Wellness Check: Spirituality

Religious communities may have played both beneficial and detrimental roles during the COVID-19 pandemic

1. In response to the COVID-19 pandemic, religious communities have had a positive impact through collaboration with government, cancelling in-person gatherings, and adapting to virtual meetings.

2. Alternatively, certain religious communities have played a detrimental role during the COVID-19 pandemic by increasing transmission and promoting mistrust/misinformation toward public health guidelines.

Evidence Rating Level: 2 (Good)

Historically, religious communities have played a major role in society’s response to epidemics. Recently, the COVID-19 pandemic has led religious communities to respond in various ways; yet, these have yet to be synthesized. As a result, the objective of the present systematic review was to summarize the roles that religious communities have played with respect to the transmission, mitigation and/or adaptation during the early stage of the COVID-19 pandemic (from December 2019 to July 2020).

Of 1000 identified records, 58 were included in the final analysis from database inception to July 2020. Articles were included if they reported epidemiological evidence of the roles that religious communities played in the transmission, mitigation and/or adaptation of COVID-19. Studies were excluded if they were thesis dissertations, pharmacological, or biochemical studies. The summary of findings was performed narratively, reporting outcomes of interest, relevant inferential statistics, and relationships between religion and COVID-19 outcomes.

Results demonstrated that in response to the COVID-19 pandemic, religious communities have had a positive impact through collaboration with government, cancelling in-person gatherings and adapting to virtual meetings. Alternatively, certain religious communities have played a detrimental role during the COVID-19 pandemic by increasing transmission and promoting mistrust/misinformation toward science and public health guidelines. However, the study was limited by the absence of risk of bias assessment due to the novelty of the COVID-19 pandemic and the desire to include all immediately available studies. Despite this, the present study provides insight on how various religious communities have responded in the early stage of the COVID-19 pandemic and inform strategies for future pandemics.

Human Papillomavirus self-sampling may be a culturally-sensitive alternative for Muslim women

1. This study identified positive aspects of Human Papillomavirus (HPV) self-sampling, included privacy and modesty, convenience, increased comfort and decreased pain amongst Muslim women.

2. The negative aspects of HPV self-sampling included religious taboo, low self-confidence in administering the test, and the perceived cost.

Evidence Rating Level: 2 (Good)

Although cervical cancer is a preventable disease with the appropriate screening tests, religious and cultural factors may lead certain women to forego screening. Muslim women in particular have been found to be more likely to have a late presentation of female cancers due to cultural factors. HPV self-sampling may provide a culturally sensitive alternative; however, its acceptance among Muslim women has not yet been studied. As a result, the objective of the present systematic review was to summarize the perceptions of Muslim women with respect to HPV self-sampling.

Of 98 identified studies, 7 (participant range from 30-839) were included in the final analysis from 2016-2020. Studies were included if they evaluated the acceptance of HPV self-sampling among Muslim women. Studies were excluded if they evaluated perception of cervical cancer screening in general. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies. Data analysis was done using the thematic analysis method.

The results demonstrated that the positive aspects of HPV self-sampling included privacy and modesty, convenience, increased comfort, and decreased pain among Muslim women. Alternatively, the negative aspects of HPV self-sampling included religious taboo, low self-confidence in administering the test and the perceived cost. However, this study was limited by the inclusion of only one study that used a qualitative method which would have aided in understanding the underlying reasons and concerns of Muslim women. Nonetheless, this study was the first to synthesize the acceptance of the HPV self-sampling test among Muslim women and provides insight into its potential clinical utility.

Meaning-centered play may increase spiritual sensitivity of children

1. In this study, mean post-test scores of spiritual sensitivities increased significantly in the intervention group.

2. Furthermore, the control group did not have a statistically significant post-test difference in spiritual sensitivity.

Evidence Rating Level: 2 (Good)

Spirituality represents a significant component of health, especially in early childhood. Play is a strategy that has shown to improve children’s social skills and creativity; however, little is known about its relationship with the development of spirituality. As a result, the present randomized controlled trial (RCT) sought to evaluate the effects of meaning-centered play on children’s spiritual sensitivity.

The present two-group RCT included 120 of 150 eligible children from May 2016 to January 2018 in Iran. Children were recruited using convenience sampling and were eligible if they were 10-11 years old and had no serious physical or mental health problems. Children were excluded if they failed to attend one or more sessions of the intervention. The intervention consisted of twelve 45-minute sessions for 6 weeks and consisted of a program aimed at familiarizing children with spiritual concepts. The control group had the current trend of the center’s plays and programs. Spiritual sensitivity was measured using the Spiritual Sensitivity Scale for Children (SSSC) before and after the intervention. Data was analyzed using Chi-square, independent-sample t test, Mann-Whitney U and Wilcoxon signed-rank tests.

Results demonstrated that following the intervention, the mean post-test scores of spiritual sensitivities increased significantly in the intervention group. Furthermore, the control group did not have a statistically significant post-test difference in spiritual sensitivity. However, this study was limited by the self-reporting nature of the study tool. Nonetheless, the accurate game design, inclusion of multiple experts, and the quality of the tool used to measure spiritual sensitivity strengthen the results of the study.

Islamic-Based Interventions may improve both depression and anxiety

1. In this study, an Islamic religion-based intervention termed “remembrance and seeking Allah’s forgiveness intervention”(RSAFI) significantly reduced levels of anxiety in women and depression in men compared to control.

2. Additionally, participants reported improvement in their general health following the intervention.

Evidence Rating Level: 3 (Average)

Emerging literature has demonstrated the effectiveness of religion-based interventions in treating mental illnesses. Muslims experience anxiety and depression differently than other populations and may rely on religion-based interventions for treatment. Since previous studies have not adequately assessed its efficacy, the present randomized controlled trial (RCT) sought to investigate the efficacy of an Islamic religion-based intervention (RSAFI) among Muslim patients in Malaysia.

The present single centre RCT included 62 patients (n=55.5% female) from a target population of 400 patients in Malaysia in 2020. Patients were selected using convenience sampling and included if they scored highly on depression and anxiety scales. They were subsequently divided by gender into 2 groups. Women who suffered from anxiety were randomly assigned to an experimental group (n=15) or a control group (n=15). Men who suffered from depression were randomly assigned to an experimental group (n=15) or a control group (n=17). Anxiety and depression were measured using the Taylor Manifest Anxiety Scale and Beck Depression Scale, respectively. Participants completed 30 sessions of RSAFI, which focused on moral and religious concepts. The control groups received the energy path program provided by the center. Data was analyzed using the analysis of covariance (ANCOVA).

Results demonstrated that RSAFI significantly reduced levels of anxiety in women and depression in men compared to the typical care control groups. Furthermore, participants reported improvement in their general health following the intervention. However, the study was limited by the restriction of anxiety and depression to women and men respectively, as well as the small sample size. Nonetheless, the present study demonstrated evidence that religious interventions may play a role in improving the mental health of Muslim men and women.

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