Spiritual Healing: A Triple Scoping Review of the Impact of Spirituality on Burn Injuries, Wounds, and Critical Care

Tomer Lagziel,Julie A Caffrey,Sheera F Lerman,Malik Muhammad Sohail,Kimberly H Khoo,Jeffrey E Janis,Harold G Koenig,Stephen J Poteet,Charles S Hultman

doi:10.3390/ebj3010016

Abstract

Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our scoping review aimed to examine the available literature for evidence of the impact of spirituality on burns, complex wounds, and critical care to shed more light on the relationship between spirituality and the conditions treated by multidisciplinary burn center teams. We performed three systematic reviews to examine the relationship between spirituality and these conditions. Searches were performed using MeSH terms utilizing four databases (MEDLINE via PubMed, Embase, Cochrane, Web of Science, and Scopus). A systematic and independent title/abstract screening was carried out by two independent reviewers and a full-text review was followed. Our review demonstrated a clear lack of overlap between study outcomes and lack of objective spirituality measurements. Most articles primarily focused on psychological outcomes, such as stress or mental health, instead of objective measures such as wound size or scar formation. We found a trend toward better psychological outcomes in patients with more spirituality, either pre-existing or interventional. To increase comparability and uniformity of outcomes, future studies would benefit from utilizing standardized spiritual assessment tools and objective wound metrics.

Highlights

In the past century, rapid technological advancements in medicine shifted careoriented services to cure-oriented medical treatment, often resulting in the neglect of the spiritual dimension of health and illness [1]
The purpose of our scoping review is to assess the current literature for reports on the impact of spirituality on burn injuries, complex wounds, and critical care recovery to analyze the relationship between spirituality and the conditions treated by multidisciplinary burn center teams
The lack of literature examining the other conditions managed by multidisciplinary burn center teams limited the power of a quantitative synthesis; the few reports that we found did suggest a beneficial relationship between spirituality and complex wounds or critical care, both for the patient and family

Summary

Introduction

Rapid technological advancements in medicine shifted careoriented services to cure-oriented medical treatment, often resulting in the neglect of the spiritual dimension of health and illness [1]. Religion and spirituality have been recognized as significant contributing factors to health by numerous studies [1], with empirical evidence suggesting that people with higher levels of spirituality have lower levels of depression, improved quality of life, and higher pain tolerance [2]. Patients suffering burn injuries may require a prolonged hospital stay with the utilization of critical care services, and burn injuries are unique as the nature of the injuries often causes psychological stress [5]. There is substantial evidence that psychological stress adversely affects the immune system. Considering the substantial level of evidence showing that negative psychological and emotional states have detrimental impacts on the process of wound healing and immune recovery, we aimed to understand the role that spirituality plays in mitigating these deleterious repercussions

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Conclusion