The objective of this meta-analysis was to determine the longitudinal positive effect of religion or spirituality (R/S) on mental health. We summarized 48 longitudinal studies (59 independent samples) using a random effects model. Mental health was operationalized as a continuous and a dichotomous distress measure, life satisfaction, well-being, and quality of life. R/S included participation in public and private religious activities, support from church members, importance of religion, intrinsic religiousness, positive religious coping, meaningfulness, and composite measures. The meta-analysis yielded a significant, but small overall effect size of r = .08 (95% CI: 0.06 to 0.10). Of eight R/S predictors that were distinguished, only participation in public religious activities and importance of religion were significantly related to mental health (r = .08 and r = .09, respectively; 95% CI: 0.04 to 0.11 and 0.05 to 0.12, respectively). In conclusion, there is evidence for a positive effect of R/S on mental health, but this effect is small.

In the current study, we investigated the psychometric properties of a Dutch translation of the posttraumatic growth inventory in a heterogeneous group of cancer patients. Its original five-factor structure was maintained. The internal consistency of the total scale, as well as its subdimensions, was satisfactory. As expected, the experience of posttraumatic growth was positively related to: emotional expression about the illness, openness to experience, and feelings of innerness. Furthermore, the scale appeared to be sensitive for the demographics age and gender. The experience of posttraumatic growth was not related to negative feelings such as avoidance, anxiety, depression, and neuroticism. Our Dutch translation of the instrument appeared to be a sound measure for the experience of posttraumatic growth in cancer patients.

Insecurely attached patients trusted their physician less than securely attached patients, and in turn were less satisfied with their physician. Their higher levels of general distress were not related to their lower levels of trust. Attachment theory provides a framework to interpret differences in patients' trust, satisfaction and distress, and may help physicians respond in such a way that their patients feel secure, which in turn is expected to result in better health outcomes.

We investigated the psychometric properties of a Dutch translation of the Personal Meaning Profile in a heterogeneous group of cancer patients. Our study resulted in a relatively short scale consisting of 39 of the 57 original items, divided into 5 factors, labeled 'relation with God'; 'dedication to life'; 'fairness of life'; 'goal-orientedness' and 'relations with other people', which can be summed to a total score of the experience of meaning in life. The internal consistency of the total scale as well as of its sub dimensions was high. The experience of meaning in life was positively related to feelings of psychological well-being and negatively to feelings of distress. Furthermore, the experience of meaning in life was also related to trait-like characteristics as personality. Future research can investigate its appropriateness for other populations than cancer patients, and if and how the experience of meaning in life eventually changes as a result of existential threats.

Implementing screening proved inefficient for recruiting distressed cancer patients post-treatment to a randomized controlled trial on PST, with need for services being much less than anticipated. Consecutively screening patients did not result in a sample representative of the larger pool of distressed patients, which may lower generalizability. An adequately powered intervention trial using screening requires a feasibility study establishing recruitment rates and dedicated, funded staff assistance.

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Purpose: This study aimed to explore factors that influence participants' perceptions of the therapeutic alliance with healthcare professionals; their participation in the alliance; and their commitment to treatment in a multidisciplinary pain rehabilitation setting. Materials and methods: A qualitative research-design was used and 26 participants in a multidisciplinary pain rehabilitation program were interviewed in-depth. Results: Initially, participants reported to be satisfied with their healthcare professionals. After deeper reflection on the therapeutic alliance, several unspoken thoughts and feelings and relational ruptures emerged. Almost all participants mentioned a history of disappointing and fragmented healthcare, and they reported on how this affected their cognitions, perceptions, and beliefs about the current program. Participants felt insufficiently empowered to voice their concerns and regularly chose to avoid confrontation by not discussing their feelings. They felt a lack of ownership of their problems and did not experience the program as person-centered. Conclusions: Several factors were found that negatively influence the quality of therapeutic alliance (agreement on bond) and efficacy of the treatment plan (agreement on goals and tasks). To improve outcomes of pain rehabilitation, healthcare professionals should systematically take into account the perceptions and needs of participants, and focus more on personalized collaboration throughout the program offered. ä IMPLICATIONS FOR REHABILITATIONDifferences in perceptions and experiences of pain, together with differences in beliefs about the causes of pain, negatively influence the therapeutic alliance. When participants and healthcare professionals operate from different paradigms, it is important that they negotiate these differences. From the perspective of participants, a clear-cut organization of healthcare that encourages collaboration is required. It is important to focus on personalized collaboration from the start and during treatment, and to recognize and discuss disagreement on diagnosis and treatment plans. During this collaboration, healthcare professionals should systematically take into account the perceptions and needs of the participants.

Aim: To explore perceptions and preferences of children, parents, and physical therapists regarding the therapeutic alliance in pediatric physical therapy in a rehabilitation setting. Methods: Qualitative phenomenological analysis of interviews with children (n ¼ 10), their parents (n ¼ 10), and physical therapists (n ¼ 10). Results: Three themes were identified: importance of trust in the physical therapist, transparency in sharing information, and negotiation concerning goals and tasks of treatment. Parents considered trust in the therapist's relational skills of greater importance to the therapeutic alliance than the therapist's technical skills. Although the physical therapists showed a strong willingness to meet the needs of children and parents, they seemed unaware of the emotional impact of positional inequality and the differences in roles and tasks of children, parents, and therapists during the treatment. Conclusion: All participants emphasized the importance of the quality of the therapeutic alliance. Nevertheless, positional inequality and differences in roles and tasks appeared to influence negotiation about goals and tasks of treatment. Children and parents are in a dependent relationship with the physical therapist. Physical therapists are challenged to find the right balance between their professional position and input on the one hand, and the emotional needs of child and parents on the other hand. ARTICLE HISTORY