Faith and Prayer

A
journal dedicated to allied health
professional practice and education Vol. 2 No.
1
ISSN 1540-580X
http://ijahsp.nova.edu

A Peer Reviewed Publication of the
College of Allied Health & Nursing
at Nova Southeastern University

Observations on Prayer as a Viable Treatment Intervention:
A Brief Review for Healthcare Providers
--------------------------------------------------------------------------------

Matthew R. Kutz, PhD, M.Ed., ATC.
Palm Beach Atlantic University
West Palm Beach, FL  

Correspondence and requests for
reprints should be directed to:

Matthew R. Kutz, PhD, M.Ed., ATC
Palm Beach Atlantic University
West Palm Beach, FL
Email: 
matthew_kutz@pba.edu

Citation:
Kutz, M. Observations on prayer as a viable treatment intervention: A
brief review for healthcare provider. The Internet Journal of Allied
Health Sciences and Practice. January 2004. Volume 2 Number 1.
Keywords: Prayer, illness, treatment, faith, faith healing

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Introduction
Prayer continues to gain much notoriety and attention as a medical
intervention.  There are many places now advocating
spirituality as a form of health care.  As clinical practices
seek to enhance the quality of care given, attention should be given to
the implementation of prayer into clinical practice.  Family
physicians have begun dialogue over how to take a spiritual history or
inventory of their patients in order to assist in recovery and
prevention if illness and disease.1 Larimore1 reports that 99% of
surveyed family physicians (n=296) believe that religious beliefs can
heal, 75% believe other people’s prayers (i.e., intercessory prayer)
can promote healing. 

Based on his own clinical practice and dialogue
with other family physicians Larimore suggests that “infrequent
religious attendance or “poverty of personal faith” should be regarded
as a risk factor that is nearly equivalent to tobacco and alcohol
abuse.1  Graber and Johnson2 state “with a growing emphasis on
holistic healthcare – serving the whole person rather than the disease
entity alone – spirituality is reemerging as a relevant factor in
serving the sick and disabled."

The current literature is replete with empirical
studies and theoretical papers on the implications of prayer in health
care.  A recent ProQuest® journal search turned out over 250
peer-reviewed references related to prayer and medicine published
between 1999 and 2002 (Table 1).  Many of these studies and
others report a significant positive correlation between prayer and
health that cannot be ignored or placed on the proverbial “shelf” until
further research is completed.

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Table
1. Articles published regarding prayer.


A Sample Recent Titles Published on Prayer in Healthcare Sample of
Journals Containing Titles on Prayer in Health Care

1.   Intercessory prayer and patient outcomes in
coronary care units
2.   The effects of spirituality on health and
healing:

A critical review for athletic trainers
3.   Faith, Prayer, and Health Outcomes in Elderly
Native Americans
4.   Prayer and Health Outcomes in Church Members
5.   Prayer and Health Outcomes in Church Lay Leaders
6.   Prayer: An Ancient Healing Practice Becomes New
Again
7.   Invoking Spirituality in Medical Care
8.   Providing Basic Spiritual Care for
Patients:

Should it be the Exclusive Domain of Pastoral Professionals

1.  The British Medical Journal
2.  American Family Physician
3.  Journal of Athletic Training
4.  Clinical Nursing Research
5.  Western Journal of Nursing Research
6.  The Journal of Parapsychology
7.  Holistic Nurse Practitioner
8.  American Journal of Public Health
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Issues in General Health
For better or worse, the influence of complementary and alternative
medicine guru’s like Deepak Chopra, M.D. and Andrew Weil, M.D. have
brought much attention to the spiritual aspects of health.
“Somebody” is listening because main stream medical science thinks
prayer and meditation is worth looking into, the National Institutes of
Health (NIH) has commissioned or is currently conducting several
research studies on the affects of meditation, a specific type of
prayer, on health (Table 2).

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Table
2. Funded research on meditation.


Current NIH Funded Research Studies8
Basic Mechanisms of Meditation and Cardiovascular Disease in Older
Blacks
Basic Mechanisms of Meditation and Cardiovascular Disease in Older
Black Woman
Effects of Meditation on Mechanism of Coronary Heart Disease
Meditation-based Treatment for Binge Eating Disorders

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As indicated by NIH,8  meditation may have
a beneficial role in the lives of certain populations or
cultures.  Paloma 3 reports in 1948 90% of people polled said
“yes”, to the question, “Do you ever pray?”  Not surprisingly
that answer has not declined much.  In 1978 89% said yes, in
1988 it was 88% and in 1991 80% of those surveyed pray weekly and 57%
pray daily.  These statistics may indicate that a majority of
people have demonstrated a faith where prayer is an important element
in regular life.  Prayer has been demonstrated to promote
significant feelings of calm, relief, rest and other feelings
associated with well-being, healing and recovery.4

In 2001, the British Medical Journal reported a randomized study of the
effects of prayer on patients with bloodstream infections which
demonstrated that the patients who received prayer had a statistically
significant shorter hospital stay and a more rapid recovery (shorter
duration of fever) than the group who did not receive prayer.5

It has been reported that 82% of Americans believe prayer can cure
serious illness and that 64% want their physicians to pray with
them.6  Also giving support to the notion that religion is key
in healing is that historically hospitals have been founded by
religious institutions, churches usually. In fact a majority of
hospitals have some sort of religious service and pastoral care
department operating along side of conventional medical
practice.  It is not uncommon to find phrases similar to “to
continue the healing ministry of Jesus Christ,” such as is found in the
mission statement of St. Vincent Mercy Medical Center in Toledo, Ohio.

One of the most poignant and commonly sited studies on the intervention
of prayer is Byrd 7 who examined via a double-blind randomized design
were neither the health care providers nor the patients knew who was
being prayed for, only the people assigned to pray knew the names of
patients and nothing else.

Byrd’s study concluded that intercessory prayer
differed significantly in six variables at discharge: 1) less
intubation and ventilation assistance, 2) fewer antibiotics, 3) fewer
diuretics, 4) fewer cardiopulmonary arrests, 5) fewer episodes of
congestive heart failure, and 6) fewer cases of pneumonia. Of
particular interest is that Byrd actually mentioned who was praying and
to whom they were praying and what was prayed, something most of the
other studies leave out.  Byrd methodologies mention that the
people offering the prayers were “committed Christians” and offered
prayers to the God of the Bible.  This brings to light a
potential controversy that certain individuals have more or less
“divine” favor and/or that a certain God is more involved, interested
or concerned in the lives of humans than others.7

Clinical Implications
In light of risking negligence as health care providers become
increasingly aware of the outcomes of prayer in our different clinical
settings and as more research is completed it will become important
that integration of prayer occur.  If further findings
continue to suggest a correlation between prayer (and other spiritual
practices) and health and recovery our patients need to be made aware
of the potential benefit.  Needless to say, prayer is
important to people and consideration of individuals religious beliefs
and convictions need to be honored by clinicians and certainly not
minimized or mocked.

Rhetorical Questions
Is it the responsibility of the clinician to let the
patient know about prayer?  Based on data are the outcomes of
prayer strong enough to indicate prayer as a “mainstream” or even
complimentary medical intervention?  If it is the general
consensus that prayer does work do all the parameters and variables
(i.e., the how to and whys) need to be fully understood before prayer
is implemented?  Should the clinician be obligated to perform
the prayer on the patient or is this something that needs to be
referred to a “specialist”, and if so can it or should it be
reimbursable by insurance companies?  Depending on the
consensus of the answers to these questions, then does the faith of the
clinician become an issue and is similarity of faith between clinician
and patient and issue?  Many questions remain concerning
prayer and health outcomes, what at least appears to be understood is
that prayer does indeed have correlation with health, healing and
recovery.

Conclusions
Theoretical and subjective data contribute substantially
to the current literature and add significant contributions to the
study and development of prayer as an intervention.  The
impact of spiritual practices and discipline such as prayer are
undeniable.  Obviously issues of faith and beliefs and how to
implement those, such as through prayer, is a topic wrought with
passion.   In light of the current literature on
prayer in healthcare it can be deemed irresponsible to dismiss prayer
wholesale as a viable intervention.


Critical Questions for Further Investigation
While the current literature clearly indicates a healthy correlation
between prayer and health benefits several other questions must be
asked.  The current research is asking many interesting
questions about prayer, but a brief review of the literature indicates
that some important questions are still missing.

Given the fervency and conviction associated with different religious
beliefs are there any correlations between intensity of faith on the
part of the individuals offering the prayers and/or individuals
receiving the prayer?  Is there any correlation between
personal faith convictions and prayer outcomes for individuals who are
of different faiths?  Does the intensity and frequency
of  the prayer(s) offered affect the outcomes?

A common Christians belief is that “the fervent
prayers of the righteous avail much”. Does the specific
religion of an individual (i.e., the deity being prayed to) affect the
outcomes of prayer and does the specific religion of the patients
receiving the prayer affect the outcomes.  Byrd’s study 7
seems to indicate that who is praying (i.e., the faith and convictions
of the prayer) impact the outcome of the prayer and may also suggest
that to Whom the prayer is offered also affects the outcome of the
prayer.  One final question is of the different types of
prayer (Table 3) are there certain types that have a greater clinical
benefit or higher probability of a beneficial outcome?

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TABLE
3. Specific type of prayer


1.
Petition: asking something for yourself
2.
Intercession: Asking something for others
3.
Confession: expressing repentance or sorrow for a wrong doing
4.
Lamentation: crying out in distress asking for vindication
5.
Adoration: giving honor or praise to God
6.
Invocation: summoning or asking for the presence of God to manifest
7.
Thanksgiving: offering gratitude to God for His actions

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References
1.  Larimore, W. L. Providing
Basic Spiritual Care for Patients: Should it be the Exclusive domain of
pastoral Professionals?  American Family Physician. 2001,
63(1) 36
2. Graber, D.R., & Johnson, J.A. Spirituality and Healthcare
Organizations. Journal of Healthcare Management. 2001; 46(1) 39-50
3. Poloma, M. The effects of Prayer on Mental Well-being.
Second Opinion. 1993; 18(3): 37-51
4. Taylor, E. J., & Outlaw, F.H.  Use of prayer among
persons with cancer. Holistic Nurse Practitioner. 2002; 16(3): 46-60.
5. Leibovici, L. (2001).  Effects of remote, retroactive
intercessory prayer on outcomes in patients with bloodstream infection:
Randomized controlled trial. British Medical Journal. Dec 2001,
323:22-29 1450-1451
6. Ameling, A. Prayer: An ancient healing practice becomes new again.
Holistic Nursing Practice. 2000; 14(3) 40-48
7. Byrd, Randolph. Positive Therapeutic Effects of Intercessory Prayer
in a Coronary Care Unit Population. Southern Medical Journal.1988;
81(7) 826-829.
8. National Institutes of Health. Web Site. 
http://search2.google.cit.nih.gov/search?q=prayer&site=NCCAM&client=NCCAM_frontend&proxystylesheet=NCCAM_frontend&output=xml_no_dtd&filter=0&getfields=*&proxyreload=1&x=9&y=5
9. Foster, R. Prayer: Finding the Hearts
True Home. San Francisco: Harper San Francisco. 1992.

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Health Benefits of Prayer
Armstrong Williams


Is any among you sick?
Let him call for the elders of the church, and let them pray over him.
(James 5:14)

Prayer heals. So
say thousands of Americans who use prayer to improve their health.
According to a study by Dr. Anne McCaffrey of the Harvard Medical
School, one-third of Americans use prayer to facilitate physical
healing. Sixty-nine percent of the 2,000 people surveyed said prayer
greatly improved their health.

Additional studies
have linked prayer to positive health outcomes with high blood
pressure, asthma, heart attacks, headaches and anxiety. "It's not a
fringe thing," says McCaffrey. "I think very mainstream Americans are
using prayer in their daily lives."

Though Western medicine, with its focus on
scientifically quantifiable results, tends to eschew the links between
prayer and healing, the Old and New Testament have long espoused the
healing power of prayer. A prayer for the sick is a regular part of
Catholic and Jewish religious services. Members of Muslim congregations
often conclude daily services by asking the imam to offer a special
prayer for those who are sick.

'This is the most
ancient, widely practiced therapy on the face of the earth," said Dr.
Mitchell Krucoff, a professor of medicine and cardiology at Duke
University Medical Center

Patients describing the benefits of prayer
often talk about how it provides a sense of well-being. Makes sense.
When we accept God, we achieve a spirituality that connects us to the
significance of life and provides an immutable foundation from which to
judge right and wrong.

This foundation is
not transient like the vain and materialistic trappings of life. It is
eternal. Even during the worst hardships, when the other things in our
lives seem to fall apart, we can still find peace in the eternal love
of God.

People who
understand this will feel God's love reflected back. That is to say, a
person cannot love God without loving himself. How could a belief
system designed to bring about such a sense of peace not have positive
general health benefits?

Of course, none of this means that
spiritual health is a substitute for traditional medicine, or that
prayer will ensure physical well-being. After all, many saints suffered
from a laundry list of physical maladies. We are only human.

But what's telling
about the Harvard study is that it reveals just how critical a
component prayer is in most Americans' lives. Doctors cannot and should
not ignore that. Traditional medicine needs to explore this critical
component of patients' lives to better understand their response to
illness and recovery. "Doctors need to realize that we don't have the
market on what people are doing to make themselves feel better," says
McCaffrey.

Of course, it is
difficult to test the effects of prayer. You cannot reduce spirituality
to a quantifiable figure. You can't measure its effects in a beaker.
Perhaps that's why physicians are loath to discuss the matter with
patients. But the fact that prayer is a critical component in most
people's lives tells us that spirituality – when combined with
traditional medicine – should be embraced as an integral part of the
health-care process.

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Can Prayer Really Heal?

Publisher: Parade Magazine
By:
Dianne Hales

Last year, Ardie Kissinger of Bloomsburg,
Pa., a shift manager at a nuclear power plant, suffered two severe
heart attacks. "I prayed. My family prayed.  I was overwhelmed
by the number of people who prayed for me," says Kissinger, 49, a
devout Baptist. "And I believe God answered those prayers. After two
life threatening attacks, I feel great-as if I don't have a heart
condition." For the next five years, researchers at the Geisinger
Medical Center in Danville, Pa., will monitor Kissinger to see whether
his faith and prayers do indeed have a measurable impact on his
long-term recovery.

This study, one of
hundreds of scientific investigations into faith and healing,
represents a new frontier for medical research. With funding from the
National Institutes of Health (NIH), investigators at Johns Hopkins are
studying a group of women with breast cancer who say a meditative
prayer twice daily. At the University of Pennsylvania, neuroscientists
are documenting changes in brain scans of meditating Tibetan Buddhists
and praying nuns. At Baptist Memorial Hospital in Memphis,patients are
receiving a "prayer intervention" before and after bypass surgery.

"We are not out to
prove that a deity exists," says Prof. Diane Becker of Johns Hopkins,
recipient of two NIH grants for research on prayer. "We are trying to
see whether prayer has meaning to people that translates into biology
and affects a disease process."

A decade ago, this
premise would have been derided as scientific heresy. "NIH wouldn't
have reviewed a protocol with the word `prayer' in the title," says Dr.
Mitchell Krucoff of Duke University, director of one of the largest
randomized prayer studies. "When we started in the 1990s, we were
afraid of being run out of town for practicing voodoo medicine."
Medical acceptance has grown along with solid scientific data on
prayer's impact, says Dr. Dale Matthews of Georgetown University,
author of The Faith Factor. He estimates that about 75% of studies of
spirituality have confirmed health benefits.  "If prayer were
available in pill form, no pharmacy could stock enough of it," he says.

Dozens of studies
have shown that individuals who pray regularly and attend religious
services stay healthier and live longer than those who rarely or never
do -- even when age, health, habits, demographics and other factors are
considered. A six-year Duke University study of 4000 men and women of
various faiths, all over 64, found that the relative risk of dying was
46% lower for those who frequently attended religious services.

Prayer -- whether
for oneself (petitionary prayer) or others (intercessory prayer}--
affects the quality, if not the quantity, of life, says Dr. Harold
Koenig, director of Duke University's Center for the Study of
Religion/Spirituality and Health: "It boosts morale, lowers agitation,
loneliness and life dissatisfaction and enhances the ability to cope in
men, women, the elderly, the young, the healthy and the sick."

Among other
groundbreaking findings in petitionary prayer research:

o
Another Duke study of the same group of 4000 people over 64, found that
those who prayed regularly had significantly lower blood pressure than
the less religious. A third study showed that those who attended
religious services had healthier immune systems than those who did not.

o
In a study at Dartmouth Medical Center, one of the best predictors of
survival among 232 heart surgery patients was the degree to which they
drew comfort and strength from religious faith and prayer.

o
According to University of Miami research, AIDS patients who became
loner term survivors were more likely to be those involved in religious
practices and engaged in volunteer work.

o
In studies at several medical centers, prayer and faith have been shown
to speed recovery from depression, alcoholism, hip surgery, drug
addiction, stroke,rheumatoid arthritis, heart attacks and bypass
surgery.

"Nobody knows what
really happens in human beings when they pray or when you pray for them
in terms of the physiological mechanisms involved," says Duke's Dr.
Krucoff. "But it's not uncommon to be clueless about mechanisms. We
cannot explain why beta-blockers reduce death rates after a heart
attack either, but we know that they do."

Some scientists
speculate that prayer may foster a state of peace and calm that could
lead to beneficial changes in the cardiovascular and immune systems.
Using sophisticated brain-imaging techniques. Dr. Andy Newberg of the
University of Pennsylvania, author of Why God Won't Go Away, has
documented changes in blood flow in particular regions of the brain
during prayer and meditation. 'This could be the link between religion
and health benefits such as lower blood pressure,slower heart rates,
decreased anxiety and an enhanced sense of well-being," he says.

To some physicians,
the evidence for the power of prayer is far too compelling to ignore.
"I decided that not using prayer on behalf of my patients was the
equivalent of withholding a needed medication or surgical procedure;'
says Dr. Larry Dossey, a former internist who is the author of Healing
Words and Prayer Is Good Medicine. "I prayed for my patients daily."

At nine medical
centers around the country, 750 patients with potentially
life-threatening heart problems participated in the MANTRA project, a
recently concluded randomized trial of intercessory prayer, or distant
healing. The names of half of the patients were given to groups
including Carmelite nuns, Buddhist monks, Sufi Muslims and Evangelical
congregations -who prayed for their recovery.

"In the next few
months we'll look at the frequency of rehospitalizations and
complications;' says Dr. Krucoff, the project's director. "We'll see if
being prayed for had an impact." In a pilot study, prayer recipients
had 50% to 100% fewer complications.

Findings from other
intercessory prayer investigations have been mixed. In two
controversial studies in San Francisco and Kansas City, Mo., patients
in coronary care units who were prayed for by strangers had lower
complication rates. But a similar study at the Mayo Clinic found "no
significant benefits" on medical outcomes. Still, a review of 23
studies of intercessory prayer involving 2774 patients, published in
the Annals of Internal Medicine, found a positive effect in 57% and
concluded that "the evidence thus far merits further study."

Skeptics remain
dubious. "The premise behind distant healing isn't scientific," says
John Chibnall, a psychologist at St. Louis University. "Studies cannot
be designed in a scientific way." Even writers on spirituality, such as
Sophy Burnham, author of 77te Path of Prayer, concede that science may
never prove that prayer can heal others. But she adds, "That doesn't
mean that people shouldn't take advantage of this wonderful tool that's
right at their fingertips."

Americans are doing
just that. In various polls, 90% say they pray; 80% believe prayers can
heal. Khalita Jones. 27, of Lexington. N.C., is one of them. Since she
was 4, a chronic, life-threatening bone marrow disease repeatedly has
brought her near death. Every time, Jones has bounced back --
astounding her doctors. "I couldn't get through a day without prayer;'
says Jones, who founded He Cares, a spirituality-based organization for
the chronically ill. "I've no doubt that it's the reason I'm as healthy
as I am despite having a potentially fatal disease."

Will science ever
be able to prove this? "While I personally believe that God heals
people in supernatural ways, I don't think science can shape a study to
prove it,"says Dr. Koenig. "But we now know enough, based on solid
research, to say that prayer, much like exercise and diet, has a
connection with better health."