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Article

Faith at the Edge of Life: A Mixed-Methods Study of Near-Death Experiences and Spiritual Transformation in the Philippines

by
Fides A. del Castillo
1,*,
Gregory S. Ching
2,
Clarence Darro del Castillo
3 and
Stefan Huber
4
1
Department of Theology and Religious Education, De La Salle University, Manila 1004, Philippines
2
Graduate Institute of Educational Administration and Policy, National ChengChi University, Taipei City 116, Taiwan
3
Lumina Foundation for Integral Human Development, Inc., Calamba 4027, Philippines
4
Institute of Empirical Research on Religion, University of Bern, Längassstr. 51, CH-3012 Berne, Switzerland
*
Author to whom correspondence should be addressed.
Religions 2025, 16(9), 1158; https://doi.org/10.3390/rel16091158
Submission received: 30 July 2025 / Revised: 31 August 2025 / Accepted: 3 September 2025 / Published: 9 September 2025
Versions Notes

Abstract

Near-death experiences (NDEs) encompass transformative existential experiences that lead to religious change. Although most previous research focused primarily on Western contexts, there remains less understanding of individuals’ interpretations of NDEs in pluralistic societies such as the Philippines. Using a mixed-methods approach, this study examined the relationship between NDEs and spiritual transformation in a sample of 683 Filipino adults who acknowledged having NDEs. Quantitative data were assessed in terms of levels of religiosity, NDE occurrence, and perceived spiritual change according to different demographics. Statistical analyses included descriptive statistics, Chi-square tests, and logistic regression. For the qualitative analysis, narrative responses on the reason why their spirituality increased, stayed the same, or decreased were thematically classified. Six focused phenomenological narratives are noted: altruism and helping others, challenges to spirituality, increased and strengthened religious practices, no changes or decreased faith, reflection and growth, and validation of divine presence. In addition, while the majority reported increased or unchanged spirituality following their NDE, only age emerged as a significant predictor of perceived spiritual change. Overall, findings highlight how personal experience, identity, and cultural beliefs shape religious meaning-making after NDEs. This study offers a culturally grounded understanding of spiritual change and highlights the value of a mixed-methods approach in religious studies.

1. Introduction

Near-death experiences (NDEs) are profound existential events that frequently trigger significant changes in individuals’ spiritual and religious orientations. Research consistently shows that NDEs often lead to heightened spirituality, shifts in religiosity, and deeper reflections on existential questions (Khanna and Greyson 2014; Long and Woollacott 2024). These transformations are observed across diverse populations, with many individuals reporting increased belief in an afterlife, greater engagement with religious practices, or even complete changes in their spiritual worldview (Khanna and Greyson 2014; McLaughlin and Malony 1984; Sutherland 1990). For others, however, NDEs can lead to spiritual conflict, alienation from organized religion, or disillusionment with previously held beliefs (Kopel and Webb 2022; Braghetta et al. 2013).
Empirical studies highlight the variability of these outcomes. Khanna and Greyson (2014) found that NDEs are frequently associated with posttraumatic growth, including greater spiritual insight, while Royse and Badger (2017) documented positive life changes following NDEs in trauma survivors. Conversely, Kopel and Webb (2022) observed that some individuals experience religious doubt or estrangement from faith communities after NDEs. This duality underscores the complex interplay of personal, cultural, and contextual factors in shaping post-NDE spiritual trajectories.
While most literature on NDEs has been documented in Western societies and points toward clinical populations, psychological correlates, or neurobiological explanations (Kopel and Webb 2022; Parnia 2017; Pratte 2022), little is known about how NDEs are interpreted in a religiously pluralistic and culturally diverse society like the Philippines (Cornelio and Aldama 2022; Macaranas 2021). In the Philippines, where Catholic, Protestant, Muslim, Indigenous, and folk spiritualties coexist, spiritual transformation may take different forms; hence, Western paradigms may not be applicable.
This study draws from the concepts on narrative psychology, religious coping, post-traumatic growth, and meaning-making to understand how individuals make sense of NDEs. These frameworks highlight that spiritual transformation is not simply a reaction to the experience. Instead, it is a function of previously held belief systems, social identities and cultural scripts. For example, religious coping theory (Pargament 1997) distinguishes between positive and negative types of religious responses to adversity, while meaning-making models (Park and Folkman 1997) focus on the reinterpretation of core beliefs in the aftermath of trauma. These concepts are useful for examining the variety of emotional, symbolic, and behavioral responses that might unfold after an NDE.
The importance of this study lies in the use of a mixed-methods approach in exploring both the cultural and personal dynamics of spiritual transformation. By integrating structured survey-oriented data with qualitative narrative accounts, the current study captures both the measurable correlates of NDEs among Filipino adults and the lived meanings of NDEs. Importantly, the study advances cross-cultural understandings of religiousness and existential meaning-making, but also offers implications for pastoral care, spiritual counseling, and public discourses related to death and faith. Five specific research objectives (RO) are as follows:
RO1: To describe the levels of self-reported spirituality or religiosity, the prevalence of NDE, and perceived changes in religiosity among respondents, and to examine their distribution across key demographic characteristics (age, gender, education, and religion).
RO2: To describe the distribution of perceived changes in religiosity or spirituality among respondents who reported experiencing a near-death event, and to identify patterns in increased, decreased, or unchanged spiritual outlook following the event.
RO3: To identify demographic and experiential predictors (e.g., NDE) of perceived spiritual change using multivariate analysis.
RO4: To categorize and analyze the open-ended responses using thematic analysis and to examine their congruence or divergence with self-reported spiritual change.
RO5: To explore how demographic characteristics and NDE status predict thematic patterns in the narrative framing of the open-ended responses (based on the coded themes), using cross-tabulation and to assess how lived context influences meaning-making narratives following NDEs.

2. Literature Review

2.1. Cultural and Spiritual Dimensions of NDE in the Philippines

A traumatic event involves an incident that severely threatens the well-being of the individual or others. It elicits intense fear, helplessness, or horror (Center for Behavioral Health Statistics and Quality 2016). Many people experience traumatic events worldwide, such as robberies, automobile accidents, and life-threatening diseases (Benjet et al. 2016, p. 327). Adolescents in low- and middle-income countries (LMICs) often experience traumatic events such as violence, severe injury, and natural disasters. Consequently, nearly one third of adolescents in LMICs may have post-traumatic stress disorder (PTSD) (Stupar et al. 2021, p. 1).
Individuals may seek support from loved ones, confront their feelings, and prioritize self-care when dealing with traumatic stress (Pratte 2022). However, those who are religiously involved often turn to their religious beliefs and practices to cope with life’s most difficult challenges (Koenig 2018; Pargament et al. 2011). In the Philippines, the majority of Filipinos believe in God. Also, Filipinos are mainly religious, and most believe there is an afterlife (Haerpfer et al. 2022). Importantly, many Filipinos use religion as a coping resource during turbulent times (Patinio 2020). Moreover, religion is also associated with many Filipino adolescents’ mental health (Estrada et al. 2019; Del Castillo et al. 2023). Empirical evidence shows that many Filipino Catholic youths use positive religious coping strategies to deal with significant life stressors (del Castillo and Alino 2020).
Surviving near-death situations or extreme physical or emotional danger can affect an individual’s spirituality and post-traumatic growth. Many people with profound spiritual experiences at the point of death (hereafter referred to as “near-death experiences” or NDEs) report more remarkable spiritual growth (Khanna and Greyson 2014). Additionally, NDEs can help trauma survivors make positive life changes (Royse and Badger 2017). While many NDEs appear to be positive, there is evidence that some are also terrifying and dreadful (Newberg and D’Aquili 1994). Although there are many studies that have been done on NDEs (Braghetta et al. 2013; Cant et al. 2012; Parnia et al. 2022; Parnia et al. 2007), to our knowledge, none have been conducted on Filipino adult NDEs and their impact on religiosity. By exploring this understudied area, the research could contribute to better well-being outcomes and support systems in a country where spiritual beliefs are deeply intertwined with daily life.

2.2. NDE: A Blend of Science, Spirituality, and Perception

Scientists view death as a process (Condic 2016). Thus, a person’s death can be reversible, provided that the cellular processes within the body have not reached biological irreversibility (Parnia et al. 2022, p. 6). There are limited reports that some individuals who appeared dead have returned to life (Sahni 2016). However, numerous people claim to have NDEs. There is no agreed-upon definition of NDEs (Charland-Verville et al. 2014). However, it generally refers to an individual’s profound spiritual experiences when under intense threat, seriously ill, or near death (Khanna and Greyson 2014; LaRosa 2025). Greyson (1983) developed the Greyson NDE Scale, a validated 16-item instrument that quantifies NDE phenomenology and is commonly used to distinguish true NDEs from other intense experiences. Although each NDE is distinct, they share some characteristics (Long 2014). Many NDE survivors report seeing and hearing outside their bodies, passing through a tunnel, or experiencing mystical light. Some individuals exposed to NDEs report having intense and generally positive emotions, reviewing their past lives, and returning to earthly life (Moody 1975, as cited in Long 2014, p. 372). Moreover, some individuals characterize their NDEs as ineffable, transcendental, and having positive transformative effects (Parnia et al. 2022, p. 7). Some scholars, however, argue that out-of-body experiences, tunnel-of-light experiences, and positive emotions associated with NDEs are psychological or neurophysiological. Consequently, they are not paranormal. The appropriate expectation of an individual, such as belief in the archetypal NDE package, can play a significant role during an NDE (Mobbs and Watt 2011).
NDEs can enhance spirituality or religiosity when perceived as religious experiences (Khanna and Greyson 2014; McLaughlin and Malony 1984; Schlieter 2018; Sutherland 1990). Even some agnostic and atheist individuals have reported a shift toward a more spiritually guided life after experiencing NDEs (San Filippo 2006). However, Kopel and Webb (2022) claimed that religion and NDEs have a complicated relationship since NDEs can result in spectacular conversions or disillusionment with organized religion. Furthermore, Parnia et al. (2022) analyzed the literature on near-death experiences. They found that NDEs “…are often used unsystematically to describe a wide range of unrelated, heterogeneous human experiences, most of which have little or no relation to death, critical illness or each other” (p. 18). For this reason, they suggest the term “recalled death experiences” or RED instead of NDE. RED is a cognitive experience during a loss of consciousness related to a life-threatening event (p. 19).
NDEs have helped some people deal with stress better. For some individuals, believing in life after death and in a benevolent God provides a framework for infusing life events with meaning, positively impacting their coping behavior (Brumm 2006). Many individuals who have experienced critical situations, comas, or NDEs report that they have tried to forget about them. They pray the rosary daily, attend church on Sundays, and study the Bible to cope (Boado et al. 2020). Nonetheless, the study of NDEs from a scientific and religious perspective may bring a paradigm shift in medical treatment. It can lead to integrating scientific research and belief with patient disease experiences (Kopel and Webb 2022).
As NDEs do not necessarily lead to profound spiritual experiences for all people exposed to them (Parnia et al. 2022), some experiencers may feel physically threatened and extremely frightened by the traumatic event. Some individuals who have experienced trauma are at risk of psychological distress if they fail to identify, describe, express, and process their distressing emotions (Fang and Chung 2019). However, religion can provide people with a sense of purpose and order in the face of death and suffering. Religiously involved people use their powerful cognition of the transcendent as a coping mechanism. Religion can contribute to mental health (van Uden and Zondag 2016). Taken together, these findings highlight the need to investigate NDEs through both spiritual and scientific lenses, more specifically within culturally and religiously diverse populations such as the Philippines.

2.3. Theoretical Perspectives on Spiritual Transformation Following NDEs

Recognizing how people understand and react to NDEs requires a theoretical framework that includes multiple perspectives. This study uses four interrelated theoretical perspectives: narrative psychology, religious coping theory, post-trauma growth, and meaning-making theories to conceptualize spiritual transformation not simply as a result of the NDE, but as a contextualized process of development inside cultural, social, and personal meaning systems.
Narrative psychology contends that individuals make sense of life events, including trauma and transition, by creating stories and reconstructing their own personal narratives (McAdams 2001). In the case of NDEs, survivors often engage in retelling and reinterpreting their experiences, and they create existential meaning and spiritual value out of the NDE narratives (Martial et al. 2017). These narratives do not appear in a cultural vacuum; rather, they draw on culturally appropriate scripts, spiritual worldviews and religious belief systems (Ursu 2022). This allows the individual to reformulate their identities after what they perceive to be an encounter with dying. Pargament (1997) theory on religious coping highlights the spectrum of positive and negative responses in the aftermath of stressful/traumatic experiences. Positive religious coping includes surrendering to a higher power, prayer, and emotional comfort (Del Castillo et al. 2023; Shannonhouse et al. 2024). Negative religious coping is associated with emotional discontent, vengeful and punitive faith attributions or questioning faith (Lee et al. 2013). In other words, when individuals confront the spiritual or non-spiritual reality of NDEs, it will be framed by their beliefs and coping strategies into either sacred meaning affirming divine presence or the non-sacred, non-divine reality challenging their own worldview. Given the Filipino context, where deep-rooted religious beliefs often provide significant psychological support, this religiosity context can be especially useful during challenging times.
Post-traumatic growth (PTG) theory proposes that an individual may experience positive psychological and existential transformations after trauma (Tedeschi and Calhoun 1996). NDEs, though potentially distressing, may stimulate greater life appreciation, spiritual insights, and stronger social connections (Khanna and Greyson 2014; Royse and Badger 2017). While PTG is not guaranteed, it relies on individual reflection, meaning reconstruction, and supportive social contexts that facilitate recovery and transformation. Lastly, Park and Folkman (1997)’s meaning-making model is centered on the cognitive and emotional effort involved in reconciling life events conflicting with an individual’s global belief system. After an NDE, an individual frequently finds his or her former worldview disrupted (Park et al. 2010). In a general meaning-making framework, when someone undergoes a difference in experience with normalcy (such as the like of an NDE), it involves reconciling that difference by either adjusting the appraisal of the event or changing the individual’s core beliefs. Therefore, it can be understood in this framework that spiritual transformation is not an automatic outcome of the NDE. Instead, it is a product of the individual integrating an NDE into their self and an understanding of life.
When put together, all of these frameworks provide a rather strong perspective for understanding how Filipino adults make sense of NDEs and report spiritual change. Additionally, they acknowledge that change is not only attributed to the event’s content but also mediated through cultural norms, pre-existing beliefs, and psychological mechanisms. Furthermore, these models provide a basis for understanding both the quantitative indications of religious change and the qualitative narratives of meaning-making, which is quite important in a religiously plural and spiritually expressive culture such as the Philippines.

3. Results

3.1. Patterns of Religiosity Among Individuals with NDE

This foundational objective provides an overview of respondents’ spiritual and experiential characteristics. Analyzing the prevalence of NDEs across demographic groups helps identify patterns of spiritual transformation that are shaped by social and cultural contexts. Understanding these patterns offers insight into how NDEs influence individuals’ worldviews and belief systems. Such knowledge contributes to a broader understanding of the role of spirituality in meaning-making and human development.
Table 1 shows the demographic profile of the 1908 respondents (cross-tabulated for participants with and without perceived NDEs). Gender distribution shows that a majority of respondents identified as female (17.77 + 40.62 ≈ 58%), followed by male (38%), and LGBTQ individuals (4%). In terms of age group, the sample was predominantly young adults aged 18–34 years (85%), with middle-aged adults (35–54 years) comprising 10%, and older adults (55 years and above) making up 5%. Regarding educational attainment, nearly half of the respondents were high school graduates (48%), while 37% were college graduates, and 16% had attained post-graduate education. Religious affiliation was overwhelmingly Roman Catholic (79%), consistent with national demographics. Other Christian denominations accounted for 17% of the sample, while 3% identified with other religions, and 1% reported having no religious affiliation (Atheist).
When asked to self-assess their level of spirituality or religiosity. A combined 89% reported moderate to high levels of religiosity: 44% identified as “moderately” religious, 25% as “quite a bit”, and 20% as “very so much”. Only 3% reported being “not at all” religious and 9% reported “not very much”. Overall, a moderate level of spirituality was noted from the entire sample with a mean score of 3.50 (SD = 0.99) on a 5-point Likert type scale. Among the 1908 respondents, 36% or 683 reported having experienced an NDE, while 64% had not. With respect to perceived spirituality or religiosity change, among valid responses (n = 657), a majority of around 15% or 285 respondents indicated an increase and around 7% or 134 respondents reported a strong increase in religiosity or spirituality. Only a small proportion reported a decrease (1% or 27 respondents) or strong decrease (1% or 24 respondents), while the remaining 10% or 187 respondents indicated no change. These results confirm that the sample largely reflects national religious and educational demographics, with a youthful age distribution and strong Catholic majority.
Table 2 shows the Chi-square tests to explore the relationship between NDE and demographic variables. Findings show a significant association between gender and reported NDE occurrence, χ2 (2, N = 1908) = 33.93, p < 0.001, indicating that the likelihood of reporting an NDE varied across gender groups. Descriptive results (please refer to Table 1) revealed that LGBTQ+ respondents (relative to their subgroup size) were more likely to report NDEs than male and female participants, with male respondents reporting the lowest incidence. This indicates that the distribution of NDE reports varied meaningfully across gender groups, with females, males, and LGBTQ+ respondents differing in their likelihood of reporting an NDE. In contrast, no statistically significant associations were found between NDE occurrence and age group, χ2 (2, N = 1908) = 2.08, p = 0.353; educational attainment, χ2 (2, N = 1908) = 1.08, p = 0.584; or religious affiliation, χ2 (3, N = 1908) = 7.26, p = 0.064. These findings highlight gender as a significant predictor of NDE reporting, while suggesting that age, education, and religious background do not substantially differentiate those who have experienced an NDE from those who have not within the study respondents.
Furthermore, perceived change in religiosity was also analyzed across various demographic categories. Table 3 shows that gender was significantly associated with perceived changes in religiosity, χ2 (8, n = 657) = 17.28, p = 0.027. This suggests that male, female, and LGBTQ respondents reported different patterns of spiritual transformation following their NDEs. Similarly, significant association was also found between age group and change in religiosity, χ2 (8, n = 657) = 40.26, p < 0.001, indicating that younger, middle-aged, and older adults differed significantly in how they perceived their spirituality to have changed after an NDE. This may reflect life stage differences in spiritual interpretation or existential meaning-making (Bicego et al. 2023; Lange et al. 2004). In contrast, no significant associations were observed between perceived spiritual change and either educational attainment, χ2 (4, n = 657) = 1.95, p = 0.744, or religious affiliation, χ2 (6, n = 657) = 6.45, p = 0.374. These results suggest that prior religious identity or level of formal education may not significantly influence how individuals interpret spiritual changes following an NDE.

3.2. Patterns of Change in Religiosity After NDE

This section narrows the focus to only those respondents who reported an NDE. Literature suggests that such experiences can act as turning points in personal belief systems (Sutherland 1990). To examine whether and how individuals perceived changes in their religiosity or spirituality following an NDE, open-ended responses were systematically recoded into three overarching categories: increase, no change, and decrease. This recoding was guided by both conceptual clarity and analytical feasibility. Similar three-directional coding schemes have been widely used in NDE research to capture the directionality of spiritual change (Greyson 2006; Park 2005; Ring 1984; van Lommel et al. 2001). Grouping responses in this way allows for a meaningful description of patterns in spiritual transformation, enabling comparison and interpretation, while maintaining the integrity of respondents’ reported experiences.
Among the 683 individuals who reported experiencing an NDE, only 657 respondents provided valid responses to the question about perceived changes in their religiosity or spirituality. Table 4 shows that the majority of respondents who experienced a near-death event reported an increase in religiosity or spirituality (n = 419, 64%). A smaller group reported no change in religiosity or spirituality (n = 187, 28%), while only a minority reported a decrease in their religious or spiritual outlook (n = 51, 8%). This distribution suggests that most participants considered NDEs a catalyst for spiritual development or renewed religious participation, consistent with prior research portraying NDEs as spiritually affirming (Greyson 2006; Ring 1984; van Lommel et al. 2001). However, the presence of respondents who reported no change or a decline also highlights the complexity and individuality of meaning-making. It is possible that some of these cases reflect false positives, instances wherein the respondents self-identified as having had an NDE, though the experience may not meet clinical or phenomenological criteria such as those outlined in the Greyson NDE Scale. These divergent interpretations are further explored through qualitative narratives in the succeeding sections.

3.3. Associations Between NDEs and Self-Reported Spiritual Transformation

This section moves from descriptive summaries to explanatory analysis, using multinomial logistic regression to identify which demographic and experiential variables are associated with different directions of spiritual change. Given the multifaceted nature of spiritual transformation, predictors such as age, gender, educational attainment, religious affiliation, and the occurrence of an NDE were included. The dependent variable was perceived change in religiosity or spirituality, categorized as increased, no change, or decreased, with “No change” serving as the reference category for comparison.
Table 5 shows the results indicating that age was a statistically significant predictor. Specifically, older individuals were more likely to report an increase in religiosity or spirituality compared to reporting no change (Odds Ratio, OR = 1.028; 95% Confidence Interval, CI [1.005, 1.052]; p = 0.017). Although statistically significant, the effect size was small and the CI was barely above 1.0, suggesting the result may reflect a minor trend amplified by the sample size rather than a strong practical effect. Nonetheless, this may imply that spiritual transformation tends to intensify with age, possibly due to life-stage reflections or accumulated existential experiences. A decrease in religiosity was inversely associated with age, but this trend was not statistically significant (p = 0.089). Other predictors, such as gender, education, religion, and NDE, did not significantly predict perceived spiritual change in either direction. Notably, the lack of association between NDEs and reported change may suggest that, while NDEs are powerful events, other personal and contextual factors mediate whether they lead to spiritual transformation. These findings indicate that demographic variables, particularly age, may influence spiritual change, yet the subjective interpretation of NDEs remains complex. To further explore how individuals make meaning of their experiences, the next section focuses on qualitative narrative accounts.

3.4. Narratives of Change: Thematic Insights into Spiritual Transformation After NDEs

To deepen understanding of how individuals interpret spiritual transformation following an NDE, thematic analysis was accomplished on the open-ended responses from those who elaborated on the reasons behind their reported spiritual change. Among the 657 individuals who experienced an NDE and answered the closed-ended change question, 310 provided valid narrative responses to Question 4 “Why or in what ways did your spirituality or religiosity increase or decrease?” This qualitative subset allowed for a closer examination of the meanings and emotions attached to perceived spiritual transformation. Importantly, this qualitative exploration complements the earlier quantitative patterns by capturing the lived meanings behind self-reported changes in religiosity or spirituality.
Six key themes emerged from the coded responses, comprising a range of experiences from an increase in faith to spiritual conflict, or decline. These themes were inductively developed and iteratively refined to reflect both common and subtle stories within the dataset. Each theme is described below in brief detail, along with illustrative quotes directly from participants’ responses.

3.4.1. Theme 1: Altruism and Helping Others

For some, spiritual change was expressed through acts of service or a heightened sense of moral responsibility. NDEs motivated them to support others, often as an expression of their faith. One respondent shared, “I built a tutorial center to help children.” These altruistic responses suggest that spiritual transformation, for some, manifested in prosocial behavior (Khanna and Greyson 2014).

3.4.2. Theme 2: Challenges to Spirituality

Some participants described how their spiritual outlook was complicated or negatively impacted following their NDE, often because the meaning they derived from the experience conflicted with their prior religious roles or community expectations. These accounts frequently involved feeling judged or excluded by religious communities or experiencing inner conflict about personal identity and belief. For example, one respondent reported, “I left the church because I am a bisexual deaconess and felt unwelcome.” This quotation illustrates how an NDE can interact with pre-existing social identities and institutional norms to produce spiritual dissonance and disengagement; it is offered to show an interaction effect (NDE × social context), not to imply that the NDE caused the respondent’s sexual orientation. Such narratives demonstrate that profound experiences do not uniformly lead to religious growth and may instead exacerbate tensions that hinder spiritual well-being.

3.4.3. Theme 3: Increased Faith and Strengthened Religious Practices

Many individuals shared that their NDE led to a deepened faith and more regular engagement in religious practices such as prayer, attending worship, or trusting in divine providence. As one respondent noted, “I put God at the center, and nothing is impossible.” These responses often described NDEs as catalysts for renewed spiritual discipline and a stronger connection to God.

3.4.4. Theme 4: No Changes or Decreased Faith

Not all NDEs led to spiritual growth. Some respondents reported no meaningful shift in their religious or spiritual orientation, while others experienced a decline in belief or disengagement from religious institutions. One participant plainly stated, “My spirituality stayed the same despite the experience.” These responses challenge the assumption that NDEs are uniformly transformative.

3.4.5. Theme 5: Reflection and Growth

Several respondents framed their experience as a moment of personal reflection that led to gratitude, renewed purpose, or acceptance of divine will. These accounts emphasized introspection rather than ritual practice. One participant remarked, “God gave me a second chance to live and be with my loved ones.” This theme highlights the transformative nature of NDEs in prompting re-evaluation of life values.

3.4.6. Theme 6: Validation of Divine Presence

A number of individuals described their NDE as proof of divine reality or miraculous intervention. These respondents often recalled supernatural experiences that affirmed their belief in a higher power. For example, one said, “I saw the face of Jesus during my battle with cancer.” These accounts demonstrate how NDEs were interpreted as direct spiritual encounters.
Table 6 below summarizes the six identified themes, their descriptive interpretations, emotional tones, and selected quotes illustrating each theme.
Lastly, many of the responses (n = 95) were too brief, ambiguous, or off-topic to be reliably classified and were categorized as “Uncategorized.” While excluded from thematic interpretation, these were retained in the overall dataset for transparency. Overall, the qualitative findings reveal that while most participants reported enhanced religiosity or spiritual reflection after their NDE, a significant minority expressed more complex or even disillusioned experiences. These diverse themes emphasize the need to view spiritual transformation as multifaceted, contingent on personal context, identity, and prior belief systems. In the next section, we explore how these thematic categories vary across demographic profiles and examine the alignment between narrative meaning-making and quantitative indicators of spiritual change.

3.5. Crosstabulation of Themes and Demographic Profiles: Understanding Diverse Spiritual Journeys

Previous objectives examined the prevalence and predictors of self-reported spiritual change following an NDE. This section shifts the analytical lens from what changes occurred to how individuals interpreted those changes. Specifically, it explores whether demographic characteristics, such as age, gender, education, and religion are associated with distinct thematic framings of spiritual transformation. This inquiry draws on perspectives from narrative psychology, which posit that interpretations of extraordinary life events are not solely shaped by the events themselves, but are filtered through an individual’s identity and broader socio-cultural context (McAdams 2001). Accordingly, the way people articulate spiritual change, whether in terms of renewed faith, altruism, spiritual struggle, or existential reflection, may reflect deeper demographic and cultural influences.
To examine this, chi-square tests were conducted between thematic categories (from open-ended responses) and key demographic variables (See Table 7). Results indicate that none of the tested demographic characteristics were significantly associated with the type of theme expressed (all p-values > 0.05). These findings suggest that the meanings individuals assign to NDEs are shaped more by personal reflection and experience than by demographic background.

4. Discussion

4.1. Interpretation of the Findings

This discussion interprets findings from both quantitative and qualitative analyses in relation to the study’s conceptual frameworks: narrative psychology, religious coping, post-traumatic growth, and meaning-making theory. These frameworks illuminate how spiritual transformation after NDEs unfolds not only as an individual reaction to crisis, but also as a socially and psychologically situated process.
Initially, we examined whether perceived changes in religiosity or spirituality following an NDE varied across demographic characteristics. While narrative psychology suggests that meaning is filtered through life histories and sociocultural contexts (McAdams 2001), our descriptive results showed significant differences by gender and age group. However, in multivariate analysis, only age significantly predicted increased spirituality, with no significant effects found for gender, education, or religious affiliation. This partially aligns with the idea that existential events such as NDEs may invoke a deeply personal meaning-making process that often transcends demographic predictors (Park 2005). In other words, spiritual transformation may not be contingent on external identities, but instead arise from an internal re-evaluation of life purpose and mortality.
In addition, the strong pattern of increased religiosity (64%) after NDEs supports the notion that these events act as spiritual turning points. From the lens of post-traumatic growth theory, such change can be seen as a positive psychological shift following crisis, particularly in domains of existential and spiritual belief (Tedeschi and Calhoun 1996). Simultaneously, religious coping theory helps explain why some individuals turn more deeply to faith after trauma; relying on spiritual resources to make sense of suffering, regain control, or experience divine support (Pargament 1997). However, the presence of respondents who reported no change or even a decrease (28% and 8%, respectively) highlights the relevance of meaning-making theory, which posits that growth is not inevitable, but depends on how individuals reconcile the disruption of their global meaning systems (Park et al. 2010).
Furthermore, multinomial regression revealed that age was a significant predictor of increased spirituality, consistent with developmental perspectives linking aging to greater existential reflection and openness to transcendence (Wink and Dillon 2002). Yet, neither education, gender, religious background, nor NDE status significantly predicted the direction of change. This supports the view that spiritual transformation is more dependent on perceived meaning rather than objective experience. This is actually an emphasis on subjective appraisal in determining whether an event leads to change (Park 2005). Thus, having an NDE may not be sufficient in itself; what matters is how the individual integrates that experience into their life story, which is a core tenet of narrative psychology.
For the qualitative results, the six identified themes from the participants’ narrative responses directly illustrate the narrative construction of meaning following an NDE. Respondents framed their experiences using diverse storylines; from the divine affirmation to existential conflict. Themes such as increased faith, validation of divine presence, and altruism align with religious coping and post-traumatic growth, suggesting that some individuals used their NDE as a springboard for renewed purpose and deepened faith. Conversely, themes like challenges to spirituality and no change reveal the complexities of religious identity, particularly for those whose experiences led to spiritual dissonance or marginalization. These findings affirm Neimeyer (2011) view that personal narratives after trauma may oscillate between growth and disruption, and that religious schemas may be revised, affirmed, or rejected depending on context. While a reclassification of themes into positive versus non-positive categories could offer additional insight into affective trends, we chose to retain the six inductively derived themes to preserve the conceptual richness and complexity of participants’ spiritual interpretations.
Lastly, although cross-tabulations did not yield statistically significant associations between demographic characteristics and thematic categories, this does not discount the importance of lived context. Drawing from narrative psychology and sociological theories of religion, Ammerman (2014) argued that spiritual narratives are shaped not only by the event itself, but also by how one’s identity interacts with prevailing social norms. For instance, marginalized individuals may express doubt or distance from organized religion despite undergoing profound experiences. The fact that the themes did not clearly cluster along demographic lines reinforces the notion that meaning-making is fluid and context-sensitive rather than structurally determined. These findings support ongoing calls for more integrated, mixed-methods approaches to studying spirituality and existential transformation.

4.2. Limitation of the Study

This study offers valuable insights into spiritual transformation following NDEs; however, several limitations should be acknowledged. First, the sample size and diversity were limited to Filipino participants, restricting the generalizability of the findings. A broader, more diverse population is needed to explore cross-cultural differences in meaning-making after NDEs. Second, the reliance on self-reported data introduces potential biases, such as memory recall errors or social desirability, which may skew results. In particular, participants were only asked whether they had experienced a near-death experience, without applying a validated diagnostic instrument such as the Greyson NDE Scale. This may have resulted in overreporting or misclassification, and future research should consider standardized screening instruments or provide an explicit definition to improve classification validity. Third, the cross-sectional design provides only a view of participants’ experiences. Longitudinal studies are needed to track spiritual transformation over time and examine its long-term development. Lastly, qualitative analysis needs statistical testing for thematic patterns. Mixed-methods approaches could strengthen the validity of future findings. Addressing these limitations in future research will enhance the understanding of spiritual transformation across diverse populations and contexts.

4.3. Future Investigation

Religiosity and spirituality, though related, are distinct constructs. Religiosity can be measured using scales like the Centrality of Religiosity Scale (CRS-5; Huber and Huber 2012), while spirituality requires tools that assess personal experiences of transcendence and meaning. Using separate scales will clarify their unique roles in spiritual transformation. Future studies should also explore the strength and content of religiosity and spirituality. This includes measuring the intensity of beliefs and practices, as well as the emotional and cognitive dimensions of these experiences. Huber and Richard (2010)’s framework on positive (e.g., gratitude) and negative (e.g., guilt) religious emotions can offer deeper insights into the complexity of spiritual experiences. These methods will enable researchers to explore how varying levels of religiosity and spirituality influence responses to NDEs. They will also facilitate cross-cultural comparisons and help track long-term spiritual trajectories, offering insights into growth, conflict, or stagnation. By differentiating and examining the strength and content of religiosity and spirituality, future studies can better capture the nuances of spiritual transformation, advancing both theory and practical applications in counseling and spiritual care.

5. Materials and Methods

5.1. Design and Procedures

The current study employed an explanatory sequential mixed-methods design to explore spiritual transformation following NDEs in a diverse Filipino population (Ivankova et al. 2006). The research began with a quantitative analysis of self-reported changes in religiosity or spirituality, followed by a qualitative examination of open-ended responses to deepen understanding of participants’ narratives and meaning-making processes. The data were collected in August 2022 utilizing a stratified multistage probability sampling method to ensure national representation across key regions, urban and rural sectors, and socio-economic classes (Etikan and Bala 2017). The original sample consisted of 2065 respondents, but for the purposes of this study, cases involving minors under 18 years old and those with incomplete responses were excluded. The final analytic sample comprised 1908 adult participants from across the Philippines.
The study adheres to standard protocols in survey research, including voluntary participation, verbal informed consent, and confidential handling of data. Respondents were assured anonymity, and no personally identifiable information was included in the dataset provided to the research team. All analyses were conducted on de-identified data, and the study aligns with ethical norms for minimal-risk social research as outlined in national and international guidelines.

5.2. Participants

The final sample consisted of 1908 adult respondents (aged 18 years and above) from across the Philippines, drawn from a larger national survey conducted in August 2022. As noted earlier, the participants were selected using a stratified multistage probability sampling method, ensuring representation from various regions (Luzon, Visayas, and Mindanao), socio-economic classes, and urban–rural areas. This sampling approach allowed the dataset to reflect the diversity of the Filipino adult population. Of the total sample, 683 respondents (36%) reported having experienced an NDE and were included in the core analysis addressing spiritual transformation. Among these, 657 individuals provided valid responses to the question on perceived changes in religiosity or spirituality, while 405 participants elaborated further through open-ended responses describing the nature and reason for their spiritual change. Demographic variables analyzed in the study included age, gender, highest educational attainment, and religious affiliation, which were used to assess group differences in perceived spiritual change and thematic interpretation of NDEs.

5.3. Measures

The current study utilized a structured survey instrument administered by Pulse Asia, which included both closed-ended and open-ended questions relevant to religiosity, NDEs, and spiritual change. The following measures were used in the analysis:
NDE—Participants were first asked whether they had ‘ever had a near-death experience (NDE).’ Responses were coded as 1 = Yes and 0 = No. Only those who responded “yes” (n = 683) were included in analyses related to perceived spiritual change. To standardize interpretation, respondents who answered ‘yes’ were shown this definition and list of common features: By this we mean a life-threatening situation in which you were close to death and had extraordinary experiences. Examples of such experiences are: Acceleration of your experience of time or thoughts, recalling events of your life as if in a movie, deep understanding of who you are, feeling of harmony, perception of deceased or spiritual beings, feeling of being separated from your own body, perception of a bright light or a border to the afterlife. Respondents reporting one or more features were classified as self-identified NDE experiencers. While this approach allows for broad screening, it may lead to false positives due to self-interpretation and lack of standardized criteria. We recognized that the Greyson NDE Scale (Greyson 1983) is a widely used instrument for identifying ‘true’ NDEs based on phenomenological features. However, due to the nature of our survey and time constraints, the scale was not applied in this study. As such, our findings reflect perceived or self-reported NDEs rather than clinically validated experiences.
Perceived Change in Religiosity/Spirituality—To assess self-reported spiritual transformation following an NDE, participants were asked: “Did your religiosity or spirituality change after the experience?” Responses were open-ended but were later recoded into three categories: 1 = Decreased, 2 = No change, and 3 = Increased. This recoding followed existing conventions in NDE and religious coping literature (e.g., Greyson 2006; Park 2005; Ring 1984) and allowed for categorical comparison.
Demographic Variables
Age: Recorded as a continuous variable and grouped into age categories for subgroup analysis.
Gender: Coded as 1 = Male, 0 = Female. Furthermore, participants were given the additional option to select an identification with a non-binary LGBTQ category.
Educational Attainment: Grouped into categories (e.g., high school, college, or postgraduate).
Religious Affiliation: Self-identified religion (e.g., Roman Catholic, other Christian denominations, others, or none).
Qualitative Narrative Response—Participants who reported a change in spirituality were invited to answer the open-ended question: “Why or in what ways did your spirituality or religiosity increase or decrease?” These narrative responses (n = 405) were subjected to thematic analysis. Responses were first classified by emotional valence (positive vs. non-positive), then inductively grouped into six overarching themes: altruism and helping others, challenges to spirituality, increased and strengthened religious practices, no changes or decreased faith, reflection and growth, and validation of divine presence. Responses that could not be reliably categorized (n = 95) were marked as “Uncategorized.”

5.4. Data Analyses

Data analysis followed a sequential explanatory mixed-methods approach, integrating both quantitative and qualitative strategies to comprehensively examine patterns and meanings of spiritual transformation following an NDE. Analyses were conducted using IBM SPSS Statistics version 26 under leased agreement from Hearne Software(IBM SPSS Statistics version 26) or quantitative data and manual thematic coding for qualitative narratives.
Quantitative Analyses—The following statistical techniques were employed for the closed-ended survey responses:
RO1: Descriptive statistics and Chi-square tests of independence were used to examine whether perceived changes in religiosity or spirituality (increase, no change, decrease) varied across demographic groups (gender, age group, education, and religion).
RO2: A frequency analysis was conducted to describe the distribution of perceived spiritual changes among respondents who experienced an NDE (n = 657). Responses were recoded into a three-category variable for comparison: increase, no change, and decrease.
RO3: Multinomial logistic regression (Field 2024) was used to identify demographic and experiential predictors of perceived spiritual change. The dependent variable was the three-level change category, with “No Change” as the reference group. Predictors included age (continuous), gender, education level, religion, and NDE (yes/no). Model estimates were reported as unstandardized coefficients (B), standard errors (SE), odds ratios (Exp(B)), and 95% confidence intervals.
RO5: To assess how thematic categories from open-ended responses were influenced by demographic factors and NDE status, Chi-square tests were conducted between thematic groupings and variables such as gender, age group, education, and religious affiliation.
Qualitative Analysis—For RO4, open-ended responses to the question, “Why or in what ways did your spirituality or religiosity increase or decrease?” (n = 405), were analyzed using inductive thematic analysis (Proudfoot 2022). An initial round of open coding identified emergent ideas (Naeem et al. 2023), which were then grouped into six overarching themes based on recurring patterns in the data. A seventh category, “Uncategorized,” included responses that were too brief or vague for reliable classification. Themes were further evaluated for emotional tone (positive vs. non-positive) (Buetow 2025) and later cross-tabulated with reported direction of spiritual change to assess convergence between qualitative tone and quantitative outcomes.

6. Conclusions

This study examined how NDEs influence spiritual transformation among Filipino adults, focusing on the interplay of personal, cultural, and demographic factors. Through five research objectives, it provided insights into spirituality as a dynamic process shaped by individual interpretation and context. Findings revealed that more than half of those who experienced NDE were reported to have increased religiosity or spirituality afterward. Gender and age were significantly associated with perceived changes in the descriptive analyses, though regression analysis identified only age as a significant predictor of increased religiosity. Education and religious affiliation were not significant predictors in either analysis, suggesting that spiritual transformation may depend more on existential and subjective factors than on structural demographics. While NDEs often served as spiritual turning points, this was not universal, since a small number of participants reported decreased religiosity. Qualitative analysis uncovered six themes of spiritual transformation: altruism and helping others, challenges to spirituality, increased and strengthened religious practices, no changes or decreased faith, reflection and growth, and validation of divine presence. These themes highlight the diversity of meaning-making processes after NDEs, ranging from deepened faith to spiritual conflict or stagnation.
The study emphasized that spiritual narratives are highly individualized, shaped more by personal interpretation than demographic factors. It integrated frameworks such as narrative psychology, religious coping, and meaning-making theories, demonstrating that spiritual change is not automatic but influenced by pre-existing beliefs and cultural norms. Moreover, the findings have implications for pastoral care, spiritual counseling, and mental health interventions, particularly in culturally diverse settings. By recognizing the varied ways people interpret NDEs, practitioners can provide more personalized and sensitive support. This study challenges assumptions about spiritual transformation, showing that NDEs can lead to growth, stagnation, or decline depending on how they are integrated into life narratives. Future research should explore long-term spiritual trajectories and the role of support systems in shaping meaning-making.

Author Contributions

Conceptualization, S.H. and F.A.d.C.; methodology, G.S.C. and F.A.d.C.; software, G.S.C. and F.A.d.C.; validation, G.S.C. and F.A.d.C.; formal analysis, G.S.C. and F.A.d.C.; investigation, F.A.d.C., G.S.C. and C.D.d.C.; resources, G.S.C., F.A.d.C., C.D.d.C. and S.H.; data curation, S.H. and F.A.d.C.; writing—original draft preparation, F.A.d.C., G.S.C. and C.D.d.C.; writing—review and editing, F.A.d.C., G.S.C., C.D.d.C. and S.H.; visualization, G.S.C. and F.A.d.C.; supervision, G.S.C., F.A.d.C., C.D.d.C. and S.H.; project administration, G.S.C., F.A.d.C., C.D.d.C. and S.H.; funding acquisition, G.S.C., F.A.d.C., C.D.d.C. and S.H. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Fu Jen Catholic University (Ref: C109126, 2021-03-05).

Informed Consent Statement

Waiver of Document of ICF. The religiosity scale protocol was reviewed and approved by the Fu Jen Catholic University Institutional Review Board (Ref: C109126). The study was conducted as an online survey. Prior to participation, all respondents were presented with an informed consent form. Proceeding to the survey by clicking “continue” indicated their voluntary consent to participate.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Conflicts of Interest

Author Clarence Darro B. del Castillo was employed by Lumina Foundation for Integral Human Development, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Abbreviation

The following abbreviation is used in this manuscript:
NDEsNear-death experiences

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Table 1. Descriptive statistics.
Table 1. Descriptive statistics.
Variables/ItemsNDE = 1/Yes
Frequency		n = 683
Percentage		NDE = 0/No
Frequency		n = 1225
Percentage
Gender
Female33917.7777540.62
Male31416.4640521.23
LGBTQ+301.57452.36
Total68335.80122564.20
Age group
Young (18–34)59130.97103053.98
Middle-aged (35–54)603.141296.76
Older adults (55+)321.68663.46
Total68335.80122564.20
Education
High School graduate33517.5657730.24
College graduate24913.0545123.64
Post-graduate995.1919710.32
Total68335.80122564.20
Religion
No religion (Atheist)60.3160.31
Roman Catholic52127.3199452.10
Other Christian denominations1296.7619210.06
Others271.42331.73
Total68335.80122564.20
Self-reported level of spirituality or religiosity
Not at all271.42251.31
Not very much663.461025.35
Moderately28014.6856229.45
Quite a bit1638.5430816.14
Very so much1477.7022811.95
Total68335.80122564.20
Perceived change in spirituality or religiosity after NDE
Strongly decreased241.26
Decreased271.42
Stay the same1879.80
Increased28514.94
Strongly increased1347.02
Total 165734.43
Note. N = 1908. 1 Of the 683 individuals who noted having NDEs, only 657 reported the change in their spirituality or religiosity.
Table 2. Chi-square test between demographics and NDE.
Table 2. Chi-square test between demographics and NDE.
DemographicDegrees of FreedomChi-Square Testp Value
Gender233.93<0.001
Age group22.080.353
Education21.080.584
Religion37.260.064
Table 3. Chi-square test between demographics and change in religiosity.
Table 3. Chi-square test between demographics and change in religiosity.
DemographicDegrees of FreedomChi-Square Testp Value
Gender817.280.027
Age group840.26<0.001
Education41.950.744
Religion66.450.374
Table 4. Perceived change in religiosity/spirituality among respondents with NDE.
Table 4. Perceived change in religiosity/spirituality among respondents with NDE.
Perceived ChangeFrequencyPercentage
Decreased518
No change18728
Increased41964
Total657100
Note. As reported earlier, among the 683 individuals who noted having an NDE, only 657 answered the change in their spirituality or religiosity question.
Table 5. Multinomial logistic regression predicting perceived change in religiosity/spirituality.
Table 5. Multinomial logistic regression predicting perceived change in religiosity/spirituality.
PredictorBSEOR(Exp(B))95% CI for ORp Value
Increase vs. No Change
Age0.0280.0121.028[1.005, 1.052]0.017 *
Gender−0.0210.2510.979[0.599, 1.600]0.931
Education0.0820.0961.086[0.899, 1.312]0.399
Religion−0.0390.0980.962[0.793, 1.166]0.692
NDE−0.3760.3300.687[0.360, 1.309]0.254
Decrease vs. No Change
Age−0.0670.0410.935[0.866, 1.010]0.089
Gender−0.1320.4360.877[0.373, 2.066]0.766
Education0.0480.1671.050[0.756, 1.459]0.775
Religion0.1280.1771.136[0.808, 1.598]0.465
NDE−0.2510.6100.778[0.236, 2.560]0.676
Note. Reference category for the dependent variable is “No Change”. * = p < 0.05. B = Unstandardized Coefficient, SE = Standard Error, OR = Odds Ratio, and CI = Confidence Interval. Gender, education, religion, and NDE are categorical predictors; age is continuous.
Table 6. Thematic categories of spiritual change reported by respondents following NDE.
Table 6. Thematic categories of spiritual change reported by respondents following NDE.
Theme & Frequency (n)DescriptionToneIllustrative Quote
  • Altruism and helping others (16)
Faith led to prosocial actions like service or supportPositive“I built a tutorial center to help
children.”
2.
Challenges to spirituality (35)
Spiritual decline or conflict due to identity or exclusionNon-positive“I left the church because I am a
bisexual deaconess…”
3.
Increased faith and strengthened practices (113)
NDE prompted deeper faith and religious devotionPositive“I put God at the center, and nothing is impossible.”
4.
No change or decreased faith (27)
No shift or decline in religious belief after NDENon-positive“My spirituality stayed the same…”
5.
Reflection and growth (26)
Introspection, gratitude, acceptance of divine willPositive“God gave me a second chance to live…”
6.
Validation of divine presence (93)
Survival attributed to divine signs or miraclesPositive“I saw the face of Jesus during my
battle…”
Note. Themes are based on open-ended responses to the question “Why or in what ways did your spirituality or religiosity increase or decrease?”.
Table 7. Chi-square test between demographics and thematic framing of spiritual change.
Table 7. Chi-square test between demographics and thematic framing of spiritual change.
DemographicDegrees of FreedomChi-Square Testp Value
Gender56.060.302
Age group1517.690.280
Education1515.430.424
Religion3542.800.166
Note. Thematic framing is based on six inductively derived themes from open-ended responses regarding changes in spirituality or religiosity. Only categorized responses (excluding “Uncategorized”) were included in the analysis.
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del Castillo, F.A.; Ching, G.S.; del Castillo, C.D.; Huber, S. Faith at the Edge of Life: A Mixed-Methods Study of Near-Death Experiences and Spiritual Transformation in the Philippines. Religions 2025, 16, 1158. https://doi.org/10.3390/rel16091158

AMA Style

del Castillo FA, Ching GS, del Castillo CD, Huber S. Faith at the Edge of Life: A Mixed-Methods Study of Near-Death Experiences and Spiritual Transformation in the Philippines. Religions. 2025; 16(9):1158. https://doi.org/10.3390/rel16091158

Chicago/Turabian Style

del Castillo, Fides A., Gregory S. Ching, Clarence Darro del Castillo, and Stefan Huber. 2025. "Faith at the Edge of Life: A Mixed-Methods Study of Near-Death Experiences and Spiritual Transformation in the Philippines" Religions 16, no. 9: 1158. https://doi.org/10.3390/rel16091158

APA Style

del Castillo, F. A., Ching, G. S., del Castillo, C. D., & Huber, S. (2025). Faith at the Edge of Life: A Mixed-Methods Study of Near-Death Experiences and Spiritual Transformation in the Philippines. Religions, 16(9), 1158. https://doi.org/10.3390/rel16091158

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