Tag: spirituality

Categories : Mental HealthTags :

Visions of Nonphysical World are Common Among Cognitively Healthy American Indians

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Visual hallucinations are common among people with Lewy body dementia and other types of dementia. Identifying visual hallucinations is an important component of a wide variety of medical and psychiatric diagnoses and treatments, but without cultural context, some patients’ symptoms can be misinterpreted or misdiagnosed.

There is little in medical literature about normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. University of Minnesota Medical School researchers sought to understand how the culture and spirituality of the American Indian Ojibwe tribe affect a doctor’s assessment of normal aging.

Publishing in JAMA Network Open, the research team found that visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. 

“Consideration of a patient’s cultural background and belief system can help avert erroneous disqualification for disease-modifying therapy, exclusion from clinical trials and all the negative ramifications associated with a misdiagnosis of psychiatric disease,” said William Mantyh, MD, an assistant professor at the University of Minnesota Medical School and  behavioural neurologist with M Health Fairview.

In partnership with an Ojibwe Tribal Nation in Minnesota, the study recruited 33 cognitively healthy tribal elders aged 55 years or older. The research found 48% of participants reported frequent transient visions of the nonphysical world that generally were benevolent and involved spiritual beings and/or ancestors. 

According to the research team, clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease. 

“Today’s environment of infrequent or insufficiently short cognitive evaluations – an average 16-minute face-to-face visit with a physician and increasing use of pre-visit symptom checklists increase the risk of falsely attributing a spiritual experience to a hallucination,” said Dr Mantyh. 

Dr Mantyh and his research team’s overarching goal is to ensure accurate diagnosis of neurodegenerative disease in American Indian communities. To reach this goal, the research team is including American Indian participants in the development of a new Alzheimer’s disease blood test. So far, more than 250 participants have been included. These new Alzheimer’s disease blood tests, up to 95% accurate, directly detect the proteins related to Alzheimer’s disease in the blood, but they also look at a patient’s APOE ε4 gene. APOE ε4 is the most significant genetic risk factor for Alzheimer’s disease, but its effect on Alzheimer’s disease depends on a patient’s ancestry. 

Source: University of Minnesota

Categories : Ethics and LawTags : 1 Comment

Terminally Ill Patients Need More than Prayer from Spiritual Leaders

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A study conducted among advanced cancer patients in Soweto has found that most patients who received palliative care and are at the end of life, have spiritual needs beyond regular prayers from spiritual leaders. Furthermore, patients who received religious or spiritual care had less physical pain, used less morphine and had higher odds of dying where they wish than those who did not.

The study involving 233 participants was conducted by a team of local and international experts led by Wits researchers.

Lead researcher Dr Mpho Ratshikana-Moloko from the Centre for Palliative Care in the Faculty of Health Sciences at Wits University says that previous research has shown that religion and spirituality are important to most patients facing life-threatening illnesses. However, this study probed further.

Using the African Palliative Care Association Palliative Outcome Scale, the research confirmed previous international findings that nearly 98% of the participants had a religious or spiritual need.

The most common spiritual need expressed by patients in Soweto was “seeking a closer connection with their God” and “forgiveness for sins”, says Ratshikana-Moloko. This finding is of significance because it calls on faith leaders to provide relevant support that responds to the needs of patients. This research-led intervention empowers leaders to move beyond prayer, explains Ratshikana-Moloko.

“This is the first study to assess the spiritual and religious needs, and religious and spirituality care provided to advanced cancer patients who received palliative care in Soweto,” says Ratshikana-Moloko.

Since the study was concluded in 2018, Wits University has developed a course in Spiritual and Chaplaincy in Palliative Care. The first cohort of faith leaders from all religious backgrounds completed in September 2023.

Palliative care to increase

Palliative care is one of the key pillars in illness management among terminally ill patients who are judged by a specialist physician as unlikely to benefit from curative-intent therapy. Often, patients are unlikely to survive beyond six months.

The South African National Policy Framework and Strategy for Palliative Care (2017–2022) incorporates spirituality into health care. However, palliative care services in South and southern Africa and elsewhere, rarely address these needs, despite available policies, guidelines and evidence.

“We have to implement what we know. The integration of spiritual care within the clinical care setting is recommended,” Ratshikana-Moloko.

South Africa faces a heavy burden of communicable and non-communicable diseases. One in six deaths globally is due to cancer, and cancer diagnoses are expected to increase by 70% in the next two decades, especially in low- and middle-income countries.

“Failure to identify and address the religious and spiritual needs of terminally-ill patients may increase distress and suffering,” Ratshikana-Moloko.

Categories : Cardiovascular DiseaseTags :

Religiosity-based Stress Linked to Cardiovascular Risk in South Asians

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In a new study, the Study on Stress, Spirituality and Health (SSSH) linked proteomics from religiosity-based stress to cardiovascular disease (CVD) risk markers. This study marks the first investigation of protein levels associated with religion and spirituality in any group.

South Asians have an elevated CVD risk compared to other racial/ethnic groups, with the biological risk factors attributable to type 2 diabetes risk factors, and the rest stemming from traditional risk factors which show no enhancements as compared to other racial/ethnic groups.

“Before we can develop the best interventions to reduce CVD disparities, we need to understand the biological pathways through which health disparities are produced,” said principal investigator and co-senior author Alexandra Shields, PhD, associate professor of Medicine at Harvard Medical School (HMS). “As this study shows, psychosocial factors—and religious or spiritual struggles in particular—can affect biological processes that lead to CVD in this high-risk population. Spirituality can also serve as a resource for resilience and have a protective effect. Given that many of the minority communities that experience higher levels of CVD also report higher levels of religiosity and spirituality, studies such as the SSSH may help identify new leverage points, such as spiritually focused psychotherapy for those in spiritual distress, that could reduce risk of CVD for such individuals.”

The study had 100 South Asian participants, 50 diagnosed with CVD and 50 without. The participants were drawn from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, which is following 1164 South Asian participants to investigate the factors that lead to heart disease among this racial/ethnic group. Three proteins were found to be involved in CVD risk after adjustment for diabetes (Contactin-5 [CNTN5], Low affinity immunoglobulin gamma Fc region receptor II-a [FCGR2A], and Complement factor B [CFB]), and of these, the expression of two (Contactin-5 and Complement factor B) were slightly modified by religious struggles interacting with adverse life events.

The results indicate that there may be unique protein expressions associated with CVD among individuals of South Asian descent, and these associations may be affected by religious struggles, such as feeling abandoned by God. “Understanding the pathways of this mechanism at the molecular level using proteomics technology is crucial to developing potential interventions that can help reduce CVD incidence in this population,” says Long H. Ngo, PhD., lead author and co-director of Biostatistics in the Division of General Medicine at BIDMC and associate professor of Medicine at HMS.

Co-senior author Towia Libermann, PhD, at Beth Israel Deaconess Medical Center, added: “The kinds of blood-based protein biomarkers used in this study are particularly effective in assessing CVD risk because they carry clinical information about risk of disease and are the most commonly used molecules for diagnostic applications.

Source: Medical Xpress

Journal information: Long H. Ngo et al, Plasma protein expression profiles, cardiovascular disease, and religious struggles among South Asians in the MASALA study, Scientific Reports (2021). DOI: 10.1038/s41598-020-79429-1