The Role of Prayer in Healing
An intriguing study published in the journal Mayo Clinic Proceedings confirmed the importance of religion and spirituality for many patients undergoing medical treatment, but found it difficult to prove that better health results from "intercessory" prayer-prayer by one or more people on behalf of another.
The single-center, randomized, double-blind trial was conducted at the Mayo Clinic in Rochester, Minn. from July 4, 1997 to Oct. 21, 1999 and involved 799 male and female coronary care patients aged 18 years or older.
According to the Mayo Clinic researchers, led by Dr. Stephen Kopecky, a number of published studies have already assessed the effects of spiritual factors on health care outcomes: 75 percent report a positive effect; 17 percent report no effect; and 7 percent report a negative effect. However, they said few have evaluated the specific effects of intercessory prayer on health outcomes.
"We sought to improve on the design of earlier studies of intercessory prayer through the application of standard experimental methods with the hope of obtaining scientific evidence to elucidate the potential role of intercessory prayer in medical care," said Kopecky, a Mayo Clinic cardiologist.
The patients were randomized into the intercessory prayer group and the control group. Intercessory prayer was administered at least once a week for 26 weeks by five intercessors per patient. No significant differences were found between the intercessory prayer group and the control group.
After 26 weeks, a medical setback (such as death, cardiac arrest, rehospitalization, coronary revascularization or an emergency department visit for cardiovascular disease) occurred in 25.6 percent of the prayer group and 29.3 percent of the control group. Among high-risk patients, such a setback occurred in 31 percent of the prayer group and 33 percent of the control group. Among low-risk patients, the difference between the groups was 17 percent for the prayer group and 24 percent for the control group.
Nonetheless, Kopecky acknowledged that in light of its widespread use in conjunction with illness, intercessory prayer deserved further exploration. "It should be noted that, in part due to the study's many limitations, this study did not measure the 'power of God,' nor should prayer offered for patients by loved ones, relatives and friends be interpreted not to play a potentially important role in the healing process," he said.
Another article published in the same issue of Mayo Clinic Proceedings examined the association between spirituality and physical health, mental health, health-related quality of life and other health outcomes.
The authors, led by Dr. Paul Mueller, reported that a majority of the nearly 350 studies of physical health and 850 studies of mental health that have used religious and spiritual variables have found that religious involvement and spirituality are associated with better health outcomes.
The researchers said most patients have a spiritual life and regard their spiritual health and physical health as equally important. People may have greater spiritual needs during illness and are looking to have those needs met, they said.
They noted that a large and growing number of studies have shown a direct relationship between religious involvement and positive health outcomes, including mortality, physical illnesses, mental illness, health-related quality of life and coping with illness. Studies also suggest that addressing the spiritual needs of patients may facilitate recovery from illness.
"Although the relationship between religious involvement and spirituality with health outcomes seems valid, it is difficult to establish causality," said Mueller, a Mayo Clinic internal medicine specialist. "The benefits of religious and spiritual involvement are likely conveyed through complex psychosocial, behavioral and biological processes that are incompletely understood."
Mueller and his colleagues suggested that physicians should take a spiritual history of their patients, which could help discern their spiritual needs during treatment.
In an accompanying editorial in the same issue, Dr. Harold Keonig of Duke University Medical Center cautioned that in the majority of cases, the physician should not attempt to address complex spiritual needs of patients. "However, when the patient is reluctant to talk with clergy and prefers to discuss spiritual matters with a trusted physician," he said, "taking a little extra time to listen and be supportive is usually all that is required."
He added that providing support for religious beliefs and practices that do not conflict with medical care may be appropriate, but when beliefs conflict with medical care, "it is important not to criticize the belief, but rather to listen, gather information, enter into the patient's world view, and maintain open lines of communication, perhaps enlisting the help of the patient's clergy."
Nonetheless, Keonig affirmed the possibility of a mutually beneficial relationship between prayer and medicine. "Religious beliefs may have a powerful influence on the health of our patients, and we need to know about them," he said.
SOURCE:
Mayo Clinic Proceedings, December 2001; 76(12):1189-1191, 1192-1198, 1225-1233