Peer Reviewed Empirical Article: Summary

Introduction

Diabetes is among the chronic diseases that can result in physical and psychological complications such as amputation, distress and low quality of life. These complications usually lead to an increased need for spirituality which patients tend to use spiritual support as a coping mechanism (Movahed et al., 2020). Numerous research has been conducted to understand the spiritual effects on the spiritual well-being of diabetes patients. The purpose of the peer-reviewed article titled “Investigating the effect of meditation on the spiritual well-being of Type-2 diabetic amputees: A clinical trial study” by Movahed et al., 2020 is to examine the influence of medical meditation on the general spiritual welfare of amputees patients of type-2 diabetes.

Diabetes accounts for approximately 4 million death every year worldwide, and because of its drastic increase in cases of the disease the WHO, has termed it as an underlying epidemic, as Movahed et al. report. With time diabetes causes chronic complications and health conditions that often result in depression, lack of interest in social activities, and lack of motivation, which affects a patient’s general well-being. In the US, amputation is the major complication of diabetes, with about 50,000 cases per year. Referring to research studies conducted in Iran, amputation surgeries are usually done on 41.5% of diabetes patients with lower limb amputation at a higher rate, coupled with hospitalization, therapy, home care and social support (Movahed et al., 2020). The hypothesis tested in this research is that health meditation as spiritual care is highly connected to spirituality. The researchers’ prediction is based on the hypothesis that diabetes leads to an increase in spiritual support. Spiritual support is used as a tool to handle and manage the health issues that comes with having diabetes.

The findings of numerous studies on this research topic have indicated that individuals who suffer from chronic illnesses for instance, diabetes and cancer use spirituality as a mechanism to handle the diseases. Through spirituality, patients find a meaning and drive in life. They ease stress, despair, and anguish hence manage the disease effectively. A study that was carried out by Jafari et al. on adults with type 2 diabetes in Iran showed that spiritual care enhances spiritual well-being. Another study by Akbar et al. stated that spiritual care is highly influential in restoring hope in diabetic patients. With numerous studies on this topic, the researchers sought to test the hypothesis that diabetes results in increased use of spiritual support as a mechanism to cope with the complication of the disease, especially amputation and that medical meditation is closely related to spirituality.

The nature of the research was a randomized clinical experiment that initially had 158 participants but was reduced to 60 eligible participants. The methodology used in the study involved the experimental design of research where the participants were grouped into experimental and control group with each group having thirty members who were amputees caused by diabetes. The eligible patients for the study were chosen through conventional sampling and were taken to Al- Zahra Hospital in Isfahan. They were then put into two groups; (experimental and control), which they randomly selected cards marked with the two groups names. The criteria for eligibility included: patient over 18 years, amputated (toes, knees, and wrist) due to diabetes, having amputation for three months, not using any complementary medicine for the last three months, interest to participate, access to video and audio facilities at home, reading and writing literacy and permitted spirituality intervention.

Sampling was done for three months, and researchers collected the data using demographic statistics form and spiritual well-being questionnaire scale (SWBS). The SWBS had two parts; religious health and existential health. Each unit had ten questions that participants answered based on a six-point Likert scale ranging from completely agree to completely disagree. Then the researchers achieved a total spiritual welfare score by adding the scores of the two subcategories (spiritual health and existential health). Then the spiritual well-being of the participant was divided into three categories: Low, which had scores of 20-40, moderate 41-99 and high 100-120. The experimental group was trained on medical meditation in a serene environment of Sedighe Tahereh Center during the three sessions which was 60-90 min long. The materials used by instructors include teaching aids, slides and direct instructions by the researcher.

The control group was provided with thorough information about diabetes, such as its complications, preventing diabetic foot ulcers, causes, symptoms, and proper hygiene. The researchers also used teaching slides and aids. After four weeks, the researchers asked each group to implement what they have learned, with the researchers following up weekly via telephones to answer any questions.

The result of the study was determined on 54 patients, although there were 60 participants initially. The other eight individuals were released due to a lack of participation to the required extent. Before the intervention, there was no significant difference in terms of average spiritual well-being in the two groups. However, after the intervention, the experimental group had a spiritual score of 97.82, while the control group had 88.40. These scores show a huge difference in the two groups after the intervention. The objective of this research was to examine the impact of spiritual care on the total spiritual well-being of type 2 diabetic amputees. The outcome of this research revealed that spiritual care significantly improves spiritual well-being. Numerous studies on the use of meditation to increase spirituality in patients with chronic diseases like cancer and diabetes have revealed findings similar to the study. For example, Mousavizadeh et al., when they investigated the effects of spiritual intercession on spiritual well-being on cancer patients, revealed that prayers enhanced the spiritual well-being of cancer patients. Also, Kemper et al.’s study disclosed that the meditation method effectively reduces worry, tension and improves spiritual progression (Movahed et al., 2020). A lot of the studies on the topic were consistent with the result of this study, including the Jafari et al. study, which indicated a positive connection between spiritual care and high quality of life in patients with chronic disease.

I think that the study was essential to exert more emphasis on the relationship between spiritual care and coping with risk factors of diabetes. It reassures readers and patients of diabetes and other chronic diseases that when patients incorporate spiritual care into their coping mechanism with such diseases, it will significantly improve their spiritual well-being and quality of life in general. The researchers could improve the study by repeating it but include a bigger population from different backgrounds. The study was limited to the only population of amputees from Al Zahra hospital, and generalization of the results to other areas can be misleading. The study should be repeated to other areas since the socio-cultural aspect also played a role in the study results. In general, the research was impressive following the detailed information provided through the study, especially on the materials and methodology used while conducting the study. The study may be necessary to the psychology counsellors since it serves as a recommendation for them to use spiritual meditation to enhance the spiritual well-being of their patients. They can also use it to manage pain in diabetic amputee patients as a spiritual care program which can also encourage the spiritual health of their patients, especially those who have an amputation as a result of suffering from type 2 diabetes.

References

Movahed, A. H., Sabouhi, F., Mohammadpourhodki, R., Mahdavi, S., Goudarzian, S., Amerian, M., … & Imeni, M. (2020). Investigating the effect of meditation on spiritual wellbeing of Type-2 diabetic amputees: A clinical trial study.