Free Health Essays - Critique of “Effects of Intercessory Prayer on Patients With Rheumatoid Arthritis”
“Effects of Intercessory Prayer on Patients With Rheumatoid Arthritis” by Matthews et al might more appropriately have been titled “Effects of Experienced Ministry on Elderly White Christian Women With Rheumatoid Arthritis,” thus somewhat negating the researchers’ findings that a “laying on of hands” may actually provide statistically significant improvements in people with rheumatoid arthritis (RA) (2000). Although the questions that guided the inquiry were clear, the study itself – funded by a foundation established by a wealthy active “Presbyterian elder” (Templeton, 2005) and by the Foundation for Spirituality and Medicine – seems to raise a few problems and more questions than answers.
One of the most striking problems in the study was the “limited statistical power of the findings” (Matthews et al, 2000, p. 1184) due to the unequal size between the control and experimental groups. Because conditions of the study were constrained due to scheduling conflicts, the experimental group was larger than the control group, making the results difficult to compare. Another problem is that a web search for the principal investigator leads to a religious web site that discusses the “awesome power of God” where Dr. Matthews has a prominent presence and is on the board of directors (Ballew, 2002), which leads one to wonder whether the results of the study may have been predetermined or would ever have been published if different. And this leads to another problem. The study seems to assume that prayer does have an effect on well being since it makes no mention of any studies that have found the opposite. Along with these glaring problems, are questions that the study itself raised: two of the most important being “did the demographics of the study group itself contribute to the findings” and “exactly what effected the improvements in the study group?”
Although the study’s findings do not suggest any untoward influence by either of its funding bodies, both organizations appear to have clear interests in, if not marrying, then at least partnering religion with science and both seemed to have had no problem overlooking the fact that this study used only a very southern, very Christian sample group – a group in which almost 8 out of 10 of the participants described religion as very important in their lives (Matthews et al, 2000, p. 1184) and many identified themselves as “born-again” Christians, even more pious and devout than “regular” Christians. Concentrating the study’s efforts on this population in an attempt to determine the effects of prayer limits its application or findings in a wider global population simply because the cohort, by virtue of its religious leanings, were already believers in prayer. The power of a belief in anything cannot be overemphasized especially since several researchers have found that “certain mental states can indeed affect physiology” (Avalos, 1997, p. 44) and even the study’s researchers admitted that “patients’ beliefs at the study’s conclusion in having received distant prayer [whether received or not] correlated highly with improvement in global well-being and reductions of pain and functional impairment” (p. 1184).
In addition, although 18% of the study was comprised of men, no mention of gender differences or similarities in results was ever made and this is problematic since it is often presumed that women are more attuned to and more apt to participants in religion than are men. Knowing whether a gender difference did exist would lend an additional piece of information with which to better evaluate the results. It would allow us to determine if the improvements noted were across the board or specific to one gender.
Further compounding the problem of the study groups was their extremely limited geographical nature along with the median age of 61.6 years – a time when loneliness often besets many and many may miss physical touch as well as personalized attention, both of which were provided by the experienced “prayer ministers from Christian Healing Ministries” (Matthews et al, 2000, p. 1179).
It was also these same ministers that create the single largest flaw in the study. Although the ministers did the praying, it was the effect of the prayer that guided the researchers and what they attempted to measure rather than the effect of the ministers themselves. Yet the ones who prayed were chosen by their ministry because they exhibited the ability to “attentively listen, [to] have a compassionate heart, [and] always [be] able to offer hope” (Coleman, 2003). For many people with disabilities, others who have these characteristics become facilitators of well-being. A 2003 study in the Journal of Rehabilitation found that many older people suffering from any number of disabilities felt better when they had “positive social interactions where they felt they were valued and supported by friends and family” as well as when their healthcare professionals were “respectful, concerned, and … willing to treat the total person” (Putnam, 2003, p. 42). Thus, the results of Matthews et al might have had as much or more to do with the attention from the ministers themselves than from the prayers they provided. This possibility is underscored by the study authors themselves when they wrote: “it is important to emphasize that this investigation evaluated the effects of experimental intercessory prayer ministry by an experienced team, and not intercessory prayer alone” (Matthews et al, 2000, p. 1184). Unfortunately, this sentence is buried within the study and the result is that the study implies it looks at intercessory prayer itself – no matter who it is provided by, since there was limited information provided about the ministers, their training, how they conducted their education classes, or much else for that matter.
It is that one damning buried line that most diminishes the study. Throughout the study, the researchers said they evaluate prayer – not those doing the praying. Their research questions were about prayer – not those doing the praying. Their results discussed the physiological findings after various time periods following intercessory prayer – not of the time that passed since the study groups were touched by compassionate individuals who prayed. We are told that the ministers involved in the distance intercessory prayers spoke weekly, but we are not told what those conversations consisted of or why they occurred or what their value may have been. We are not told of how the “laying on of hands” took place or for how long or what words were said or how the patients perceived the ceremony. In other words, we are told too little.
Perhaps too, the researchers discounted the effect they had on the participants simply by their willingness to look at a more complete picture of the patient rather than just at his or her arthritis measurements. And, perhaps this all highlights another problem in that the researchers, although perhaps qualified to conduct a study, were unable to separate that which was said to be studied from that which should have been a very distinctive variable but one that was never measured. In addition, since part of the results come from religious assessments rather than medical ones, it would have been helpful to the readers to see what was being asked and why that particular assessment was being used rather than instead being pointed to a footnote leading to a single journal article.
The study did have its positive moments. Major variables were clearly identified and measurable; results were given as percentages as well as raw numbers; the types of assessments used, such as the Arthritis Impact Measurement Scale and the Modified Health Assessment Questionnaire, seemed appropriate to the research questions; the participants were told of “the specific nature of the prayer intervention”; and the researchers obtained informed consent (Matthews et al, 2000, p. 1179). In addition, the same individual interviewer was used with all study participants thus likely eliminating any sort of misinterpretation of patient questionnaires or answers. Of course, this would not be possible in a random study that used a more reasonable sample population and thus could also be seen as a potential failure.
Another of the study’s positive points is that it limited its research questions and discussion to the physiological and medically measurable effects of prayer rather than, for instance, looking at the influence of spirituality on patient attitude or which words in a prayer were more beneficial. Yet here, too, a few problems can be noted. Although mention was made of a few other studies involving prayer, discussion of those studies and their positive or negative findings were not given with one exception and it was that exception - dealt with in one sentence in the study (Matthews et al, 2000, p. 1177) - which formed the two research questions in the study. However, an additional failing is found here as well. While the first research question was methodically dealt with using several primary and secondary analyses with enumerated results, the second research question dealing with distant intercessory prayer, was only briefly analyzed making one feel a need to place trust in the researchers’ finding that it provided no additional results rather than in observing such through actual numbers.
Bibliography
BALLEW, J. 2002. Dr. Dale Matthews: Biography. The Awesome Power of God [online]. Beverley Hills, CA. Available from: http://awesomepower.net/matthews.htm [Accessed: 2 April 2005].
AVALOS, H. 1997. Is faith good for you? Free Inquiry, 17 (4), 44-46.
COLEMAN, E. 2003. Framework for developing a healing ministry: part 2. Christian Healing Ministries [online]. Jacksonville, FL: Christian Healing Ministries. Available from: http://www.christianhealingmin.org/framework2.htm [Accessed: 2 April 2005].
PUTNAM, M., GEENEN, S., POWERS, L.E., SAXTON, M., FINNEY, S., & DAUTEL, P. 2003. Health and wellness: People with disabilities discuss barriers and facilitators to well being. Journal of Rehabilitation, 69 (1), 37 - 45.
JOHN TEMPLETON FOUNDATION, 2005. Biography: Sir John Templeton [online]. West Conshohocken, PA: John Templeton Foundation. Available from: http://www.templeton.org/sir_john_templeton/index.asp [Accessed: 2 April 2005].
MATTHEWS, D, MARLOWE, S, and MACNUTT F, 2000. Effects of intercessory prayer on patients with rheumatoid arthritis. Southern Medical Journal, 93 (12), 1177 – 1186.
