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Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: a qualitative study

Authors: Rainbow Tin Hung Ho, Caitlin Kar Pui Chan, Phyllis Hau Yan Lo, Ping Ho Wong, Cecilia Lai Wan Chan, Pamela Pui Yu Leung, Eric Yu Hai Chen

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Spirituality has received increased attention in the psychiatric literature; however, it remains underexplored on a global level. Knowledge about spirituality of persons with schizophrenia is often hampered by positive and negative symptoms, which limit their expression of spiritual needs and shift mental-health professionals’ focus from spiritual care to symptom control. Differences in the ways that the two parties understand spirituality may create different expectations and further hinder the provision of high-quality holistic care. This study investigated the meaning and roles of spirituality from the perspectives of persons with schizophrenia and mental-health professionals.

Methods

A qualitative design with semi-structured individual interviews was adopted. The analysis was based on data collected from interviews with 18 clients diagnosed with schizophrenia and 19 mental-health professionals from public hospitals and mental-health community rehabilitation centres in Hong Kong. Data were collected and analysed based on grounded theory principles.

Results

Both clients and professionals regarded spirituality as an inherent part of a person’s well-being, clients’ rehabilitation, and their lives in general. At the personal level, the clients’ descriptions were more factual, concrete, short term, and affective, whereas the professionals’ descriptions were more abstract, complex, and cognitive. At the communal level, both parties had a similar understanding of spirituality but different interpretations of its role in recovery from mental illness. The clients regarded spirituality as a source of giving and receiving love and care, whereas the professionals regarded it as a means of receiving support and managing symptoms.

Conclusions

Building a common understanding on the concept of spirituality and the significant role it plays in rehabilitation between clients and mental-health professionals is an essential first step to support clients’ spiritual health. Clients tend to seek for stability, peace, and growth rather than an existential quest; while professionals hold a more pathological perspective, viewing spirituality as a means to relieve symptoms, increase social acceptance, and cope with illness experiences. The differential understanding of the two perspectives provides insight and perhaps a roadmap for developing spiritual assessments and holistic care in the psychiatric context.
Literature
2.
go back to reference Hadzic M. Spirituality and mental health: current research and future directions. J Spiritual Ment Health. 2011;13(4):223–35.CrossRef Hadzic M. Spirituality and mental health: current research and future directions. J Spiritual Ment Health. 2011;13(4):223–35.CrossRef
4.
go back to reference Mizock L, Millner UC, Russinova Z. Spiritual and religious issues in psychotherapy with schizophrenia: cultural implications and implementation. Religions. 2012;3(1):82–98.CrossRef Mizock L, Millner UC, Russinova Z. Spiritual and religious issues in psychotherapy with schizophrenia: cultural implications and implementation. Religions. 2012;3(1):82–98.CrossRef
8.
go back to reference Sullivan WP. Recoiling, regrouping, and recovering: first‐person accounts of the role of spirituality in the course of serious mental illness. New Dir Ment Health Serv. 1998;1998(80):25–33.CrossRef Sullivan WP. Recoiling, regrouping, and recovering: first‐person accounts of the role of spirituality in the course of serious mental illness. New Dir Ment Health Serv. 1998;1998(80):25–33.CrossRef
9.
go back to reference Sullivan WP. “It helps me to be a whole person”: the role of spirituality among the mentally challenged. Psychiatr Rehabil J. 1993;16(3):125–34. Sullivan WP. “It helps me to be a whole person”: the role of spirituality among the mentally challenged. Psychiatr Rehabil J. 1993;16(3):125–34.
10.
go back to reference Kirov G, Kemp R, Kirov K, David AS. Religious faith after psychotic illness. Psychopathology. 1998;31(5):234–45.CrossRefPubMed Kirov G, Kemp R, Kirov K, David AS. Religious faith after psychotic illness. Psychopathology. 1998;31(5):234–45.CrossRefPubMed
11.
go back to reference Crossley JP, Salter DP. A question of finding harmony: a grounded theory study of clinical psychologists’ experience of addressing spiritual beliefs in therapy. Psychol Psychother. 2005;78(3):295–313. doi:10.1348/147608305X26783.CrossRefPubMed Crossley JP, Salter DP. A question of finding harmony: a grounded theory study of clinical psychologists’ experience of addressing spiritual beliefs in therapy. Psychol Psychother. 2005;78(3):295–313. doi:10.​1348/​147608305X26783.CrossRefPubMed
13.
go back to reference McSherry W, Jamieson S. The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. J Clin Nurs. 2013;22(21–22):3170–82. doi:10.1111/Jocn.12411.CrossRefPubMed McSherry W, Jamieson S. The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. J Clin Nurs. 2013;22(21–22):3170–82. doi:10.​1111/​Jocn.​12411.CrossRefPubMed
15.
go back to reference Corrigan P, McCorkle B, Schell B, Kidder K. Religion and spirituality in the lives of people with serious mental illness. Community Ment Health J. 2003;39(6):487–99.CrossRefPubMed Corrigan P, McCorkle B, Schell B, Kidder K. Religion and spirituality in the lives of people with serious mental illness. Community Ment Health J. 2003;39(6):487–99.CrossRefPubMed
16.
go back to reference Lukoff D, Everest HC. The myths in mental-illness. J Transpersonal Psy. 1985;17(2):123–53. Lukoff D, Everest HC. The myths in mental-illness. J Transpersonal Psy. 1985;17(2):123–53.
18.
go back to reference Siddle R, Haddock G, Tarrier N, Faragher EB. Religious delusions in patients admitted to hospital with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2002;37(3):130–8.CrossRefPubMed Siddle R, Haddock G, Tarrier N, Faragher EB. Religious delusions in patients admitted to hospital with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2002;37(3):130–8.CrossRefPubMed
19.
go back to reference Mohr S, Huguelet P. The relationship between schizophrenia and religion and its implications for care. Swiss Med Wkly. 2004;134(25–26):369–76.PubMed Mohr S, Huguelet P. The relationship between schizophrenia and religion and its implications for care. Swiss Med Wkly. 2004;134(25–26):369–76.PubMed
20.
go back to reference Swinton J. Spirituality in mental health care: rediscovering a forgotten dimension. London: Jessica Kingsley Publishers; 2001. Swinton J. Spirituality in mental health care: rediscovering a forgotten dimension. London: Jessica Kingsley Publishers; 2001.
21.
go back to reference Ospina S. Qualitative research. In: Goethals GR, Sorenson GJ, MacGregor-Burns J, editors. Encyclopedia of leadership. London: Sage; 2004. p. 1279–84. Ospina S. Qualitative research. In: Goethals GR, Sorenson GJ, MacGregor-Burns J, editors. Encyclopedia of leadership. London: Sage; 2004. p. 1279–84.
22.
go back to reference Patton M. Qualitative evaluation and research methods. Beverly Hills, CA: Sage; 1990. Patton M. Qualitative evaluation and research methods. Beverly Hills, CA: Sage; 1990.
24.
go back to reference Geekie J. The uncertainty of being: existential aspects of the experience of psychosis. In: Geekie J, Randal P, Lampshire D, Read J, editors. Experiencing Psychosis: Personal and Professional Perspectives. London: Routledge; 2012. p. 87–95. Geekie J. The uncertainty of being: existential aspects of the experience of psychosis. In: Geekie J, Randal P, Lampshire D, Read J, editors. Experiencing Psychosis: Personal and Professional Perspectives. London: Routledge; 2012. p. 87–95.
25.
go back to reference Charmaz K. The grounded theory method: an explication and interpretation. In: Glaser BG, editor. More grounded theory methodology: a reader. Mill Valley, CA: Sociology Press; 1994. p. 95–115. Charmaz K. The grounded theory method: an explication and interpretation. In: Glaser BG, editor. More grounded theory methodology: a reader. Mill Valley, CA: Sociology Press; 1994. p. 95–115.
26.
go back to reference Charmaz K. Grounded theory. In: Smith J, Harré R, Van Langenhove L, editors. Rethinking methods in psychology. London: Sage; 1995. p. 27–49.CrossRef Charmaz K. Grounded theory. In: Smith J, Harré R, Van Langenhove L, editors. Rethinking methods in psychology. London: Sage; 1995. p. 27–49.CrossRef
27.
go back to reference Glaser BG. Theoretical sensitivity: advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press; 1978. Glaser BG. Theoretical sensitivity: advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press; 1978.
28.
go back to reference Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine; 1967. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine; 1967.
29.
go back to reference Glaser BG. Doing grounded theory: issues and discussions. Mill Valley, CA: Sociology Press; 1998. Glaser BG. Doing grounded theory: issues and discussions. Mill Valley, CA: Sociology Press; 1998.
30.
go back to reference Glaser BG. Conceptualization: on theory and theorizing using grounded theory. Int J Qual Methods. 2002;1(2):23–38. Glaser BG. Conceptualization: on theory and theorizing using grounded theory. Int J Qual Methods. 2002;1(2):23–38.
31.
go back to reference Charmaz K. An invitation to grounded theory. Constructing grounded theory: a practical guide through qualitative analysis. London: Sage; 2006. p. 1–12. Charmaz K. An invitation to grounded theory. Constructing grounded theory: a practical guide through qualitative analysis. London: Sage; 2006. p. 1–12.
32.
go back to reference Corbin J, Strauss A. Grounded theory research: procedures, canons and evaluative criteria. Qual Sociol. 1990;19(6):418–27. Corbin J, Strauss A. Grounded theory research: procedures, canons and evaluative criteria. Qual Sociol. 1990;19(6):418–27.
33.
34.
go back to reference Canda ER, Furman LD. Spiritual diversity in social work practice: the heart of helping. New York: Oxford University Press; 2009. Canda ER, Furman LD. Spiritual diversity in social work practice: the heart of helping. New York: Oxford University Press; 2009.
37.
38.
39.
go back to reference Frankl VE. Man’s search for meaning. London: Hodder & Stoughton; 1959. Frankl VE. Man’s search for meaning. London: Hodder & Stoughton; 1959.
41.
go back to reference American Psychiatric Association. DSM-IV-TR: Diagnostic and statistical manual of mental disorders, text revision. 4th ed. Washington, DC: American Psychiatric Association; 2000. American Psychiatric Association. DSM-IV-TR: Diagnostic and statistical manual of mental disorders, text revision. 4th ed. Washington, DC: American Psychiatric Association; 2000.
42.
go back to reference Takkinen S, Ruoppila I. Meaning in life in three samples of elderly persons with high cognitive functioning. Int J Aging Hum Dev. 2001;53(1):51–73.CrossRefPubMed Takkinen S, Ruoppila I. Meaning in life in three samples of elderly persons with high cognitive functioning. Int J Aging Hum Dev. 2001;53(1):51–73.CrossRefPubMed
43.
go back to reference Thera N. The heart of buddhist meditation. New York: Weiser; 1962. Thera N. The heart of buddhist meditation. New York: Weiser; 1962.
44.
go back to reference Chan CKP, Lo PHY, Chen EYH, Ho RTH. Coping with illness experiences in patients with schizophrenia: the role of peacefulness. J Schizophr Res. 2015;2(1):1007. Chan CKP, Lo PHY, Chen EYH, Ho RTH. Coping with illness experiences in patients with schizophrenia: the role of peacefulness. J Schizophr Res. 2015;2(1):1007.
45.
go back to reference Lam CS, Tsang HWH, Corrigan PW, Lee YT, Angell B, Shi K, et al. Chinese lay theory and mental illness stigma: implications for research and practices. J Rehabil. 2010;76(1):35–40. Lam CS, Tsang HWH, Corrigan PW, Lee YT, Angell B, Shi K, et al. Chinese lay theory and mental illness stigma: implications for research and practices. J Rehabil. 2010;76(1):35–40.
47.
go back to reference Lee YT, Wang DY. Aboriginal people in Taiwan, continent China and the Americas: ethnic inquiry into common root and ancestral connection. In: Li X, Pan Z, editors. Taiwan in the twenty-first century. Lanham, MD: University Press of America, Inc; 2003. Lee YT, Wang DY. Aboriginal people in Taiwan, continent China and the Americas: ethnic inquiry into common root and ancestral connection. In: Li X, Pan Z, editors. Taiwan in the twenty-first century. Lanham, MD: University Press of America, Inc; 2003.
48.
go back to reference Pearson V, Yiu MY. Public attitudes towards mental health facilities: A study in Hong Kong. Soc Work Soc Sci Rev. 1993;4:59–82. Pearson V, Yiu MY. Public attitudes towards mental health facilities: A study in Hong Kong. Soc Work Soc Sci Rev. 1993;4:59–82.
49.
go back to reference Lee E. Chinese families. In: McGoldrick M, Giordano J, Pearce JK, editors. Ethnicity and family therapy. 2nd ed. New York: Guildford; 1996. p. 248–67. Lee E. Chinese families. In: McGoldrick M, Giordano J, Pearce JK, editors. Ethnicity and family therapy. 2nd ed. New York: Guildford; 1996. p. 248–67.
50.
go back to reference Tsoi WF. Mental health in Singapore and its relation to Chinese culture. In: Tseng WS, Wu DYH, editors. Chinese culture and mental health. Orlando: Academic; 1985. p. 229–50.CrossRef Tsoi WF. Mental health in Singapore and its relation to Chinese culture. In: Tseng WS, Wu DYH, editors. Chinese culture and mental health. Orlando: Academic; 1985. p. 229–50.CrossRef
51.
53.
go back to reference Jackson M, Fulford KW. Spiritual experience and psychopathology. Philos Psychiatr Psychol. 1997;4(1):41–65.CrossRef Jackson M, Fulford KW. Spiritual experience and psychopathology. Philos Psychiatr Psychol. 1997;4(1):41–65.CrossRef
Metadata
Title
Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: a qualitative study
Authors
Rainbow Tin Hung Ho
Caitlin Kar Pui Chan
Phyllis Hau Yan Lo
Ping Ho Wong
Cecilia Lai Wan Chan
Pamela Pui Yu Leung
Eric Yu Hai Chen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0796-7

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