(CNN) Carol Kochon prayed during her husband's 42-day hospitalization for Covid-19.
Susceptible to lung infections, Rob Kochon had been feeling sick and developing shortness of breath for about four days when he was was admitted to a Florida hospital on Tuesday, March 17. He was diagnosed with double pneumonia.
The next day, a coronavirus test came back positive. On Friday, Rob was relocated downtown to AdventHealth Orlando so he could be intubated. On March 29, he flatlined three times after mucus blocked his lungs.
During Rob's stay, Carol felt alone, sad, concerned and feared the unknown. As a faithful Christian for more than 40 years, she turned to praying to God and meditating upon Bible scriptures.
"I think that it probably encouraged me," Carol said. "It calmed me at moments. ... I think it centered me back again and reminded me that I was not in charge."
Carol prayed alone and with family, mostly on her knees in deference or while walking. The goal wasn't to change God's mind, Carol said. "God was in control of this before it happened."
The purpose was to surrender her own desires and align herself with God to hear whatever he had to say. "I know it's a two-way conversation," she said. "I really felt the peace of God telling me that I wasn't even supposed to worry about that. So I did not worry. I'm usually a planner, but I knew that God had a plan."
AdventHealth, a faith-based hospital system, facilitated virtual visits between Rob and Carol, through which Carol and family could pray over and encourage Rob. Rob was in and out of consciousness, but he remembered some of these moments, he said.
Carol and Rob credited prayer as one of the factors that led to his recovery. Rob is back home now, recuperating.
The Kochons aren't the only people who have prayed over pandemic-related outcomes. In March, the Pew Research Center reported that in a survey, 55% of US adults said they had prayed for an end to the spread of coronavirus.
Large majorities of Americans generally and US Christians specifically who pray daily have turned to prayer during the outbreak. But so did some who seldom or never pray, and people who didn't belong to any religion have started praying.
"People often turn to prayer in situations where they experience intense negative feelings, such as anger, grief or fear," said Brad Bushman, a professor of communication at The Ohio State University. "All of these things are common during a pandemic. People also pray when they feel like something is out of their control, and they need help from a 'higher power.'"
Despite how many Americans pray and how often, scientific research on the health benefits is limited. But based on what science has shown, prayer might help reduce stress, loneliness and fear.
Studying prayer has been challenging for several reasons, said Kevin Masters, a professor of clinical health psychology at the University of Colorado, Denver.
"Many scientists are very skeptical about anything religious," he said. There are also issues to overcome during a study, he said: What is prayer? Can researchers rely on self-reports? Will all participants mean the same thing by "prayer," or will some think thoughts while others formally pray? If scientists study prayer in a laboratory, how do they conduct the study?
Not many scholars are interested in studying prayer for the long-term, a factor which isn't helped by meager funding for research, he added. A dearth of studies means there are no established methods from which to draw on for further, more thorough studies.
Additionally, scientists can't study God as a mechanism the way they can with a new drug or surgical technique — so it can be difficult to find the process that would explain any results.
"Science is about testing observable relationships, processes and mechanisms," Masters said. "But almost by definition, prayer, as operationalized in these studies, invokes involvement of God or a higher being, something outside the boundaries of natural phenomenon, which science cannot really study."
Science can, however, study the outcomes of the belief in God rather than the existence — such a study might ask whether people who believe strongly in God report a better quality of life than people who do not believe in God.
It has also been difficult to prove whether any benefits derive from distant intercessory prayer, or when people were separated into groups in which they didn't know who was or wasn't being prayed for from a distance.
"These studies were meant to be truly a test of prayer by eliminating any natural explanations (e.g., psychological support) that could account for significant differences between groups," Masters said.
Another "major problem" with the distant intercessory prayer studies, Masters added, is that researchers can't keep people from praying for the individuals in the control (not to be prayed for) group.
"Imagine a drug study testing the effects of a new antidepressant. Participants are assigned to the treatment (new drug) and control (placebo) groups," Masters explained. "But if those in the control group go get a prescription for an existing antidepressant, they are now receiving the treatment. A finding of no differences between groups would not be surprising."
Given the limitations, it's difficult to tell whether the mental and emotional relief some people feel by praying stems from practically casting their cares upon another being, or whether the relief is provided by a metaphysical God intervening and lifting the mental load.
Previous studies have associated prayer with a sense of calmness, peace, encouragement or social support.
"We are now quite aware that psychological experiences are intimately associated with important physiological processes, including immune system functioning," Masters said. "To the extent that prayer can impact those psychological processes we have, potentially, naturalistic explanations for how prayer could impact health."
People pray for several reasons, said Dr. Christina Puchalski, a professor of medicine and health science at The George Washington University and director of The George Washington University Institute for Spirituality and Health.
They pray for specific outcomes; to share their angst and suffering in a relational context; to show gratitude; and to reflect, she said.
Prayer can foster a sense of connection, whether it's to a higher power, what a person finds important in life or their values, said Ryan Bremner, an associate professor of psychology at the University of St. Thomas in Minnesota.
Prayer can reduce feelings of isolation, anxiety and fear as well.
"Rituals in general serve a calming function," Bremner said. "They distract the mind which might otherwise go down one of those rabbit holes of useless worry, and they give us a sense of influence or control over something that may not be ultimately controllable."
A 2009 study on the effects of prayer on depression and anxiety found that members of a group had lower rates of depression and anxiety and were more optimistic after sessions in which they prayed for one another, compared to the control group (which had no prayer sessions).
Most findings on the health benefits of prayer have been from studies in which people prayed in groups (intercessory prayer). "There are strong associations between religiosity and both health and happiness, but they are only predicted by service attendance," Bremner said.
Social support and the amelioration of loneliness could be the mechanisms responsible for the benefits of intercessory prayer, Masters said.
Prayer and meditation can have a lot in common, Bremner said. Both might increase mindfulness and prevent excessive worry.
But they're systematically different, as prayer entails working through thoughts and circumstances while meditation focuses on clearing the mind. Prayer also implies the context of a relationship with a higher being rather than a solitary journey, Puchalski said. Praying within a relationship with God that feels loving and supportive may help with managing stress and life's challenges.
A study that compared secular and spiritual forms of meditation found that the spiritual meditation group was less anxious and more positive than the other groups. In secular meditation, participants centered on words or texts of self-affirmation. The spiritual meditation group focused on words that described the loving nature of God.
When participants submerged a hand in near-freezing water for an experiment, the spiritual meditation group tolerated the pain almost twice as long as the other groups.
A 2011 study found prayer can help reduce anger and aggression. In a series of experiments in which participants either prayed for or thought about a stranger, a person who angered them or a friend in need, members of the prayer group were more likely to feel less anger and aggression after a provocation.
Another study found that when dating and married partners prayed for one another, they tended to be less aggressive and more inclined to forgive.
"Prayer may help people see situations 'in a new light' or from a different perspective," Ohio State University's Bushman, coauthor of the 2011 study, said.
And behavior exhibited when praying is the opposite of entering the fight-or-flight response when there is danger or conflict, said Bremner, who was first author of the 2011 study. When you perceive danger, you're keyed up and focused on the external world. When you pray, you're internally focused and attempting to be calm and peaceful.
However, all types of prayer might not work in the same way — when hospitalized patients appraised God as a kind supporter, their mental and physical health improved. But when they perceived God as punishing or were angry with God, their health declined.
In addition to research interest and funding, a few different methods could potentially make a quality study on the effects of belief in prayer on psychological health, Masters said.
Longitudinal studies — which follow people over time and collect data at several points — are necessary to determine whether prayer promotes good or poor health, or which came first. Praying more could be associated with vitality if it keeps the person calm and centered, or with illness if the person prays because he's sick and worried.
Studies could measure physiological factors as well, to determine whether prayer facilitates a physiological process predictive of health outcomes.
Ecological momentary assessment studies, which allow people to virtually record actions in real time, would help when seeking associations between prayer and health on a regular basis.