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Prayer in Clinical Practice: What Does Evidence Support? 2.5 ANCC contact hours Prayer in Clinical Practice: What Does Evidence Support? By YeounSoo Kim-Godwin 208 JCN/Volume 30, Number 4 journalofchristiannursing.com Copyright © 2013 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. ABSTRACT: A Korean-born U.S. nurse educator shares a perspective on prayer in clinical settings in South Korea and asks what appropriate, ethical prayer practice should be in the United States. A review of research on prayer for health and in nursing practice is offered, concluding with evidence-based suggestions for prayer with and for patients in clinical settings. KEY WORDS: complementary alternative medicine (CAM), nursing, prayer, religion, spiritual care am a Korean-born registered patients during my brief hospital work nurse who came to the United experience in America. I had not States as an adult. During my considered negative implications of undergraduate clinical experiences prayer in nursing until I read Taylor’s in Korea, I shared my Christian 2011 article, “Spiritual Care: Evange- Ifaith with patients and prayed with lism at the Bedside?” in the Journal of them on many occasions. At times, my Christian Nursing. It had not occurred instructors expressed concern because to me that nurses could be reprimand- they thought I focused on “spiritual ed, penalized, or even suspended for care” more than clinical skills; how- praying with a patient. This led me to ever, I felt I was doing the right thing research prayer practices for health to incorporating spiritual care. After discover suggestions for prayer for completing the undergraduate nursing Christian nurses in clinical settings. program, I started my nursing career at a remote island in Korea where over PRAYER IN THE UNITED STATES 3,000 leprosy patients stayed through- Prayer is a common practice in out their lives. Working with these the United States. The Barna Group, patients for 3 years, I learned the most which has been conducting an annual desired role of a nurse for this popula- tracking survey of religious behavior tion was to be with them, eat with in the United States for over two them, and pray for/with them. After I decades, reported that 77% of respon- left the island, I worked as a staff nurse dents prayed to God during the past at a Christian hospital in Korea where week in 1999, and 83% did so in 2004. all staff started the day with a prayer Three out of four adults associated worship service, and were expected to with non-Christian faiths reported pray for patients. As a result, it became they prayed in a typical week and natural for me to pray for and with even three of 10 atheists and agnostics my patients. admitted to praying (Barna Group, I did not experience any ethical or 2004). In 2005, in a Newsweek/ legal conflicts regarding prayer with Beliefnet Poll of 1,004 American adults, 64% of respondents prayed YeounSoo Kim-Godwin, PhD, RN, every day; only 8% of respondents is a Professor at the School of Nurs- ing, University of North Carolina reported they never prayed (Beliefnet, Wilmington, teaching Community 2005). More recently, according to a Health Nursing and Transcultural Health Care. Before she came to the USA TODAY/Gallup poll of 1,000 United States, she studied Healing Ministry at the Asian adults in May 2010, 92% believed Center for Theological Studies and Mission (ACTS) in God and 83% said God answers in South Korea. Accepted by peer review 7/18/2012. their prayers; 57% of adults favored a The author declares no conflict of interest. National Day of Prayer (Grossman, DOI:10.1097/CNJ.0b013e31826c2219 2010). Barna reported again in 2011 journalofchristiannursing.com JCN/October-December 2013 209 Copyright © 2013 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. Christian nurses need to employ best practices in praying for patients. that “slightly more than four out of by various racial and ethnic groups intercessory prayer to alleviate illness five Americans pray during a typical (Tippens, Marsman, & Zwickey, 2009). have shown no consistent or clear week” (p. 172), or over 80%. Using a cross-sectional survey with effects of intercessory prayer. However Prayer is a common practice for a stratified random sample age of 40 the reviewers suggest no changes be health. According to a national survey and over, O’Connor, Pronk, Tan, and made in the provision of prayer for the on use of prayer (N = 2,055), 35% of Whitebird (2005) found that among sick, as well as better methodologies be respondents used prayer for health 4,404 survey respondents, 47.2% of used in prayer research (Oliver, 2013). concerns; 75% of these prayed for respondents reported they pray for In spite of the methodological concern wellness, and 22% prayed for specific health, and 90.3% of these believed and criticism of measuring the medical conditions; of those praying for prayer improved their health. Those effectiveness of prayer, trends indicate specific medical conditions, 69% found who prayed had significantly less the public believes there are positive prayer very helpful (McCaffrey, smoking and alcohol use; were more health benefits of prayer (Choo, 2011; Eisenberg, Legedza, Davis, & Phillips, likely to have a regular primary care Denholm, 2008; Peteet, 2010; 2004). According to the Centers for provider; and had more preventive Vannemreddy, Bryan, & Nanda, Disease Control and Prevention (CDC) care visits, influenza immunizations, 2009). Nursing reports also support and the National Center for Comple- vegetable intake, satisfaction with the value of prayer for improvement mentary and Alternative Medicine care, and social support. Koenig, King, of health and healing (Helming, 2011; (NCCAM), prayer was ranked the and Carson (2012) concluded from an Nance, Quinn Griffin, McNulty, & most commonly used complementary exhaustive review of research that Fitzpatrick, 2010; Shelly, 2005). and alternative medicine (CAM) people of all faiths and walks of life The term, intercessory prayer (IP), among 31,044 adults in 2002; 43% use prayer in life, health, and illness goes beyond the basic definition of reported they used prayer specifically with positive outcomes. prayer. IP intercedes between God and for their own health during the last 12 human beings on behalf of someone months (ranked as first among the listed DOES PRAYER WORK? else, trusting God will act for the good 10 CAM), 24% received prayer by A variety of empirical studies have of that person (Strang, 2011). Although others for their own health (ranked attempted to test the efficacy of prayer there is no contact between the as second), and 9.6% participated in on health with little conclusive results individual praying or the person receiv- a prayer group for their own health (Krucoff & Crater, 2010; Narayanasamy ing the prayer in distance intercessory (ranked as sixth) (Barnes, Powell- & Narayanasamy, 2008). Some argue prayer (DIP), proximal intercessory Griner, McFann, & Nahin, 2004). that it is beyond human research to prayer (PIP) refers to direct-contact Prayer was not included in the prove God’s response to prayer (Ahmed prayer, frequently involving touch, by 2007 National Health Interview & Hall, 2008; Gaudia, 2007), if not one or more persons on behalf of Survey by NCCAM and most likely inappropriate to “test” God. Others another (Brown, Mory, Williams, & will not be assessed again soon in believe scientific design can reliably McClymond, 2010; Nance et al., national government surveys (2012). examine potential health benefits of 2010). According to Hollywell and The rationale for this is the term prayer while simultaneously recogniz- Walker (2009), private or personal “prayer” is widely used in multiple ing the methodological limitation of prayer needs to be distinguished from ways by diverse spiritualities and prayer research (Krucoff & Crater, DIP in which the individual is prayed cannot be specifically measured, may 2010; Oliver, 2013; Peteet, 2010). for by an external agent, with or falsely inflate reported CAM use, and Cochrane Collaboration reviews in without the knowledge and approval may mask differences in CAM use 2000, 2004, and 2009 of research on of the recipient. 210 JCN/Volume 30, Number 4 journalofchristiannursing.com Copyright © 2013 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. Although DIP is one of the types of PRAYER AMONG PATIENTS the role of optimism in explaining prayer most studied and with contro- A considerable number of studies the relationship between prayer and versial findings, PIP has been less have identified prayer as a frequent and well-being. They reported that prior studied, but has shown more positive favored coping method among patients. to surgery, 88% of respondents effects on health. Brown et al. (2010) Coleman et al. (2006) analyzed an expressed a belief in the importance reported a statistically significant ethnically diverse convenience sample of prayer and intended to use personal increase in auditory and visual of 1,071 HIV-infected adults and prayer to cope with difficulties related function after PIP in rural Mozam- found prayer was used for managing to surgery; however, the researchers did bique subjects. Masters and Spielmans HIV-related anxiety, depression, fatigue, not distinguish between different types (2007) analyzed the effects of DIP and nausea, regardless of ethnic groups. of prayer (Ai et al., 2007). using 15 empirical studies and con- Specifically, older African Americans, cluded there is no scientific discernable Hispanics, and females were more PRAYER BY NURSES effect for DIP on health; the authors likely to use prayer for the manage- A survey conducted by Taylor and raised a methodological concern that ment of symptoms. The authors Mamier (2005) indicated that the the impossibility of a true control concluded that although not all ethnic majority of patients prefer to receive group presents a significant barrier in groups rely on the use of prayer, for prayer from their nurses.
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