The purpose of this review was to investigate what, why, and how patients pray. Our findings reveal that even in the face of illness, prayer remains multifaceted. Five main categories for the content and purpose of prayer were identified: 1 disease-centered prayer, 2 assurance-centered prayer, 3 God-centered prayer, 4 others-centered prayer, and 5 lamentations.
One should of course note that these categories are not mutually exclusive. Not surprisingly, disease-centered prayer was most common. However, although patients often prayed for their disease to improve or their pain to be relieved, they did not always believe or even hope for a cure. Patients may prefer to avoid asking for physical healing out of fear that God will not answer their prayer or as surrender to God's will esp. Muslims, cf. Rezaei et al.
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As Dein and Pargament suggest, prayers for psychological rather than physical changes may help people to avoid cognitive dissonance and continue to believe that God can, if he wants, intervene in the world [ 40 ]. For this reason, it is not surprising that prayers regarding disease management and decision-making were nearly as common as prayers for the disease itself. Participants also prayed for positive contributions to their experience of the disease, that is, the ability to find meaning or something positive in their disease.
According to Pargament, religion and its expression through prayer help people to understand and bear suffering by viewing them in a larger, spiritual context [ 41 ]. One surprising result of this review was that only very few studies mentioned prayers of lamentation, that is, complaint, fear, or doubt, although most religions know such struggles as inherent aspects of faith. This raises the question of whether researchers have turned a blind eye to these less pleasant aspects of prayer or whether they truly play a minor role for patients.
However, researchers may also have chosen to avoid addressing these issues because they might believe that such unpleasant aspects of prayer do not benefit patients' well-being and do not help patients to cope. Although desperate pleas and complaints to God may be associated with a greater level of anxiety, this aspect of prayer of patients deserves further research, whatever the physiological associations. Prayers of fear, complaint, and doubt are a central motif in the biblical psalms and are often reported today by clinical chaplains.
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In fact, they play an important role in spiritual traditions, as epitomized in the biblical person and experience of Job. Are doubts, despair, desolation, and complaints not part of the religious experience of patients which may find expression in religion's natural language of prayer? In addition to a lack of focus on unpleasant aspects of prayer such as complaint or doubt, our review of the literature revealed further blind spots in research on prayer among those suffering from disease.
Foremost, there is a comparative richness of data on patients from Christian backgrounds. Only one study in our review specifically investigated prayer among Muslim patients; none focused exclusively on Jewish or Hindu patients. Furthermore, a majority of studies investigated the use of prayer in patients suffering from cancer. Other chronic diseases received limited attention. Participants in most studies were on average over 50 years of age.
It would be interesting to investigate prayer among a greater variety of populations, in regard to the disease, culture, and stage of life. After all, the aphoristic statement of a hospital chaplain and retreat director seems to reflect the deeply human reality hidden in most hospitals, that is, that the most intense spiritual retreats are not usually lived and worked through in houses of retreat but in hospital beds [ 32 ]. At first glance, the personal prayer practices of patients may not appear relevant to health care professionals.
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However, we believe our findings can be useful for clinical practice because praying can be regarded as a strategy to cope and to connect with a higher source providing meaning and hope [ 42 , 43 ]. Our results have shown that many patients turn to prayer for guidance regarding treatment decisions and disease management. Physicians should be aware of this possibility and may find it helpful to address the influence of patients' prayer on their treatment decisions in a short spiritual history [ 44 ].
The results of this review on how patients pray may also be useful in the clinical setting in order to provide a suitable environment for prayer. For example, health care professionals may cooperate with the clinical chaplain to provide spiritual reading material or a quiet environment in which to pray.
Whether health care professionals should offer to pray with patients is debated among professionals.
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On the other hand, in a study by Balboni et al. The authors thank Franziska Faas MA for her cooperation in screening the databases and selecting the articles for this review. This review provides a structured picture of what research has grasped about the personal or private prayer of patients suffering from chronic physical disease. It does not offer clues to some kind of disease-specific prayer activities or empirical data on differences between the prayer of patients and prayer of general population.
This may be one possible direction for future research along with investigating prayer among patients with acute diseases. Although an attempt was made to include all relevant studies, it is possible that some may not have been found. In addition, this review does not provide a thorough criticism of the methods and strategies of the papers included. Furthermore, it was not our aim to conduct a meta-analysis, and therefore, this review has not included statistical analyses on the samples from the included 16 studies.
Nevertheless, this review provides a detailed picture of the current research and indicates a need and possible directions for future research. The authors declare that there is no conflict of interests regarding the publication of this paper. National Center for Biotechnology Information , U. Evid Based Complement Alternat Med. Published online Feb Author information Article notes Copyright and License information Disclaimer.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Background. Introduction Personal prayer of patients has been shown to be both positively [ 1 , 2 ] and negatively [ 3 — 5 ] correlated with their physical and mental well-being.
Search Results Using the aforementioned search terms, we found potentially relevant articles in the searched databases, after excluding duplicates. Open in a separate window. Figure 1. Data Extraction and Analysis After identifying articles for inclusion in the review, data from each study was extracted on the following topics: general study design qualitative, quantitative, etc.
Description of Studies As shown in Table 1 , among the selected studies the selected studies, 10 had a qualitative design Taylor and Taylor report about the same study and sample from different perspectives , 3 a quantitative design, and 3 used mixed-methods. Table 1 Overview on identified studies. Ai et al. Cotton et al.
Crane et al. Harvey and Silverman [ 36 ] What role does spirituality play in the self-management of chronic illness in adults? Participants asked for alleviation from their illness and used prayer to shape their experience of the disease. Harvey and Cook [ 37 ] What role does spirituality play in the self-management of chronic illness among adult women with chronic conditions? Klafke et al.
Lagman et al. Prayer helped participants to find strength and see their illness in a positive light.
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Levine et al. Most women prayed for healing but also offered thanks and asked for guidance, strength, comfort, and protection before surgery or for others. Meraviglia [ 31 ] How can an instrument for assessing prayer activities, experiences, and attitudes of people with cancer be adapted? As physical functioning decreased, the use of prayer increased. Individual characteristics e. Richmond et al.
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Smith et al. Also, participants questioned the meaning of having cancer, the nature of God, why God does not always answer prayers. Taylor and Outlaw [ 27 ] Why, when, and how do person with cancer pray and what outcomes do they expect? In particular, patients often prayed for healing, guidance regarding treatment, and help getting through day to day life. Walton and Sullivan [ 28 ] What meaning does spirituality have for men with prostate cancer and how does it influence their treatment?
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