocesses involvingmultiplepsychologicaldomains.Conclusion: In conjunction, both studies seemedtopoint towards affording religiosity a central andpervasiveroleinlifeashavingasalubriouseffect,of-feredsupportfortheexplanatorybenefitsofemploy-ingahumanistic-existentialtheoreticalframeinthisinquiry field and placed an emphasis onmeaning-making playing a primary intermediary role in therelationshipofinterest.

Session 5: Implementing Religion & Spirituality into Medical Practice

Developments in Spiritual Care Education in German Speaking Countries

Dr. phil. Piret Paal ProfessurfürSpiritualCare,KlinikumderUniversitätMünchen,Munich,Germany(Co-Authors:TraugottRoser,EckhardFrick)

Background:Thisarticleexaminesspiritualcaretrain-ingprovidedtohealthcareprofessionalsinGermany,

AustriaandSwitzerland.Thepaperrevealstheextentofavailabletraining,definesthetargetgroup(s)and

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teachingaims, additionallyprovidinga listofdeliv-ered competencies, applied teaching and perform-anceassessmentmethods.Methods:In2013,anonlinesurveywasconductedamongthemembersoftheInternationalSocietyforHealthandSpiritualCare.Thesurveycontained10questionsandanopenfieldforbestpracticeadvice.SPSS21wasusedforstatisticaldataanalysisandtheMAXQDA2007forthematiccontentanalysis.Results:33educatorsparticipatedinthesurvey.Themainprovidersofspiritualcaretrainingarehospitals(36%,n=18).57%(n=17)of spiritualcare trainingformspartofpalliativecareeducation.43%(n=13)ofspiritualcareeducationisprimarilyboundtotheChristiantradition.36%(n=11)ofprovidedtrainingshavenodirectassociationwithanyreligiousconvic-tion.64%(n=19)ofrespondentsadmittedthattheydonot use any specificdefinition for spiritual care.22%(n=14)ofavailablespiritualcareeducationleadsto someacademicdegree.30% (n=19)of trainingformpartofaneducationprogrammeleadingtoa

formal qualification.Content analysis revealed thatspiritualtrainingformedicalstudents,physiciansinpaediatrics,andchaplainstakeplaceonlyinthecon-text of palliative care education. Courses providedformultidisciplinaryteameducationmaybepartofpalliativecaretraining.Otherthemes,suchasdeeplistening,compassionatepresence,bedsidespiritual-ityorbiographicalworkonthebasisoflogo-therapy,arediscussedwithintheframeworkofspiritualcare.Conclusions:Spiritualcareisoftenapproachedasanintegralpartofgriefmanagement,communication/interaction training, palliative care, (medical) eth-ics,psychologicalorreligiouscounsellingorculturalcompetencies.Educatorspointouttheimportanceofcompetencybasedspiritualcareeducation,practicaltrainingandmaintaining the linkbetween spiritualcareeducationandclinicalpractice.Furtherelabora-tiononthespecificsofspiritualcarecorecompeten-cies,teachingandperformanceassessmentmethodsisneeded.

Transferring Spiritual and Palliative Care Competency through Work Place Learning - A Hospice Teaching Team’s Experience

Kirsten Anne Tornoe, RNPhDstudent,Ass.Professor,NorwegianSchoolofTheology,Oslo&CenterforthePsychologyofReligion,InnlandetHospital,Ottestad,Norway(Co-Authors:LarsJohanDanbolt,KariKvigne,VenkeSørlie)

Background:Addressing terminally ill patients’ exis-tentialorspiritualissuesisoftenasourceofanxietyfor healthcare providers. There is an internationaltrend towards unskilled care workers in long-termcare.Registerednursesspendmoretimesupervisingunskilledstafftoensurethatpatientsreceivequalitycareduring theirfinaldays.Researchingworkplacelearning in palliative and spiritual care is thereforeimportant. Few studies have been conducted con-cerningeducationandtrainingoftheworkforceinthisfield.Mostspiritualcareresearchhasbeencon-ducted inAnglo-Americancontexts.This study isacontributiontotheScandinavianbodyofknowledgeinspiritualcare.Design:Qualitativestudy.Methods:Datawasgatheredthroughafocusgroupinterviewwiththreeexperthospicenurses in2012.Datawasanalyzedusingphenomenological-herme-neuticalmethod.Findings: Spiritual Care was intuitively embeddedin the experts’ holistic practice. Key spiritual carethemesthatemergedwere:workingwithone’sheart,managingemotions(fearandcourage), identifyingspiritualneeds,actingasdooropenerstoexistential

and spiritual conversations, using intuition to seizethe rightmoment and the right approach,Talking,listening,beingsilent,beingwiththepatientinthe“Room of Death”. Personal spiritual and palliativecareknowledgewastransferredthroughsituationalbedsidesupervision,reflectivedialogueandlectures.Theteamobservedthatcareworkersbecamemorecourageousandskillfulwithexistentiallychargedpa-tientencountersthroughthesupervisionprocess.Intheteam’sopinion“Bedsidesupervision”promoteda greater learning experience than listening to lec-tures.Conclusion: The findings suggest that transferringexperiencebasedspiritualandpalliativecareknowl-edge through“workplace learning“maybeanef-ficient way to develop care workers’ nursing com-petency.Further researchon theeffectsof situatedbedsidesupervisioninpalliativeandspiritualcareisthereforerecommended.

Keywords:Staffdevelopment,palliativecare,spiritu-ality,phenomenological-hermeneuticalstudy,focusgroup

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Spiritual Care and the Organisation of Inter-Professional Cooperation in Acute-Care Hospitals: Con-cepts, Implementation and Effectiveness of Interventions Dr. phil. Regula Gasser PhDstudentattheTheologicalDepartment,UniversityofZurich,Switzerland(Co-Author:RalphKunz)

TheWorldHealthOrganisation’sdefinitionofpallia-tive care includes the treatment of spir-itual issues.There isnowabroadconsensus thatallprofession-al groups should be involved in meeting patients’spiritualneeds.Awiderangeofmodelsofspiritualhistory have been developed to effectively assessindividual patient requirements. However, existingassessment instrumentsprovidenoguidance inde-terminingtheparticularcompetencesandorganisa-tionof inter-professionalcooperation.Thus far, thecomplexorganisationalstructuresofSwisscantonalanduniversityhospitaldepartmentshavepreventedeffective assessment. Due to a lack of coordinatedbasic research on spirituality concepts and on sys-temsof inter-professional cooperation, there is cur-rentlynoconcretedataontheimplementationandeffectivenessofspiritualcareorontheinterventionprocessinSwitzerland.Atpresent,thecollectionandinterpretation of data on patients’ spiritual needsand the subsequent interventions appear to be ar-bitrarilydeterminedbytheattitudesofthespecialist

staffinvolved.AnumberofstudiesconductedinBrit-ainandtheUSAhaveshownthatspiritualityisavitalresource in improvingtreatmentoutcomes.Equally,an assessment of spirituality captures key elementsofpatients’health-relatedqualityoflifethatarenotcomprehensivelymeasuredbypsychosocialmedicalhistories.Forthesereasons,acute-carehospitalshaveshownan interestboth in integratingspiritualcareintopalliative care, and inenabling suchmeasuresto benefit patients in other hospital departments.Our researchproject tackles these issues ina three-stageapproach.Initiallytheprojectoutlinesandes-tablishes similarities anddifferences in the spiritual-ityconceptsofmedicalstaffandchaplains inthreeacute-carehospitals.Asasecondstage,casestudiesareusedtorelatethoseconceptstopatients’needs.Lastly,theresearchprojectaimstoprovideimportantinsights regarding thecontinueddevelopmentandimplementationof spiritualassessmentwithaviewto improving inter-professional cooperation in spir-itualcare.

What Does the SDAT Bring to the Health Team?

Etienne RochatChaplain,Centrehospitalieruniversitairevaudois,Lausanne,Switzerland(Co-Authors:DürstAV,Rubli-TruchardE,MonodS)

Background:TheSDAT isavalidated tool toassessspiritual distress in elderly hospitalized patients. Itconsists of a 20-30 minutes semi-structured inter-viewperformedby thechaplain followedbya spe-cific analysis. The interview addresses the differentsub-dimensionscharacterizingthespiritualneedsofthepatient(needforlifebalance,forconnection,forvalues acknowledgment, need tomaintain controlandidentity).TheSDATallowstoidentifydisturbedsub-dimensions or unmet needs, to diagnose pres-enceandintensityofspiritualdistress,todeterminewhichsub-dimensionthepatientisfocusedonandtomakerecommendationstohealthteammembers.MrL(84)livingalone,inconflictwithhiscloserela-tives, suffering from diabetes and from renal andcardiacinsufficiency,ishospitalized.Beforereturninghome,hemustovercomegaitproblems.Afteraoneweek treatment, the health team sees no progressandMr L does not seem to understand the treat-ments’ significance but is still willing to go home.Althoughhehashiscapacityofdiscernment,discus-sionswithhimleavethehealthteaminadeadend.Methods:SinceMrLrefusestomeetthepsychiatrist,

doctorsrequireanassessmentofthespiritualdimen-sionwiththeSDATthechaplaincarriesout.Thispro-cedureandtheensuingdiscussionallowsthehealthteamandthechaplaintobuildanewcareplan.Results:Theassessmentwith theSDAT reveals thatthepatientsuffersfromseverespiritualdistressandthat thepatient’s focus ison the sub-dimensionofTranscendence.Theperturbations‘specificityonthe4 sub-dimensions and the patient’s focus lead thechaplaintogivetheserecommendations:1)tocon-siderhowMrLrelatestoothersinordertochangethewaytocommunicatewithhim,2)to interveneon the sub-dimension of Transcendence with thegoaltorecoverressources in it,3)tokeepinmindthatMrLwillnotseethetreatment’sadvantagesasaprimarygoal,4)toleteachhealthprofessionalbe-gin tobuild an alliancebefore to carryon its ownintervention.Conclusion:Insuchablockedsituation,SDATallowsto reassess the care plan on the basis of the chap-lain’srecommendations.Itforceseachhealthteam’smembertochangehispointofviewonthepatientinordertorealizeareallycomprehensivecareplan.

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Session 6: Research on Patients’ Understanding of Religion & Spiritu-ality - Measures, Interpretations, and Mottoes

Validating a Patient Reported Outcome Measure of Spiritual Care

Prof. Dr. Austyn Snowden & The Rev. Iain Telfer ChairinMentalHealth,UWS,Scotland,UK&SpiritualandPastoralCare,TheRoyalInfirmaryofEdinburgh,UK

Background: In order to provide optimal spiritualcaretopeopleitisimportanttounderstandhowtheybenefitfromit.Oneofthebestwaystounderstandtheimpactofcomplexinterventionsistodevelopapatientreportedoutcomemeasure(PROM).PROMsare designed to be reliable and valid measures ofspecific interventions.Theyemerged fromresearchintohip surgery recoverybut soonappearedas ro-bustmeasuresofmuchmorecomplexinterventions.However,thereisnoPROMtomeasuretheoutcomeofspiritualcare.Method: Between 2010 and 2013 NHS EducationScotland funded a project designed to constructandtestaprototypespiritualcarePROM.ThePROMwasconstructedfromtheliteratureonspiritualcare(Snowdenetal,2013)andrefinediterativelyoveraseries of workshops with chaplains and service ex-perts (Snowden&Telfer,2012a,2012b), culminat-inginafiveitemPROMdesignedtocapturekeyele-mentsofspiritualcare:1.Honesty2.Anxiety3.Understanding4.Control5.PeaceThePROMwaspilottestedinasampleof70peopleattendingchaplaincyservices inNHSLothian,Scot-landduring2012.Dataonperceivedqualityofchap-laincyinterventionwasalsocollected.Results: 39people responded.Results showed thatthefivePROMitemswerereliable(α=0.84)andpar-

ticipantsfoundtheitemstobecoherentandeasytounderstand,suggestinggoodfacevalidity.Therewasasignificantrelationshipbetweenself-reportedqual-ityofthechaplaincyinterventionandallthePROMitems. In particular ‘being able to talk aboutwhatwasonmymind’wassignificantlyassociatedwithalloutcomes(Snowdenetal.,2012).Discussion:Thenextphaseofthestudyistosubjectthesepromisingfindings tomore robustvalidation.Thispresentationwillbeginbysummarisingthekeyfindingsaboveinordertocontextualizeandexplaintheprotocolfornextphase.Thiswillincludetestingconvergentvaliditywithrelatedmeasures inasam-pleofpeoplewhobenefitfromaCommunityChap-laincyListening(CCL)ServiceinGeneralPracticeset-tingsacrossScotland.Strengths andweaknesses of this approachwill bediscussed and recommendations made for longitu-dinalfollowup.

ReferencesSnowden,A.,Telfer, I. J.,Kelly, E.K.,Bunniss, S.&Mowat,H.(2013).TheconstructionoftheLothianPROM.TheScottishJournalofHealthcareChaplaincy,16,3–13.Snowden,A.,Telfer,I.,Kelly,E.,Mowat,H.,Bunniss,S., & Howard, N. (2012). Healthcare Chaplaincy:the Lothian Chaplaincy Patient ReportedOutcomeMeasure(PROM)(p.111).Gourock.Retrievedfromwww.snowdenresearch.co.uk

Interpretations of Chaplaincy Care by Clients in Psychiatric Care

Prof. Dr. Martin WaltonProf.SpiritualCare,Chaplain,ProtestantTheologicalUniversityGroningen,TheNetherlands

Howdo thosewho receive care from chaplains in-terpretthatcare?Inaqualitativeresearchproject24clientsinpsychiatriccareintheNetherlandswerein-terviewed.Theinterviewmaterialwasanalysedwiththehelpofthematicandformalcoding.Preliminaryresults were presented to panels of psychiatric pa-tientsandchaplainsinpsychiatriccareforcommentandvalidation.Theinterviewmaterialprovidesabasistocommentonthefocusofchaplaincycareandonconceptuali-

zationsofchaplaincyandspiritualcare.Fortheinter-viewedclientschaplaincycareisnotaboutspiritualityalone,butalsotiedtohumandignity.Theydoreportthatchaplaincycarecontributed to theirwellbeingaswellas tomorespecifically religiousgoals.Theirstatements allow for commenting on goal orienta-tionofchaplaincycareandonreportedanddesiredoutcomes. In addition diverse perspectives on inte-grationofchaplaincyandspiritualcareinpsychiatrictreatmentcanbeoffered.

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God Image, Personality, and Mental Health

Dr. Hanneke Schaap-JonkerAss.Prof.PsychologyofReligion,UniversityofGroningen;Co-ordinatorCentreforReligion,Worldview,andMentalHealth,DimenceInstituteforMentalHealthCare,Zwolle,TheNetherlands(Co-Author:ArjanBraam)

TheGodimage(cognitiveandemotionalaspectsoftherepresentationoftherelationshipwithGod)isacoreaspectof religious/ spiritual life,being relatedtopsychic life.Aimof thispaper is tooffer insightintothecomplexityofGodImagepsychology,andto identify common patterns, both in the normalpopulation,aswellinpopulationsofclientsinmen-talhealthcare.ResultsofvariousstudiesintheNeth-

erlandswill be presented, inwhich theGod repre-sentationwasassessedwiththeQuestionnaireGodImage,asdevelopedbyMurken.FocusisonGodim-agetypesinrelationtopersonalityorganizationandpersonalitytraits,whichwasinvestigatedindifferentagegroupsandsettings(population-basedsamples/outpatientsamples).

Life Motto’s in Dementia Care. Issues of Loss, Longing and Spirituality in Dementia Caregivers Stories

Dr. Hanneke MuthertAss.-Prof.PsychologyofReligion,UniversityGroningen,TheNetherlands

Inspring2013aDutchwebsitewas launched:pra-tenovergezondheid.nl.Thiswebsite isbeing setupasacounterpartoftheinternationalDIPExinitiative,thereby following the success story of the UK siteHealthtalkonline.org. In 1999 AnnMcPherson andAndrewHerxheimerbegantheirOxfordinitiativetoprovidereliableinformationaboutordinarypeople’sexperiencesofhealthandillness.IntheNetherlands,thefirstanduntilnowonlyresearchtopicisdementia.Theinformationfortheprojectwascollectedbyaninterviewmethodthatexploredallthoseissuespeo-pleareconfrontedwithandwanttotalkaboutfroman insider’s perspective. A fundamental underlyingassumption thereby is that once being confrontedwithdementiaasapatient,orasafamilymemberofalovedonewithdementia,oneisnotonlyinterestedinmedical information,but in reliablepersonal sto-riesaswell.(Theymayfindanswerstoquestionslike:How do other people dealwith those confrontingconsequencesofthis illness?Whatdootherpeopledotopersistcaringfortheirrelativesdayafterday?)Indescribinga full rangeofexperiences,visitorsofthesitearesupportedininformeddecision-making.AspsychologistsofreligionoftheUniversityofGro-ningen,we had the opportunity to add a number

ofquestionstotheinterviewshelpingustoexploresomeof themainexistentialmeaning issues in thelivesoftheinterviewedpeople.Thispaperpresentsour most remarkable findings. One of them high-lights the difference in utterances when the inter-viewer specificallyaskedabout religiousor spiritualsubjectscomparingtowhatwefoundinotherpartsof the interview. Another one stresses the difficul-tiesintheinterviewprocessinaskingmorepreciselyaboutexactlytheseexistentialissues.Inanalysingtheinterviewmaterial on religious and spiritual topicsweusedthesamedescriptivemethodliketheotherDIPExresearchersattachedtotheDutchsubproject.Additionally, we introduced a more interpretativetheoretical framework with specific constructivistandpsychodynamic key concepts aboutmourningprocessesand(role)-identityincaregiving,whichre-sultedinamorecomprehensiveoverviewofthespir-itual/religious topics in the interviews. The centralargumentofthispaperfocusesonlifemottosasanimportantsourceofinformationinthiscontext.Talk-ing about thosemottos seemed tohelp caregiverstogivewordstotheirmoreambivalentexperiences,relatedtotheirexistentialanswersandquestions.

Construction of an Instrument for Measuring Implicit Aspects of God Representations

Henk StulpPhDstudent,ReformedUniversityofAppliedSciences,Zwolle,TheNetherlands

Background: Researchhas demonstrated a positiveinfluenceof religiosity/spiritualityonwellbeingandmentalhealth. Religiousbeliefs,partlyunconsciousandinternalizedthroughreligioussocialization,have

a great impact on theway a person perceives theworldandmaypromoteageneralpositiveattitudetowardsstressors.Moreover,thebeliefinapersonalgodmayforfollowersofatheisticdoctrinecontrib-

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utetoasenseofsafety,controlandprotectionthatenablesthemtocopewithstressfulsituations.Aper-son’srepresentationofGodseemstoplayacentralrole in theseprocesses.Fromtheperspectiveofanattachment and object relation theory framework,significant relationships have been found betweengodrepresentationsandtherapeuticallyrelevantvar-iables suchaspersonalitypathologyand(religious)coping. Both approaches emphasize that god rep-resentationsareforanimportantpartimplicit.Theyarebasedonearlyexperienceswithimportantcare-takersthatcreateinternalworkingmodelsthatfilternewexperiences andholdunconscious knowledgeandproceduresabouthowtointerpretbehaviorandhow tobehave. Important limitationsof almost allresearcharetheexclusiveuseofexplicit(self-report)measuresandthe restriction tonon-clinicalpopula-tions.Noqualitativestudieswithimplicitmeasuresofgodrepresentationsareknown.Thereforewedevel-opedaninstrumentformeasuringimplicitaspectsofgodrepresentationbymeansofaformalanalysisofnarratives,evokedbyanespeciallyforthisstudyde-

veloped religious Thematic Apperception Test (TAT-GR). Stories told about the images of this test areanalyzedwiththeadjustedSCORS-codingsystemfortheTATtomeasuresomeone’srepresentationofGod.Researchquestion:Arethemeasuresofthisnewin-strumentreliableandvalid?Method: The study is conducted on 140 religiousyoung adults; 70 hospitalized or day-care patientswith severe personality problems and 70 non-pa-tients.Patients’representationsofGodandconcep-tual-theoretically relatedvariableswillbemeasuredbeforeandaftertreatment.Internalconsistencyandinter-rater reliabilityof the scalesof the instrumentwill be determined. Validitywill be determined byinvestigating the relations between this implicit in-strumentandexplicitand(asfarasavailable)implicitmeasures of personality pathology, personality or-ganization, object-relational functioning, wellbeingand(religious)coping.Results: Preliminary results regarding reliability andvaliditywillbereportedanddiscussed.

Session 7: Religion/Spirituality and Health Behaviour

Keep Trying and Leave the Rest to Allah: How Diabetic Indonesian Muslim Adults Manage Self-Care and Religion

Iman PermanaPhDstudent,Manchester,UK

Background: Diabetes, as a chronic disease, is af-fecting the person physically, psychologically andsocially, especially due to the complications. An in-tegratedandcomprehensivetreatmentisnecessaryto overcome the illness, including promotion andpreventivemeasurewhichunderpinnedtheconceptof self-care. Self-care is believed to be essential inpromotingwellbeing andmaintaining any chronicconditions.Many studies have revealed the role ofreligiosityorspiritualityinmaintainingdiabetes.Thisstudyisaimedtoexploretheinfluenceofreligiosityonself-careactivityamongMuslimadultswithtype2diabetesinYogyakarta,Indonesia.Method: the study used a mixed method design,withaconvenientsampleoftype2diabeticMuslimadults. Two questionnaires, theMuslim Piety (Has-san,2007)andtheSummaryofDiabetesSelf-CareActivity (Toobert, et al., 2000) served as screeningtools. Based on the responses individualswere cat-egorised into one of four groups: high religiosity/high self-care (H/H), high religiosity/low self-care(H/L), low religiosity/ high self-care (L/H), and lowreligiosity/low self-care (L/L). To gain a richer un-derstandingoftheimpactofreligiononself-care,a30-90minutesemi-structuredinterviewwasusedto

24 participants from different groups. Polzer/Miles(2007)proposethreetypologies:GodisBackground;God is Forefront; and God is Healer. This theoreti-calframeworkinformedthein-depthinterviewsandanalysis of study data to gain a deeper theoreticalunderstandingof the relationshipbetween religionandself-managementfromtherespondents.Results: 100 responses to the questionnaire (58 fe-male/42male),averageagewas58.14±10.65with19theyoungestand85oldestrespondent.Ofthe4categories:86(H/H),8(H/L),4(L/H),2(L/L).Basedonthetheoretical frameworkfromPolzer/Miles,24interviews revealed: 14 respondentswere affiliatedwiththefirsttypology,5tothesecond,1tothethird.Anewtypologyfromfourrespondents:boththeper-sonandAllahhadthesameroleindeterminingtheresult. A key theme emerged from 6 respondentsacrossdifferenttypologies:keepontryingandleavetheresttoAllah;anindividualshouldmakeagreateffort managing their own health care then leavetheresult toAllah;an IslamicteachingofTawakkal,the obligation of a human being to do their bestand leave the result toAllah.While, the studyalsoshowedtheinfluenceoftheJavanesespiritualvaluesofKejawen,whichempathisedharmonywithother.

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Predictors of Polish Students´ Life Satisfaction and General Health Resources

Prof. Dr. Janusz Surzykiewicz & Prof. Dr. Arndt Büssing FacultyofAppliedSciencesCatholicUniversityEichstätt-Ingolstadt,Eichstätt,Germany/InstituteofSocialPrevention,WarsawUniversity,Warsaw,PolandFacultyofHealth,UniversityofWitten/Herdecke,Germany

Background:Resilienceisanindividual´stendencytocopewith adversities like stress, social vulnerabilityor illness. Thus,building resilience factors in youthisessentialforenablingandstrengtheningapersontolaterfightagainstpersonalthreads.Itisassumed,thatwork hope and self-efficacy aswell as aspectsofspiritualitycouldberesourcesoftheirlifesatisfac-tionandthereforepredictorsforresilienceintermsofpositivehealthcognitions.Methods:Inananonymoussurvey,weenrolled1.047Polishstudents(meanage18±1.4years;51%female,49%male)recruitedfromdifferentmiddleschoolsindistrictsofWarsawandBialysto.Standardizedself-re-portquestionnairesweredistributed,i.e.,AspectsofSpiritualityQuestionnaire(ASP)inits13-itemstudentversionwhichdifferentiates4factors(i.e.,ReligiousOrientation:Prayer/TrustinGod;SearchforInsight/ Wisdom; Conscious interactions; Transcendenceconviction),the10-itemBriefMultidimensionalLifeSatisfactionScale (BMLSS), self-efficacyexpectation(SWE),andtheWorkHopeScale(WHS).Results:Although81%ofthestudentsbelongtotheCatholic denomination, 42% would regard them-selvesasneitherreligiousnorspiritual.Comparisonsoftheassessedconstructsbetweennon-religiousandreligiousstudentsrevealedlowestlifesatisfactionin

non-religiousstudentswhencomparedtotheir reli-giouscounterparts (F=7.7;p<.0001); similar resultswere also shown for students´ work hope (F=4.1;p<.0001). In contrast, religious students showedhighestscoresforwell-being,self-efficacyandworkhope.Because we were interested which variables maypredict students´ life satisfaction, we performedstepwise regression analyses and found that self-ef-ficacy expectationwas thebest predictor,with fur-ther influences of Conscious Interactions, ReligiousOrientation,lowerage,and,however,lowSearchforInsight/Wisdom (R2=.32). Gender, parental status,WorkHopeandTranscendenceConvictionwerenotamongthesignificantpredictors.Althoughstudents´workhopewaspredictedbestbyReligiousOrienta-tion andother variables, thepredictive powerwaslow(R2=.09).Conclusion: The study showed that among thestrongest predictors of students´ life satisfactionwereself-efficacyexpectationandaspectsofspiritu-ality.Asexpectedtheseconstructsalsogoalongwithpositivehealthcognitionsandthuscanbestatedasimportantresiliencefactors.Educationalimplicationswillbediscussed.

The Association of Religious Affiliation and Body Mass Index (BMI): An Analysis from the Health Sur-vey for England Dr. Deborah LycettPrincipalLecturerinDietetics,CoventryUniversity,UK

Background:Obesity andobesity-relatedmorbidityandmortality isanon-goingconcern indevelopedcountries[1].Religionhasbeenshowntobeassoci-atedwithreducedprematuremortalityandmorbid-ity[2],however,theassociationbetweenreligionandobesity isunclear. Ina systematic reviewsevenoutof36studies investigatingtheassociationbetweenreligion or spirituality andbodyweight reported alower body weight among those who associatedthemselves with a religion. Thirty-nine percent re-ported a higher bodyweight, 6% reportedmixedresultsand36%foundnoassociation.Examinationofthehighestqualitystudiesfoundthatincrosssec-tional studies religious involvementwas associatedwithahigherBMI,particularlyamongethnicminori-ties,butinlongitudinalstudiestherewasnoassocia-tion[2].AllthesestudieswereintheUS,exceptonein theNetherlandswhich foundnoassociation.To

datetherehavebeennostudiesintheUKtoinvesti-gatethisassociation.Method:Thisisacross-sectionalstudyusingHealthSurvey for England, 2004, data to investigate theassociation of religious affiliation and Body MassIndex(BMI).Arepresentativesampleof6704adults(16 years or older)were included. Interviewswereadministered,questionnairesself-completed,heightandweightwasmeasured.Sequential linear regres-sion models were used and analysis according tosmokingstatuswasalsoconductedseparately.Results: Religious affiliation was associated with a0.73kg/m2 higher BMI in the English populationcomparedtothosewhodidnotaffiliatethemselvesto a religion. Over half of this association was ex-plainedbyavariationindemographiccharacteristics.Patterns of alcohol consumption explained a smallamountofthisassociation,whilefruitandvegetable

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consumptionandphysicalactivityleveldidnot.Lesssmokinginthosereligiouslyaffiliatedaccountedfor0.06kg/m2oftheassociation.Amongnever-smokers0.45kg/m2higherBMIinreligiouslyaffiliatedpeopleremainedunexplained.Conclusion:Prospectivestudieswithvalidatedmeas-ures of religion to capture intrinsic religiosity andmeasures of dietary energy are needed in the UKandacrossEurope.Religiouscommunitiesmayneedgreater healthy weight promotion or benefit from

interventionstailoredtocomplementtheirreligiousbeliefs.

References:The Surgeon General (US)(2001): Call To ActionTo Prevent andDecreaseOverweight andObesity;ODPHP;CDCP;NIH(US).Rockville.KoenigH,KingD,CarsonVB(2012):HandbookofReligion and Health. Oxford University Press, USA;2nded.

Role and Influence of Christian Faith on ART Adherence and Adherence Counseling: A Case of Myung Sung Christian Medical Center, Addis Ababa, Ethiopia

Naod Mekonnen Ethiopia(Co-Author:MastewalMekonnen)

Background: Around 34 million people are livingwithHIVallovertheworld,where2/3ofthemareliv-inginSub-SaharanAfricancountries.EthiopiaasoneofthecountriesoftheSub-SaharanAfricancountryisaffectedbyHIVandAIDS.Estimatednumbersof800 000 people are living with HIV. The introduc-tionoffreeARTandthedifferentworkdoneintheaspectofpreventionsuchasawarenesscreationcon-tributed tosignificantdecrement in theprevalenceratefrom6.5%in2005to1.5%in2011.Besidetheachieved success the issue of adherence to ART ispertinentsinceadherencetothemedicationcanaf-fectthetreatmentoutcomeeitherpositivelyornega-tively. Here in this prospect different studies showthat therearepositiveandnegative factors for theachievementofoptimaladherence.Oneof the fac-tors is the influenceofreligious faithonadherenceandadherencecounseling.Objective: This research is aimed at explaining theroleof religious faithonadherence toARTandad-herencecounseling.

Methods: thedata’swere collectedqualitativelyus-inginterviewguidequestions.ConvenientsamplingtechniquewasusedtoselectthestudyareawhichisMyungSungChristianMedicalCenter.Apurposivesamplingmethodwasalsousedtoselectthestudygroupsorsubjects.Inadditiontotheseaconvenientsamplingmethodwasusedtoselecttheintervieweesinthehealthinstitutionaswellasthereligiouslead-ers.Finally,thedatawereinterpretedandanalyzedqualitativelybyformingthemes.Results: The studyuncovers thatChristian religiousfaithhasapositiveroleintheadherencetoARTandit also shows that religious leaders are not playingtheirroletofillthegapintheworkofHIVandAIDSespeciallyonadherencetoART.Conclusion and Recommendation: The role of theChurch ministers, health care professionals andaboveallpeoplelivingwithHIVisimportantfortheachievement of optimal ART adherence. So, thesedifferentsectorsneedtoworkhandinhandfortheaccomplishmentofbetterandevenoptimalARTad-herenceinpeoplelivingwiththevirus.

Association between Health Behaviour and Religion/Spirituality in Adolescents. A Cross-Sectional Survey of Austrian High Schools Gabriele Gäbler, MScDietitian,Villach,Austria(Co-Authors:HermannToplak,RenéHefti,JosefHaas,ElisabethPail)

Background:Theprevalenceofcertainriskfactorsforchronicdiseasessuchassmoking,alcoholabuse,lowfruitandvegetableconsumption,andlackofphysi-calactivity ishighamongyoungpeople.Theselife-stylefactorsinfluenceoneanotherandarefurtheraf-fectedbysocialandenvironmentalfactors.EvidencefromAmericasuggests that there isapositiveasso-

ciationbetweenreligion/spiritualityandthesehealthbehaviours.TheaimofthisstudyistoexplorewhetherasimilarassociationexistsinAustria,anEuropeancountry.Method: A cross-sectional study was carried outacrosssevenrandomlyselectedhighschools.Where-byatotalof22511th-gradepupils(64%girls,36%

Precedingtheconferencetherewasa4-dayPre-Con-ferenceResearchWorkshopwithProf.HaroldKoenig.The workshopwas open to all interested in doingresearchon religion, spiritualityandhealth (accept-ingparticipants of any educational level or degree,including theologians,chaplains,physicians,nurses,psychologists,pastoralcounselors,publichealthspe-cialists,epidemiologists,orotherpotential research-ers).ProfessorHaroldKoenigisknownasseniorau-thorofthe“HandbookofReligionandHealth”.HeholdsauniversityteachingpositionasfullprofessoratDukeUniversityMedicalCenter(InternalMedicine,Psychiatry,andBehavioralSciences).Furthermoreheisco-directoroftheCenterforSpirituality,TheologyandHealth.Thiscenteroffers–amongstothers–a2-yearpost-docprograminreligionandhealth,whichDr.Koenighascompressedinto4-dayworkshops.MentorshipmeetingswithProf.Koenigallowedpar-ticipantstodiscussindividualresearchprojects.

The following topics have been discussed:• Historical connections between religion and

healthcare• Previousresearchonreligion,spiritualityandhealth• Strengthsandweaknessesofpreviousresearch• Theologicalconsiderationsandconcerns• Highestprioritystudiesforfutureresearch• Strengths and weaknesses of religion/spirituality

measures• Designingdifferenttypesofresearchprojects• Fundingandmanagingaresearchproject• Writinga researchpaper forpublication;getting

itpublished• Presentingresearchtopublicaudiences;working

withthemedia• Developinganacademiccareerinthisarea

Manytopicsofthisworkshopareaccessiblein:

Pre-Conference WorkshopwithProf.Harold.G.KoenigM.D.,May18-21,2014

Koenig, HG (2011): Spirituality andHealthReserach:Methods,Measure-ments,Statistics,andRessources.

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boys;averageage16.4years,were interviewedbymeansofanonlinequestionnaire.Results: There are significant gender differences inthe associationsbetweenhealthbehaviours and re-ligion/spirituality. There is a positive correlationbe-tweenreligion/spiritualityandhealthy foodchoicesandmealfrequency;inthecaseofboys,thereisanadditionalpositivecorrelationwithphysicalactivity.Thereisalsoanegativecorrelationwithsmokingandfrequencyofgettingdrunk.Theresultsofthebinarylogisticregressionmodelsindicatethatreligion/spir-ituality is a significant predictor for the number of

cigarettessmokeddailyandproblemdrinking,evenafter controlling for gender, stress perception andothercorrelatedhealthbehaviours.Conclusion:Thisstudyshowsthatreligion/spiritualityispositivelyassociatedwithseveralbeneficialhealthbehaviours. Further studies are needed to exploretheinfluenceofotherconfoundingvariablesonthisassociatione.g.socioeconomicstatus,familydynam-ics, social influence and personality types. Surveysinvestigatinghealthbehaviours amongadolescentsshouldincludequestionsonreligion/spirituality.

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Posters

Posters(inalphabeticalorder)Theposterswillbeexhibitedintheentrancehallduringthewholeconference.Theauthorsarepresentatlunchtime12:30-14:00onFriday,May23rd.

Dr. Gina Andrade AbdalaProfessora do Mestrado em Promoção da Saúde -UNASP SP, Doutoranda PROESA-EE/USP, Sao Paulo,Brazil

Faith Community Nursing (FCN): Integrating Faith and Health Care in the Community(Co-Authors:MariaDyrceDiasMeira,CarlosAntônioTeixeira)

Introduction:At leastfive institutionscan takecareof our health, if well functioning: the health sys-tem, family, school,workplaceandthechurch.Yes,churches shouldbe conscious of its important roleinmaintaining thememberandcommunity´squal-ityoflife(Solari-Twadell,McDermott,2006).Objec-tives:ToreporttheexperienceoftheimplementationofFaithCommunityNursinginBrazil,proposingtheinitialgoalofcreatingspiritualityworkshops forhy-pertensive through8 remediesofnature related toaspiritualreflectionbasedonaBiblicalstory.Italsointendstopromoteholistichealthinchurchesand/orcommunities, incorporatingavarietyof faith tra-ditions.Methodology:Thisactivitywasbasedonin-ternationalnursingprograminthefaithcommunityfoundedbyWestberg inChicago in1983.Hewasscheduledtopresentthe4modulesoftheacademiccurriculumofECF:spirituality,holistichealth,profes-sionalism and community. A partnership betweenAdventistUniversityofSaoPaulo(UNASP)andInter-nationalParishNurseResourceCenter(IPNRC)wasdone.Results:PartnershipbetweenBrazilandIPNRCwas established andduring themeeting of 4 days(22to25November),16lectureson4moduleswerepresented,aswellasdynamicswith suggestionsofhowtoapplytheworkshopsincommunities.The34nurseswhoparticipatedwereopen to the lectures.Theywerealsoengaged, touchedandparticipatedinplanningtheworkshopsonspirituality.Intheend,6ofthemwerewillingtoapplythe“project”intheircommunitiesandinfuturetheseexperimentswillbereportedandevaluatedbypeersforfuturegenerali-zations.Conclusion:Due to the low incomeof thepopulation, inwhichonly26.3%(49.1millionpeo-ple) are covered by health insurance (IBGE, 2008),ECFprogramwillbeconfiguredasabridgetosolveortrytopromotereligiouscopinginhealthdifficul-tiesencountered.Theprojectwillnotbe restrictedonlytopeoplewhodonothaveahealthinsuranceplan,buttoallwhowantstosatisfythisspiritualdi-mension,sooverlookedinhumanlife.It´sphilosophyistotreatthewholeperson:mind,bodyandspirit.

The nursing profession was chosen by Granger in1983becausetheyarepreparedforbothfields:sci-entificandbehavioral.Thenurseisnottobeseenasanattendantofprimarycareonly,butsomeonewhowill facilitate theuseofavailable sourcesof churchand community envisioning theholistic healthpro-motion.(Blome,2003).

Prof. Christopher BondMissouriWesternStateUniversity,USA

Caring for the Caregiver: Health, Spiritual and Communication Privacy Needs

Caregiversaredefinedas theprimary facilitatorsofthe care andneedsof apatientorperson inneedofcare.Caringforanotherpersonisbothrewardingandchallengingasacaregiverlearnstobalanceandmanagefamily,work,andcaregivingresponsibilities.Manytimesacaregiver’sself-careandspiritualcon-nectionsdiminish as both thephysical andmentalstress of caregiving increases. This increased stresscan lead to feelingsofneglect andburnout.Oftencaregiversconsiderwhattheycanorshoulddoforapatientorfamilywhileneglectingthemselves.Caregiversandpatientsobtainthemajorityoftheirsocialization and communication through one an-other, which in turn, affects a caregiver and a pa-tient’s Quality of Life (QoL) as measured throughmany factors including health outcomes, spiritualneeds, communication competence and privacy.Sincemanydisparitiesexistbetweentheviewsandneedsofthecaregiverandpatient,caregiversexpe-riencemisunderstandings leading todecreasedpsy-chological,spiritualandphysicalwell-beingforboththepatientandcaregiver,which,inturn,mayaffecttheoverallQoLforboththepatientandcaregiver.ByapplyingthetheoreticalframeworksofSelf-CareDeficit Theory and the relational health communi-cationmodel,thispresentationwilldiscussmypastresearchexaminingcaregiverQoLscorestopsycho-socialvariablesandoffersuggestionsonhowcaregiv-erscanincreasetheiroverallQoLasitrelatestotheirhealth, spiritual and communication privacy needs.Theroleofhealthprovidersandtrainingrequiredtomonitor the self-careof caregiverswith a focusonspiritualneedswillalsobediscussed.Throughcom-munication competence skills andmaintaining car-egiverself-care,boththecaregiverandpatient’sQoLcanbemaintainedandincreased.

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Posters

Prof. Dr. Arjan BraamPsychiatrist,AltrechtMentalHealthCareUtrecht,Al-trecht,TheNetherlands

Towards a Multidisciplinary Guideline Religion, Spirituality and Psychiatry: what do we need?(Co-Authors:CarloLeget,PietVerhagen)

Objectives:ThefieldofMentalHealthcareharboursa long traditionofHealthcareChaplaincy and Spir-itualCounselling.Duetosecularizationandempha-sisonindividualmeaningmaking,theprofessionofchaplaincy is subject tochange.AMultidisciplinaryGuidelineonReligion,Spirituality(R/S)andPsychia-trywill address: (1) organizing R/S consultation incontemporarypatientcare,(2)categorizingresearchfindings,and(3)professionalismwithrespecttoR/Sinpsychiatricpracticeandeducation.Methods:Thefollowingareasofparticularattentionareselected:(1)valueswithrespecttoR/S, (2)R/Sinmental health care practice, (3) R/S counselling,and(4)collaboration.Contentsarederivedfromtwosources:brainstormsessionswithkeyparticipantsinthe field of R/S andpsychiatry, and reviews of R/Sguidelinesinothersettingsorcountries.Results:Withrespecttovaluediscussions(1), thereisarichtraditionofthought.Formentalhealthcarepractice (2), there is some substance of empiricalstudiesjustifyingtheattentionforR/S.Littleresearchis available on the level of counselling practice (3)and collaboration. The existing guidelines in pal-liativemedicineoffer valuable insights,butarenotcompletewithrespecttomatterssuchasstigmatiza-tion.Conclusions:Futurestepsincludetheverificationofthe core themeswith specialists in the field, thera-pists,counsellors,andpatients.ReferencesLeget,C.,Staps,T.,Geer,J.vande,Mur-Arnoldi,C.,Wulp, M., & Jochemsen, H. (2010). Spiritual careguideline[Spirituelezorg;Landelijkerichtlijn,Versie1.0].Utrecht:VerenigingvanIntegraleKankercentra(www.palialine.nl, Dutch; www.oncoline.nl/spiritual-care,English).

Darunee Chanlertrith Thailand

Did Spirituality of Hemodialysis Patients Differ From Chronic Kidney Disease Stage V Patients?(Co-Authors: Areewan Cheawchanwattana, Warap-ornSaisunantararom)

Objectives:Health-relatedqualityoflife(HRQoL)wasrecognizedasan importantoutcome foradvancedchronicdiseases,especiallyend-stagerenaldiseases(ESRD). The common aspects of HRQoL, such asphysical, mental and social domains, were usually

evaluated in ESRD patients, however research onspiritualityinthesepatientswerelimited.Thisstudyaimed tocompare spiritualityofhemodialysis (HD)patientsandchronickidneydiseasestageV(CKD-V)patients.Methods:TheprotocolofstudywasapprovedbytheHospital EthicCommittee. Total of31HDand63CKD-Vpatientswereaskedforconsentandthenin-terviewedofspiritualityusingFunctionalAssessmentof Chronic Illness Therapy – Spiritual Well-Being(FACIT-Sp). Spirituality scores (FacitMeaning, FacitPeace,FacitFaith,andFacitTotalScores)ofCKD-Vand HD patients were compared by using Mann-WhitneyUtest,sincescoredistributionswerehighlyskewed. Additionally, multiple linear regression al-nalyseswereappliedtocomparethescoresbetweenthetwogroupsthatwereadjustedbycontributingfactors including age, gender, and marital status(married). The significance levels were set at 0.05(2-sidedtests)forallanalyses.Results:Allfactors,gender,age,married,andpatientgroups, resulted insignificantdifferencesofall spir-itualityscoresbyusingMann-WhitneyUtest.SinceCKD-V patients had significantly more proportionsoffemalegenderandunmarriedstatusthanHDpa-tients, and were significantly older, then the inter-pretationofscorecomparisonsshouldbebasedonmultiplelinearregressionanalyses.SpiritualityscoresofCKD-VpatientsasmeasuredbyFacit-Spwerenon-significantlygreaterthanthoseofHDpatientsafteradjustedbygender,age,andmaritalstatus.However,the multiple linear regression analyses of all Facit-Sp scores found thatmalegenderhad significantlylowerscoresofspiritualitywhencomparedtofemalegender[FacitMeaning-1.59(p=0.024),FacitPeace-2.37 (p=0.004), Facit Faith -2.87 (p=0.001), FacitTotalScore-6.83(p=0.001)],whileageandmaritalstatuswerenon-significant.Conclusions:Thespiritualitydidnotdifferbystagesof chronic kidney diseases, however patient char-acteristicsuchasgenderassociatedwithspirituality.Then any intervention that designed for spiritualityimprovement should be considered to involve pa-tientcharacteristicsasun-negligiblefactors.

Dr. Dagmar A.S. CorryLecturerinPsychology,GlyndwrUniversity,Wrexham,Wales,&TheBamfordCentreforMentalHealthandWellbeing, University of Ulster, Derry/Londonderry,NorthernIreland

Testing the Theory of Transformative Coping us-ing the Creative Coping Scale and the Spiritual Coping Scale(Co-Authors:JohnMallett,ChristopherA.Lewis)

Inanattempttoempiricallytestthetheoryoftrans-formativecoping(TTC),thepresentstudyexamined

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whether,andtowhichextent,creativeandspiritualcoping is applied in combination among a sampleof 714 adults, and whether their application is as-sociatedwithhope,self-esteem,andmeaninginlife.For theise purposes, two new theory-based instru-ments,theCreativeCopingScale(CCS-10),andtheSpiritualCopingScale(SCS-18),wereemployed,un-dergoingconfirmatoryfactoranalysisintheprocess.Scores on allmeasureswere quite low in this sam-ple,withdemographicdifferencesevident. Inkeep-ingwith theTTC,apositive, significant correlationbetweenscoresontheCCS-10andtheSCS-18wasfound, along with positive, significant associationsbetweencreativeandspiritualcopingandmeasuresofhope,self-esteemandmeaninginlife.Recommen-dationsforfurthercross-culturalresearchweremadeandpracticalapplicationsdiscussed.

Gabrielle DiederichMissouriWesternStateUniversity,USA

The Tanning Temple: Health, Spirit and Body Modification(Co-Author:KayteFisette)

Forthispresentation,wewilldescribethephenome-nonoftanningintheUnitedStatesofAmerica(USA).Peopleofdifferentagesandethnicbackgroundsusetanningbedsandsalonsasatypeofbodymodifica-tionaswellasformeditationandrelaxation.How-ever,manyChristiandenominationsintheUSAstatetanningisasinandviewthebodyasGod’stempledue to the interpretation of a specific Bible verse:“ThebodyisGod’stemple...ifyoudestroythetem-ple,youdestroyGod.”Othersrejecttanningduetothe potential health risks due to over tanning andexposuretoultravioletrays.SomestatesnowhavelawsprotectingyouthfromusingtanningsalonsandbedswithIllinoisforbiddinganyoneundertheageof18fromtanningbeginningJanuary1,2014.Although tanning receives critiques fromAmericansociety, preliminary research indicates people aretanningmorefrequentlytofulfillboththeirmentaland spiritual well-being. Through semi–structuredinterviewswithfrequentusersoftanningsalons,wedeterminedhowindividualsexperiencespiritualben-efitsandifthereareanydifferencesamongChristiandenominationsandreligiousbeliefs.Additionally,aquestionnairewasdistributedatvarious tanning sa-lons toassess religiousdemographics,bodymodifi-cation beliefs, why someone continues to tan, fre-quency,andstressreliefandmeditationpurposes.

Jacob DowellMissouriWesternStateUniversity,USA

Is Circumcision a Choice? An Analysis of Religious Beliefs and Health Benefits on Circumcision Deci-sions(Co-Author:StephenSolomon)

Thisstudyexaminesthevariousreligiouspreferences,rites, and health benefits and risks of circumcisionwithafocusonthecircumcisionpracticesofChristi-anityandIslam.ThestudywasconductedaftertheCouncilofEurope’sdecisiontobancircumcisiononmalesundertheageof15whichsparkedIsraeliandJewish protests. Additionally, a growing number ofanti-circumcisiongroupshaveformedinmanycoun-tries and throughout theUnited States of America(USA).Amulti-countrysampleofmalesansweredaquestionnaire sent via an online survey to supportgroupsofmenwhohaveconcernsaboutbeingpre-viouslycircumcisedbasedontheirparents’religiousrites,beliefsorasastandardmedicalpracticeforaparticularcountry.Thesamequestionnairewassenttoonlinesupportgroupswhosupportandadvocateforcircumcision.Specifically,thestudywillexaminewhetherornotmalesshouldhaveapersonalexemp-tionincircumcisiondecisionsregardlessofreligiousdoctrines and rites andwhy somemales desire re-storativesurgeries.

Prof. Dr. George FitchettRushUniversityMedicalCenter,Chicago,USA

Case Studies in Contemporary Spiritual Care: Chaplains’ Interventions with Critical Responses(Co-Author:SteveNolan)

Announcing a forthcoming (2014) collection ofchaplaincasestudies(tobepublishedlaterasCaseStudies in Contemporary Spiritual Care: Chaplains’InterventionswithCriticalResponses),thisposterar-guesthathealthcarechaplaincyhasreachedapointwhereitneedstodevelopabodyofpublishedcasestudies.Theposterdescribesthereasonswhyabodyof chaplain case studies is necessary, it presents amodelthatchaplainscanuseforwritingcasestudiesanditdetailskeyethicalissueschaplainsshouldcon-siderwhenpresentingandpublishingcasestudies.The poster describes three reasons why a body ofpublishedchaplaincasestudiesisneeded.First,aslittleisunderstoodaboutwhatchaplainsac-tuallydo,abodyofcasestudiesprovidesempiricaldata about the kinds of spiritual care interventionschaplainsmake.Thisdatawillprovideafoundationfor further research into thequality andefficacyofchaplains’spiritualcare.Second,casestudiesplayanimportantpartinbothinitial training and in continuing professional de-

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velopment. This bodyof casematerialwill play animportantroleintrainingnewchaplainsandwillbea resource for the continuing education of experi-encedchaplains.Third, case studies provide real insight into howprofessionalswork.As such, theycanhelpeducatehealth care colleagues and thewider public abouttheworkofhealthcarechaplains.Theposterpresentsanoutlineforthecontentsofachaplaincasestudy:Introduction,detailingthesub-jectofthecase,thechaplainandthesiteofcare;theHistoryofthePastoralRelationship,includingsignifi-cantencountersandverbatim;DiscussionofSpiritualAssessment,SpiritualNeeds,SpiritualCare Interven-tions,andOutcomes;Summary.Finally, theposter presents key ethical issues tobeconsideredby chaplainswhenpresentingandpub-lishingtheircasestudies.Theposterwillincludebriefsummariesoftwoofthechaplaincasestudies.

Kendra GreerMissouriWesternStateUniversity,USA

An Analysis of Spiritual Meditation and Religious Beliefs on Stress Reports and Job Satisfaction of Healthcare Providers(Co-Author:JessicaKlaus)

Manyreligiousculturesincorporatemeditationintotheirdaily livesaspartofparticular spiritualbeliefs.Additionally, many studies provide connections be-tween meditation and stress reduction. However,limitedstudiesexaminehowanindividual’sreligiouspreferencesaffecttheuseofmeditationandreportsof stress especiallywithinworkplace settings.Medi-tation, especially spiritual mediation, can decreaseheartrateandbloodpressureandimproveperceivedwell-being.Manystudiesshowthatspiritualmedia-tion can increase an individual’s self-efficacy andstrengthened impulse control, which, in turn, canaffectjobsatisfactionandanincreasedspiritualcon-nectiontoothersandtheenvironment.Healthcareworkersareincreasinglyoverworkedandhavehigherthanaveragereportsofjobrelatedstressandburnout.Thisprojectwillanalyzetheuseofspir-itualmediationtechniquesandwillthensurveyvari-oushealthcareprovidersontheirrespectivereligiouspreferences,mediation frequency and how reportsof meditation affect stress reports, job satisfaction,andreportsofspiritualconnectionwithpatientsandotherhealthcareproviders.

Anna JanowiczFundacjaLubiePomagac,Gdanzk,Poland

Preliminary research among catholic chaplains, and professionals and volunteers involved in new method of team pastoral work from St. John of God Order in Poland (Co-Authors:PiotrKrakowiak,MarekKrobicki)

Polandisconsideredoneofmostcatholiccountriesin Europe.Number of vocations is still among thehighest inEurope.Oneofcatholicpriest’sactivitieshereisrelatedtochaplaincyinhealthandsocialcarefacilities. There are some chaplains from other de-nominations(protestantororthodox).Recentchang-es,especiallyintegrationwithEUandopenborderschangevisionofreligiousandspiritualneedsofpop-ulationinPoland.Oneoftheareaswhenthischangeisdramaticallyseenishealthandsocialcareenviron-ment.Seeingit,PolishProvinceofSt.ofJohnofGodOrderhasstartedaninnovativeprograminPolandofteampastoralworkinhealthandsocialcareinstitu-tion.In2011firsteditionofpostgraduatetrainingforfuturechaplainsandpastoralassistantsinPolandhadbeenlaunched.Firstgroupof40students(ordainedpriests, religiousmenandwomenand laypeople -mostlywomen)finished“St.JohnofGodSchool”in2013,butthereisstillnocultureofteamwork,espe-ciallywithlaypeople.ThisinitialstudyshowsresultsfromcatholicenvironmentofSt.JohnofGodOrder,and students of postgraduate school for team pas-toral careperceptionof differences in spiritual andreligiousneeds among their patientswith compari-sonwithothercatholicchaplainsinhealthandsocialcareinstitutionsinPoland.Openquestionswerepre-sentedinananonymousquestionnaireforreligiousandlaypeople,professionalsandvolunteersfrom10institutionsofSt. JohnofGodOrder inPolandandforstudentsofthefirsteditionofpostgraduatetrain-ing“St.JohnofGodSchool”andthesecondedition.Thesamequestionswouldbesendingtoallcatholicchaplains working in health and social care institu-tions(around1000emailcontacts).Resultswillindi-catedifferencesamongthosewhoarealreadywork-inginteamsinspiritualandpastoralcareandthosewho still prefer traditional,mostly individual, ritualandreligiouswayofdealingwithspiritualdimensionofcare.ObtainresultswillinformthosewhowanttospreadtheteampastoralworkinPolandandEasternEuropeandincludespiritualcareintopastoralcareinhealthandsocialcaresettingshowtodealwiththeseissuesinthefuture.Itwillhelptopromotetheteampastoralworkwithreligiousandlaypeopleinthefu-tureandwillshowareasofdifficulties,problemsandfearsintheshiftfrommainlyritualpastoralcareintomoreopen, ecumenical and intercultural approachofspiritualcarewithrespecttocatholictradition,rit-ualsandsacramentsinhealthandsocialcaresetting.

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Renske Kruizinga Researcher, PhD-Student, Amsterdam, The Nether-lands

Development and evaluation of a new interven-tion on experiences of contingency and ultimate life goals to address spiritual concerns of ad-vanced cancer patients(Co-Authors:M.Scherer-Rath,J.B.A.M.Schilderman,M.A.G.Sprangers,H.W.M.vanLaarhoven)

Background: Spiritual care plays an important rolein thewell-beingofcancerpatients–especially forpatientswith incurablecancer.Nevertheless,appro-priate, effective, and brief interventions to addressspiritualconcernsarelimited.Objectives:Theobjectivesofthispilotaretodevelopand test a brief interviewmodelwith an e-applica-tiononexperiencesofcontingencyandultimatelifegoalstoaddressspiritualconcerns.Method: The interviewmodel consists of two con-sultationsofonehourwithaspiritualcaregiver.Theresult of Consultation I is a reconstruction of theparticipants’most important lifeeventsandhis/herinterpretation.Theresultoftheanalysis,carriedoutby the spiritual counsellor, is a framework for ob-servation and interpretation. In Consultation II theparticipantreflectsonthisframeworkanddiscussesthe(in)consistencybetweenlifeeventsandlifegoalswith the spiritual counsellor.Nine spiritual counsel-lorsfromsevenhospitalsparticipated.Allcounsellorshadtwotrainingsessionsafterwhichtheypractisedthe interventionwith students. For the pilot studythe spiritual counsellors interviewed a patientwithincurable cancer. All 9 interviews were recorded,transcribedandanalyzedusingAtlas.ti.Thepilotwasevaluated from participants’ and counsellors’ per-spective.Results:Thepilot-studyisongoing.Thefirstresultsoftheevaluationformsandinterviewsafterwardsshowthat fromparticipants’andcounsellors’perspectivetheinterventionisevaluatedpositively.Discussion:Theobjectiveofthepilotstudyistoim-provethesubsequentlyplannedrandomizedcontrol-ledtrial(RCT)toevaluatetheeffectoftheinterven-tiononqualityoflifeandspiritualwellbeing.Insightinto one’s ultimate life goals is expected to helppatientstointegratealifeeventsuchascancerintotheirlives.Aprospectivestudyinpatientsisneededtoempiricallyexaminewhetherinsightintoone’sul-timatelifegoalsimprovesqualityoflifeandspiritualwellbeing.Theinterventioncanaidinfurtherprofes-sionalizationofspiritualcounselling.

Prof. Dr. Christopher Alan LewisDepartment of Psychology, Glyndwr University,Wrexham,Wales,UK

Dissociation and Religiosity: The Role of Religious Experience(Co-Author:MichaelJ.Breslin)

Dissociation can be conceptualized as a disruptionin integrated processing of psychological informa-tion,duetoalterationsinconsciousness.Anemerg-ingbodyofresearchhasexaminedtherelationshipbetweendissociationandreligiosity.Mixedfindingssuggest aweak positive association between thesetwo constructs. There is some evidence to suggestthatreligiousexperienceisthedimensionofreligios-ity that is associatedwithdissociation.Thepresentaimwas to investigate if dissociationpredicted reli-giousexperienceoverandaboveareligiositymeas-ure,specificallyfrequencyofprayer.Asampleof371Irish respondentscompleted theMeasureofPrayerType,theMScaleShortVersion,andtheDissociativeExperiencesScale.Binarylogisticregressionshowedthat religiousexperiencewaspredictedbydissocia-tion,controllingforfrequencyofprayer.Resultssug-gestedthatreligiousexperienceisthedimensionofreligiositythatisassociatedwithdissociation.

Prof. Dr. Christopher Alan LewisDepartment of Psychology, Glyndwr University,Wrexham,Wales,UK

Understandings of the Word “Spirituality” Among a Sample of University Students in the UK(Co-Authors: Emyr Williams, Peter la Cour, JoannePike)

Withinthesocialscientificstudyofreligion,therehasbeen a significant amount of research on spiritual-ity, especially in the area of health andwell-being.Despitethis,thetermspiritualityremainspoorlyde-finedandunderstood.Therehavebeenonlyasmallnumberofstudiesthathaveexaminedthesemanticsof spirituality.Theaimof thepresent studywas toexaminetheunderstandingsofthewordspiritualityamongasampleof120universitystudentsintheUK.Buildingontheworkof laCour,Ausker,andHvidt(2012) in Denmark, respondents evaluated whichoutofalistof115wordsindicatedspirituality.Factoranalysisoftheresponsesresultedinsixdifferentun-derstandingsofspirituality:1.Spiritualityasaffective,2.NewAge,3.Transcendency,4.Embodiedexperi-ences of spirituality, 5.Mysticism, 6. Spirituality asother.Theseresultsindicatethatamongthepresentsample there was a divergence of common under-standing of the term spirituality. Resultswere com-paredtothoseoflaCouretal.(2012)amongDan-ishadults,andbothsimilaritiesanddifferencewere

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found.Limitationsofthepresentstudyareoutlinedandsuggestionsforfurtherresearchareprovided.

Corey MyersMissouriWesternStateUniversity,USA

Creative Artistry or Spiritual Healing? Musicians’ Perceptions of Creating and Performing Music for Healing

The role of music as a healing instrument has sig-nificanthistoricalrootswithinmainstreamandtribalreligionsdatingback to50,000B.C.E. Thehealingpowersofmusic, especiallywithinChristianity, canhavemeaningful effects on an individual’s spiritual,mentalandphysiologicalselfasalteredrealitiesandperceptions are achieved through listening and in-teracting to various sounds and structuredmusicalexperiences.Itisthroughthesemusicalexperiencesandmanipulationofsoundthatlistenersexperiencethedivineandperceivethemselvesashealed.How-ever,thehealedindividualmayormaynotperceivethemselves as a patient nor view amusician as anactualhealer.The inverse isalsopossibly true: themusicianmaynot see themselves as an actual spir-itualhealer,butmoreasamusicalartisan.Throughboth surveys and interviews of worship musiciansof various Christian and non-Christian groups, thisstudywill examine theperceptionsofmusicians ashealerswhenplayingandcreatingmusic.ThestudywillalsoexaminetheSpiritualandhealingconnect-edness among amusical experience, themusician(healer)andthelistener(patient).

Dr. phil. Piret Paal ProfessurfürSpiritualCare,KlinikumderUniversitätMünchen,Munich,Germany

Spiritual Care Trainings Provided to Healthcare Professionals – a Systematic Review(Co-Authors:YousefHelo,EckhardFrick)

Background: Recent studies have pointed out thatthere isanurgentneedforcompetencybasedspir-itualcareeducationandpracticaltrainingthatmain-tains the linkbetween spiritual care educationandcarepractice.Toexplainthereasons for incorporat-ingspiritualcareintoeducationalmodelsforhealth-careprofessionalsanelaborationonthespecificsofspiritual care core competencies, teaching andper-formanceassessmentmethodsisneeded.Aims:Thissystematicreviewofavailableliteratureisconducted in order to identify spiritual care educa-tionprovidedtohealthcareprofessionalsandsystem-atically and critically appraise training aims, medi-atedcompetenciesandpredictedoutcomesor/and

measured results. The review concentrates on spir-itualcareeducationprovidedtoundergraduateandgraduate health care professionals alreadyworkingthewards. The review describes the course details,targetgroupandconsidersanypredictedoutcomesand/ormeasured results, such asparticipants’ satis-faction,viewsontheirindividualadvantagesorover-alleffectivenessofprovidedtraining.Methods: 10 databaseswere searched up to 2013Week 27. The search considered original peer-re-viewed journal articles and excluded letters to theeditorsandeditorials,reviews,conferenceabstracts,brief communications, books and thesis. ArticlespublishedinEnglishlanguagewereconsidered.Thesearchexcludedtrainingandinterventionsprovidedto voluntary workers, general public, families, par-entsandethnic/traditionalhealersaswellashealth-careservicesprovidedbyfaithcommunity/parish.Results: After removal of duplicates the electronicsearchingofeachdatabaseresultedin4910hits.Ex-cludingirrelevantarticlesbasedontitleandabstractthetworeviewersestablished60relevantarticlesforthefinalappraisal.Conclusion:Thefindingsofthisreviewleadtoabet-terunderstandingofspiritualcareeducationprovid-edtohealthcareprofessionals.

Dr. Jakub PawlikowskiDepartmentofEthicsandHumanPhilosophy,Medi-calUniversityofLublin,Poland

Beliefs in Miraculous Healings, Religiosity and Meaning in Life

Background: Throughout centuries many interpre-tationsofmiraculoushealingshavebeenofferedbyphilosophers,theologians,physicians,andpsycholo-gists. Different approaches to miracles originatedfrom differences in understanding God (transcend-entorimmanent)andnature(deterministicorinde-terministic) and the relationshipbetweenGodandnature.Despitemany sceptical arguments, a greatmajorityofpeople(approximately70%)inmodernWesternsocietiesshareabelief inmiracles,millionsofsickpeoplepilgrimagetosanctuariesseekingformiraclesandtheVaticanCongregationfortheCaus-esofSaintsproclaimedhundredsdecreesonmiraclesthroughthelastdecades.Theaimoftheresearchwasdescribingthesocialper-ceptionofmiraculoushealings,andtherelationshipbetween beliefs in miraculous healings, religiosityandmeaninginlife.Methods: A survey was conducted on a group of178respondents from18to30yearsold(M=21,5;SD=2,31), 90%Catholics. Respondentswere askedto fill out an anonymous questionnaire contain-ing Duke University Religion IndexDUREL (Koenig& Buessing, 2010); Meaning in Life Questionnaire

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(MLQ),a10-itemmeasureofthePresenceofMean-inginLife,andtheSearchforMeaninginLife(Stegeretal.,2006);BeliefsaboutMiraculousHealingsScale(Wiechetek&Pawlikowki,2012)an8itemmeasureinwhichparticipantsusingLikertscaleratetheirun-derstandinganddefinitionofmiraculoushealings.Results:Resultsindicatethat88%oftherespondentsbelieveinmiracles.ParticipantsmostfrequentlyunderstoodmiraculoushealingsasaresultofGod’saction, lessoften as the effectof still undiscoveredpossibilitiesofthehumanorganismorthenature,andtheleastastheeffectofmedicalambiguousdiagnosisordatamanipulation.Respondents with stronger religiosity and highermeaning in life,morefrequentlybelievethatmirac-uloushealingsareanactofGod(r=0,680,p<0,01;r=0,171,p<0,024)andnottheeffectofsupernaturalpowersactivity(p>0,05).Thoserespondentsarealsoconvinced thatmiraculoushealings arenot anout-come of amedical ambiguous diagnosis (r=-0,458,p<0,01),theeffectofsuggestion(r=-0,516,p<0,01)orunknownnaturallaws(r=-0,433,p<0,01).Conclusions:Religiosity and meaning in life is connected withunderstanding miraculous healings in transcenden-talandnon-naturalisticway.ThesephenomenaaremoreoftenunderstoodascausedbyaspecificBeingratherthanbyanunidentifiedfactor.

Dr. Jakub Pawlikowski & Jaroslaw SakDepartmentofEthicsandHumanPhilosophy,Medi-calUniversityofLublin,Poland&DepartmentofSo-cialPsychologyandPsychologyofReligion,TheJohnPaulIICatholicUniversityofLublin,Poland

Doctors’ Religiosity and Belief in Miracles(Co-Authors:MichalWiechetek,MarekJarosz)

Background: The discussion onmiraculous healinghasbeenpresent forcenturies inphilosophy, theol-ogyandalsomedicine.Nowadays,amiracleisoneofthemostimportantissuesinthedebatebetweenscience and religion. Sometimes, the conviction isexpressed that scientists and physicians do not be-lieve(orshouldnotbelieve)inmiracles.Theaimofthesurveywastoverifythehypothesisthatdoctorsdobelieveinmiraculoushealingsandthatthisbeliefisconnectedwiththeirreligiosity.Method: An anonymous questionnaire consistedof: standardized Polish Scale of Religious Attitudes(SReAt), questions related to the belief inmiracles(understoodasGod’sintervention)andtheobserva-tionofpatients’unexplainedrecoveries.Theresearchwascarriedoutonagroupof324physicians;51%women,49%men;averageworkexperience:17.03years;93%Catholics.

Results: Majority of the physicians (67%) declaredthebeliefinmiracles.Significantdifferencesbetweendoctorswithhighandlowreligiositywereobserved(92% and 27% respectively; χ2 =95,63; p<0,01).Approximately one-fourth of the physicians (27%)declared that they observed miraculous healingsamong their patients. It was related to religiosity(31%inhighreligiositygroupvs14%inlowreligios-itygroup;χ2=6,57;p<0,05)andthelengthofmedi-cal practice (e.g. more frequently among doctorswithlongermedicalpractice;p<0,05).Conclusion:Majorityofthephysicians isopenmind-ed to the transcendent interpretation of patients’unexplained recoveries. Religiosity is an importantfactorshapingdoctors’beliefs inmiraclesandtheirinterpretationofmedicallyunexplainedrecoveries.

Lori Pollard RN, BScNFacultyLecturer,FacultyofNursing,UniversityofAl-berta,Alberta,Canada

Debriefing for Spiritual Growth in Nursing Educa-tion and Practice(Co-Authors:JillVihos,GerriC.Lasiuk)

Debriefingisapedagogicalstrategyusedinnursingeducationtoallowstudentstocreatepersonalmean-ingandisessentialforexperientiallearning.Duringdebriefing, students reflect on their practice andthroughvariousactivities theyareguidedtounder-stand, analyze, and synthesize their thoughts, feel-ings,andbehaviourwiththeintentofapplyingnewlearningtofuturepractice.Debriefingactivitiesmayincludegroupreflection,theprovisionofone-to-onefeedbacktostudentsbyinstructors,anddialogueaf-terinteractionswithpatientsandtheirfamilies.Thepracticeofdebriefingisfundamentaltounderstand-ingwho one is as an individual learner and practi-tioner.Fornursingstudents,recognizingone’sspiritandwhatitpersonallymeanstobeanurseisfounda-tionaltotheirmoralgrowth.Whennursesacknowl-edge their personal identity, they are able to setthemselvesasidetounderstandthelivedexperienceofthepatientstheycarefor.Encouraginglearnerstotalkabouttheirpracticecancontributetopersonaltransformation,professionalgrowthand lead toac-cumulation of nursing knowledge. When nursingstudents can articulatewho they are as profession-als,theycanmeettheirspiritualneeds,andarebet-ter able tomeet the spiritual healthneeds of theirpatients.Debriefingalsosocializesnursingstudentsintopracticethroughrecognizingtheimportanceofestablishing safe spaces to engage in collaboration,caring communication, role clarification and reflec-tionaboutlearningexperienceswithinapeergroup.In nursing education, learning outcomes from de-briefingarereflectedincognitive,affectiveandsocial

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growthoverthedurationof theirnursingprogram.Debriefing learning experiences helps learners toengagewith the lived experience of others and fa-cilitatesappreciatingthehumanityofotherswhichisnecessaryforprovidingsafe,competentcareinnurs-ingpractice.Thepracticeofdebriefingisanessentialcomponentofthenursingstudents’learningprocesstowards their spiritual and professional transforma-tionintobecominganurse.

Waraporn SaisunantararomPharmacist,Mahasarakham,Thailand

The Psychometric Property of WHOQOL-SRPB Thai Version in Chronic Kidney Diseases Stage V Patients(Co-Authors: AreewanCheawchanwattana, Talerng-sakKanjanabuch,MaliwanBuranapatana)

Objectives:TotranslatetheEnglishversionofWorldHealthOrganizationQualityofLife-Spirituality,Reli-giousnessandPersonalBeliefs(WHOQOL-SRPB)intoThailanguageversionandevaluateitspsychometricproperty.Methods: The WHOQOL-SRPB was translated intoThai according to theprotocolofWorldHealthOr-ganization’s translation methodology. The psycho-metricpropertyofWHOQOL-SRPBwasexaminedin63ChronicKidneyDiseasesStageV(CKD-V)patients.ThepsychometricpropertyofWHOQOL-SRPBThaiversionwasevaluatedastheinternalconsistencyreli-ability,Cronbach’salpha,andtheconstructvalidityusing a spirituality concurrent measure, the Func-tionalAssessmentofChronicIllnessTherapy–Spirit-ualWell-Being(FACIT-Sp).ScoresofWHOQOL-SRPBandFacit-Spwereexaminedtheirrelationshipbyus-ingSpearmanRhocorrelation.Results:WHOQOL-SRPBThaiVersionisvalidandreli-able.ThehighvalueofCronbach’salpha(0.94;95%CI 0.92-0.96) of overall WHOQOL-SRPB 32 itemsindicated the high reliability property. The Spear-manRhocorrelationoftotalscoresofWHQOL-SRPBandFacit-Spwas0.73.Thustheexpectedhighcor-relationindicatedtheconvergentvalidity,atypeofconstructvalidity,sincethetwoquestionnairesweredesignedtocapturespirituality.Conclusions:TheThaiversionofWHOQOL-SRPB isa valid and reliable instrument in CKD-V patients.However, there is stillaneed for futureresearchtoexamine other psychometric property within thispopulation, and psychometric property in a wide-spreadofotherThaipatientpopulations.

Dr. Hanneke Schaap-JonkerAss.-Prof Psych of Religion, University Groningen,TheNetherlands

Autism and Religion: Anxiety or Uncertainty? (Co-Authors:BramSizoo,RoanneGlas)

InanexplorativestudyonAutismSpectrumDisorder(ASD)andGodrepresentationsamongDutchortho-doxProtestants,theGodrepresentationwascharac-terizedbymoreanxiety,comparedtopsychiatricpa-tientswithoutASDornon-patients.Themoreautistictraitswerereported,themorethisanxietyincreased.Onanitemlevel,thisanxietywastypifiedbyuncer-tainty(Schaap-Jonker,Sizoo,Schothorst-vanRoekel&Corveleyn,2013).However, inthisstudy it isnotclearwhethertheseanxiousanduncertainfeelingsofthosewithASDarespecifictothereligiousdomain,andwhethertheseGod image traits are specific to thosewithASD; itcouldbethatpatientswithananxietydisorderwillreport comparable feelings in relationship to God.Furthermore,thesamplewhichwasinvestigateddidnotrepresentthegeneralgroupofASDpatients intheNetherlands.Therefore,weperformeda follow-upstudyinwhichpatientswithASDwerecomparedto patientswith an anxiety disorder and a controlgroupofnon-patients.Inthisposter,thefirstresultsofthefollow-upstudywillbepresented.

Katarzyna Skrzypinska

The Threefold Nature of Spirituality Model as an explanation of Health Equilibrum

TheThreefoldNatureofSpiritualityModel(TNS)ex-plainshowspiritualsphereworks.Oneofthemostimportant aspect of human existence iswell-beingandgoodhealth.Manyauthorsaskabouttheinflu-ence of spirituality on these domains (Frankl, An-tonovsky, Koenig). The theoretical premises allowforthepredictionthatpsychologicalcoreofspiritu-alitycanbeconsideredfunctionallyinthethreefoldperspective: 1/ as the cognitive scheme (themostconstrictedunderstanding),2/ as thedimensionofpersonality (the broader understanding), 3/ as theattitudetowardslife(thewidestperspective).TNSmodelisthetryofdescriptionofadynamicna-tureof spirituality in these three functionalaspects.Therapeutic work with cognitive schema as a coreof spiritualitymaybenotenoughto restorehealthequilibrium.Thenextsteptohelpthepatientisworkwithstructuresofpersonalityandhisattitudetolife.Only holistic understanding of spirituality and itsmechanismscangiveproductiveresults intheareaofhumanhealth.

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Posters

Jodi StambackMissouriWesternStateUniversity,USA

Religious Excuse or Religious Immunity? An Anal-ysis of Religion, Veganism and Immunization Choice and Legislation in the United States of America

All50 states in theUnitedStatesofAmerica (USA)contain legislation regarding immunizations of itscitizens primarily targeted to school-aged children.Of these states, 48 allow for religious exemptionswith the exception beingMississippi andWest Vir-ginia.Nineteenstatesallowexemptionsfromimmu-nizationsonthegroundsofphilosophicalandmoraldilemmas.Theseexemptionspresentpotential issuesforthoseindividuals and familieswho are against immuniza-tions for amultitude of reasons including religiousbeliefs. For instance, some immunizations containingredientsobtainedfromporcine,bovine,orstemcells harvested from aborted fetuses. While thesecomponents go directly against the teachings ofsomereligions,whataboutstatesinwhichreligiousimmunitydoesnotapply?Form some individuals, such as Vegans and Veg-etarians, thecomponentsof the immunizationsareequally as offensive.While there are 19 states thatallowexemptions tobemadeonphilosophical ob-jections,31statesdonotallowssuchexemptionstobemade.Thiswould,byvirtueofmoral reasoning,force those in question to claim religious exemp-tions to be excused from the immunization(s). Tocounteractagainstthis,somestateshavelegislationinplacethatensurethatthepetitionerhasclaimedthereligiousexemptionwithanestablishedreligiousorganization, or even on some cases, prove mem-bershiptoaparticularreligiousorganization.Otherstatesallowexceptionstobemadeonthegroundsoftruemoralconcern.Thisstudywillattempttotakeaqualitativeapproachtodeterminingtheefficacyofallowingreligiousandphilosophical exemptions to immunization legisla-tionintheUSA.

Ashley TaylorDukeUniversity,Durham,NC,USA

A Shifting Religiosity: The Spiritual Journeys of Duke University College Students

As a Duke University Cultural Anthropology sen-ior, Ibegan toexplore theways inwhich studentsconduct theirown formsof spiritual exploration inan increasingly secular environment. My researchsuggestedan intriguingtrendamongststudents todevelopapersonalspiritualjourneywithinavarietyof contexts, such as the studyof academics, using

psychedelicdrugs,travelling,aswellasfromwithinaparticular religion.Thesestudentsutilizedtheir spe-cificpracticesorreligiousframeworkfortheultimaterealizationofanindividualspirituality,whichwasnotnecessarilyconcernedwiththeexistenceofGodoraparticularreligiouscommunity.Thisshiftofreligiousexperienceimpliesaculturaltrendamongstthecol-lege-agegenerationthatallowsthemtoinnovativelypursuetheirowncreationofaspiritualpath inthe21stcentury.DukeUniversity,apastMethodistandcurrentlysecu-lar,privatecollegeprovidesaspecificexampleofthelargershiftwithincontemporarysocietyawayfrominstitutionalized forms of religion (Dean 2002, 12).Insteadofsuggestingatotaldeclineofreligiosity,therecentdeclineoftraditionalformsofworshipallowsforaspiritualthrivingwithinamultitudeofdifferentcontexts(Dean2012,14).AlexanderandHelenAs-tin,professorsofhighereducationatUCLA,describespiritualityas“amultifacetedqualitythatinvolvesanactivequestforanswerstolife’sbigquestions.Ithastodowithourinteriorsubjectivelife:thevaluesthatwe holdmost dear, our sense ofwhowe are andwherewecomefrom,ourbeliefsaboutwhywearehere, themeaningandpurpose thatwesee inourworkandourlife,andoursenseofconnectednesstoeachotherandtotheworldaroundus”(AstinandAstin2010,4).Thisdefinitionisseparatefromanun-derstandingofbeingreligious.Forthepurposesofthispaper,religiouswillrefertobelongingtoacertaininstitution,asoneofmyinter-viewees,Kathryn, suggested.My research suggeststhatspiritualityhasbecomeamajorconcernofcol-legestudentsinnewcontextsthatareoftennotex-clusivelyassociatedwithreligiousinstitutions.

Fazilah TwiningSenior Lecturer inMentalHealthNursing, PhD stu-dent,CoventryUniversity,Coventry,UK

What are the Experiences of Spirituality amongst People with Mental Health Problems? Findings from a Systematic Literature Review and the Im-plications for Mental Health Care

Little is known about the experience of spiritualityandmental health from the perspective of peoplewho are struggling with mental health problems.The aim of this presentation is to discuss the find-ingsofasystematicliteraturereviewtoexaminetheresearchonspiritualityandmentalhealth.Thepur-poseofthereviewistounderstandtheexperienceofspirituality andmental health from theperspectiveof serviceusers. Muchof the literature focusesonprofessionals’ understandingof spiritualityhoweverwhereare thevoicesofpeoplewithmentalhealthproblems? The majority of UK research into therelationshipbetween spirituality andmental health

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Posters

considers the main issues from the perspective ofnurses (Pike2011). Nurses’beliefs regarding spir-itualneedsandspiritualcarehavebeenthoroughlyexploredacrossarangeofspecialities.Lessresearchhoweverhasbeenconductedtounderstandspiritu-alityandspiritualcareneedsfromthepatient’sper-spectiveandasa result thepatientvoicehasbeenlostintheevidencebase.ThefindingsindicatethattheevidencebasefromserviceusersisheavilylinkedtoaJudaeo-Christianperspective.Agapwithintheliteratureisthevoicesofpeoplefromotherculturalandreligiousbackgrounds.Professionallynursesarerequiredtopayattentiontospiritualneedsinhealthcareprovision.Despitethisrequirementandthepositivelinksbetweenspiritualexpressionandmentalwellbeing,spiritualneedsfailtobeaddressedincurrentclinicalpractice.Serviceusersinmentalhealthcarewanttotalkabouttheirbeliefs however there remains a fear that spiritualactivity will be pathologised by clinicians as symp-tomsofmentalillnessratherthanacknowledgedasakeyfactorinaperson’srecovery(Gilbert,KaurandParkes2010).Furthermoreresearchfindingssuggestthatspiritualexperiencesofserviceusersareignoredbymental health professionals (Nicholls 2002; Tur-bot2004). Lindridge (2007)argues that cliniciansperceive individuals’ spiritual experiences as causesorsignsofmentalillnessandasaconsequencetheyarereluctanttoapproachthesubject.Thefindingsofthereviewwillbepresentedandtheimplications for mental health practice will be dis-cussed in relation to exploringwaysof connectingwithpeopleandunderstandinghowpeoplewhoareexperiencingdistressmightbebettersupported.

Somporn Kantharadussadee Triamchaisri Thailand

Application Buddhism Practical Concepts to Heal Chronic Illness Patients(Co-Authors:PakvipaWongwan,PramukOsiri)

The prevalence ofmigraine headaches among164Thai monks in Bangkok Metropolis, Thailand was57.9%with53.7%havingsleepproblems,46.3%hadthrobbingpain,68.4%wereinvolvedwithdailyactivities, 59.9% showed left or right hemiplegicheadaches,32.6%resultedfromstress,and58.1%showed moderate to high intensity of headaches.Migraine intensity was positively correlated withsleepinghours(r=0.477,P=0.000).SKT 8 BuddhistMeditation Based InterventionwasusedtohealmigraineheadacheamongThaimonks.Case-control study is designed to collect data be-foreandafterintervention.Resultsshowedthatafterexperiment,migraineheadache among caseswerehealedwithin 15minutes session.Quality of sleep

houralsoimprovedwhencomparetocontrolgroupand before receiving intervention significantly. Thestudysuggeststhatdifferentreligiouscultureshouldbestudiedtoconfirmtheeffectivenessofthismodal-ity.

Lynne E. VanderpotUniversityofAberdeen,Scotland,U.K.

The interrelationship between psychiatric medi-cation and the spirituality of people with mental health problems: A phenomenological explora-tion.

Introduction: Contemporary healthcare continuesto acknowledge the positive benefit of spiritualityformentalhealth.Researchshowshighratesoftheuseofspiritualityasacopingmechanisminpeoplewithmentalhealthproblems.Giventhesharpriseofpsychiatricmedicationuseinthelastquartercentury,itisthoughtthatasignificantportionofthispopula-tionwouldbeprescribedmedication.Todate,littleattentionhasbeengiventotheinterrelationshipbe-tweenpsychiatricmedicationandspirituality.The medicalization of mental health problems hasbeencriticizedforreducinghumansufferingtobio-logical conditionswhich canbe sufficiently treatedbychemicalintervention.Howsuchinterventionsin-teractwithspiritualityisnotyetknown,yetthereisagrowingcallamongresearchersandpractitionerstodocumenthowpsychiatricdrugsaffectpeopleoverlongperiodsoftime.Objective: The aim of this poster is to give a briefreviewoftheliteraturewhichshowsaneedforquali-tative research exploring the patient’s perspectiveregarding the interrelationship between spiritualityand psychiatric medication. Examples from initialfindings inanongoingstudywillbereviewed. It ishopedthatby listeningtothevoicesofthosewhoarelivingspirituallywhiletakingpsychiatricmedica-tion,newinsightswillemergewhichmayinformandimprovetreatmentpractices.Method:HermeneuticPhenomenology.Thismethodisidealforpreservingandraisingthevalueofaper-son’suniquelivedexperience.Hermeneuticphenom-enology isanempowering research strategywhichrecognizes subjective experience as a cornerstoneofknowledge. Itoffersonewayof interpretingthetacit,significantmeaningsconcealedwithinhumanexperience.Discussion:Patientperspectivesareacriticalaspectof evidence based practices. By introducing the in-terrelationship between spirituality and psychiatricmedication, ameaningful conversationmay ensuewhich provides new insight into furthering the ef-ficacyof contemporarymental health and spiritualcarepractices.

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Posters

Prof. Dr. Kurt WeisFormerInstituteofSociology,TechnicalUniversityofMunich,Germany

Body Techniques of Different Cultures for Spiritu-ality, Holistic Experience and Healing

Allsensoryperceptions,allexperiences,alltheknowl-edgeabouttheinnerandouterworldsthuslygained,are made with the body. Which body techniquesandwhich physical structural conditions did or dootherculturesusetodirectinnerprocessesandcon-sciousnessexpandingexperiencesonthesearchforspirituality?Intherediscoveryoftraditionalreligiouscultures,inournewfocusonwellness,insportsandinfashionthebodyis“booming”.Itisalsobeingre-discoveredfor itsabilitytoprovideheightenedspir-itualandphysicalexperiences.The paper addresses a wide range of spiritual dis-ciplines, techniques, rituals and related practices.Some people even run to reach a level of enlight-enment.Seekingenlightenment throughtheirownbodies, e.g., Tendai Buddhistmonks on Japan’s sa-credMountHieicover52.5milesdaily,incredibly,for100-daystretches.Ontheotherside,inourWesternculture,sport-reachingitspinnacleintheOlympics-isregardedprimarilyasacompetitiveenterprise.Incontrast,mosttraditionalcultures(reflectedinsomemoderntrends)practicedbodymasteryandcontroltechniquesforavarietyofotherpurposes,including:1.religiousculturesandmonastictraditionsusefast-ing,silence,meditationandsolitudetogaindeeperinsight, spiritual strength, healing and enlighten-ment;2.variousoldcultures fromMesoamerica totheFarEastusebreathingtechniquesforrelaxation,inner strength, health and spiritual experiences; 3.the highly developed Yoga techniques stemmingfromancientIndiantraditionsaimatenergetic,ther-apeutic and consciousness-widening experiencesand,ultimately,theunificationofhumanandgodlyconsciousness; 4. in traditional Far Eastern martialarts,bodyandmindaretrainedandconditionedtoinfluenceeachother;5. inoldtribalcultures,danc-ing and runningwere used to produce trance-likestatesor toexpandconsciousness;6. religiously fo-cused self-mutilation from the blood rituals of theancient Maya to the medieval flagellants and themoderncrucifixionritualsinthePhilippinesareusedfor penitence, trance, visions and other spiritualexperiences; 7. old andneo-Shamanic cultures usepsychoactive plants to expand states of conscious-nessandforhealing;8.love,theartofsurrenderandmeltingtogether, isoneofthebasicpowersoftheuniverse.Allreligionsaddressit.Christianmysticsre-portedit.Indiantemplesshowit.SpiritualschoolsofTantrateachit;9.inmodernexperientialeducationoradventure therapywithnaturepronesports,wetry to foster innerstabilityandtodevelopmaturityin juveniledelinquentsandeventopmanagers;10.

peopleengaginginmodernextremeandriskysportslookforpeakexperiencesandthesenseandmean-ingof life;11.modern“trendy”sportsusingskate,snow,surforkiteboardsare toutedasprovidingatotallynewsensationofafloatingandglidingbodybetweenstrainandrelaxation;12.onlytheancientandmodernOlympic Games are not interested inanytranscendenceorspirituality.Theyhavebeenor-ganizedprimarilytoensurethefameofthewinners,thefunofthespectatorsandthefinancesofpromot-ersandthemedia.This paper analyzes themethods and the goals ofall twelve approaches tousing thehumanbody. Itthusshedslightonthereligiouslyandculturallydif-ferentwaystoholisticandspiritualexperiences.Theauthorincludesreportsonhisownexperiences.Hespentthefirstfourweeksof2014intheAmazonjun-gleandwillalsotelltheaudience,howhewasable,withthehelpofthenativeshamansandtheirmasterplants,tocurehisprostatecancer.

Robert WhitleyDouglas Mental Health University Institute, McGillUniversity,Montreal,Canada

The Bio-Bio-Bio model of Psychiatry: What Room for Religion and Spirituality?(Co-Authors:RobWhitle,AnnaMiller)

Many commentators have argued that the tradi-tional‘bio-psycho-social’modelofmentalillnesshasnowbeen replacedby a ‘bio-bio-bio’model ofge-netic causation,braindisease andpharmacologicalintervention. This begs the question, how can reli-gionandspiritualitybeintegratedintoapsychiatrythat is becoming overwhelmingly biological? Theauthorsarguethatwidertrendsinmedicineandre-habilitation science canbeharnessed to justify thebetter integration of spirituality and religion intomental health care.Wewill discuss three trends inthisregard,thesebeing(i)theincreasingpopularityoftherenewedconceptof‘recovery’,whichtakesaholisticperspectiveonmentalhealth care; (ii) callsformore‘person-centredcare’and‘culturalcompe-tence’,whichbydefinitionmaynecessitateattentiontopatients’religiousandspiritualneeds;(iii)theim-perativetopracticeevidence-basedmedicine,whichmustipsofactoconsiderthestrongevidencebasedindicatingthetherapeuticroleofreligionandspiritu-ality.Itisourcontentionthatthesewidertrendswith-inmedicinecanbedeployedtoensurethatreligiousandspiritualperspectivesonhealingare integratedintoeverydaypsychiatriccare.

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Posters

Kayla WingMissouriWesternStateUniversity,USA

Tweet, Pray, Lift: Social Media and Religion’s Af-fect on Perceived Physical Health

Inaworldthatreliessoheavilyonsocialinteraction,it is important tounderstandhowsocialmedia im-pactsareasofhuman life.Themostbasicdesireofhumannatureistofeelasenseofbelongingorhavesomeformofgroupidentification.Thisstudyappliesthenotionofcommunitytotheperceptionofone’sphysical health. In addition to physical health, reli-gionisexamined.Theaffectsofreligiousbeliefsandpracticesareappliedtophysicalhealthperceptionsandsocialmediausage.Thisisimportantsincemanypeopleseekbothreligiousandphysicalhealthinfor-mationonvarioussocialmediaoutlets.Thedataforthis studywas collected from participants (n=124)whocompletedanonlinesurvey.Socialmediausageandreligionarecomparedandcontrastedtobetterunderstand if and what influences one’s perceivedphysicalhealth.The studyexamines if andhow re-ligion and perceived physical health affect an indi-vidual’ssocialmediausage.

KeyWords: Religion, Socialmedia, physical health,physicalactivity

Dr. Elisabeth Ansen ZederPsychologist,Villars-sur-Glane,Switzerland

Implementation of a Philosophical Community of Inquiry (PCI) in an Intermediary Care Institution(Co-Author:JoëlleGaillardWasser)

This researchProject aims the implementationof aPhilosophical Community of Inquiry (PCI) in an in-termediarycareinstitutionforpatientssufferingfromtemporarypsychoneurosis,basedonthefoundationsofdifferenttheoriesandclinicalpractices.First,werefertotherecentphilosophicalpracticesofclinicalpsychologists(suchasreportedbyCinq-Mars,C. 2005; Ribalet, J., 2008 ; Loison-Apter, E. 2010 ;Remacle,M.&François,A.2011)whousePCI inaclinicalperspective.Second, concerning practical psychotherapy, exis-tentialanalysisorlogotherapy(Frankl,2006;Yalom,I,2008)isused.Third,werefertothebranchofpositivepsychologywhichfocusesonoptimizingtheforcesthatencour-agehumanbeingstoexercisetheirinbuiltefficiency,theiremotionalandcognitivemanagementanddis-covertheirtalents,therebyincreasingtheirdevelop-ment and learning capacity enabling them todealwiththeirsuffering(Seligman,1992;SeligmanandPeterson,2004).Fourth,concerningcare,aholistic

approachtorecoveryandtheimportanceofthisap-proachbyProvencher(2002).Furthermore, we advocate the rehumanisation ofpsychotherapy that incorporates existential ques-tions in relationwith a transcendentor spiritual di-mension as an integral part of our humanity. Thework of researchers such as Huguelet (2003) andBrandt(2010),aswellasthepsychiatristHell(2002)formourbasis.Thisresearchprojectseeksaqualitativeandexplora-toryapproachinordertoanswerthefollowingques-tion:Whatareexpectedoutcomesfortherehabilita-tionoftheparticipantsinaPCI?InMay 2014, the conditions necessary for the im-plementationof theproject in the aforementionedenvironmentwillbedescribed.

KeyWords:PhilosophicalCommunityofInquiry;Re-covery;PhilosophyandCare;SpiritualityandCare;PositivePsychology

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GeneralInformation

The Conference Venue

Address:

Faculty of Health Sciences, University of Malta,

South Auditorium, Education and Management Block, Mater Dei Hospital;

B´Kara Bypass, B´Kara MSD 2090

The graphic below shows the Conference Venue which belongs to the Faculty of Health Sciences

of the University of Malta.

The South Auditorium is part of the red buildings.

Organized by:

Research Institute for

Spirituality and Health

&

Faculty of Health Sciences,

University of Malta