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PRAYER IN CLINICAL PRACTICE
Science and Healing
By Candy Gunther Brown
384 pp., Cambridge, MA: Harvard University, 2012, $29.95, hardcover.
Review: The contemporary jury about whether prayer can cure physical disease was in, then out, and now, with Testing Prayer by Candy Gunther Brown, the jury may be back again from deliberating on this fascinating topic. That is, 20 years ago Dr. Larry Dossey published a large review of scientific and anecdotal medical evidence indicating that prayer can cure disease. This interest in prayer in the medical community flourished during the next dozen years with multiple studies, including randomized clinical trials costing millions of dollars that were designed to test the efficacy of intercessory prayer (IP). The outcome of these endeavors was summarized in a 2009 Cochrane Review, which concluded that the evidence was “equivocal and, although some of the results of individual studies suggest a positive effect of intercessory prayer, the majority do not and the evidence does not support a recommendation either in favor or against the use of intercessory prayer” (Roberts, Ahmed, Hall, & Davison, 2009, p. 2).
Although such reviews have suggested no further resources be allocated to study the ability of IP to cure disease, Brown has revisited this controversial area for scientific study. In “Testing Prayer,” Brown (an Associate Professor of Religious Studies at Indiana University, Bloomington) offers the verdict of “no, but” (p. 20) to the question of whether science can prove (or better, fail to disprove) the efficacy of prayer.
The Introduction and Chapter 2 are a necessary read, as they review not only the findings of previous empirical studies about prayer but also their sociopolitical context. Brown identifies what have been the scientific limitations of this research and begins to recognize the theological limitations of it as well. She explains how such study must be informed not only by good science but also good theology. These two disciplines of science and religion, which have historically challenged each other, should learn from each other.
Chapter 1 tells the story of the Toronto Blessing, a charismatic revival experience involving spiritual healing associated with prayer that has subsequently gone global. Observing this phenomenon started Brown's research program on prayer—”proximal intercessory prayer” (PIP; rather than distant IP, often the subject of previous research). Other chapters describe the author's mostly qualitative research investigating physical healing after PIP from charismatic–Pentecostal Christian healers in South America and Africa.
Brown ends with a discussion that integrates her findings in a tentative theoretical model about the healing effects of prayer. More specifically, this theory proposes that God's love works directly or indirectly (through healers) to effect healing. While God's love tapped through PIP may effect physical healing sometimes, sometimes it effects no scientifically measurable outcomes. What may be more important is the experience of divine love expressed in the act of praying. Given Brown's in-depth and well-researched analysis, it is easy to agree with her that continued research in this area—if guided by more comprehensive theory and more suitable methods—will be beneficial—Elizabeth Johnston Taylor, PhD, RN, Associate Professor, School of Nursing, Loma Linda University, Loma Linda, CA.
Roberts, L., Ahmed, I., Hall, S., & Davison, A. (2009). Intercessory prayer for the alleviation of ill health. Cochrane Database of Systematic Reviews, (2), CD000368. doi:10.1002/14651858.CD000368.pub3
Impact on Health and Quality of Life
By Ian N. Oliver
157 pp., New York, NY: Springer, 2013, $129.00, hardcover.
Review:Investigating Prayer is an exhaustive overview of prayer research from around the world, coupled with a report of a large randomized blinded study of intercessory prayer in patients with cancer in Australia. Oliver, a physician, researcher, and head of Cancer Council Australia, notes that in the West, healthcare was within the domain of religion until the time of the Enlightenment and states this book explores the interface of science and religion, attempting to bring the two together. Oliver thoroughly explores prayer from multiple theological and scientific perspectives and tackles hard issues like the ethics of trying to measure God and praying or not praying for patients, as well as quantifying something metaphysical like prayer for the purpose of science. After a thorough discussion and review of prayer, Oliver attempts to address all of the previous criticisms of prayer research in this Australian study. Why do such a study of prayer? Oliver writes, “Prayer is probably the most common intervention for illness outside of physical medicine” (p. 95).
Oliver's study enrolled a diverse group of 999 cancer patients to assess the impact of Christian remote intercessory prayer on spiritual well-being. The study was triple blinded, meaning the patients, researchers, and intercessors were all blinded and no one knew who was being prayed for or not prayed for. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness—Spiritual Well-being—12-item scale at baseline and 6 months. The intervention group showed greater improvements over time in spiritual well-being and its components of peace, faith, and emotional and functional well-being than the control group. The improvements were small but statistically significant and believed to have an impact on patients' quality of life.
Oliver's exhaustive review of prayer and scientific literature, both positive and negative, make this book a treasure chest for anyone interested in prayer as well as spirituality. The topics covered include the role of spirituality in illness, prayer as complementary or alternative therapy, the relationship between spiritual well-being and quality of life, instruments for assessing religious and spiritual belief, and possible directions for further research. A unique issue Oliver tackles is the impact of the study on the team who conducted the trial, from the ethics committee chair to one of the principal investigators who was an atheist. Investigating Prayer is easy-to-read and contains a wealth of information for clinicians and researchers on all sides of the prayer debate. I highly recommend the book.—KSS
SPIRITUALITY AND HEALTH RESEARCH
Methods, Measurement, Statistics, and Resources
By Harold G. Koenig
466 pp., West Conshohocken, PA: Templeton, 2011, $49.95, paperback.
Review: Harold G. Koenig, physician, researcher, teacher, prolific author, frequently sought after speaker, and former RN, is an international authority on spirituality in the context of health and illness. Koenig's career researching spirituality and religion has spanned three decades. Presently, Koenig teaches medicine and psychiatry at Duke University and directs the Duke Center for Spirituality, Theology, and Health. I can think of few others who could offer the authoritative discussion about researching spirituality and health that Spirituality and Health Research provides.
The contents of this volume were originally developed for summer workshops on researching spirituality that Koenig has organized for the past 8 years for novice and advanced researchers from many disciplines. Thus, this extremely instructive book is intended for anyone wanting to empirically study spirituality or religion from a health perspective. As I read, I find helpful instruction and perspective even though I have dedicated some time myself to researching spirituality. I can also see that a graduate student without any experience would be able to easily comprehend and apply the contents of this resource.
In 21 easy-to-read chapters, the reader is guided through discussions about existent literature and significance of studying religion and spirituality, and to how to disseminate such research findings. Part 1 presents an overview of the research in this field with a discussion of its strengths, weaknesses, and challenges; Koenig then proposes a research agenda. Part 2 discusses methods and design issues, from identifying an appropriate research question and variables, to sampling, and considerations of qualitative and quantitative designs (i.e., observational and clinical trials). Part 3 fleshes out measurement problems, including what variable/s to measure. (Koenig prefers the cleaner variable of religion to that of spirituality.) Part 4 explores various means for statistical analysis, including the important need to recognize confounders, explanatory variables, and moderators. Part 5 discusses how to publish findings and suggestions for obtaining funding.
Accompanying the text is a glossary of research lingo, something very helpful for the young researcher. I enjoyed the use of callouts on nearly every page; these callouts put in bold relief the salient points of the book. Without reservation, I urge any nurse wanting to conduct research on spirituality and health to read this repository of information and insight.—Elizabeth Johnston Taylor, PhD, RN, Associate Professor, School of Nursing, Loma Linda University, Loma Linda, CA.
COMPLEMENTARY ALTERNATIVE MEDICINE
The Christian Handbook, Updated & Expanded
By Dónal O'Mathúna and Walter Larimore
512 pp., Grand Rapids, MI: Zondervan, 2009 ePub, paperback, $22.99, ePub, $6.64.
Review: Alternative Medicine by O'Mathúna and Larimore, originally published in 2001, was updated and expanded in 2007. More recently in June 2009, an ePub edition was released. The Christian Handbook lives up to its catchy cover of guiding patients and healthcare professionals in “the options, the claims, the evidence, how to choose wisely” (front cover).
With support from the Christian Medical and Dental Association, the authors Dónal O'Mathúna, PhD, a bioethicist and pharmacist, and Walter Larimore, MD, a family physician, bring their expertise to respond to the lack of clear resources for patients and healthcare professionals in exploring alternative/complementary therapies. O'Mathúna and Larimore evaluated hundreds of alternative/complementary therapies and remedies from two perspectives: 1) scientific research for evidence supporting the therapy as effective, possibly helpful, or without merit; and 2) an orthodox Judeo-Christian worldview through Scripture (p. 14).
Part 1, “Evaluating Alternative Medicine,” provides an overview of alternative medicine and the growing interest among Christians. The chapter “Faith Based Healing” differentiates what the Bible does and does not say about health. A chapter titled “Gurus, Fraud, Quackery or Wisdom” guides the reader in discerning possible fraudulent therapies using 25 warning signs. There are also chapters on “Health Lifestyle” and “Alternative Medicine and Children.”
Part 2 presents the scientific and spiritual evaluation of over 30 therapies including acupressure, prayer, and yoga, and includes an extensive section on diets and dieting. New to this edition include spiritual implications ratings for therapies related to non-Christian healing rituals and traditions. Part 3 includes an evaluation of a wide range of herbal remedies, vitamins, and dietary supplements. Each therapy or remedy evaluated includes the origin of its use (What It Is) and how it works (Claims), scientific information (Study Findings), which are scaled as positive or negative to indicate the strength of the evidence, as well as the possible or actual harmful effects (Cautions), and concludes with overall recommendations (Recommendations).
The authors don't label alternative medicine as good or bad. They point out the proven benefits and unproven claims, while divulging spiritual concerns where appropriate (p. 21). This tool is a must have resource for all Christians, especial healthcare practitioners who guide patients in therapy choices. The low ePub price is reason enough to have this valuable resource.—Carrie M. Dameron, MSN, RNBC, Associate Professor of Nursing at Ohlone College, Fremont, CA, and an on-call medical/surgical staff nurse.
CALL THE MIDWIFE
A Memoir of Birth, Joy, and Hard Times
by Jennifer Worth
340 pp., Hudson, NY: Penguin, 2012, $16.00, paperback.
Review: Nurses know the work they do is brimming with the drama of life, but literature is surprisingly lacking in stories that reflect the essence of our fascinating world. Call the Midwife (originally The Midwife, 2009), recently popularized in a British Broadcasting Company series on public television, captures the drama of real-world nursing with stories of nursing and midwifery in the 1950s during post-World War II in London's East End. The nurses were devoted to caring for their patients at a time when antibiotics were rare, maternal mortality was high, and little medical interest was paid to maternal–child health. Worth trained as a nurse at the Royal Berkshire Hospital in Reading and then moved to London to train as a midwife. The book is, in part, her memoir of the work in London.
The compelling and dramatic stories of life and death observed by Worth and her young nurse colleagues are interspersed with stories about the endearing and influential Anglican nuns devoted to nursing and midwifery with whom Worth and the other young nurses live. Worth, raised a “nominal Methodist,” was perplexed to consider any connection between faith and being a nurse until Sister Julienne gently shares that “Jesus Christ is our strength and our guidance here” (p. 28). Worth comes to realize that Sister Julienne exerts a strong yet subtle influence on her, which was “way out of proportion to her words or her appearance. She was not imposing or commanding, nor arresting in any way...but something radiated from her and, ponder as I might, I could not understand it. It did not occur to me at the time that her radiance had a spiritual dimension, owing nothing to the values of the temporal world” (p. 28).
In this memoir, Worth reflects on her patients and her professional heritage with compassion, wisdom, and spiritual insight. She loves her patients, the nuns, and their selfless work and comes to the surprising understanding that “perhaps ... could it be the love of God?” (p. 313) in them that she is witnessing? Worth discovers that nurses (and others) cannot love ignorant and challenging people living in filth and squalor and lice- and rat-infested areas except by loving “God, and through His grace come to love His people” (p. 319). It is through the quiet, gentle words, and works of the nuns that Worth realizes what she had spent years trying to understand could be found in the simple phrase, “Go with God.” The story ends as her faith begins: “That evening, (she) started to read the Gospels” (p. 319).
Call the Midwife is the first of a trilogy by Worth about her work as a nurse in the East End. All three books (Shadows of the Workhouse, Farewell to the East End) are a delightful read as Worth brings to life the experience of real-world nursing.—Susan Primm Lehmann, MSN, RN, Clinical Assistant Professor, University of Iowa College of Nursing, Iowa City, IA.