Complementary Alternative Cardiovascular Medicine

Chapter 9 /Prayer and CVD 139
Many measurement tools exist to gauge a person’s religiousness and
spirituality. The Duke University Religion Index (DUREL) specifically
addresses the dimensions of religion associated with health outcome,
including organizational religiousness, nonorganizational religiousness,
and intrinsic religiousness (5). Spirituality scales include the Index of
Spiritual Orientation, INSPIRIT (Index of Core Spiritual Experiences),
and the FACIT Spiritual Well-Being Scale. Numerous other scales exist
and are discussed in depth in Koenig’s book (5).
Prayer, particularly “healing prayer,” can also be characterized in
many ways or practiced in a range of prayer “models,” from prayer that
petitions for a specific response to prayer seeking the achievement of
harmony with higher purposes, which may surpass human understanding.
In the patient’s world, self-prayer and the prayers of loved ones may
be ascendant as a component of spiritual consciousness. In clinical trials,
specific petitionary or “intercessory prayer” is the most researched prayer
model to date, presumably because it lends itself to the conceptual paradigms
of “therapy.” Intercessory prayer has been defined as prayer calling
“for aid to others” (6). “Distant healing,” referring to intercessory
prayer “strategies that purport to heal through some exchange or channeling
of supraphysical energy” (7) independent of proximity to the
patient, is a model of prayer with a structure that supports the conduct of
double-blind clinical trial designs. Many other descriptors, such as the
language of prayer, and the content of prayer, the number of individuals
or congregations praying, the timing and duration of prayer, and the
intensity, passion, faith, and concentration of the intercessors, all constitute
what can currently only be considered a range of qualitative descriptors
of prayer methods and models.
Prayer has the potential to exert effects on not only the intended
recipient of the prayer but also the individual performing it, as well as
possibly other unknown recipients. Patients and their families often pray
for healing and recovery, for physicians and other care providers to
perform their procedures successfully and without complications, for
God or another Divine Being to “watch over” the patient during the
illness, and with many other intentions and goals. In the absence of
mechanistic insight or knowledge, it must be recognized that all of these
qualitative descriptors incorporate an enormous influence of intuitive
metaphor, with almost no definitive scientific evidence to support any
prayer model in particular.
Independent of the mechanism or mechanisms, ample evidence exists
that emotional and spiritual states affect health outcomes. Studies have
been conducted on the association between religion and depression,
anxiety, hypertension, and cancer, as well as heart disease. Although not