La prière aide-t-elle les patients?

[A.T.]

16 juillet 2005 - USA - The Lancet medical journal

Selon une étude, la prière n'a pas augmenté le taux de survie de patients, alors que d'autres techniques, elles, ont marché, par exemple la musique et le toucher.

http://www.latimes.com/features/health/ ... &cset=true

[A.T.]

Selon une autre étude qui vient d'être publiée dans le American Heart Journal (avril 2006) on a trouvé une relation entre la prière et la santé de malades pour qui ont priait. Il n'y a qu'un petit problème, la corrélation est négative!
Voici d'abord le titre de l'article et ses auteurs:

934 Study of the Therapeutic Effects of Intercessory
Prayer (STEP) in cardiac bypass patients: A
multicenter randomized trial of uncertainty and
certainty of receiving intercessory prayer

Herbert Benson, MD, Jeffery A. Dusek, PhD, Jane B.
Sherwood, RN, Peter Lam, PhD, Charles F. Bethea,
MD, William Carpenter, MDiv, Sidney Levitsky, MD,
Peter C. Hill, MD, Donald W. Clem, Jr, MA, Manoj
K. Jain, MD, MPH, David Drumel, MDiv, Stephen L.
Kopecky, MD, Paul S. Mueller, MD, Dean Marek,
Sue Rollins, RN, MPH, and Patricia L. Hibberd, MD,
PhD, Boston, MA; Oklahoma City, OK; Washington,
DC; Memphis, TN; and Rochester, MN

http://download.journals.elsevierhealth ... 001955.pdf

L'étude a porté sur 1,800 patients devant subir une opération cardiaque:
600 d'entre eux savaient que des gens prieraient pour eux,
600 autres savaient que l'on prierait peut-être pour eux et l'on a effectivement prié pour eux, et
600 autres savaient que l'on prierait peut-être pour eux et l'on n'a pas prié pour eux.

Les chercheurs ont trouvé que la prière n'a fait aucune différence chez ceux qui n'étaient pas sûr si on allait prier pour eux. Par contre, chez ceux qui savaient que l'on allait prier pour eux, on a noté plus de risques de complications post-opératoires.

http://www.nature.com/news/2006/060327/ ... 16.html#B1

[Gaël]

Je n'arrive pas du tout à comprendre la position de Richard Sloan, interviewé dans l'article, qui considère ce genre d'études comme du gaspillage :

"At least some researchers think that the trial, which cost US$2.4 million, was a colossal waste of time and money. "We don't need studies like this," says behavioural scientist Richard Sloan, an authority on prayer and medicine at Columbia University in New York City.
Prayer is highly valued by many people, says Sloan, and there is no need for scientists to empirically prove whether or not it works. "It's demeaning of the religious experience."

Au contraire, à mon avis les études de ce genre sont absolument nécessaires (et il est dommage qu'il n'y en ait pas plus) étant donné le nombre de gens croyant réellement au pouvoir de la prière, parfois au point de risquer leur vie en rejetant la médecine au profit de la prière. S'ils se trompent et qu'on peut le prouver, il est primordial de le faire.

[Ghost]

Selon une autre étude qui vient d'être publiée dans le American Heart Journal (avril 2006) on a trouvé une relation entre la prière et la santé de malades pour qui ont priait. Il n'y a qu'un petit problème, la corrélation est négative!
...Les chercheurs ont trouvé que la prière n'a fait aucune différence chez ceux qui n'étaient pas sûr si on allait prier pour eux. Par contre, chez ceux qui savaient que l'on allait prier pour eux, on a noté plus de risques de complications post-opératoires.

http://www.nature.com/news/2006/060327/ ... 16.html#B1

Il y a deux façons de vivre une maladie:
- La combattre tout en l'acceptant sereinement (espoir, amour, joie, positivisme).
- La combattre en la refusant anxieusement (peur, haine, stress, négativisme).

L'anxiété est le principal facteur aggravant et je ne suis pas étonné du résultat de ces prières. Ce n'est pas un scientifique zézé qui peut comprendre ça.

C'est donc un état d'être fondamental indépendant de toutes croyances qui va le plus influencer une guérison.

Malheureusement il n'existe aucun médicament pouvant modifier l'état d'être de négatif à positif et c'est plutôt par un travail et une prière personnelle que l'on peut arriver à progresser à ce niveau.

C'est vrai qu'ils feraient mieux de dépenser leur argent à meilleur escient...

Ghost

[A.T.]

C'est vrai qu'ils feraient mieux de dépenser leur argent à meilleur escient...
Ghost

Mais cette étude aide les croyants. Elle leur apprend que pour prier pour un malade, mieux vaut ne pas lui dire. Cela augmentera peut-être ses chances.

[Ghost]

C'est vrai qu'ils feraient mieux de dépenser leur argent à meilleur escient...
Ghost

Mais cette étude aide les croyants. Elle leur apprend que pour prier pour un malade, mieux vaut ne pas lui dire. Cela augmentera peut-être ses chances.

Et oui, c'est ça le vrai altruisme.

Plus sérieusement, ces études c'est vraiment n'importe quoi. L'important c'est que le malade n'ait aucune pression. La sérénité ou l'anxiété de l'entourage est communicative et peut être néfaste. C'est plus l'état d'être général de chacun qui influe plutôt que la prière elle-même.

Faudrait peut-être plutôt savoir s'il y a une corrélation entre sérénité et croyance. Mais j'en doute fort.

Ghost

[Jean-Francois]

Je n'arrive pas du tout à comprendre la position de Richard Sloan, interviewé dans l'article, qui considère ce genre d'études comme du gaspillage

Ca devient du gaspillage car le chien est mort depuis longtemps et qu'étudier son pouls est une perte de moyens. Les seules études qui ont donné des résultats positifs ont été magouillées a posteriori (voir le dico sceptique).

De plus, 2,4 millions de $US, c'est quand même une belle somme pour un protocole qui, de toute façon, est floué dès le départ car on ne sait pas ce qu'on fait dès le départ (prier qui? Prier comment? etc.*). Au mieux, on obtient un résultat positif qu'on ne sait pas attribuer, au pire on obtient des résultats négatifs qui ne veulent rien dire (sauf, j'imagine, qu'il faut continuer les recherches... comme pour bien d'autres patathérapies alternatives). Après tout, si Dieu veut cacher sa présence, il peut très bien truquer ces expériences.

Je te laisse ce qu'en écrit le physicien Bob Park:
"MIRACLE MEDICINE: PRAYERS OF SCIENTISTS HAVE BEEN ANSWERED.
The long-awaited study of intercessory prayer for coronary bypass patients was released yesterday (see last week's WN). A small increase in complications, attributed to "performance anxiety," was found in a subset of patients who were told that strangers were praying for them. Otherwise, there was nothing. Scientists are relieved of course; science is tough enough without having to worry that somebody on their knees in East Cupcake, Iowa can override natural law. The study of 1800 patients took almost ten years and cost $2.4M, mostly from the Templeton Foundation. Of course, there are calls for further study. Where do we start? What are the units of prayer? Do prayers of Pat Robertson count more than those of death-row inmates? What is the optimum posture of the supplicant? Where can we learn these things?" What's New du 31 Mars 2006).
Et surtout:
"MIRACLE MEDICINE: WASH POST HYPES PRAYER STUDY ON PAGE ONE.
Today, in a major front-page story, staff writer Rob Stein tells us that "the largest, best-designed study of intercessory prayer" is being published in two weeks. What does it say? The secret is guarded as tightly as the Academy Awards. However, as I write this, the world population clock reads 6,505,424,096. Most of them pray. A bunch of them pray 5 times a day. They pray mostly for their health, or that of loved ones, making prayer by far the most widely practiced medical therapy. It's a wonder anyone is still sick. No one doubts that personal "petitionary" prayer benefits believers. Optimism is good medicine. To the believer, prayer is a stronger placebo than sugar pills. Stein, however, has his facts wrong. The controversy (if there ever was one among scientists) was settled in 1872 by Sir Francis Galton when he published "Statistical Inquiries into the Efficacy of Prayer." Galton, a cousin of Charles Darwin, recognized that remote prayer by strangers would be blind to the placebo effect. Since the Order for Morning Prayer of the Church of England includes prayers for the health and long life of the monarch and the archbishop, he compared their longevity to that of the general population and found no difference. So who is doing this new study? Herbert Benson, founder and president of the Mind-Body Institute, who touted the health benefits of prayer in his 1975 bestseller "The Relaxation Effect." It would be a miracle if he now discovers there's nothing to it. It's in our hands now, we have two weeks to pray that the study turns out to be objective." (Ibid, le 24 Mars 2006).

Bref, ce genre d'étude c'est de la foutaise. Même l'idée que ça pourrait convaincre les croyants est grandement fausse... il n'y a qu'à voir les lilshao ("même si ce n'est pas vrai, je continuerai à y croire"**) et autres croyants qui fréquentent le forum.

Jean-François

* Oui, chaque croyant aura sa "réponse intime" à ces questions, mais il sera incapable de comprendre le problème méthodologique que ces incertitudes posent.
** Même attitude que lorsqu'il écrit: "D'un coté ca sert a rien de me convaincre parce que que cette vidéo soit fausse ou non je suis convaincu a 100% qu'il existe de la vie dans l'univers et a 90% que des sondes extra terrestres volent dans notre ciel"... en plus insidieux car l'idée de Dieu et que Dieu peut agir repose encore plus sur une foi irrationnelle que les ET.

[ti-poil]

C'est vrai qu'ils feraient mieux de dépenser leur argent à meilleur escient...
Ghost

Mais cette étude aide les croyants. Elle leur apprend que pour prier pour un malade, mieux vaut ne pas lui dire. Cela augmentera peut-être ses chances.

Outre les prières des autres faut d'abord s'occuper de soi,n'est-ce pas 8)

[Archemyst]

Salut ,

Et oui Ti poil car la priere de masse remplie la cuve d'energie dite Egregore !

Dont une qui dure depuis plus de 2000 ans je vous laisse deviner laquelle 8)

[adhemar]

C'est assez surprenant, cette étude qui montre une corrélation négative entre une amélioration de l'état du patient et la prière. Pas de corrélation, j'aurais compris. Une corrélation positive légère aurait été aisément expliquée par le fait que la prière est une forme de soutien moral du malade.

Adhémar

[Ghost]

C'est assez surprenant, cette étude qui montre une corrélation négative entre une amélioration de l'état du patient et la prière. Pas de corrélation, j'aurais compris. Une corrélation positive légère aurait été aisément expliquée par le fait que la prière est une forme de soutien moral du malade.

Adhémar

Comme je l'ai déjà écrit, moi ça ne me surprend pas. Je ne connais pas le protocole exact de ces expériences mais je pense que le fait que le malade sache que certains prient pour lui lui met un stress et une pression négative car il a peur de décevoir.

Comme l'a dit Ti-poil, avant d'attendre les prières des autres vaut mieux déjà prier pour soi. La prière est sensée toucher l'esprit d'essence divine qui est en nous. Le chemin le plus direct pour atteindre notre esprit (l'inconscient) est notre propre mental (le conscient). Mais prier est un mot à connotation religieuse inutile. On peut tout aussi bien parler de positivisme et auto-suggestion.

Je ne connaissais pas le lien de Ti-Poil que je trouve excellent. Il étaye tout à fait ce que j'expliquais plus haut. J'ai vaguement parcouru les articles de JF qui semblent dire la même chose que moi...

Ghost

[ti-poil]

C'est assez surprenant, cette étude qui montre une corrélation négative entre une amélioration de l'état du patient et la prière. Pas de corrélation, j'aurais compris. Une corrélation positive légère aurait été aisément expliquée par le fait que la prière est une forme de soutien moral du malade.

Adhémar

Ce qui me surprend le plus est de voir AT faire l'apologie du controle de l'esprit sur la matière.

[Ghost]

C'est assez surprenant, cette étude qui montre une corrélation négative entre une amélioration de l'état du patient et la prière. Pas de corrélation, j'aurais compris. Une corrélation positive légère aurait été aisément expliquée par le fait que la prière est une forme de soutien moral du malade.

Adhémar

Ce qui me surprend le plus est de voir AT faire l'apologie du controle de l'esprit sur la matière.

Ne te fais pas trop d'illusions sur AT.
Ce n'est pas du contrôle de la matière inerte qu'il s'agit mais du corps physique vivant. C'est différent mais non moins intéressant...

Ghost

[A.T.]

Ce qui me surprend le plus est de voir AT faire l'apologie du controle de l'esprit sur la matière.

Qu'est ce que tu veux dire exactement ti-poil? L'esprit, je ne parle pas ici d'une entité immatérielle, influence certes la matière. L'effet placebo en est un exemple.

[ti-poil]

L'esprit, je ne parle pas ici d'une entité immatérielle, influence certes la matière.

C'est quoi cette phrase?

Bon, tu semble au moins d'accord avec Ceci?

[A.T.]

L'esprit, je ne parle pas ici d'une entité immatérielle, influence certes la matière.

C'est quoi cette phrase?

Bon, tu semble au moins d'accord avec Ceci?

En gros oui.

[A.T.]

Voici une autre étude sur les effets de la prière sur la santé, publiée dans la revue Holistic Nursing Practice (mars-avril 2006). Contrairement à l'étude précédente, on examine ici le pouvoir de la prière faite par le malade lui-même. Plus précisément, il s'agit d'évaluer le pouvoir de la prière sur la diminution de quatre symptômes (anxiété, dépression, fatigue et nausées) reliés au sida. L'étude conclut à une certaine efficacité de la prière.

Malgré le biais dû au fait que ce sont les malades eux-mêmes qui évaluent le degré d'efficacité de la prière, il est fort probable que la prière ait une certaine efficacité, comme la méditation en aurait aussi selon d'autres études, ces techniques amenant une réduction du stress.


Prayer as a complementary health strategy for managing HIV-related symptoms among ethnically diverse patients.

Christopher Lance Coleman, Lucille S. Eller, Kathleen M. Nokes, Eli Bunch, Nancy R. Reynolds, Inge B. Corless, Pam Dole, Jeanne K. Kemppainen, Kenn Kirksey, Liz Sefieik, Patrice K. Nicholas, Mary Jane Hamilton, Yun-Fang Tsai, William L. Holzemer. Holistic Nursing Practice. March-April 2006 v20 i2 p65(8 ).

Data were analyzed from an ethnically diverse convenience sample comprising 1071 adults participating in a multisite study. Older African Americans, Hispanics, and females were more likely to use prayer as a complementary health strategy for HIV-related anxiety, depression, fatigue, and nausea. Implications for future studies are discussed. KEY WORDS: complementary health strategies, ethnicity, HIV/AIDS, prayer, symptom management Holist Nurs Pract 2006;20(2):65-72

**********

Previous studies have demonstrated differences in how ethnic groups relied on different complementary health strategies such as prayer for managing health conditions. (1-3) Studies investigating the effects of prayer on health discovered that there is a strong association between the efficaciousness of prayer, one's belief in the efficacy of prayer, improved functional health status, better coping with hemodialysis, and managing acute healthcare problems. (1,4-6) The findings from these studies suggest that when faced with the uncertainty of health conditions, individuals who used prayer as complementary health strategy reported improved physical and psychological well-being. Regardless of the physical or psychological condition, prayer was associated with better physical or psychological well-being among individuals with an illness.

Considerable research has documented the significance of prayer to both the physical and the mental health of African Americans. (7-10) These studies underscored the significance of using prayer as a complementary health strategy for maintaining psychological and physical well-being. The central hypothesis pursued by these studies investigated whether prayer, used as a complementary health strategy, would influence psychological or physical health outcomes in African Americans. The consensus was clear: African Americans attributed their physical and psychological well-being to engaging in prayer as a complementary health strategy for managing the sequelae associated with their health conditions.

One researcher highlighted the historical significance of religion to African Americans and reported that most African Americans have some religious affiliation, which could explain their reliance on prayer for coping with stress related to illnesses or disease states. (11) These findings have implications for understanding the prevalence to which other ethnic groups rely on prayer as an alternative complementary health strategy for managing health conditions. For example, they could provide a framework to guide the manner in which nurses/healthcare providers construct clinical modalities to help patients manage their illness experience. In addition, knowing that certain ethnic groups are more likely to rely on prayer as an alternative complementary health strategy provides a potential rationale for nurses and other healthcare providers to integrate the use of prayer into their clinical practice.

The question arising from the above findings is do ethnic groups differ in their use of prayer as a complementary health strategy for managing health conditions? Studies exploring this question discovered a pattern that suggested nonwhites relied on prayer differently than whites for coping with chronic pain, functional impairment, and depression. (12-15) What makes these findings compelling to our analysis is that nonwhites were more likely to rate prayer as an important and efficacious complementary health strategy than the white study participants.

Since few studies have explored the use of prayer as a complementary health strategy for managing human immunodeficiency virus (HIV)-related symptoms among ethnically diverse HIV-infected individuals, the primary objective of this analysis was to describe the differences in the use of prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea in an ethnically diverse sample (N = 1071 adults) who were HIV seropositive participating in a multisite study. The study sites were located in the United States, Taiwan, and Norway.

METHODS

Data were collected using a convenience sample of 1071 (n = 876, United States; n = 118, Norway; and n = 77, Taiwan) HIV-infected individuals who were participating in a multisite study investigating health strategies for symptom management as one of its objectives by the University of California, San Francisco (UCSF) International HIV/AIDS (acquired immunodeficiency syndrome) Nursing Research Network. For this analysis, the data collected were analyzed from a demographic questionnaire developed by the authors, an HIV symptom checklist, and self-care activity sheets containing categories of complementary health strategies for symptom management. For the multisite study, data were collected from community-based clinics, outpatient clinics, peer support groups, and through the mail.

In the multisite study, participants were asked to select the number of days the HIV-related symptoms--anxiety, depression, fatigue, and nausea--were experienced during the past week. If a particular symptom was endorsed, they were asked to rate the frequency (the number of days the symptoms occurred) and intensity of the HIV symptom on a scale of 1 to 10 (1 = low, 10 = very high). For each symptom endorsed, the participants were instructed to select self-care management strategies from a 23-item checklist categorized by activities/thoughts, exercise, medications, complementary therapies, substance use, and other strategies.

Our analysis focused on the complementary therapy category, therefore, we selected only those cases where prayer was used as a complementary health strategy, to describe the predictors of prayer use for managing HIV-related anxiety, depression, fatigue, and nausea.

STUDY INSTRUMENTS

A demographic questionnaire developed by the authors was used to collect data on the following characteristics: gender; age; race/ethnicity; education; income; health insurance; employment; HIV data--AIDS diagnosis, CD4 counts, and HIV symptoms; and whether an individual believed they acquired HIV from having sex with a man or a woman.

Self-care study sheets

The self-care activity sheets were derived from an earlier study investigating self-care symptom management in people living with HIV/AIDS. Participants in this previous study were asked in an open-ended format to identify the most occurring physical and psychological symptoms. Twenty-three self-care behaviors were reported and were categorized by activities and thoughts, exercise, medications, complementary therapies, substance use, and other. For each self-care activity, participants were asked to indicate yes or no as to whether they had tried a particular health strategy, how often they used the strategy (daily, weekly, or monthly), and the effectiveness of the health strategy on a scale of 1 to 10 (1 = not at all effective; 10 = very effective) for managing HIV-related symptoms.

Prayer was a symptom management strategy within the complementary category for only the following HIV-related symptoms: anxiety, depression, fatigue, and nausea. Therefore, we chose to focus our analysis on the use of prayer as a complementary health strategy for managing these symptoms. Content validity of the scale was supported by nurse experts in HIV/AIDS care and additional pilot testing of the items was conducted with persons with HIV/AIDS.

The Revised Sign and Symptom Checklist for Persons with HIV Disease

The Revised Sign and Symptom Checklist for Persons with HIV Disease (SSC-HIV rev) has 3 parts; however, for the analysis only part I and part II were used. (16,17) Part I consists of 45 items and 11 factor scores, along with a total score, with reliability estimates ranging from 0.76 to 0.91; part II consists of 19 HIV-related symptoms that do not cluster into factor scores but may be of interest from a clinical perspective. (16) For the scale, experiencing HIV symptoms can range from mild (1) to moderate (2) to severe (3). Symptoms are only endorsed if an individual is experiencing them on the day of data collection and are left blank if not experienced on that day. For the analysis, the mean number of HIV symptoms was calculated.

Human subjects protection

An institutional review board for the protection of human subjects approved the study protocol for each site--California State University, Fresno; Hunter College, City University of New York; Massachusetts General Hospital, Institute of Health Professions, Boston, Mass; Ohio State University; College of Nursing of Rutgers, the State University of New Jersey; St Vincent's Hospital, New York; Texas A&M University--Corpus Christi; University of California, San Francisco; University of North Carolina, Wilmington; College of Nursing, Virginia Commonwealth University; National Taiwan University; and University of Oslo. Informed consent was obtained, providing an explanation of the study purpose, procedures, possible risks and discomforts, and benefits. Assurance of confidentiality was provided through a written consent form prior to administering the questionnaire.

RESULTS

Data were analyzed using SPSS Version 12.0 on the final sample of 1071 ethnically diverse HIV-infected men and women who were from multiple study sites within the United States, Norway, and Taiwan, with a mean age of 41.80 [+ or -] 8.36 years having a range of 20 to 84. The sample comprised African Americans (n = 448, 25%), whites/Anglo non-Hispanics (n = 273, 18%), Hispanics/Latinos (n = 189, 12%), Asians/Pacific Islanders (n = 126, 2%), Native American Indians (n = 17, 1%), and other (n = 13). These ethnic categories were also used to classify the study participants from Taiwan and Norway. Hereafter, nonwhite will be used to classify African Americans, Hispanics/Latinos, Asian Pacific Islanders, and Native Americans, and white will be used to classify those who are whites/Anglo non-Hispanics.

The demographic data indicated a greater proportion of the white study participants reported attending college and beyond than the nonwhite study participants. A higher proportion of nonwhites study participants had medical insurance and had more children. A greater proportion of the white study participants knew their CD4 cell counts than the nonwhite study participants. Both groups reported fairly similar mean scores of HIV symptoms, but their scores did not differ significantly. Comparatively, a higher number of the white study participants reported having sex with men, and more nonwhite study participants reported having sex with women. A greater frequency of the white study participants reported acquiring HIV by having sex with men.

Chi-square analysis determined significant differences exist between the nonwhite and white study participants and the frequency of prayer use for managing HIV-related anxiety, depression, fatigue, and nausea. Seventy-two percent of nonwhites reported experiencing anxiety in the past week, and 73% of those experiencing anxiety reported using prayer as a complementary health strategy.

A higher proportion of nonwhite study participants who experienced HIV-related anxiety, depression, fatigue, and nausea during the past week reported using prayer as a complementary health strategy for alleviating these HIV-related symptoms than the white study participants. The t test showed that while the nonwhite study participants rated the effectiveness of prayer as a complementary health strategy for managing HIV-related anxiety, depression, and fatigue significantly higher than the white study participants; overall, both groups rated prayer to be efficacious, and the differences in the rating of effectiveness was not significant (Tables 1-3).

Because few studies have described predictors of self-prayer as complementary health strategy for symptom management for individuals living with HIV/AIDS, a multiple logistic regression analysis was used to describe the predictors of the use of prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea when controlling for demographic variables in an ethnically diverse sample.

For analysis, the ethnicity of the United States, Taiwan, and Norway

study participants was dummy coded into the following groups: 1 = African Americans, 2 = whites, 3 = Asian Pacific Islanders, 4 = Hispanics, and 5 = Native Americans. Gender, income, and education were dummy coded as follows: gender: 1 = female, 0 = nonfemale; income: 1 = not adequate, 0 = adequate; and education: 1 = completed high school or more, 0 = high school or less. Listwise deletion was used in the analytic strategy to address missing values. Four regression models using simultaneous entry were calculated on the HIV-related symptoms--anxiety, depression, fatigue, and nausea--with the use of prayer or not using prayer as the dependent variable. The Hosmer and Lemeshow Test was used to test the overall fit of the logistic regression models.

Because the study participants varied in their selection of prayer as a complementary health strategy for a given HIV-related symptom, the sample size varied among the 4 regression models. The regression analysis showed that African Americans were 6.17 times and Hispanic Americans 2.67 times more likely to use prayer for managing HIV-related anxiety than whites. In addition, for every 0.029 increase in age, the study participants were 1.0 times more likely to use prayer than those who were younger. Females were 1.8 times more likely to use prayer for managing symptoms of anxiety than the male participants.

When using prayer for managing depressive symptoms, African Americans were 5.78 times and Hispanic Americans 2.8 times more likely to rely on prayer than the white study participants. Older study participants experiencing an increase in HIV symptoms were more likely to use prayer than younger participants or those reporting few HIV symptoms. Females were 2.2 times more likely to use prayer for depression than male study participants. To manage symptoms of fatigue, African Americans were 4.6 times and Hispanic Americans 3.4 times more likely to use prayer than the other ethnic groups. Those reporting experiencing a 0.008-unit increase in HIV symptoms and a 0.037-unit increase in age were 1.0 times more likely to use prayer to manage symptoms of fatigue.

The female participants were 2.4 times more likely to use prayer for managing fatigue. The final model showed that for every 0.009-unit increase of HIV symptoms, study participants experiencing HIV symptoms were 1.0 times--and the female participants 2.4 times--more likely to use prayer for managing nausea than the male participants who reported experiencing few HIV symptoms (Tables 4-7).

DISCUSSION

Regardless of ethnic group, prayer was used for managing HIV-related anxiety, depression, fatigue, and nausea. Nevertheless, ethnic groups did differ in their use of prayer. These findings are consistent with previous studies, however; it contributes new knowledge about how prayer is used as a complementary health strategy for the management of HIV-related anxiety, depression, fatigue, and nausea in an ethnically diverse sample of HIV-infected individuals. Very few studies have examined the use of prayer as a health strategy for managing HIV-related anxiety, depression, fatigue, and nausea among HIV-infected individuals. Our analysis described the significance of certain predictors of the use of prayer as an efficacious alternative complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea among the study participants. However, there are limitations to consider.

STUDY LIMITATIONS

The use of a cross-sectional design limits the generalizability of the findings of our analysis. While we did control for socioeconomic status and gender, the lack of an experimental design did not allow us to control for all of the potential confounders to our analysis. Hence, further rigorous studies are needed to determine whether our findings can be replicated. In addition, we acknowledge that there are inherent weaknesses in relying on self-report data on the use of prayer as a complementary health strategy, as perception is subjective. Geographic differences were also not accounted for in the analysis given the sample sizes varied, therefore, our ability to attribute any differences in the use of prayer by national or international origin is clearly limited. While it is feasible to report international variations in the use of prayer, one must interpret any finding with caution given the differences in religious or spiritual practices between the United States, Taiwan, and Norway, which is why no contrasts comparisons were made between the United States and the other countries.

In addition, while our analysis is significant, we clearly bear in mind that we did not assess previous prayer activities. Furthermore, we did not investigate the effectiveness of intercessory prayer (ie, praying for others), as it was not the objective of the analysis. These limitations make it essential for future researchers to employ more robust study designs to continue investigating the efficacy of the use of prayer as a complementary health strategy for managing HIV-related symptoms.

Previous research studies indicated that prayer has been used as a complementary health strategy for managing stroke, rheumatoid arthritis, depression, and self-esteem. (17-21) A central empirical finding reported by these studies is that study participants perceived prayer to be helpful for managing the uncertainty associated with these conditions. Studies examining complementary health strategies used by persons with HIV infection provided data that substantiated how individuals with HIV infection sought a variety of health strategies for managing their HIV-related anxiety and fatigue. (22-24)

Because of the uncertainty that each day brings to an individual living with HIV/AIDS, the feasibility of being able to access alternative resources to traditional medical care becomes paramount. Nurses/healthcare providers are challenged to incorporate alternative therapeutic approaches when teaching HIV-infected individuals effective health strategies for managing the comorbidities associated with HIV infection. An understanding of how different ethnic groups may employ alternative complementary health strategies to manage their HIV-related symptoms has the potential to provide nurses/healthcare providers with the necessary tools for enhancing the physical and mental well-being of their patients who are HIV seropositive.

Although our analysis did not specifically examine the effects of intercessory prayer, we employed an analytical method to capture self-report data about the use, frequency, and the effectiveness of using self-prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea.

Based on the analysis, the physical or psychological benefit derived from using prayer as a complementary health strategy for HIV-related anxiety, depression, fatigue, and nausea warrants further exploration of the use of prayer for managing symptoms experienced by individuals living with HIV infection. When individuals are experiencing a physical illness such as HIV infection, our analysis revealed that prayer is a significant buffer for coping with the unpleasant symptoms associated with HIV infection. This important finding provides data to nurses/healthcare providers about the frequency and effectiveness of the use of prayer as a complementary health strategy.

Exploring how to incorporate prayer into clinical practice as a complementary health strategy for alleviating HIV-related anxiety, depression, fatigue, and nausea are important clinical practice activities for nurses/healthcare providers providing medical care to an ethnically diverse HIV-infected population. Investigating whether the frequency of prayer is correlated with the amount of HIV-related anxiety, depression, fatigue, and nausea experienced by HIV-infected individuals--or whether nurses/healthcare providers are sufficiently trained in using prayer for promoting healthy responses among HIV-infected populations that are ethnically diverse--are important clinical implications that warrant further investigation.

Our analysis contributes to the evidence found in other studies describing the use of prayer as a complementary health strategy for improving the health of individuals with declined functional status, lung cancer, and poor psychological well-being. (1-3) Ethnicity, gender, age, and HIV symptoms were significant predictors of the use of prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea in the analysis. Our analysis suggests that for the study participants experiencing HIV-related anxiety, depression, fatigue, and nausea, ethnic differences, being older, experiencing HIV symptoms, and being female accounted for the selection of prayer as a complementary health strategy. However, the authors do not suggest the findings are an indication that whites did not value the use of prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea. On the other hand, our analysis indicated one's ethnicity did predict the odds of the use of prayer, which may be a reflection of the cultural norms within a particular ethnic group.

NURSING IMPLICATIONS

The analysis is relevant to nurse/healthcare providers when developing clinical health strategies for improving health outcomes in HIV-infected patients. Hence, nurses/healthcare providers can be more cognizant that while not all ethnic groups rely on the use of prayer, for those who do, engaging in self-prayer may buffer the stress associated with HIV-related anxiety, depression, fatigue, and nausea. In addition to nurses/healthcare providers, our analysis has implications for researchers as well.

RESEARCH IMPLICATIONS

Our analysis provides a foundation for future work to continue to explore the prevalence of self-prayer among different ethnic groups living with HIV/AIDS. Since few studies have explored the use of prayer as a complementary health strategy for managing HIV-related anxiety, depression, fatigue, and nausea, more studies are needed to corroborate our analysis. This is essential since our analysis was limited by a nonprobabilistic design and other factors previously described.

Future research should employ designs that are more rigorous to tease out the complex intricacies associated with using prayer as complementary health strategy for symptoms associated with HIV infection. More studies examining both intercessory prayer and self-prayer as a complementary health strategy for managing HIV-related symptoms are necessary because more knowledge about the use of these activities for managing disease-related symptoms, in general, and among the symptoms experienced by HIV-infected individuals, will advance the science of using prayer as a complementary health strategy.

CONCLUSIONS

Understanding behavior responses to HIV infection and other health conditions is complex and is often difficult to quantify. However, given the plethora of empirical evidence describing the importance of prayer as a complementary health strategy, more research is clearly warranted to compare the efficacy of prayer along with other clinical health modalities that could be potentially beneficial to individuals who are HIV seropositive.

REFERENCES

(1.) Palmer RF, Katerndahl D, Morgan-Kidd J. A randomized trial of the effects of remote intercessory prayer: interactions with personal beliefs on problem-specific outcomes and functional status. J Altern Complement Med. 2004;10(3):438--448.

(2.) Meraviglia MG. The effects of spirituality on well-being of people with lung cancer. Oncol Nurs Forum. 2004;31(1):89-94.

(3.) Tloczynski J, Fritzsch S. Intercessory prayer in psychological well-being: using a multiple-baseline, across-subjects design. Psychol Rep. 2002;91(3, Pt 1):731-741.

(4.) Berman E, Merz JF, Rudnick M, et al. Religiosity in a hemodialysis population and its relationship to satisfaction with medical care, satisfaction with life, and adherence. Am J Kidney Dis. 2004;44(3):488-497.

(5.) Koenig HG, George LK, Titus P, Meador KG. Religion, spirituality, and acute care hospitalization and long-term care use by older patients. Arch Intern Med. 2004; 164:1579-1585.

(6.) McCaffrey AM, Eisenberg DM, Legedza AT, Davis RB, Phillips RS. Prayer for health cancers: results of a national survey on prevelence and patterns of use. Arch Intern Med. 2004; 164(8 ):858-862.

(7.) Banks-Wallace J, Parks L. It's all sacred: African American women's perspectives on spirituality. Issues Ment Health Nurs. 2004;25(1):25-45.

(8.) Conner NE, Eller LS. Spiritual perspectives, needs and nursing interventions of Christian African-Americans. J Adv Nurs. 2004;46(6):624-632.

9. Coleman CL. The contribution of religious and existential well-being to depression among African American heterosexuals with HIV infection. Issues Ment Health Nurs. 2004;25(1): 103-110.

(10.) Dessio W, Wade C, Chao M, Kronenberg F, Cushman LE, Kalmuss E. Religion, spirituality, and healthcare choices of African American women: results of a national survey. Ethn Dis. 2004; 14(2): 189-197.

(11.) Carter JH. Religion/spirituality in African-American culture: an essential aspect of psychiatric care. J Natl Med Assoc. 2002;94(5):371-375.

(12.) Dunn KS, Horgas AL. Religious and nonreligious coping in older adults experiencing chronic pain. Pain Manag Nurs. 2004;5(1):19-28.

(13.) Cummings SM, Neff JA, Husaini BA. Functional impairment as a predictor of depressive symptomatology: the role race, religiosity, and social support. Health Soc Work. 2003;28(1):23-32.

(14.) Ang DC, Ibrahim SA, Burant CJ, Siminoff LA, Kwoh CK. Ethnic differences in the perception of prayer and consideration of joint arthroplasty. Med Care. 2002;40(6):471-476.

(15.) Cooper LA, Brown C, Vu HT, Ford DE, Powe NR. How important is intrinsic spirituality in depression care? A comparison of white and African-American primary care patients. J Gen Intent Med. 2001;16(9):634-638.

(16.) Holzemer WL, Hudson A, Kirksey KM, Hamilton MJ, Bakken S. The revised sign and symptom check-list for HIV (SSC-HIV rev). J Assoc Nurses AIDS Care. 2001;12(5):60-70.

(17.) Robinson-Smith G. Prayer after stroke. Its relationship to quality of life. J Holistic Nurs. 2002;20(4):352-366.

(18.) Williams T. Intercessory prayer and its effect on patients with rheumatoid arthritis. Ky Nurse. 2002;50(1): 16.

(19.) Ameling A, Povilonis M. Spirituality, meaning, mental health, and nursing. J Psychosoc Nurs Ment Health Serv. 2001;39(8 ):10.

(20.) Harding OG. The healing power of intercessory prayer. West Indian Med J. 2001 ;50(4):269-272.

(21.) O'Laoire S. An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression. Altern Ther Health Med. 1997;3(6):39-53.

(22.) Kemppainen J, Holzemer W, Nokes K, et al. Self-care management of anxiety and fear in HIV disease. J Assoc Nurses AIDS Care. 2003;14(2):21-29.

(23.) Corless I, Bunch E, Kemppainen J, et al. Self-care for fatigue in patients with HIV. Oncol Nurs Forum. 2002;29(5):E60-E69.

(24.) Kirksey K, Goodroad B, Kemppainen J, et al. Complementary therapy use in persons with HIV/AIDS. J Holistic Nurs. 2002;20(3):264-278.

* Christopher Lance Coleman, PhD, MPH, APRN-BC, ACRN * Lucille S. Eller, PhD, RN

* Kathleen M. Nokes, PhD, RN, FAAN * Eli Bunch, DNSc, RN * Nancy R. Reynolds, PhD, CNP, FAAN

* Inge B. Corless, PhD, RN, FAAN * Pam Dole, EdD, MPH, RN, NP * Jeanne K. Kemppainen, PhD, RN

* Kenn Kirksey, PhD, RN, APRN-BC, CNS * Liz Seficik, PhD, RN, CS

* Patrice K. Nicholas, DNSc, MPH, RN, ANP * Mary Jane Hamilton, PhD, RN

* Yun-Fang Tsai, PhD, RN * William L. Holzemer, PhD, RN, FAAN

From the University of Pennsylvania, Philadelphia, Pa (Dr Coleman); the College of Nursing of Rutgers, the State University of New Jersey (Dr Eller); the Hunter College, City University of New York (Dr Nokes); the University of Oslo (Dr Bunch); the Ohio State University (Dr Reynolds); the Massachusetts General Hospital, Institute of Health Professions, Boston, Mass (Drs Corless and Nicholas); the Greenwich House, New York (Dr Dole); the University of North Carolina, Wilmington, NC (Dr Kemppainen); the University of California, San Francisco (Holzemer); the Ben Taub General Hospital, Houston, Tex (Dr Kirksey); the Texas A&M University--Corpus Christi (Drs Seficik and Hamilton); and the National Taiwan University, Taiwan (Dr Tsai).

[ti-poil]

L'étude a porté sur 1,800 patients devant subir une opération cardiaque:
600 d'entre eux savaient que des gens prieraient pour eux,
600 autres savaient que l'on prierait peut-être pour eux et l'on a effectivement prié pour eux, et
600 autres savaient que l'on prierait peut-être pour eux et l'on n'a pas prié pour eux.

Les chercheurs ont trouvé que la prière n'a fait aucune différence chez ceux qui n'étaient pas sûr si on allait prier pour eux. Par contre, chez ceux qui savaient que l'on allait prier pour eux, on a noté plus de risques de complications post-opératoires.

http://www.nature.com/news/2006/060327/ ... 16.html#B1

Il serait également interessant de savoir de ce nombre de 1,800 patients la proportion AT et croyant?
Cette donné est disponible?

[adhemar]

Salut AT,

Le résultat de cette dernière étude est moins surprenant. En revanche, je ne trouve toujours pas d'explication convaincante pour la corrélation inverse. Il y a bien l'hypothèse de Ghost - du stress induit par les proches via leurs prières - mais ça ne me convainc qu'à 75%.


Adhémar

[A.T.]

Il serait également interessant de savoir de ce nombre de 1,800 patients la proportion AT et croyant?
Cette donné est disponible?

Non. C'est vrai que l'on aurait pu voir si les croyants étaient davantage favorisés par la prière, ce qui aurait pu être un indice que l'effet placebo a opéré ou un indice de ...l'existence de Dieu.

Le résultat de cette dernière étude est moins surprenant. En revanche, je ne trouve toujours pas d'explication convaincante pour la corrélation inverse. Il y a bien l'hypothèse de Ghost - du stress induit par les proches via leurs prières - mais ça ne me convainc qu'à 75%.

Les experts pensent que la révélation qu'on allait prier pour eux les a rendus plus anxieux. Mais de toute façon il n'y a pas eu une grande différence par rapport aux autres groupes (14% seulement). Je pense que l'étude tend à nous indiquer seulement que la prière n'a pas d'effet sur la santé d'un autre.

[ti-poil]

Il serait également interessant de savoir de ce nombre de 1,800 patients la proportion AT et croyant?
Cette donné est disponible?

Non. C'est vrai que l'on aurait pu voir si les croyants étaient davantage favorisés par la prière, ce qui aurait pu être un indice que l'effet placebo a opéré ou un indice de ...l'existence de Dieu.

Serait curieux de voir la réaction/stress du AT en toi qui verrai une couple de prieurs(euses) dans sa chambre d'hopital?

T'es cuit au mieux la camisole.

[A.T.]

Serait curieux de voir la réaction/stress du AT en toi qui verrai une couple de prieurs(euses) dans sa chambre d'hopital?

T'es cuit au mieux la camisole.

Non, j'suis pas fanatique. Ça me ferait de la compagnie.

[ti-poil]

Serait curieux de voir la réaction/stress du AT en toi qui verrai une couple de prieurs(euses) dans sa chambre d'hopital?

T'es cuit au mieux la camisole.

Non, j'suis pas fanatique. Ça me ferait de la compagnie.

Moi non plus, sauf que force est d'admettre qu'ils me tomberais religieusement sur les nerfs.

Autres résumés d'études sur le sujet.

[Mikaël]

Salut AT,

Le résultat de cette dernière étude est moins surprenant. En revanche, je ne trouve toujours pas d'explication convaincante pour la corrélation inverse. Il y a bien l'hypothèse de Ghost - du stress induit par les proches via leurs prières - mais ça ne me convainc qu'à 75%.


Adhémar

C'est simple, Dieu en a marre de se faire prier pour des guérisons, alors il se rebiffe pour que le laisse un peu tranquille

Autres possibilités :

- Les patients étaient en majorité des hérétiques confessant un autre Dieu que celui qui a été prié

- Les résultats ont été magouillés par un lobby d'athées extrémistes et brûleurs d'églises, de croyants, de cierges (euh, non, pas de cierges...).

- Dieu existe vraiment et a voulu nous apporter un signe de son existence, mais comme Dieu n'a pas à être commandé, qu'il aime nous surprendre, et qu'il a des tendances sado-maso, il nous a apporté un signe inverse de celui attendu. Alléluia ! Nous n'avons qu'à remercier le Seigneur !

[A.T.]

chez ceux qui savaient que l'on allait prier pour eux, on a noté plus de risques de complications post-opératoires.

En conclusion de cette étude, on peut dire que si vous voulez du mal à quelqu'un, priez pour lui! Et dites-le lui!


Mais, plus sérieusement, que pensez-vous de l'entêtement de la ville de Laval, Québec, à vouloir conserver la prière en début des séances du conseil? Voici la prière en question:
« Daignez, Seigneur, nous vous en supplions, nous accorder votre grâce et les lumières nécessaires pour la conduite de notre assemblée et la bonne administration de notre ville. Amen! »
Il me semble qu'une prière intérieure ferait aussi bien l'affaire, leur Dieu étant supposé entendre cela aussi. Donc, je propose une minute de silence. Mais de grâce, que le maire cesse d'utiliser nos taxes pour défendre un bout de phrase!