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684
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
Objevo: Evaluar el efecto de la plegaria
sobre la ansiedad de pacientes con cáncer
en tratamiento quimioterápico. Método:
Estudio casi experimental con pre y post in-
tervención. Fueron reclutados 20 pacientes
hospitalizados en tratamiento de quimiote-
rapia endovensa connua. Los voluntarios
fueron evaluados por medio de encuesta,
ulizándose un cuesonario de rasgos so-
ciodemográcos, clínicos y espirituales, el
Índice de Religiosidad de la Universidad de
Duke - DUREL y el Inventario de Ansiedad
Trazo-Estado. Fueron vericadas las señales
vitales y recogido el corsol de la saliva. La
intervención aplicada fue la plegaria, y la re-
colección de datos sucedió en tres momen-
tos: primera recolección (basal), pre y post
intervención. Resultados: Los datos encon-
trados entre las recolecciones pre y post
intervención revelaron diferencias estadís-
camente signicavas para el estado de
ansiedad (p=<0,00), la presión arterial (sis-
tólica, p=0,00; diastólica, p=<0,00) y la fre-
cuencia respiratoria (p=0,04). Conclusión:
La plegaria demostró ser una estrategia
eciente en la reducción de la ansiedad del
paciente en tratamiento de quimioterapia.
Neoplasias
Quimioterapia
Espiritualidad
Religión
Ansiedad
Enfermería oncológica
Objevo: Avaliar o efeito da prece sobre
a ansiedade de pacientes com câncer em
tratamento quimioterápico. Método: Estu-
do quase experimental com pré e pós-in-
tervenção. Foram recrutados 20 pacientes
internados em tratamento de quimiotera-
pia endovenosa connua. Os voluntários
foram avaliados por meio de entrevista,
ulizando um quesonário de caracterís-
cas sociodemográcas, clínicas e espiritu-
ais, o Índice de Religiosidade da Universi-
dade de Duke – DUREL e o Inventário de
Ansiedade Traço-Estado. Foram aferidos os
sinais vitais e coletado o corsol salivar. A
intervenção aplicada foi a prece e a coleta
de dados ocorreu em três momentos: pri-
meira coleta (basal), pré e pós-intervenção.
Resultados: Os dados encontrados entre
as coletas pré e pós-intervenção revelaram
diferenças estascamente signicavas
para o estado de ansiedade (p=<0,00), a
pressão arterial (sistólica, p=0,00; diastó-
lica, p=<0,00) e a frequência respiratória
(p=0,04). Conclusão: A prece demonstrou
ser uma estratégia eciente na redução da
ansiedade do paciente em tratamento de
quimioterapia.
Neoplasias
Quimioterapia
Espiritualidade
Religião
Ansiedade
Enfermagem oncológica
Objecve: To evaluate the eect of prayer
on anxiety in cancer paents undergoing
chemotherapy. Method: Quasi-experimen-
tal study, with pre and post-intervenon.
Twenty paents admied to treatment
of connuous intravenous chemotherapy
were recruited. The volunteers were evalu-
ated through interviews using a queson-
naire of sociodemographic, clinical and
spiritual characteriscs, the Index of Reli-
giosity Duke University and the State-Trait
Anxiety Inventory. Vital signs were mea-
sured and collected salivary corsol. The
intervenon was applied prayer and data
collecon occurred in three phases: rst
collecon (baseline), pre and post-inter-
venon. Results: The data found between
the pre and post-intervenon samples
showed dierent stascally signicant
for state anxiety (p= <0.00), blood pres-
sure (systolic, p=0.00, diastolic, p=<0.00)
and respiratory rate (p=0.04). Conclusion:
Prayer, therefore, proved to be an eecve
strategy in reducing the anxiety of the pa-
ent undergoing chemotherapy.
Neoplasms
Drug therapy
Spirituality
Religion
Anxiety
Oncology nursing
Effectiveness of prayer in reducing
anxiety in cancer patients
Original article
685
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
Cancer is a sgmazed illness, for it brings suering and
changes to a person’s life
(1)
, as well as possibly causing de-
pression and anxiety
(2)
. People aected by cancer experi-
ence hospitalizaon, which includes hospital roune, wait-
ing for informaon, and a restricted number of visitors, all
of which can cause various reacons to the situaon
(3)
.
In light of the above and the sgma surrounding the
illness, feelings of fear and insecurity can arise, potenally
inuencing cancer treatment. Thus, reducing paents’
anxiety is necessary
(3)
.
The term anxiety comes from the
Greek word anshein, which means to oppress, to suf-
focate, and it can cause changes in the body, such as in-
creased heart and respiratory rate
(4)
. In addion to physi-
cal alteraons, social, psychological and spiritual aspects
are also aected.
Nurses are the professionals who accompany paents
and their families during the illness process, from diagnosis
to rehabilitaon. Comprehensive care must include physi-
cal, social, psychological and spiritual aspects. Nurses can
treat anxiety using acvies proposed by the Nursing Inter-
venons Classicaon (NIC)
(5)
,
which provides suggesons
such as trying to understand the paent’s point of view
regarding the feared situaon, listening closely, administer-
ing anxiety medicaon, and encouraging the family to stay
with the paent, as well as others. Such intervenons also
include taking a calm, reassuring approach and providing
paents with orientaon on relaxaon techniques.
In this sense, it is important for nurses to develop
strategies for reducing or eliminang anxiety and calming
paents. Studies have observed that spiritual experiences
can reduce anxiety levels
(6-7)
.
Spirituality can be pracced through prayer, classied
into two types: Peons, when those who pray ask God
for something for themselves; or intercession, when those
who pray ask God for something on someone else’s be-
half
(8)
. The act of prayer is a frequent spiritual acvity that
promotes well-being, facilitates the health-illness process
and oers health benets
(9)
.
Prayer is one of the acvies proposed for nursing in-
tervenons that provide spiritual support and facilitate
spiritual growth
(5)
. It is a strategy used to meet the spiri-
tual needs of paents and a calming technique. So why
not use it for reducing anxiety?
An invesgaon of studies aimed at understanding
prayer in a clinical context favors its use in nursing care, in
order to provide paents with well-being. Furthermore,
such invesgaons contribute to nursing knowledge and
strengthen care strategies involving non-convenonal thera-
pies. It is important to conduct studies on this topic in order
to evaluate the scienc eect of prayer and thus validate
its use by health professionals when caring for paents
(10)
.
The objecve of this study was to evaluate the eect
of prayer on the anxiety of cancer paents submied to
chemotherapy.
This was a quasi-experimental pre-post intervenon
study, conducted in the inpaent sector of a philanthropic
hospital in the South of the state of Minas Gerais, Brazil.
It took place between February and December 2012 with
paents submied to connuous intravenous anneo-
plasc chemotherapy.
We chose a convenience sample consisng of 45 pa-
ents receiving treatment in the oncology sector. Inclu-
sion criteria were having a cancer diagnosis, being over
18 years of age, receiving chemotherapy, being willing to
receive prayer and being clinically stable. Criteria for ex-
clusion were presenng hearing or speech impairments,
not being available for collecon of baseline corsol data
at eight in the morning and having received fewer than
three applicaons of chemotherapy during the data col-
lecon period.
Twenty-four paents were selected according to the
inclusion criteria and four individuals le the study be-
cause their chemotherapy treatment was interrupted
and/or they began to present hearing impairments.
Therefore, the nal sample comprised 20 paents.
Data collecon consisted of evaluang signs of anxiety
with the State-Trait Anxiety Inventory, measuring blood
pressure, respiratory rate and heart rate and applying the
prayer intervenon. First, we interviewed parcipants us-
ing a quesonnaire about sociodemographic and clinical
characteriscs created by the researcher based on the ob-
jecves and theme of the study, which was submied to a
pre-test renement process.
Parcipants were given the Duke University Religion
Index (DUREL)
(11)
, an instrument whose Brazilian Portu-
guese version has been properly validated
(12)
. It consists
of a ve-item scale measuring three dimensions of religi-
osity: organizaonal religious acvity (ORA); non-organi-
zaonal religious acvity (NORA) and intrinsic religiosity
(IR). The scores for each of the three dimensions must be
considered separately and there is no need to calculate
a total score
(11)
.
For ORA and NORA, a score lower than
three characterizes high levels of religious acvity; greater
than three, low levels of religious acvity. For the RI item,
a score below 7.5 characterizes high religiosity, and higher
than 7.5, low religiosity.
Subsequently, we applied the State-Trait Anxiety Inven-
tory (STAI)
(13)
, validated in Brazil by Biaggio et al.
(14)
It is an
instrument containing 40 statements describing a person’s
feelings, distributed in two parts, trait (STAI-T) and state
(STAI-S), each part consisng of 20 statements. Answers
are given on a four-point Likert scale (1 – absolutely not to
686
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
4 – very much). Scores for each subscale range from 20 to
80 points and indicate mild (0-30), moderate (31-49) and
severe levels of anxiety (greater than or equal to 50)
(13)
.
The rst sample of 1.0 ml of saliva for salivary cor-
sol analysis, called basal corsol, was gathered at 8 am
with Salivee® tubes
(15)
.
These were stored in a thermal
bag with ice and immediately sent to the laboratory for
analysis, conducted with the electrochemiluminescence
method. It is worth nong that whenever samples were
not immediately taken to the laboratory, they were main-
tained at a temperature between 2
o
C and 8
o
C for a maxi-
mum of 48 hours.
Heart rate, respiratory rate and blood pressure were
always measured in this sequence, 30 minutes aer rest
and with the paent sing up against the head of the
bed
(16)
.
Furthermore, as recommended by the adopted
literature, heart and respiratory rates were measured
through palpaon, using a chronometer for a one-minute
period. We used indirect measurement of blood pressure,
through the auscultatory method, using a stethoscope
and an aneroid sphygmomanometer in accordance with
Brazilian Society of Cardiology guidelines
(17)
.
For pre-intervenon data collecon, parcipants were
given the STAI-S once more, but not the STAI-T, which was
applied only once in the beginning. Saliva samples and vi-
tal sign measurements were also gathered by the same
examiner and with the same procedures as those adopted
for basal data collecon.
Soon aer, the prayer intervenon was carried out, cre-
ated and conducted by the researcher. It was a Chrisan
prayer, with no invocaon of saints, cing Psalm 138 of the
Bible, which speaks of divine omniscience: God knows all
and sees all. The prayer was in the form of an audio record-
ing 11 minutes long of a musician’s voice with good dicon.
Parcipants listened to the recording using earphones with
a protecve plasc covering and were instructed to sit or
lie comfortably with their eyes closed to promote concen-
traon. Furthermore, they held hands with the researcher,
who conducted a silent intercession prayer.
There is no gold standard available in the literature for
prayer applicaon determining its format, beginning, du-
raon or the person who will apply the technique
(18)
.
To
guarantee the rigorousness and repeatability of the inves-
gaon, we sought to standardize the me and locaon of
the prayer, as well as always using the same type of prayer
and the same intercessor.
Thirty minutes aer prayer, paents were given the
STAI-S once more. Subsequently, saliva samples were
gathered and vital signs measured in the standardized se-
quence and by the same trained examiner (post-interven-
on data collecon).
For each of the pre-and post-intervenon observa-
ons on the STAI-S, saliva samples, and vital signs, three
repeons of data collecon were done in order to mea-
sure the repeatability of the observaons. This was needed
in order to increase the credibility of the data obtained
(19)
.
The control group received the same protocol, with no
prayer intervenon. The examiner remained beside them
during the same length of me as the prayer, conducng
a moment of personal interacon, which consisted of ob-
serving, listening to and giving aenon to the paent.
Results were charted and analyzed with the BioEstat 5.0
program. We used the two-sample t-test or the Wilcoxon
signed-rank test to compare state anxiety levels, salivary
corsol, blood pressure, and heart and respiratory rates
pre- and post-intervenon. For comparison between con-
trol and intervenon groups, we used the Mann-Whitney
U test or t-test specic for two independent samples. A
5% signicance level was adopted.
The study was approved by the research ethics com-
miee of the Federal University of Alfenas (Protocol no.
063/2011) and data were gathered only aer a Free and
Informed Consent form was signed.
Of the 20 subjects who parcipated in the study, 15
(75%) were male and ve (25%), female. Table 1 displays
other invesgated sociodemographic characteriscs.
Table 1 – Sample sociodemographic characteristics - Alfenas,
Minas Gerais, Brazil, 2012
Sociodemographic characteristics f* %
Age
<40 years 2 10
40 to 50 years 4 20
51 to 60 years 11 55
61 to 70 years 3 15
Education Level
No formal schooling 1 5
Completed Elementary School 15 75
Completed High School 2 10
Completed Higher Education 2 10
Marital Status
Single 2 10
Married/Cohabitation 15 75
Divorced 3 15
Family income
Less than a monthly minimum wage
(MMW)
1 5
One to three MMW 16 80
Four to six MMW 2 10
Does not know 1 05
Religion
Catholic 13 65
Evangelical 6 30
No religion, but spiritualized 1 5
Jehovah’s witness 0 0
687
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
With respect to religious characteriscs (Table 2), the
sample revealed a high level of religiosity for the three
DUREL dimensions: organizaonal, non-organizaonal
and intrinsic religiosity. All paents reported prayer prac-
ce, as well as belief in its power. High religiosity was es-
pecially related to intrinsic religiosity and experiencing re-
ligiosity fully: Feeling God’s presence and striving to live in
accordance with one’s religious belief.
and one (5%), prostate. Considering me of illness discov-
ery, 12 (60%) reported having discovered the disease one to
six months before beginning treatment; four (20%), six to 10
months; and the others (20%), more than 10 months before.
The anxiety prole of the sample, as measured by the
complete STAI the rst me, before conducng the inter-
venon, displayed moderate levels of anxiety (Table 3).
Table 2 – Description of subject’s religiosity according to the
Duke University Religion Index (DUREL) – Alfenas, Minas
Gerais, Brazil, 2012
ORGANIZATIONAL RELIGIOUS ACTIVITY
A) How often do you attend church or other religious meetings?
n=20 %
1. More than once a week
4 20
2. Once a week 5 25
3. Two or three times a month 2 10
4. A few times a year 7 35
5. Once a year or less 1 5
6. Never
1 5
NON-ORGANIZATIONAL RELIGIOUS ACTIVITY
B) How often do you spend time in private religious
activities, such as prayer, meditation or studying the Bible or
other religious texts?
1. More than once a day
4 20
2. Once a week 13 65
3. Two or three times a month 0 0
4. A few times a year 0 0
5. Once a year or less 02 10
6. Never
01 05
INTRINSIC RELIGIOSITY
C) In my life, I experience the presence of the Divine (i.e., God).
1. Denitely true of me
19 95
2. Tends to be true 1 5
3. Unsure 0 0
4. Tends not to be true 0 0
5. Denitely not true
0 0
D) My religious beliefs are what really lie behind my whole
approach to life.
1. Denitely true of me
18 90
2. Tends to be true 0 0
3. Unsure 1 5
4. Tends not to be true 1 5
5. Denitely not true
0 0
E) I try hard to carry my religion over into all other dealings in life.
1. Denitely true of me
16 80
2. Tends to be true 1 5
3. Unsure 2 10
4. Tends not to be true 1 5
5. Denitely not true
0 0
Table 3 – Baseline anxiety prole - Alfenas, Minas Gerais,
Brazil, 2012
Variables
Group
( x
¯
± s )
Trait anxiety
36.2 ± 9.9
State anxiety 35.2 ± 7.1
Salivary cortisol (nmol/L) 9.7 ± 6.5
Systolic BP (mmHg) 118.5 ± 16.9
Diastolic BP (mmHg) 78.2 ± 14.1
Respiration (breaths per minute) 18.7 ± 3.1
Heart rate (bpm)
71.1 ± 9.4
Table 4 – Comparison between pre-and post-intervention means
- Alfenas, Minas Gerais, Brazil, 2012
Variables
Pre-
intervention
Post-
intervention
p-value*
x
¯
s x
¯
s
State anxiety
33.52 4.92 28.42 5.57 < 0
Salivary cortisol
(nmol/L)
10.31 6.66 10.61 6.61 0.57
Systolic BP (mmHg) 122.08 12.98 115.33 11.58 0
Diastolic BP (mmHg) 80.83 10.37 76.5 9.6 < 0
Respiration (breaths per
minute)
20.43 4.58 18.2 3.33 0.04
Heart rate (bpm)
70.58 10.24 68.8 6.31 0.07
s
Regarding clinical characteriscs, only two individuals
presented comorbidies such as diabetes and hyperten-
sion. With respect to the cancer’s locaon, 10 (50%) pre-
sented head and neck cancer; four (20%), intesnal; two
(10%), stomach; two (10%), bone marrow; one (5%), liver;
Anxiety state was inuenced by non-organizaonal
religious acvity, according to Spearman’s coecient
(p=0.01), and displayed a correlaon with age group
(p=0.01). No other sociodemographic characterisc inu-
enced anxiety in this study.
When comparing all pre- and post-intervenon means,
we idened modied values for state anxiety, blood pres-
sure and respiraon rate, conrming the eecveness of
prayer on these variables (Table 4).
According to the STAI-S, anxiety levels were reduced
aer prayer at each moment. Blood pressure was reduced
in the three measurements aer prayer, with values be-
low 120/80 mmHg, which is considered an adequate
value according to the Brazilian Society of Cardiology
(17)
.
Respiratory rate was also reduced signicantly, all values
registering above normal levels before intervenon but
showing a mean level of 18 rpm aer prayer, which is
within the standard range of 12 to 20 rpm
(16)
.
Values re-
lated to anxiety levels and vital signs were reduced aer
each intervenon and for all three repeons of pre- and
post-intervenon observaon (Table 5).
688
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
In oncology, paents’ lives are changed aer diagno-
sis and treatment; moreover, each paent responds dif-
ferently to situaons experienced during hospitalizaon,
which can generate anxiety
(2-3)
.
This was the case for the
subjects of this study, who required hospitalizaon in or-
der to receive connuous intravenous chemotherapy.
Among these paents, we observed a moderate level
of both trait (mean value 36.2) and state (mean value
35.2) anxiety, in response to the illness, treatment and
hospitalizaon process. Trait anxiety presented a corre-
laon with age group (p=0.01; r=0.52), for the older the
interviewee, the higher the anxiety level. Parcipants’
state anxiety presented a signicant relaon (p=0.01;
r=0.54) with non-organizaonal religious acvity, which
is related to individual religious acvity. Therefore, the
stronger the paents’ personal relaonship with God,
the less anxious they were.
Findings of a previous study
(20)
demonstrated that can-
cer paents submied to chemotherapy used religious/
spiritual coping methods for dealing with the disease and
would have liked to receive spiritual care from health pro-
fessionals. In this sense, the use of comprehensive prac-
ces or even pracces directed toward paents’ spiritual
dimension can be an important strategy to help cope with
cancer, its treatment and any consequent anxiety.
Furthermore, spirituality by means of prayer is ben-
ecial, for it leads to tension relief, increased hope and
reduced anxiety
(21)
.
Carrying out spiritual care is a chal-
lenge and requires that spirituality be included in profes-
sional training and that investments be made in research
in order to solidify knowledge of the phenomenon. Religi-
osity/spirituality can be considered a coping strategy for
paents diagnosed with cancer, whose treatment is per-
meated by stressful events, given the impact that the ill-
ness has on the person’s life
(7)
.
In the present study we used the spiritual pracce of
prayer. Its use as a supporng therapy for cancer treat-
ment must be strengthened, for we found that it caused a
posive eect on people’s lives
(22)
.
The intensity of parci-
pants’ anxiety was reduced, going from moderate to mild
(p< 0.00) aer prayer was applied.
When comparing the results of pre- and post-inter-
venon data collecon, we observed signicant altera-
ons in anxiety levels (p<0.00), respiratory rate (p=0.04)
and blood pressure (p= 0.00) of paents who received
prayer. Among other alteraons, anxiety causes increased
blood pressure, heart rate and respiratory rate
(4)
.
Thus, we
can infer that prayers can reduce the intensity of anxiety,
blood pressure and respiratory rate levels of paents.
Prayer can be a signicant pracce for stabilizing vital
signs, not only for people receiving chemotherapy, but
also for other paents or even people in good health.
This was the case in a study that used the Hail Mary
prayer in a sample of 23 healthy adults. The results dis-
played reduced respiratory rate and improved cardiac
funcon parameters
(23)
.
Praying the rosary, in addion
to being a religious pracce, was found to be a health
pracce; a result that also occurred in the present study
with paents receiving chemotherapy, but with a Chris-
an prayer that did not invoke saints and was conducted
in an ecumenical manner.
Prayer did not present a signicant correlaon (p=0.57)
with parcipants’ salivary corsol levels. In this sense, the
literature has demonstrated that the response of salivary
corsol to condions of stress and anxiety can vary, for
corsol can present elevated levels in response to acute
stress or be reduced with chronic stress
(15)
.
Prayer can be a care opon that contributes benecial-
ly to convenonal treatment. It also aends to the spiri-
tual dimension of paents hospitalized for chemotherapy.
The applicaon of prayer provides a new perspecve for
nursing care of these paents.
Prayer was eecve in reducing the anxiety of paents
receiving chemotherapy. It is important to assess the anxi-
ety of these paents, especially those submied to con-
nuous intravenous treatment. Intervenons directed at
reducing anxiety can help paents with treatment adhe-
sion and provide them with a greater sense of well-being.
Table 5 – Mean ( x¯ ) and sample standard deviation (s) of data
collected at three repetitions of pre- and post-intervention obser-
vation - Alfenas, Minas Gerais, Brazil, 2012
Variables
1
st
repetition
( x
¯
± s )
2
nd
repetition
( x
¯
± s )
3
rd
repetition
( x
¯
± s )
Pre-intervention
State anxiety 34.20 ± 5.99 33.35 ± 5.30 33.00 ± 6.29
Salivary cortisol
(nmol/L)
9.65 ± 7.71 10.55 ± 8.09 9.40 ± 6.75
Systolic BP
(mmHg)
119.75 ± 14.64 121.25 ±18.05 125.25 ± 18.46
Diastolic BP
(mmHg)
79.00 ± 12.52 80.50 ± 17.31 83.00 ± 13.42
Respiration
(breaths per
minute)
27.14 ± 23.55 23.00 ± 20.25 23.95 ± 20.06
Heart rate
(bpm)
68.28 ± 21.27 74.43 ± 14.19 74.67 ± 12.39
Post-intervention
State anxiety 31.48 ± 18.98 32.43 ± 18.72 33.00 ± 18.67
Salivary cortisol
(nmol/L)
9.75 ± 7.68 11.00 ± 7.67 9.70 ± 7.02
Systolic BP
(mmHg)
115.25 ± 13.32 115.25 ± 16.18 115.50 ± 15.38
Diastolic BP
(mmHg)
77.00 ± 8.64 76.00 ± 14.20 76.50 ± 14.24
Respiration
(breaths per
minute)
18.05 ± 3.84 18.50 ± 3.91 18.05 ± 3.47
Heart rate
(bpm)
68.80 ± 9.52 68.95 ± 8.96 68.65 ± 7.06
689
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
The use of various means of invesgang anxiety facili-
tates and reinforces its idencaon. Among those used
in this study, measuring vital signs is eecve because
they are considered to be indicators of bodily vital func-
ons and are a roune part of nursing clinical pracce. It
is a simple technique that is cost-free and requires lile
me. The applicaon of a psychometric instrument is al-
so a simple, quick method of self-evaluaon; however, a
trained person is required to calculate the score. On the
other hand, salivary corsol analysis is more costly; even
though it is not an invasive procedure, it requires labora-
tory analysis and also requires a trained professional for
sample gathering and pernent recommendaons.
We concluded that nursing clinical pracce places pro-
fessionals in a posion to invesgate paent’s anxiety and
treat it through alternave therapies such as prayer. This
method aends to paents’ spiritual dimension and was
found to be eecve in reducing anxiety. Furthermore, its
use is simple and can be connuous, resulng in no nan-
cial costs and no change to the hospital service roune.
However, its use as a technique must sll be tested.
One of the limitaons of this study relates to the sam-
ple size, which prevents the generalizaon of the results.
This calls for replicaon of the invesgaon with a larger
sample size; especially with a clinical trial model so that
control and treatment group results can be compared.
Nonetheless, the results of the study have implicaons for
nursing clinical pracce, for it oers a standardized prayer
protocol that lasts a maximum of 10 minutes. The prayer
can be recorded and oered to paents to listen through
headphones during a chemotherapy session; it can also
be conducted by nurses themselves, in the form of inter-
cession, should the paent so desire.
Nursing sta can use prayer as a strategy for provid-
ing paents with spiritual support, in order to aend to
the needs related to their spirituality or even to help the
paent cope with the illness, its treatment and conse-
quent anxiety.
1. Souza BF, Pires FH, Dewulf NLS, Inocen A, Silva AE, Miasso
AI. Paents on chemotherapy: depression and adherence to
treatment. Rev Esc Enferm USP. 2013; 47(1):61-8.
2. Jadoon NA, Munir W, Shahzad MA, Choudhry ZS. Assessment
of depression and anxiety in adult câncer outpaents: a cross-
seconal study. BMC Cancer. 2010;10:594.
3. Silva MEDC, Silva LDC, Dantas Araújo DOR, Duarte IS, Sousa
JFM. Assistência de enfermagem ao paciente oncológico no
hospital. Rev Enferm UFPI. 2013;2(n.esp):69-75.
4. Lin MF, Hsieh YJ, Hsu YY, Fetzer S, Hsu MC. A randomized
controlled trial of the eect of music therapy and verbal
relaxaon on chemotherapy-induced anxiety. J Clin Nurs.
2011;20(7-8):988-99.
5. McCloskey JC, Bulechek GM. Classicação das intervenções
de enfermagem. Porto Alegre: Artmed; 2010.
6. Barrera TL, Zeno D, Buch AL, Barber CR, Stanley MA. Integrang
religion and spirituality into treatment for late-life anxiety:
three case studies. Cogn Behav Pract. 2012;19(2):346-58.
7. Fornazari SA, Ferreira RER. Religiosidade/espiritualidade em
pacientes oncológicos: qualidade de vida e saúde. Psicol Teor
Pesq. 2010;26(2):265-72.
8. Tosta CE. A prece cura? Brasília Med. 2004;41(1-4):38-45.
9. Caldeira S. Cuidado espiritual: rezar como intervenção de
enfermagem. CuidArte Enferm. 2009;3(2):157-64.
10. Tosta CE. Prece e cura. In: Teixeira EFB, Müller MC, Silva JDT.
Espiritualidade e qualidade de vida. Porto Alegre: Ed.PUCRS;
2004. p.105-24.
11. Koenig H, Parkerson GR Jr, Meador KG. Religion Index for
psychiatric research: a 5-item measure for use in health
outcomes studies. Am J Psychiatry. 1997;154(6):885-6.
12. Taunay TCDE, Gondim FAA, Macêdo DS, Moreira-Almeida A,
Gurgel LA, Andrade LMS, et al. Validação da versão brasileira
da escala de religiosidade de Duke (DUREL). Rev Psiq Clín.
2012;39(4):130-5.
13. Andreani R, Seabra ML. A estabilidade do IDATE-traço:
avaliação após cinco anos. Rev ABP-APAL. 1993;15(1):21-5.
14. Biaggio AMB, Natalício L, Spielberger CD. Desenvolvimento
da forma experimental em português do Inventário de
Ansiedade Traço-Estado (IDATE) de Spielberger. Arq Bras
Psicol. 1977;19(3):31-44.
15. Soo-Quee DK, Choon-Huat GK. The use of salivary
biomarkers in occupaonal and environmental medicine.
Occup Environ Med. 2007;64(3):202-10.
16. Poer PA, Perry AG. Fundamentos de enfermagem. Rio de
Janeiro: Elsevier; 2009.
17. Sociedade Brasileira de Hipertensão; Sociedade Brasileira de
Nefrologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras
Cardiol. 2010;95(1 Supl.1):1-51.
18. Guimarães HP, Avezum A. O impacto da espiritualidade na
saúde sica. Rev Psiq Clín. 2007;34(1):88-94.
690
Carvalho CC, Chaves ECL, Iunes DH,
Simão TP, Grasselli CSM, Braga CG
19. Polit DF, Beck CT, Hungler BP. Fundamentos de pesquisa em
enfermagem: métodos, avaliação e ulização. Porto Alegre:
Artmed; 2004.
20. Mesquita AC, Chaves ECL, Avelino CCV, Nogueira DA, Panzini
RG, Carvalho EC. The use of religious/spiritual coping among
paents with cancer undergoing chemotherapy treatment.
Rev Lano Am Enfermagem. 2013;21(2):539-45.
21. Zenevicz L, Moriguchi Y, Madureira VSF. The religiosity
in the process of living geng old. Rev Esc Enferm USP.
2013;47(2):433-9.
22. Asn JA, Stone J, Abrams DI, Moore DH, Couey P, Buscemi
R, et al. The ecacy of distant healing for human
immunodeciency virus-results of a randomized trial. Altern
Ther Health Med. 2006;12(6):36-41.
23. Bernardi L, Sleight P, Bandinelli G, Cence S, Faorini
L, Wdowczyc-Szulc J, et al. Eect of rosary prayer and yoga
mantras on autonomic cardiovascular rhythms: comparave
study. BMJ. 2001;323(7327):1446-49.
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