Prayer in Iranian cancer patients undergoing chemotherapy

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Summary

Chronic illnesses such as cancer are very stressful events and prayer is a valuable coping strategy for Muslim cancer patients.

This study was conducted to assess the impact of prayer in Iranian cancer patients undergoing chemotherapy. A descriptive cross sectional survey was conducted on 360 cancer patients over 20 years of age who were able to read and write. Data collection employed Meraviglia's prayer questionnaire.

Mean scores of prayer activity, prayer experience and attitude toward prayer were, respectively, (94.5±12.98), (51.2±7.49) and (38.2±4.84). Mean of total scores was (184.05±21.67). Significant relationships were observed between age, marital status and educational level with prayer activity, prayer experience and attitude toward prayer (P⩽0.001). Also the relationship between sex and prayer activity was significant (P⩽0.01).

Conclusion

Individual characteristics had an important effect on prayer. It is suggested that health care providers can augment holistic care to these patients by encouraging prayer.

Introduction

Prayer is the natural language of religious experiences.1 It is a spiritual and, for many, also a religious practice.2 Prayer can be generally defined as “human communication” with divine and spiritual entities.1

Spiritual practices such as prayer have been used by individuals for every type of illness and across all age groups, cultures and religions.3

One of the largest religions in the world is Islam4 with Iran representing one of the biggest Islamic countries with the Muslim religion representing 99% of the population.

Islam literally means ‘surrender’ to the will of God. It is a religion dating back to the 7th century AC when The Prophet Mohammad (P.B.U.H.) received revelations, described as verbal messages from God, over a 20-year period. These messages form the religious text called the Qur’an.5 Muslims believe in a chain of Prophets starting with Adam and ending with The Prophet Mohammad (P.B.U.H.).6 The central belief of Islam is that there is only one God and Mohammad (P.B.U.H.) is God's Prophet. There are several branches of Islam—the Sunnites, the Shiites (with several sub-branches). Muslims have a very organized prayer life in which prayer is recited several times a day. The Qur’an is regarded as the authority of how to surrender to God's will in different situations in life.7

Muslims believe that humans are helpless against the smallest pathogen, the Virus, and despite all the mounting research, continue to be ignorant about the cause of cancer and many other debilitating diseases. God created mankind and created a clear reminder that no matter how strong and arrogant humans become, they are still very weak in front of God, and will die one day.4

The worldview of Muslim patients towards health and illness incorporates the notion of receiving illness and death with patience, meditation and prayers. Muslim patients understand that illness, suffering and dying are part of life and a test from God.

Health and illness become part of the continuum of being, and prayer remains the salvation in both health and sickness. It is narrated that the Prophet Mohammad (P.B.U.H.) said that: “The prayer of the sick person will never be rejected, until he recovers”.6

In illness, the awareness of God increases and Muslims becomes closer to God by realizing their own weakness. They increase their prayers because God says: “O you, who believe, seek help with steadfastness and prayer. For God is with those who are steadfast”. During this time Muslims ask forgiveness from God because they believe that God is ever forgiving. Inner peace can only be achieved by believing in God, and remembering Him frequently and asking for His help and forgiveness in times of difficulties.8 The Qur’an says: “Howa al-shafi” means, the curer is God4 and “Call on me; I will answer your prayer”.9

There are considerable prayers for Muslims in the Islamic rituals, which resolve stress and which ensure their survival in a world beset with increasing strife and conflict. There are seven tools used by Muslims. These are shown in Table 1.

Section snippets

Background

The diagnosis of cancer can initiate considerable distress for patients.12 Cancer robs people of their hopes and dreams and threatens not only the patient's physical body but also their spirit.13

Most cancer patients use religious and spiritual resources in response to the diagnosis of their disease. Prayer is the most commonly used religious practice.14 Prayer is a desire to communication with God/higher power or “Absolute”.15 For this study, prayer is defined as an activity and expression of

Methods

The study used a descriptive cross-sectional design. Subjects in the sample were cancer patients undergoing chemotherapy and sequentially referred to one hospital and one cancer institute in Tehran. Inclusion criteria were (1) at least 20 years of age, (2) Muslim religion, (3) ability to read and write, and (4) awareness of their own disease. Exclusion criteria were (1) having chronic illnesses such as cardiac, pulmonary, hepatic, nephrotic, and psychotic diseases and (2) use of antipsychotic

Pilot study results

The pilot study was conducted on 50 cancer patients. More than half of the participants were men (54%). The age range of sample was between 20 and 63 years (Mean=38.7, SD=10.64), 78% of the patients were married; more than two-thirds of the participants had a primary or high school education and ethnically more than half were Fars (Persian) (56%). The majority of patients were diagnosed with breast cancer (32%) with a mean duration of 1.7 year. The mean chemotherapy cycle was 8.2 with 40% of

Discussion

Findings revealed that cancer patients gained higher score in attitude toward prayer subscale. This may be due to the stressful situation patients found themselves in when being treated for cancer and effect of this upon their attitude toward spiritual matters. It would seem that for some Muslims affected by chronic and incurable disease such as cancer, their attitudes toward prayer is reinforced. Mean scores of participants were higher than the mean scores reported by other studies.12, 17 This

Summary and conclusions

This research suggests that demographic characteristics like age, sex, marital status, and educational level are influential factors affecting the important role of prayer in Iranian people with cancer undergoing chemotherapy.

Several implications for clinical practice can be drawn from this study.

Health care professionals should recognize the impact of personal and educational characteristics when caring for patients.

Graduate and post-graduate training should address the importance of prayer

Research implications

This research was performed with cancer patients. It is suggested that it would be valuable to conduct this study with patients experiencing chronic illnesses such as cardiovascular disease, diabetes, asthma and so on.

While this is a relatively small-scale study and conducted with one particular religious group of people diagnosed with cancer, it would be very interesting to explore the impact of prayer on other groups of patients as well as in other religious groups.

Generally, when issues such

Acknowledgments

The authors acknowledge Dr. Martha Meravigila from the college of nursing, University of Texas, for her assistance in this study.

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