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INTRODUCTION

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In recent years, there has been an accumulation of empirical evidence demonstrating the positive role of religious practice and spirituality on mental health and quality of life (QOL) pertaining to coping with chronic disease. In this case, QOL generally refers to "… those aspects of life and human function considered essential for living fully."1 Attention to holistic patient care, or "whole patient care," is now accepted as the best practice within medical care. In addition, the interdisciplinary approach to health care has a strong advocate in the Joint Commission on Accreditation of Healthcare (JCAHO), which acknowledged in 2003 that "…patients' psychosocial, spiritual, and cultural values affect how they respond to their care."2 Nevertheless, recipients of health care in the USA report dissatisfaction with the lack of spiritually sensitive care.3 This chapter delineates the influences that family and culture play in the patient's religious development and spiritual coping with illness and suffering. For the purpose of this discussion, "family" is defined as "… any group of people who are related biologically, legally, or emotionally."4 Like Seaburn, I assume that all families exist within a cultural web or context that must be taken into consideration when trying to understand the decision-making process in which they are engaged. To continue Seaburn's thought: "Each family may be influenced by its own history with illness, its health beliefs, its religious tradition(s), its racial background, its nation of origin, and other vital factors that contribute to how families define themselves and make meaning of their experiences." The term "culture" is defined as "… the sum of the integrated patterns of knowledge, beliefs, and behaviors of a given community."5 Furthermore, it can be asserted that culture "… mediates the rapport between the individual and the outer world, and it contributes to a person's identity."6 It can also be argued that "family" is one form or context that fits the definition for culture. The family nexus functions as the most intimate relational form of culture, and thus plays a primary role in the development of personhood. Thus, the starting point for understanding how to alleviate suffering in the context of illness, taking into account the impact of family and culture on the life of the patient, is to have a basic grasp of personhood and the nature of suffering.

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"Religion," for the purposes of this discussion, can be understood as the ways in which communities of faith organize and live their lives in relation to each other and the transcendent. On the other hand, spirituality is defined as: "… that human dimension that seeks meaning through intra-, inter-, and transpersonal connectedness." It should be understood that religion and spirituality are complicated constructs, often defying description in terms of how they function to bring about healing and wholeness in the context of illness and suffering. Nevertheless, religion and spirituality offer human beings the possibility of transcending life's vicissitudes, such as illness, and ...

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