https://www.commed.vcu.edu/Chronic_Disease/2012/cochranrvwrschbias.pdf

The Cochrane Collaboration's tool for assessing risk of bias in randomised trials

Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs? Issues: Selection, maturation, history, mortality, testing, regression towrd the mean, selection by maturation, treatment by mortality, treatment by testing, measured treatment variables Increase: Eliminate the threats, above all do experimental manipulations, random assignment, and counterbalancing.

Reliability and validity

Empirical studies have identified significant links between religion and spirituality and health. The reasons for these associations, however, are unclear. Typically, religion and spirituality have been measured by global indices (e.g., frequency of church attendance, self-rated religiousness and spirituality) that do not specify how or why religion and spirituality affect health. The authors highlight recent advances in the delineation of religion and spirituality concepts and measures theoretically and functionally connected to health. They also point to areas for areas for growth in religion and spirituality conceptualization and measurement. Through measures of religion and spirituality more conceptually related to physical and mental health (e.g., closeness to God, religious orientation and motivation, religious support, religious struggle), psychologists are discovering more about the distinctive contributions of religiousness and spirituality to health and well-being.

http://psych415.class.uic.edu/Readings/Hill,%20Conceptualization%20of%20spirituality,%20AmPsy,%202003.pdf

Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and mental health research.

The investigation of spiritual/religious factors in health is clearly warranted and clinically relevant. This special section explores the persistent predictive relationship between religious variables and health, and its implications for future research and practice. The section reviews epidemiological evidence linking religiousness to morbidity and mortality, possible biological pathways linking spirituality/religiousness to health, and advances in the assessment of spiritual/religious variables in research and practice. This introduction provides an overview of this field of research and addresses 3 related methodological issues: definitions of terms, approaches to statistical control, and criteria used to judge the level of supporting evidence for specific hypotheses. The study of spirituality and health is a true frontier for psychology and one with high public interest.

https://psycnet.apa.org/journals/amp/58/1/24.pdf

Spirituality, religion, and health. An emerging research field.

This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.

/pdf/religion-spirituality-and-health-the-research-and-clinical-3g4ye41fgm.pdf

Religion, Spirituality, and Health: The Research and Clinical Implications

Plante, Sherman, Research on Faith and Health: New Approaches to Old Questions. Part I: Faith and Health in the General Population: Research and Theory. Thoresen, Harris, Oman, Spirituality, Religion, and Health: Evidence, Issues, and Concerns. McCullough, Religious Involvement and Mortality: Answers and More Questions. Wink, Dillon, Religious Involvement and Health Outcomes in Late Adulthood: Findings from a Longitudinal Study of Women and Men. Worthington, Berry, Parrott, Unforgiveness, Forgiveness, Religion, and Health. Sherman, Simonton, Assessment of Religiousness and Spirituality in Health Research. Part II: Faith and Health in Special Populations. Sherman, Simonton, Religious Involvement Among Cancer Patients: Associations with Adjustment and Quality of Life. Remle, Koenig, Religion and Health in HIV/AIDS Communities. Willis, Wallston, Johnson, Tobacco and Alcohol Use among Young Adults: Exploring Religious Faith, Locus of Health Control, and Coping Strategies as Predictors. Plante, Sharma, Religious Faith and Mental Health Outcomes. Part III: Faith and Health in the Clinic. Chirban, Assessing Religious and Spiritual Concerns in Psychotherapy. Tan, Dong, Spiritual Interventions in Healing and Wholeness. Shafranske, Religious Beliefs, Attitudes, and Personal and Professional Practices of Physicians and Psychologists Specializing in Rehabilitation Medicine. Part IV: Commentaries on Research Concerning Faith and Health. Sloan, Bagiella, Powell, Without a Prayer: Methodological Problems, Ethical Challenges, and Misrepresentations in the Study of Religion, Spirituality, and Medicine. Smith, Religion and Spirituality in the Science and Practice of Health Psychology: Openness, Skepticism, and the Agnosticism of Methodology. Sherman, Plante, Conclusions and Future Directions for Research on Faith and Health.

Faith and Health: Psychological Perspectives

Although religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, a meta-analysis of the relation between R/S and patient-reported physical health in cancer patients was performed. A search of PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library yielded 2073 abstracts, which were independently evaluated by pairs of raters. The meta-analysis was conducted for 497 effect sizes from 101 unique samples encompassing more than 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and 'other' dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher z scores) were calculated with generalized estimating equations with robust variance estimation. Overall R/S was associated with overall physical health (z = 0.153, P < .001); this relation was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z = 0.167, P < .001), functional well-being (z = 0.343, P < .001), and physical symptoms (z = 0.282, P < .001). Cognitive R/S was associated with physical well-being (z = 0.079, P < .05) and functional well-being (z = 0.090, P < .01). 'Other' R/S was associated with functional well-being (z = 0.100, P < .05). In conclusion, the results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients' religious and spiritual needs as part of comprehensive cancer care.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.29353

Religion, spirituality, and physical health in cancer patients: A meta-analysis.

Objective To evaluate the reliability and validity of a new, disease-specific quality-of-life measure for patients with head and neck cancer: the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire—QLQ-H&N35. Design Cross-sectional study using questionnaire data and medical chart review. Setting Academic tertiary care otolaryngology clinic. Participants One hundred twenty ambulatory patients, including 30 patients with advanced head and neck cancer in each of the following stages of treatment: (1) prior to treatment, (2) during active treatment, (3) within 6 months of completing treatment, and (4) more than 6 months after completing treatment. In addition, (5) a comparison group of 40 patients without malignant disease was included (total sample, N=160). Main Outcome Measures Scores on EORTC Quality of Life Core Questionnaire (QLQ-C30) and head and neck module (QLQ-H&N35), Profile of Mood States, and Impact of Events Scale. Results The QLQ-H&N35 demonstrated acceptable reliability (internal consistency). It successfully discriminated between cancer patients and the comparison group, and among subgroups of cancer patients at different phases of treatment (construct validity). The instrument was sensitive to the effects of radiation treatment and to site of disease. Its low-to-moderate correlations with the EORTC core questionnaire indicated that the QLQ-H&N35 provided unique information (discriminant validity). Scores were significantly associated with a number of demographic variables. Conclusion Results support the use of this disease-specific measure to assess quality of life among patients with advanced head and neck cancer.

https://jamanetwork.com/journals/jamaotolaryngology/articlepdf/404513/ooa8397.pdf

Assessing quality of life in patients with head and neck cancer: cross-validation of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Head and Neck module (QLQ-H&N35).

Background: The incorporation of chemotherapy and radiation, either sequentially or concurrently, has been increasingly used for organ preservation in patients with advanced laryngeal cancer. Traditional outcome measuresofclinicalresponsesuchaslocoregionalcontroland survival have been similar for patients treated with chemoradiotherapy and those treated with total laryngectomy (TL). The impact of concurrent chemoradiotherapy for laryngeal preservation on the overall quality of life (QOL) of patients has not been clearly evaluated, particularly in direct comparison with TL. Objective:TocomparetheQOLofpatientstreatedwith concurrentchemoradiotherapywiththosetreatedwithTL. Design: Nonrandomized, retrospective, cross-sectional study. Setting: Academic tertiary care referral center. Methods: The study included 42 patients with advanced stage III or IV cancer of the larynx, who were treated with either concurrent chemoradiotherapy or TL with postoperative radiation therapy. Patients had to be without evidence of recurrence and to have completed therapy at least 3 months prior to inclusion in the study. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–C30 (EORTC QLQ-C30) in tandem with the head and neck module (EORTC QLQ-H&N35).

https://jamanetwork.com/journals/jamaotolaryngology/articlepdf/647797/ooa30129.pdf

Quality of Life for Patients Following Total Laryngectomy vs Chemoradiation for Laryngeal Preservation

Growing interest has focused on relationships between health and religious coping among cancer patients. However, little is known about the health correlates of negative or conflicted religious responses. The current study examined general religiousness and two modes of cancer-specific religious coping, drawing closer to faith (positive) and struggling with faith (negative), among 213 multiple myeloma patients evaluated at the same point in treatment, during their initial work-up for autologous stem cell transplantation. The outcomes assessed included standardized measures and clinician ratings of depression, general distress, physical functioning, mental health functioning, pain, and fatigue. Results indicated that, after adjusting for relevant control variables, negative religious coping was associated with significantly poorer functioning on all outcomes but one: depression, distress, mental health, pain, and fatigue. Neither general religiousness nor positive religious coping was significantly related to any of the outcomes measured. Results highlight the role of negative or ambivalent religious responses to illness.

Allen C. Sherman

Papers

Faith and Health: Psychological Perspectives

Religion, spirituality, and physical health in cancer patients: A meta-analysis.

Assessing quality of life in patients with head and neck cancer: cross-validation of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Head and Neck module (QLQ-H&N35).

Quality of Life for Patients Following Total Laryngectomy vs Chemoradiation for Laryngeal Preservation

Religious struggle and religious comfort in response to illness: health outcomes among stem cell transplant patients.