Search Results (113)

Background: Spirituality is increasingly seen as a key component of patient-centered care, especially in serious illness or surgery. However, its role among surgical patients in Eastern Europe remains underexplored. Objective: To assess daily spiritual experiences among surgical patients compared to healthy individuals in the Bucovina region (northeastern Romania). Methods: This observational case-control study included 102 participants (51 surgical patients and 51 healthy controls), recruited between March 2023 and April 2024. Participants completed the validated Romanian version of the Daily Spiritual Experiences Scale (DSES). Results: Surgical patients reported significantly higher mean DSES scores (M = 66.27, SD = 16.40) than healthy individuals (M = 55.06, SD = 12.81; p < 0.001). Higher scores were also associated with female gender (p = 0.002), older age, and oncological conditions. Widowed and highly educated participants showed a trend toward higher spirituality, though it was not statistically significant. Conclusions: Surgery may intensify spiritual experiences, possibly as a coping response to perceived risk. Addressing spiritual needs in perioperative care—particularly among women, older adults, and oncology patients—could enhance holistic care and improve patient well-being. Full article

Background: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention. Full article

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

Parents provide most of the support needed for children with cerebral palsy (CP) to increase the child’s participation and independence. Understanding the experiences of parents caring for children with CP is essential for developing effective family programs and services. The current knowledge about parents’ experiences in CP is based on studies in Western countries, with little known about this phenomenon in Arab countries like Saudi Arabia. This study aimed to understand the unique experiences and support needs of Saudi parents caring for children with CP from a social-ecological perspective. We conducted a qualitative, exploratory, descriptive study involving 12 semi-structured interviews with mothers and fathers of children with different types of CP. We analyzed the data using a reflexive thematic approach, following six distinct phases. Participants’ narratives revealed a complex caregiving journey marked by both challenges and rewards. Support from Saudi nuclear and extended family members was considered important; however, many parents expressed a need for additional physical and financial assistance from their families. Parents reported feeling stressed and experiencing challenges in accessing and navigating educational and healthcare services. Our findings highlight that Islamic values play a crucial role in the experiences of Saudi parents. These values foster a sense of collectivism, highlighting the importance of family support and community involvement, which can affect the Saudi caregiving environment. Parents remain an essential yet often invisible part of the Saudi caregiving system. Without adequate support, parents are at risk of experiencing social, financial, academic, physical, and mental health challenges, which may affect their overall family well-being. Future work may need to consider spiritual and gender roles when developing programs or services to support Saudi parents of children with CP. Full article

This study investigates the integration of Artificial Intelligence (AI) in Religious Education (RE), a field traditionally rooted in spiritual formation and human interaction. Amid increasing digital transformation in education, theological institutions are exploring AI tools for teaching, assessment, and pastoral engagement. Using a critical literature review and analysis of institutional case studies, the paper examines the historical development of AI in education, current applications in general and theological contexts, and the ethical challenges it introduces, especially regarding decision making, data privacy, and bias as well as didactically grounded opportunities such as AI-mediated dialogic simulations. The study identifies both the pedagogical advantages of AI, such as personalization and administrative efficiency, and the risks of theological distortion, overreliance, and epistemic conformity. It presents a range of real-world implementations from institutions like Harvard Divinity School and the Oxford Centre for Digital Theology, highlighting best practices and cautionary approaches. The findings suggest that AI can enrich RE when deployed thoughtfully and ethically, but it must not replace the relational and formational aspects central to RE. The paper concludes by recommending policy development, ethical oversight, and interdisciplinary collaboration to guide responsible integration. This research contributes to the growing discourse on how AI can be aligned with the spiritual and intellectual goals of RE in a rapidly evolving digital age. Full article

The construction of complex systems is of great significance in enhancing national competitiveness and promoting social development. However, the academic community currently lacks a systematic understanding of its sustainable innovation mechanism. This study selected the China Manned Space Engineering Application System (CMSEAS) as a representative case of a complex system. Research data were collected by a multi-method approach including document literature, internal data, field research, and interviews. Through the lens of grounded theory, the study delves into how the complex system achieves local innovation and how to maintain the sustainability of innovation. Findings indicate that, firstly, late-mover advantage and spiritual strength jointly contribute to the knowledge accumulation of national major task-oriented complex systems, and this knowledge accumulation significantly improves the innovation ability of complex systems. Secondly, while emphasizing the enhancement of innovation capabilities, it is imperative for complex systems to implement holistic risk management, which is an important guarantee for successfully achieving the goal. Thirdly, in the context of market failure, the whole nation system provides strong support for the national major task-oriented complex system. The overall institution and overall capacity constitute the backbone for ensuring sustainable innovation. Full article

Background: Ukrainian refugees fleeing the conflict between Russia and Ukraine may face significant challenges to their physical, psycho-emotional, social, and spiritual wellbeing. Aim: To identify the health needs of Ukrainian refugees seen in primary care facilities in Tenerife, Canary Islands, Spain. Methods: A mixed-methods design was employed. Quantitative data were obtained through a descriptive analysis of health records, while qualitative data were collected via focus group interviews and thematic analysis of testimonies. Results: The sample comprised 59 individuals (45.4% of all patients seen). Eight participants from five family groups took part in the focus group. The typical profile of a Ukrainian refugee in the Canary Islands is female (79.7%), relatively young, with a high socio-cultural background, generally in good health, travelling alone or with her minor children. The main reasons for consultation were routine health check-ups and control blood tests. The NANDA-I nursing diagnoses indicated a need for psycho-emotional care, with the most prevalent being Risk for Relocation Stress Syndrome (27.1%); Interrupted Family Processes, Disturbed sleep pattern, Risk for Impaired Resilience (13.6% each); and Anxiety (11.9%). Participants rated the healthcare system positively, but language barriers and long waiting times for access to specific services were noted as limitations. The primary social demands include seeking employment, learning the language, and increasing support groups among Ukrainians themselves. Conclusions: This study underscores the need for a tailored approach to refugee care, considering their unique circumstances and needs. Early provision of information about available healthcare services and protocols can facilitate access, manage expectations, and aid decision-making. Full article

Background/Objectives: In recent years, the number of cancer survivors has rapidly increased in Switzerland, as well as worldwide. As cancer increasingly becomes a chronic condition, numerous bio-psycho-social and spiritual challenges emerge, leading to significant needs for this population. The aims of this study were to determine the experiences of Swiss cancer survivors with two domains, i.e., health-related information and healthcare systems, and their risk factors, and to see whether these experiences align with the needs identified in the literature. Methods: Data from the cross-sectional multicentred survey Swiss Cancer Patient Experiences were analysed. A total of 1870 adult Swiss cancer survivors were included in the analysis. For each domain, an overall score ranging between 0 (poor experience) and 10 (excellent experience) was constructed including 11 and 10 questions, respectively. The questions that highlighted non-positive experiences by patients were grouped to calculate so-called “problematic” scores for each domain; linear and logistic regressions were conducted to identify the variables influencing these problematic scores needs. Results: The mean overall and “problematic” scores were 7.5 (SD 2.6) and 6.8 (SD 3.2), respectively, for health-related information, and 8.0 (SD 2.4) and 7.0 (SD 3.6), respectively, for the healthcare system. Four variables were found to be associated with the problematic scores: geographical location, foregoing care, self-assessed health, and level of health literacy. Conclusions: Swiss cancer survivors reported problematic experiences in the domains of information and healthcare systems which could lead to unmet needs. The systematic assessment of these needs is recommended to improve patients’ experiences and provide more effective and supportive follow-up care. Full article

Indigenous frameworks suggest environmental risk and protective factors for American Indian (AI) children’s development can be understood in terms of connecting and disconnecting forces in five domains: spirituality, family, intergenerational ties, community, and environment/land. This study examined the prevalence of these forces among 156 urban AI parents and their children (mean age = 10.69, SD = 1.92) and investigated associations with child executive function (EF). Parents reported on three disconnecting forces (parent stressful life events, discrimination, and neighborhood risks) and two connecting forces (knowledge of tribal history and engagement with cultural beliefs and traditional practices). Parents rated children’s EF using the Behavior Rating Inventory of Executive Function (BRIEF), and a subsample of children (n = 81) provided self-report EF data. Controlling for income and child age, connecting forces (parent engagement with cultural beliefs and traditional practices and knowledge of tribal history) were associated with higher parent-reported and child self-reported EF, while disconnecting forces (discrimination and neighborhood risk) were related to lower child EF. Findings highlight the protective role of cultural connectedness for urban AI children’s cognitive development, and the importance of centering Indigenous theory in risk and resilience research with AI families. Full article

Growth in forms of violence germinates from the abject soil of racism and colonialism. This article investigates religious racism in Brazil in the State of Rio de Janeiro through in-depth case studies and published data. First, I analyze how religious racism is utilized as a means to legitimize the demonization and consequent violence directed at Afro-Brazilian religions. Through an analysis of terreiro leaders’ discourses, I present a conception in which demonization and deliberate attacks imply the persecution of ways of being, existing, doing, and living of Black African origin. I use this lens to highlight the role that neo-Pentecostal churches and the theology of spiritual battle play in the resurgence of violence against Afro-religious people. Then, I problematize the harmful relationships between the demonization of terreiros and the extremely warlike conception of Christian faith. Ultimately, I argue that racist theological discourse of demonization manifests itself through verbal, physical, psychological, moral, and patrimonial aggression, putting the existence of terreiro peoples and communities at risk. Full article

The intensifying urbanization has led to the increasing risk of urban landscape character fading away. How to inherit and control the “genes” of urban landscape features is a crucial issue that needs urgent resolution. To address this issue, this study draws on the theory of biological genes, employing methods such as historical information translation, deconstruction and extraction of landscape features, and genetic analysis to establish a research paradigm of “holistic composition interpretation—dynamic evolution interpretation” for historic urban landscape genes. The study applies this paradigm in practice using Harbin, China, as an example. The results indicate that: (1) The historic urban landscape genes are comprised of explicit landscape pattern genes; street and alley texture genes; architectural appearance genes; and implicit human settlement culture genes, industrial culture genes, historical culture genes, and spiritual culture genes. (2) The evolutionary traits of Harbin’s historic urban landscape genes manifest in several ways: the evolution of its landscape pattern genes, featuring “three-tiered terraces, balanced spatial arrangement, surrounded by mountains and rivers, and fan-shaped radial layout”; the evolution of its street and alley texture genes, exhibited through “a blend of Chinese and Western styles, sprawling and interconnected, unit linkage, and multi-dimensional intersections”; the evolution of its architectural style genes, marked by “diverse styles, a harmonious fusion of Chinese and Western elements, grouped interdependence, and adaptation to the times”; the evolution of its human settlement culture genes, highlighted by “a secluded lifestyle, diverse customs, and the coexistence of Chinese and Western cultures”; the evolution of its historical culture genes, distinguished by “unity in diversity and multicultural differentiation”; and the evolution of its spiritual culture genes, characterized by “pluralistic beliefs and inclusiveness”. (3) The essential difference between historic urban landscape genes and other genes lies in their adaptive evolution in response to environmental changes over generations and their ability to reveal the influence mechanisms among genes, between genes and landscape features, and between genes and the environment. The distinction between historic urban landscape genes and other types of genes lies in the adaptive changes that historic urban landscape gene types undergo in response to changes in time and environment. The historic urban landscape gene system itself undergoes adaptive evolution with the urban environment of various historical periods, leading to the emergence and differentiation of new levels. This study can provide new insights into urban heritage conservation, urban landscape management, and rational allocation of urban land use. Full article

Existing research on sense of community in educational contexts shows positive associations with well-being and negative associations with mental health symptoms. However, exploration of students’ sense of community within the seminary context is minimal. Drawing on the relational spirituality model, which posits oscillating experiences of dwelling and seeking in a dialectical growth process, we framed sense of community as horizontal dwelling. We used mixture modeling to generate subgroups using items from a measure of sense of community and then explored associations between sense of community and various demographic predictors and personal formation outcomes, including well-being and symptoms, along with virtues and religiousness/spirituality. We did so within the unique context of the COVID-19 pandemic. We used a sample of graduate students from 18 Christian seminaries across North America (N = 867; M_age = 31.95; 48.1% female; 60% White). Factor mixture results supported a 3-class solution, with one class reporting consistently greater ratings of sense of community, labeled the strongly connected, another class reporting consistent mid-level ratings, labeled the moderately connected, and a third class reporting consistently lower ratings, and labeled the disaffected. Results for the disaffected showed a pattern of associations with lower well-being and greater symptoms, and lower religiousness/spirituality, along with greater pandemic stress. The strongly connected showed greater levels of virtuousness, well-being and religiousness/spirituality, and lower symptoms, although they were also more likely to report greater illusory health. The pattern of associations for the moderately connected was a blend of similarities with the other two subgroups. The disaffected also showed a modest risk effect for lower well-being and greater symptoms over time. Findings pointed to providing greater horizontal dwelling among the disaffected and the need for greater seeking among the strongly connected. Full article

This paper explores the cross-cultural interpretation of “the goodness and evil of human nature” by Jesuit missionary Giulio Aleni in the late Ming Dynasty, and it examines the intersections and complementarity between Catholicism and Confucianism in moral ethics based on Aleni’s integration. The study finds that Aleni, while basically adhering to the Catholic “original sin”, connected the “spirituality” endowed to humans at the beginning of God’s creation with the Confucian ontological concepts such as “ultimate good” (zhishan 至善); centering on “self-mastery” (zizhuan 自專), “sharpening” (dili 砥礪), and “overcoming nature” (kexing 克性), he actively guided the goodness–evil debate towards a Confucian practical morality, and sacred doctrines are served as an impetus of moral practices. The redemption, together with reward and punishment of God, further intensifies the ultimate concern and the way of transcendence. Aleni’s bridging and synthesizing of the two traditions is highly significant: concerning both sanctity and practicality of ethics can to some extent overcome the risks brought by the instrumentalization of ethics or the illusory issues of existence. This has important implications for the self-development and integration of Christian and Confucian morality. Full article

Objectives: To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved. Design: A systematic review and meta-analysis. Data source: PubMed, CINAHL, Scopus and Web of Science. Background: Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings. Methods: A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis. Results: We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety. Conclusions: The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety. Full article

Individuals who migrate from their home country face a variety of challenges while adapting to the culture in the United States. Immigrant communities are at a significantly higher risk for poor health outcomes; therefore, assessing healthcare treatment for diverse and resilient immigrant populations, including Hispanic/Latine communities, is crucial to preserving their health, culture, and spirit. A paucity of literature exists surrounding perceptions of well-being in immigrant, Hispanic/Latine adults managing chronic diseases. Past studies have shown a discrepancy between providers’ and patients’ perceptions of healthcare options for overall well-being. We aim to share varying perspectives found within our work geared towards improving the quality of life for Hispanic/Latine immigrants managing chronic disease, especially type 2 diabetes mellitus and hypertension. The primary objective of this article is to strengthen the understanding of intersections between social, physical, financial, and spiritual health within an (im)migrant Hispanic/Latine community using semi-structured ethnographic interviews. These interviews have highlighted community resilience, demonstrating that individuals can adapt to major life transitions while maintaining balance across dimensions of health. This knowledge could be implemented by actively listening to patient concerns regarding their health dimensions to improve individualized and patient-centric care. Full article