For many people globally, church attendance is an integral part of their lives. They make it a point to be in church, listen to and revere their spiritual advisors. According to the University of Minnesota (2016), there are many roles that a spiritual advisor plays. A spiritual advisor could function as a chaplain, ordained clergy, rabbi, priest, minister, and spiritual director in even primary healthcare delivery. A physician or healthcare worker can also act as spiritual advisor in some cases; however, most health workers prefer spiritual issues to be handled by experts in spirituality.
In some advanced jurisdictions, the work of a Chaplain in primary healthcare delivery is to oversee the spiritual needs of patients, usually in a hospital or clinic. In these countries, Chaplains who deliver spiritual services within the primary healthcare system are mandated to have some advanced educational credentials apart from their normal theological training.
The standard for this training is usually one to two years of certified Clinical Pastoral Education, which is endorsed and accredited by The Association for Clinical Pastoral Education, Inc. Such Clinical Pastors are trained to provide support and nurture patients' faith. “They may or may not be associated with a particular denomination, but they typically work with patients of all faiths. Spiritual directors are trained to be "listening presences" who help people deepen their faith lives. A spiritual director may work with a patient alongside a chaplain in a hospital and may continue with that patient after they are released from the hospital”, says University of Minnesota.
Empirical studies have proven that prayer can be employed as complementary medicine to improve the quality of life of the patient (Obu & Aggrey-Bluwey, 2021). Alternatively, some patients decide to employ prayer as a standalone treatment at the expense of standard conventional medical care. In light of the above, the question is, what are the ramifications of using prayer as complementary or alternative medicine in primary healthcare delivery, as compared to standard conventional medical care?
The National Center of Complementary and Alternative Medicine (NCCAM) examined the use of Complementary and Alternative Medicine (CAM) in a population sample of 31, 000 people in the US. The data showed that 36% of people use CAM. When prayer was included in the definition of CAM, the statistic increased to 62%. Almost half of the respondents used prayer for their own health (43%), some sought the prayer of others (24%), and a smaller number participated in prayer groups that focused specifically on personal health issues (10%). Compared with other practices such as transcendental meditation, yoga, tai chi, qigong and reiki, prayer was by far the most popular alternative form of therapy.
Another study by McCaffrey et al., (2004) of Harvard Medical School indicated that a third of adults used prayer in addition to conventional medical care for specific health-related problems. Of the 35% of respondents who used prayer for health concerns, 75% prayed for wellness and 22% prayed for specific health conditions. Of those who prayed, 70% reported prayer to be very helpful. The authors of the study noted that while prayer for health concerns was a highly prevalent practice, patients rarely discussed the use of prayer with their doctors.
Prayer: What is it?
The word "prayer" comes from the Latin word precarius, which means "obtained by begging, to entreat." Prayer is rooted in the belief that there is a power greater than oneself, that can influence one's life. It is the act of raising hearts and minds to God or a higher power.
There is no one set way to pray. Prayer exists in many forms such as spoken prayer, silent prayer, and prayers of the mind and heart, and union with God. Prayers may be directed (e.g., prayers for specific things) or non-directed, with no specific outcome in mind.
O’Mathuna (1999) is of the opinion that Christian understanding of prayer, which includes an answer to prayer, is dependent on the power and will of God, not that of the petitioners. The researcher had this to say: “God is not swayed by the number of prayers or by geographic distances. He responds at various times and in ways that are not always anticipated by the person praying. An answer to prayer may come in the form of increased ability to deal with illness and tragedy, and not necessarily in acts of miraculous intervention or healing”.
Prayer is a communication to God. It is done by those who trust the power of word and thought. Jesus taught people to say the Lord's Prayer. Prayer can be spoken, be done in silence (no talking), or sung in a song. It can be used to praise God or to ask for something including help and forgiveness.
Jevons (1910) argues that Prayer is an invocation or an act that seeks to activate a rapport with an object of worship through deliberate communication. In the narrow sense, the term refers to an act of supplication or intercession directed towards a deity (a god), or a deified ancestor. More generally, prayer can also have the purpose of thanksgiving or praise, and in comparative religion, is closely associated with more abstract forms of meditation and with charms or spells.
Concept of Prayer as Complementary Medicine
Wahbeh et al., (2008) agrees that in the area of Complementary medicine, prayer is often viewed as a mind-body therapy to “focus on the relationships between the brain, mind, body, and behavior, and their effect on health and disease” and is “often implemented by patients because of the low physical and emotional risk, the relatively low cost, and its ability to allow patients to take a more active role in their treatment.”
Scientific studies on Prayer on Health
The emergence of the COVID-19 pandemic with its high trends in infections and mortality has seen many people pray to seek God’s interventions. In Ghana, Pastors and Churches have turned to God to deliver the nation from Covid-19. Many prophesies have attempted at dealing with the timeline of the pandemic departure. Prior to the emergence of the pandemic in Ghana, Archbishop Nicholas Duncan Williams, president of Action Chapel International, prophesied that no one will die of the pandemic in Ghana. However, as it stands, more than one thousand Ghanaians have died of the Pandemic. Thus, does this mean that prayer does not work? Maybe, we need to see the work of Lakkireddy, a cardiologist at the Kansas City Heart Rhythm Institute. Lakkireddy is the principal investigator in a clinical trial involving 1000 patients with COVID-19 infections severe enough that they require intensive care.
The four-month study, launched on May 1, seeks to investigate "the role of remote intercessory multi-denominational prayer on clinical outcomes in COVID-19 patients". According to a description provided to the National Institutes of Health, Half of the patients, randomly chosen, will receive a "universal" prayer offered in five denominational forms, via Christianity, Hinduism, Islam, Judaism, and Buddhism. The other 500 patients will constitute the control group. All the patients will receive the standard of care prescribed by their medical providers. Lakkireddy has assembled a steering committee of medical professionals to oversee the study.
As we wait to see the results of this study, prayer seems to have effect on other health outcomes. For instance, Kang et al’s study demonstrates that 77 newly-diagnosed breast cancer patients reported an improvement in their quality of life while using various Complementary and Alternative Medicine (CAM) over a 6-month period. When 88% of these women used prayer as their form of CAM, their quality of life increased over 6 months, their stress and mood level (anger, depression, anxiety) surprisingly also decreased, which they attributed to prayer. These patients revealed that prayer allowed them to be in “control” of their efforts to fight through their cancer.
Prayer, Church Attendance and Quality of Life.
Scholars, over the past couple of years, are now of the assertion that weekly church attendance puts people on healthy grounds. A case in point is one study in the United States which demonstrates that prayer adds 2 or 3 years to one’s life (Hall, 2006).
Another study also found a 7-year difference in life expectancy at age 20 between those who never attended church and those who attended church more than once a week (Nam, & Ellison, 1999). Further evidence suggests that religious obedience boosts the immune system and decreases blood pressure (Koenig & Cohen, 2004; Woods, Antoni, Ironson, & Kling, 1999). The variable that affirmed this on health is church attendance (Shahabi, & Thoresen, 2003).
Scholars have argued that the positive effects of church attendance on health may be due to social support, operationalized as an increase in social networks and more supportive social relationships (Ellison & George, 2002) or to the healthy behaviors of people more cautious not to drink, take drugs, or have casual sex (Clarke, Beeghley, & Cochran, 1990).
Diverse mechanisms demonstrate some scientific support: cognitive outcomes that enable emotional coping efforts (Smiley, & Gonzalez, 1988; Sharp, 2010) and, in general a sense of meaning and coherence (Ellison, 1991).
Luhrmann (2013) agrees that there is increasing evidence that the way God is understood also affects health outcomes. An empirical study further proved that people who reported that they experienced God as close and loving also reported significantly fewer psychiatric symptoms compared to those who reported that they experienced God as not approving and unforgiving, or creating and judging (Galek, & Koenig, 2010).
This notwithstanding, according to the Washington Post article by Michelle (2008), "prayer is the most common complement to mainstream medicine, far outpacing acupuncture, herbs, vitamins and other alternative remedies." The scientific studies on prayer efficacy are however limited. The field remains minute, with about $5 million spent worldwide on such research each year. Benedict Carey (2013) on the other hand also argues that the efficacy of prayer has been the topic of various studies since at least 1872. Such studies were generally designed to ascertain whether intercessory prayer has a blind effect on the health of "third parties", who are unaware that they are being prayed for.
Krause and Hayward, (2013) study examined an overlooked aspect of prayer: trust-based prayer beliefs. People with this orientation believe that God knows that best way to answer a prayer and the He selects the best time to provide an answer. Data was obtained from a nationwide longitudinal survey of older people. Three main findings emerged from the study. First, the results revealed that Conservative Protestants are more likely to endorse trust-based prayer beliefs. Secondly, these prayer beliefs tend to be reinforced through prayer groups and informal support from fellow church members. Thirdly, the data indicated that stronger trust-based prayer beliefs are associated with a greater sense of life satisfaction over time.
Study on Intercessory Prayer
Martin (2013) study argues that these "studies on intercessory prayer" have revealed no objective effect. However, Bernardi et al., (2001) study on intercessory prayer, specifically, on meditative prayer, reported that by praying the rosary or reciting yoga mantras at specific rates, baroreflex sensitivity increased significantly in cardiovascular patients.
According to Bar (2015), the baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that helps to maintain blood pressure at nearly constant levels. “The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure reflexively causes the heart rate to decrease and also causes blood pressure to decrease. Decreased blood pressure decreases baroreflex activation and causes heart rate to increase and to restore blood pressure levels”
Leslie et al (2008) further used Eysenck's dimensional model of personality based on neuroticism and psychoticism to assess the mental health of high school students based on their self-reported frequency of prayer. For students both in Catholic and Protestant schools, higher levels of prayer were associated with better mental health as measured by lower psychoticism scores. However, among pupils attending Catholic schools, higher levels of prayer were also associated with higher neuroticism scores.
Wikipedia (2016) notes that it has also been suggested that if a person knows that he or she is being prayed for it can be uplifting and increase morale, thus aiding recovery. It further argues that prayer can reduce psychological stress, regardless of the god or gods a person prays to, a result that is consistent with a variety of hypotheses as to what may cause such an effect.
According to a study by CentraState Healthcare System (2009), "the psychological benefits of prayer may help reduce stress and anxiety, promote a more positive outlook, and strengthen the will to live." Other practices such as Yoga, T'ai chi, and meditation may also have a positive impact on physical and psychological health.
Meisenhelder and Chandler (2001) study examined data obtained from 1,421 Presbyterian pastors surveyed by mail and found that their self-reported frequency of prayer was well-correlated with their self-perception of health and vitality. Though, this research methodology has integral limitations with self-selection, selection bias, and residual confounding, the authors admitted that the direction of perceived prayer and health relationships "remains inconclusive due to the limits of the correlational research design".
Chamberlain and Allan (2007) largest study found no significant differences in patients recovering from heart surgery whether the patients were prayed for or not. Austin et al (2001) meta-analysis of several studies related to distant intercessory healing looked at 2774 patients in 23 studies, and found that 13 studies showed statistically significant positive results, 9 studies showed no effect, and 1 study showed a negative result.
In conclusion we found that there is a role of prayer, spirituality and church attendance in healthcare and improving patient health outcomes, and this phenomenon needs to be explored to improve patients’ quality of life.
Noble Prof. Raphael Nyarkotey Obu, is the President of Nyarkotey college of Holistic Medicine and a final year LLB Law student. He also holds an MBA and MA in theology, and is a Chartered Management Consultant in the Natural Health industry. Lawrencia Aggrey-Bluwey is an Assistant Lecturer with the Department of Health Administration and Education, University of Education, Winneba, and is currently a PhD student in Health Policy at the University of Ghana Business School. E mail: [email protected]