Intercessory Prayer:
Positive
Effects on Clinical Outcomes
Rene' Jackson, RN,
BSN
The Dallas Morning News reported, “…to many people who believe in God, there’s no question that prayer works. Proving it by scientific means is another matter…”
There appears to be a complexity involved in attempting to measure prayer rationally, statistically, or empirically. Little is understood about the power and mystery of prayer, spirituality, divinity, and how it intersects with the human/social equation.
Social science and religious communities seem reluctant to interact on the subject of examining the efficacy of prayer in health issues. This type of research, though, is receiving more attention as the role of faith and spirituality in health and healing is being seriously examined (O’Mathuna, 1999).
Prayer means different things to different people. Some researchers think it is just a mental effort by the afflicted person to improve his/her physical or emotional well-being, or that of another. Others believe it is a form of sending healing energy. For those who believe in God, prayer is a request for Divine will to be carried out in a particular situation. For them, it impacts the state of mind, but is not a state of mind. The person praying requests something specific, but remembers that the prayer will only be answered if it is in line with the perfect will of God. In this context, it is difficult to measure the outcomes of prayer scientifically. It is obviously difficult to know God’s will in many circumstances; why some illnesses are allowed to proceed, while others are healed. So how do clinical trials control for “God’s will”?
Faith is also an important factor in prayer, and everyone’s level of faith is different. How do researchers measure for that?
There are still many unanswered questions for researchers to delve into with regard to prayer and health. Do prayerful people expect positive responses to all they prayer for, and should they? What constitutes a positive response? God’s responses to prayer are complex, so how can they be adequately measured? Is prayer only needed when someone is ill, or when other resources are exhausted?
An article in Time magazine in 1998 revealed that 82% of Americans believed in the power of prayer, but though nurses and doctors are concerned with any factor that affects a patient’s physical health, in the clinical arena many fail to recognize patients’ spiritual needs. Most studies examining prayer and health are correlational, leaving unanswered the question of whether prayer is causing the observed changes in health (Munson, et al). Like all aspects of healthcare, spiritual care involves assessing the patient’s present status, identifying any problem areas and developing a strategy to help the patient overcome his/her difficulties. Nurses, in general, recognize the inherent uniqueness of the individual and that each one’s spiritual beliefs are very personal, but a trusting relationship between patient and nurse has to be present before a patient’s spiritual concerns can be explored (Carroll, 2001).
Physicians, as well as nurses, can begin to incorporate spirituality into medical practice in three ways: scientific study of the subject; assessing the patient’s spirituality and diagnosis of spiritual distress; and therapeutic interventions. Scientific study involves evaluating the current evidence for a link between spirituality and health, and planning further study to clarify these effects.
Spirituality and prayer are very complex concepts, and are even more so when meshed with healthcare. In the nursing profession, both are defined in the context of each nurse’s personal, social, cultural, and religious beliefs, as well as the patient’s. Indeed, in the 1990s virtually all definitions relating to spirituality in medical and nursing literature recognize that spirituality is not always associated with religion (Carroll, 2001), but nurses don’t always relate the two.
In order to recognize patients’ spiritual needs, nurses must first explore their own spirituality. A nurse’s mental, social, and spiritual experiences influence the practice of patient care, and assist with spiritual assessment and support for hospitalized patients. Studies reveal that generally nurses are uncomfortable assessing patients’ spiritual needs, except for hospice nurses who are more aware of such support needed by patients and families.
Patients who are ill often are fearful and spiritually distressed. These fears may be well-hidden but are manifested in several ways, including anger, withdrawal and restlessness. When a patient is first admitted, the spiritual assessment is superficial, but tends to development as the patient and nurse get acquainted. Nurses cannot force prayer and spiritual conversations on patients, as it is the patient’s right to decide when and if they will occur. But nurses can demonstrate that they are able to help the spiritually-distressed patient through acceptance, warmth, and a genuine desire to understand the patient’s thoughts, feelings, and self-evaluations (Carroll, 2001).
The spiritual dimension of healthcare cannot be separated from other aspects of care. But medical literature shows that there is a variance of opinion on whether health outcomes are positively correlated with prayer, since it is very subjective, depending on each one’s beliefs. Nonetheless, it is important to keep an open mind regarding new methods of study, being ever mindful that there are some things that may never be fully understood (Anandarajah, 2001).
BACKGROUND
As far back as 1872, Francis Galton
conducted the first empirical study of the role petitionary prayer plays to
health. In 1883, he considered the question again: “Do persons who pray or are
prayed for, recover on the average more rapidly than others?”
Galton tested the hypothesis that prayer
would enhance the well-being of those who prayed, as well as the well-being of
those who were prayed for. He examined the average life span of the English
aristocracy who, despite the practice of the English people praying for their
sovereigns, had only a modest life expectancy. He also noted that the clergy of
the day had a shorter life expectancy, and were generally in poor health, as
compared to lawyers or physicians. Galton also observed the high rate of
insanity, and religious madness, among the nobility. He concluded in his study
that there was little statistical evidence for the efficacy of petitionary
prayer. The study was interesting though, because it raised many questions
about empirically studying petitionary prayer.
Attempts to study petitionary prayer have
been made throughout the 20th century, demonstrating the inherent
difficulties: design problems and deficiencies, including no random assignment
to the treatment groups, and studies that were suggestive, but not
statistically significant. Some researchers have asserted that though they
don’t discount the efficacy of prayer itself, they doubt it could be
effectively subjected to empirical analysis.
One ground-breaking study, completed in 1988 by Dr. Randolph Byrd, investigated the therapeutic effect of intercessory prayer on coronary care patients, producing results that were described as remarkable. The double-blind randomized test of prayer efficacy, with a sample of 393 coronary care patients at San Francisco General Hospital, concluded that patients fared better when they received prayer. While the positive results are certainly welcome, this study reveals the problems of basing conclusions about the effectiveness of prayer on scientific research (O’Mathuna, 1999).
Other studies have concluded that prayer is interwoven with a person’s view of his or her own health and healing, and that it may be just a helpful coping mechanism.
In 1997, it was reported that at least
30 of the top medical schools in the United States are offering teaching
programs on the subject of faith and prayer in the healing process. Drs.
Theodore Chamberlain and Christopher Hall, in their book, Realized Religion,
say that while the overall paucity of research in this area limits conclusion,
it is deemed possible to say that “prayer that is mature and characterized by
meditative, mystical and fuller religious experience appears to be related at
least in some aspects of adjustment, happiness, general life satisfaction, and
perhaps healing.” Even though more research is called for, they say scientific
evidence convincingly demonstrates that the natural by-product of religion
shows long life, less illness, better physical and mental health…and less
alcohol and substance abuse.
The book documents more than 300 studies
demonstrating a positive relationship between the practice of prayer/faith and
the survival rate of surgical patients, recovery from depression, anxiety, and
more. Some of those studies, to be expected in those that are unbiased, show
conflicting results. Researchers interested in investigating the literature
dealing with the nature and efficacy of prayers will soon discover that this is
a subject that has historically been largely unexplored from an empirical
approach (Chamberlain, et al. 2000).
Contemporary research on prayer and
health takes two forms (Petrowsky, et al., 1996): asking subjects if they think
or have evidence that prayer impacts health positively, or by using objective,
measurable scientific methods. The first approach has respondents making
retroactive assessments of prayer benefits. It does not control for other
variables that could have caused healing, such as type of medical treatment and
passage of time. This type of research is considered too subjective for
clinical documentation. The second approach assesses prayer to determine its
impact on health, and the measurements are made while holding constant other
factors that could influence the outcome.
Many patients, doctors, and nurses believe spirituality and prayer play an important part in their lives. Studies suggest a positive correlation between prayer, spirituality and health outcomes, and that this positive relationship continues to increase.
At this time, though, prayer and
spirituality do not seem to be pervasive topics in healthcare, but only in
scientific circles. Even though regulatory agencies for healthcare providers
mandate questioning patients upon admission on their spiritual/religious
beliefs, the assessment continues to be superficial. Ideally, therapeutic
interventions of prayer could be incorporated into the medical encounter
between patients and healthcare staff, but because of time constraints,
nurse/patient ratio, paperwork, etc., this does not occur consistently across
the board.
More studies need to be done to evaluate
whether prayer is important in health care; whether or not it facilitates the
healing process. Though the efficacy of prayer is not easily measurable,
studies do indicate it may in fact be generally beneficial to human health.
Rene' Jackson, RN, BSN is a registered
nurse and currently employed as a special procedures nurse at Charlotte
Regional Medical Center in Punta Gorda, FL. She is also a freelance health
writer. Her book, The Death of Mammography will be published by Caveat
Press www.caveatbooks.com in 2005.
She can be reached through her web site at www.rjacksonrn.com
or e-mail at rene@rjacksonrn.com
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