As people age, they usually develop chronic diseases (e.g., cataracts), some of which can be painful (i.e., degenerative joint disease). In addition, eventually all succumb to a terminal illness, which may be painful (e.g., prostate or breast cancer with bone metastases). However, spiritual activity may help prevent some common chronic diseases (e.g., hypertension) and may alleviate the pain associated with conditions that develop (23).
When pain occurs, patients typically seek relief, often resorting to spirituality. For example, in a study of hospitalized patients experiencing pain, spiritual activity was used almost as often as analgesics (62% vs 67%, respectively) (24). Similarly, patients with a painful chronic disease (i.e., rheumatoid arthritis) often use spirituality (25). But, does spiritual activity (e.g., prayer) really help?
At least 34 studies have assessed the relationship between spirituality and health outcomes; almost all reported a beneficial effect (26). In addition, 10 studies specifically evaluated the relationship between spirituality and pain. Of these, three (one randomized controlled trial) found that spirituality was associated with alleviation of pain (27). For example, among patients with pain due primarily to rheumatological conditions, spiritual activity was associated with less pain and improved coping with pain (28). Similarly, in women with gynecologic cancer, fear (including fear of pain) was the most prominent symptom, with a large portion (76%) of the women using spiritual activity to alleviate their fear (29).
Thus, patients experiencing pain use spirituality almost as often as they use analgesics. As pain intensifies, so does the spiritual activity (prayer increases as pain increases). Although data are sparse, pain seems to diminish in response to spiritual activity. But, does spirituality still help as hope for a cure diminishes? For example, does prayer help the clearly terminal patient?
Spirituality is often used as a coping strategy by patients with incurable diseases. For example, among patients admitted to a nursing home, 86% used spirituality (e.g., prayer, Bible reading) as a means to cope with declining health (30). Use of spirituality by patients nearing death likely helps because spiritual activity is associated with improved mood (31) and provides hope (of an afterlife, of seeing loved ones again in heaven) (32).
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