ObjectiveTo examine whether religious and spiritual interventions (RSIs) can promote physical health and quality of life in individuals.MethodsThe following databases were used to conduct a systematic review: PubMed, Scopus, Web of Science, EMBASE, PsycINFO, Cochrane, and Scielo. Randomized controlled trials that evaluated RSIs regarding physical health outcomes and/or quality of life in English, Spanish or Portuguese were included. RSI protocols performed at a distance (i.e. intercessory prayer) or for psychiatric disorders were excluded. This study consisted of two phases: (a) reading titles and abstracts, and (b) assessing the full articles and their methodological quality using the Cochrane Back Review Group scale.ResultsIn total, 7,070 articles were identified in the search, but 6884 were excluded in phase 1 because they were off topic or repeated in databases. Among the 186 articles included in phase 2, 140 were excluded because they did not fit the inclusion criteria and 16 did not have adequate randomization process. Thus, a final selection of 30 articles remained. The participants of the selected studies were classified in three groups: chronic patients (e.g., cancer, obesity, pain), healthy individuals and healthcare professionals. The outcomes assessed included quality of life, physical activity, pain, cardiac outcomes, promotion of health behaviors, clinical practice of healthcare professionals and satisfaction with protocols. The divergence concerning scales and protocols proposed did not allow a meta-analysis. RSIs as a psychotherapy approach were performed in 40% of the studies, and the control group was more likely to use an educational intervention (56.7%). The results revealed small effect sizes favoring RSIs in quality of life and pain outcomes and very small effects sizes in physical activity, promotion of health behaviors and clinical practice of health professionals compared with other complementary strategies. Other outcomes, such as cardiac measures and satisfaction with the protocols, revealed no evidence for RSIs. Regarding the quality of the selected articles according to the Cochrane Back Review Group Scale, the average score was 6.83 (SD = 9.08) on a scale of 11, demonstrating robustness in the studies.ConclusionClinical trials on RSIs demonstrated that they had small benefits compared with other complementary health therapies by reducing pain and weight, improving quality of life and promoting health behaviors. The lack of clinical trials that included biological outcomes and the diversity of approaches indicate a need for more studies to understand the possible mechanisms of action of RSIs and their roles in health care.

Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp 12) is one of the most used and most validated instruments for assessing spiritual well-being in the world. Some Brazilian studies have used this instrument without, however, assessing its psychometric properties. The present study aims to validate the Portuguese version of the FACIT-Sp 12 among Brazilian psychiatric inpatients. A self-administered questionnaire, covering spiritual well-being (FACIT-Sp 12), depression, anxiety, religiosity, quality of life, and optimism, was administered. Of those who met the inclusion criteria, 579 patients were invited to participate and 493 (85.1 %) were able to fill out the FACIT-Sp 12 twice (test and retest). Subsequently, the validation analysis was carried out. Estimation of test-retest reliability, discriminant, and convergent validity was determined by the Spearman's correlation test, and the internal consistency was examined by the Cronbach's alpha. The sample was predominantly male (63.9 %) with a mean age of 35.9 years, and the most common psychiatric condition was bipolar disorder (25.7 %) followed by schizophrenia (20.4 %), drug use (20.0 %), and depression (17.6 %) according to ICD-10. The total FACIT-Sp 12 scale as well as the subscales demonstrated high internal consistency (coefficient alphas ranging from 0.893 for the total scale to 0.655 for the Meaning subscale), good convergent and divergent validity, and satisfactory test-retest reliability (rho = 0.699). The Portuguese version of FACIT-Sp 12 is a valid and reliable measure to use in Brazilian psychiatric inpatients. The availability of a brief and broad measure of spiritual well-being can help the study of spirituality and its influence on health by researchers from countries that speak the Portuguese language.

We concluded that Spiritist "passe" effectively inhibited growth in bacterial cultures compared to LOH with intention or no LOH. Further studies comparing different intentions and types of LOH in cultures of cells and microorganisms are warranted.

Although there is a wide array of evidence showing the beneficial effect of religiosity on violence among adolescents, nationwide studies in the general population are scarce. This study aims to explore whether religiosity is associated or not with diminishing violence in a Brazilian population-based representative sample. This observational cross-sectional study was conducted in 2011-2012 using face-to-face interviews and included 4,608 individuals 14 years and older. The survey included measures of religiosity (religious affiliation and importance of religion), violence (involvement in fights, domestic violence and police detention), depression, social support and alcohol dependence. We used logistic regression models and mediation analyses. In the total sample analyses, after adjustments, having a religious affiliation was inversely associated with lower involvement in fights (OR = 0.60, CI95%:0.37-0.98) and less police detention (OR = 0.37,CI95%:0.20-0.70), whereas the importance of religion was only associated with less fights (OR = 0.60,CI95%:0.36-0.99). Subanalyses revealed different associations depending on the age group evaluated. Mediation tests showed that the association of religious affiliation on violence outcomes was mediated by alcohol use. In conclusion, religiosity seems to be an important factor associated with lower levels of violence in this nationwide representative survey and alcohol dependence seems to mediate this relationship. Health professionals should be aware of these findings in their clinical practice.

No abstract

Esta dissertação ou tese está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver alfabético).

BackgroundAlthough observational studies have already shown promising results of flourishing, a broader concept of health based on positive psychology, there is still a gap in the literature regarding studies that combine different topics of flourishing in a single intervention.ObjectivesTo develop a comprehensive and integrate intervention based on positive psychology gathering different topics of flourishing to improve mental health outcomes in individuals with depressive symptoms.MethodsThe following steps were performed: (1) a comprehensive literature review; (2) the designing of a 12-session group intervention based on the values, virtues, and topics of flourishing; (3) assessment of the rationale, coherence, and feasibility by a panel of healthcare professionals answering semi-structured questions, and (4) application of an e-Delphi technique including mental health experts to reach a consensus of at least 80% for each item of the protocol.ResultsA total of 25 experts participated in the study, 8 in the panel with semi-structured questions and 17 in the e-Delphi technique. A three-round e-Delphi technique was required to reach a consensus for all items. In the first round, a consensus was reached for 86.2% of the items. The remaining items (13.8%) were either excluded or reformulated. In the second round, a consensus was not obtained on one item, which was reformulated and approved in the third round. Qualitative analyses of the open questions were performed and suggestions for the protocol were considered. The final version of the intervention was composed of 12 weekly group sessions with 90-min each. The topics included in the intervention were physical and mental health, virtues and character strengths, love, gratitude, kindness, volunteering, happiness, social support, family, friends and community, forgiveness, compassion, resilience, spirituality, purpose and meaning of life, imagining the “best possible future,” and flourishing.ConclusionThe flourishing intervention was successfully developed using an e-Delphi technique. The intervention is ready to be tested in an experimental study to verify its feasibility and effectiveness.

Diversos estudos têm sido publicados sobre a influência das crenças e práticas espirituais e religiosas na saúde mental. Diante de tais evidências, foram propostas estratégias com o objetivo de estimular a dimensão espiritual de pacientes, focando-se principalmente no enfrentamento de diferentes doenças. Porém, ainda são poucos os estudos que avaliam os possíveis efeitos e mecanismos de ação dessas intervenções espirituais/religiosas (IERs) através de ensaios clínicos randomizados. De acordo com a literatura científica, as IERs têm obtido resultados similares ou superiores a outras abordagens complementares em saúde, incluindo redução de sintomas de ansiedade e estresse, diminuição na intensidade do consumo de drogas, menor exaustão emocional em profissionais da saúde e uma tendência a menor sintomatologia depressiva. Como essas intervenções são heterogêneas, há uma discussão acerca da adequação dos conteúdos das IERs, na tentativa de uniformizar o treinamento dos profissionais de saúde e o material ofertado aos pacientes. Notase, também, a necessidade de um cuidado no desenho metodológico desse tipo de intervenção, com a realização de estudos com metodologias mais robustas. A busca e avaliação dessas novas intervenções poderão auxiliar no desenvolvimento de estratégias mais integrativas, facilitando o tratamento complementar em saúde mental.