Perceived Stress, Geopathic Stress and Spirituality of Male Prison Inmates

Method: The study design is a descriptive-correlational study that was conducted among 144 conveniently and purposively selected male inmates of certain city Rehabilitation Center in the Philippines, during the third quarter of fiscal Year 2019. The data gathering for the study utilized the adopted Perceived Stress Scale53, the Religiosity/Spirituality Scale54 and the researcher55 GS instrument. Some of the items in the instruments were slightly modified with corresponding vernacular language translations in order to fit with prison inmates’ context. The percentage analysis, mean, standard deviation, MannWhitney U test, and Kruskall Wallis H test with probability level set at 0.05 alpha.


Introduction
A growing literature documents the rising (though recently stabilized) incarceration rates and detrimental consequences of incarceration for mental health [1][2][3] . There are also evidences that underscore the negative influence of stress on health in connection with the notion that incarceration is a stressful and stigmatizing life event brought the challenge to look into the association between incarceration and mental health [4][5][6][7] . Likewise, the psychological impact of incarceration are well recognized by early researchers describing how the imprisonment and regimentation of imprisonment lead inmates to experience mental health disorders than they might have had if they had remained in the normal public life 8,9 . Furthermore, theories had articulated that apart from the criminal feature, many inmates manifest mental disorders in prison as an effect of the stress of incarceration 10 . This may be due to the fact that while in prison, inmates encounter new people, environment, and way of life, which are, in most cases hostile and extremely stressful [11][12][13] .
Stress is a mental health problem associated with diverse physical and mental disorders including depression; a non-specific biological experience sprang from stressful situations 14 . Experiencing a moderate level of stress is normal adaptation to daily pressures: however, extreme levels are indication of psychological distress with varied physical and emotional reactions depending on the stage 15 . Currently, in United States, psychiatric illness is over-represented in correctional populations compared with the general population-more than half of all inmates have a mental health diagnosis 16 . Correctional facilities are legally obligated to address the medical and mental health needs of the persons committed to them. As a result, more psychiatrists are practicing in jails and prisons. Indeed, suffering from stress either acute or chronic in a prison environment is closely associated to depression, is generally more prevalent among new inmates, and making them more prone for suicidal ideation 17 . Thus, correctional facilities' obligation to provide for inmates' mental health needs and describes correctional mental health processes and how psychiatrists can play a role in screening, evaluation, and suicidal prevention 18 .
A particular study among prison inmates of the State of Santa Catarina revealed that symptoms of depression were not associated with specific mental disorders, but rather with the unwholesome surroundings of prison environment, such as: overcrowding and limited space, bad odor smelling and airless cells; unhealthy food; inactive lifestyle; living with intimidating and violent individuals, including correctional officers, and lack of sunlight and human interaction 19 . These also include inadequate penal and judicial systems and prison resources, with resultant delays in access to justice and speedy trial, the humiliation of being 'jailed', the concern regarding their family's welfare, the horrible isolation, all add to the stresses of incarceration 20 . Moreover, most of the prisoners are ill equipped to cope with the intense stress of prison life and if not treated creates depressive cognitions that can potentially develop into suicidal ideation 21 . Thus, some of the mental health problems among inmates were most likely associated to unwholesome depressive prison environment that if not properly treated or addressed may lead to unexpected suicidal death.
On the other angle, geopathic zone (GZ) are placed on the surface of the earth affected by Geopathic Stress (GS) that can cause serious and long-term illnesses and psychological conditions for people who stay over them for a long period of time [22][23][24][25][26][27][28] . GS is the disruption of Earth's natural energy field causing harmful radiations to emanate from earth surface. This disruption may be caused because of underground water streams, underground fissures, concentration of some minerals or magnetic gridlines 24 . Some of the health problems caused by GS are resistance to treatment, feeling run down and exhausted, depression, nervousness, variations in blood pressure and heart rate, insomnia, restless sleep, chronic stress, feeling cold, headaches, nervousness, asthma and behavioural problems in children 23,24,30 . These energies from the subsurface of the earth at a specific location have the ability to change the normal functioning of human system 30 and had always been ignored because most of the people are unaware of its occurrence and its harmful effects on human health 24,26 . As affirmed, stress is known to adversely affect health as soon as it is present for longer periods [32][33][34][35] and also true to GS. According to Hacker et al. 25 , certain location on the surface of the earth can indeed induce stress. Such zones might cause distress ("malignant stress") even when staying at a short period of time. However, if present for an extended period of time, eustress may in a little time change to distress and thereby weaken the immune system. Because of the active suppression of the immune and other bodily systems, it appears most likely that in some persons, the development of more complex diseases is increased when individual kept on staying for longer times at GS zones (e.g., if stayed at their sleeping area, or at the area where their working chair is frequently placed). Likewise, staying within geopathically stressed areas for a period of time may have a negative impacts on therapeutic processes (e.g. in hospitals or recovery homes), on good sleeping, on personal relationships, especially in communication with partners (e.g. aggression), work performance and overall health. Those people who are at the early stages of ill health may become more sensitive to various kinds of disease when staying longer within GS zone, as well as observe that recovery may takes longer than normal. In the later stage, it could be thought that chronic stress caused by GS may finally even lead to the development of malignant disease. Moreover, it was explained that the disturbed zones (known as GS zone in the present study) could no matter if in animals, plants or humans, weaken the immune system by causing stress 25 . Thus, GS induces distress and suppress immune system, lead to chronic stress and development of various diseases. A challenge is made to all health-care professionals who are dedicated to the development of response to chronically applied stressors, terming the latter condition 'general adaptation syndrome', which is also known in the literature as Selye's Syndrome 46 . The syndrome divides the total response from stress into three phases: the alarm reaction, the stage of resistance and the stage of exhaustion. When individuals are exposed to a stressor, they are at first taken off guard, then attempt to maintain homeostasis by resisting the change, and eventually fall victim to exhaustion in countering the stressor. As affirmed 47 , stressors are assumed to be conditions or circumstances that are considered threatening or demanding, or go beyond a person's capacity to handle. When an individual is open to a stressor, he/ she will exhibit a stress reaction; for this study perceived longer stay in prison served as stressor. Long period stress includes the sympathetic nervous system, the innate immune system and the hypothalamic-pituitary-adrenal axis (also known as the HPA). Since it's not possible to eliminate every stressor in prison, it's important to find ways to cope with stress. Knowing the signs and stages of stress can help inmates take appropriate steps to manage their stress level and lower their risk of complications. Conversely, it's essential for one's body to repair and recover during the resistance stage. If not, their risk for exhaustion rises. If they can't eliminate a stressful event, they may opt to engage in religious or spiritual activities to cope and maintain a healthy stress level or to stay away from exposure within GS zone that directly triggered stress in order to avoid from its harmful effect on their health. Conversely, if untreated, stress however downplayed at times, could be hazardous 48 .
The impetus for this research stemmed, in part, from the relative dearth of scholarly research on the impact of GS and spirituality on male inmates levels of perceived stress. Indeed, an extensive literature search on perceived stress, GS and spirituality were done in other fields but scanty on the relationships of the variables among male inmates incarceration stress. The present study was designed, in part, to explore the level of perceived stress, extent of GS and level of spirituality in a certain city rehabilitation center in the Philippines as one way of contributing to the literature on coping and managing the stress of incarceration.
From the foregoing theoretical constructs, the researchers deemed it necessary to delineate the possible impact male inmates' level of spirituality, GS and certain demographic factors on their level of perceived stress. Does inmates level of perceived stress is influenced by their level of spirituality, GS, and demographic variables such as age, educational attainment, length of incarceration and status of case? This question must be answered. Hence, the study was conducted.
holistic care to further their understanding and awareness of this phenomenon.
Finally, research demonstrates largely positive associations between religiosity and well-being [36][37][38] . Previous research 39 has found that 90 percent of African Americans indicate religion is important in their daily lives; prior studies have also shown that using religion and spirituality to cope with and adapt to stressful circumstances can mitigate stress. Likewise, research also revealed religious belief and practice is connected with greater resiliency for those who strong belief and close relationship with God. For example, a national study of veteran's health emphasized the significant protective impact of spirituality 40 . The higher the level of spiritual belief the lesser the chance for hostile mental health problem including posttraumatic stress disorder, alcoholism, major depressive disorder, and suicidal ideation. It shows that veterans who are highly spiritual had a strong sense of gratitude and purpose in life. Spirituality as a coping strategy can have a positive effect on helping individuals handle 41 with stressful prison life. Therefore, by examining the association between inmates' spirituality and perceived stress, we may be able to gain a better understanding of the impact of spiritual activities on inmates' level of stress and eventually can maximize the rehabilitative benefits of incarceration.
This study is anchored on the positions on the importance of religious and spiritual beliefs on the improvements in the health 37,38 . Research 42 specifically revealed the positive association of spiritual coping with lower stress and high resiliency. Those who adopted religious coping methods such as seeking spiritual support developed the ability to cope with the stress of challenging prison life. Likewise, research has shown that the majority of people those are suffered ill health while sleeping in the GS zones 30,43,44 . Furthermore, it has been reported that certain location on the surface of the earth can indeed induce stress. Such zones might cause distress ("malignant stress") and weaken the immune system even when staying at a short period of time 25 and negatively affect physical and mental health. It is thought that some of the male inmates might be affected by GS 39 ; however, its impact on health issues has been ignored due to lack of awareness of its presence in certain locations 26 . It stands to reason therefore that GS and spirituality might significantly influence the inmates' levels of perceived stress.
Specifically, this study zeroes in on the mental health development strategies for prison inmates by espousing the idea that their spirituality, GS, and certain demographic factors could be a critical factor for the stress reduction. The researchers based their assumption from Selye's proposal stipulated that stress was present in an individual throughout the entire period of exposure to a nonspecific demand 45 . Selye distinguished acute stress from the total

Method
The study employed the descriptive-correlational method of research. According to Traverse 49 , the descriptive method is designed to gather information and to describe the nature of a situation as it existed at the time of the study was conducted and to help detect significant relationships between the current phenomena. The presentation and discussion of the findings were made utilizing the descriptive-analytical method.

Locale and Population
The study was conducted in one of the city rehabilitation centers in the Philippines. The city correctional had separate prisons for women and male prisoners. In City Jail, the prison building is called dormitory that is managed by a female or male warden. However, the other institution is managed by a male warden. The city jail is serving a nearby trial court; this prison houses mainly under trial prisoners and those serving shorter sentences. Depending on the gravity of the case and sentence of female prisoners, usually for long term imprisonment both institution transfers their prisoners to the national correctional institution, which is a state prison, located in Manila, the capital of the Philippines.
The institutions adhere to the recommendation of the UN released resolution on the reformation of prison services through education 50 . Practiced therewith, is the Therapeutic Community Modality Program (TCMP), a setup policy from the National Bureau of Jail Management and Penology (BJMP). TCMP is a national project for all prisons and penal farms in the Philippines. This is a program targeting behaviour management, intellectual and spiritual, emotional and psychological, and survival/ vocational trainings for imprisoned individuals. This structured program is facilitated by trained jail staffs and offered to willing participants 51 .
As stated in the Bureau of Correction, the Therapeutic Community (TC) Program signifies an active, highly organized environment with defined limitations in moral and ethical aspects. The main purpose is to nurture personal growth among inmates. This is done by reforming an individual's behavior and attitudes through the inmates' community working together to assist themselves and each other, bringing back self-confidence, and preparing them for their returning into their families and friends as wholesome and productive members of the community 52 .

Ethical Considerations
The researcher obtained an Ethics Clearance from the Ethics Review Committee and also got signed informed consent from the respondents. All participants were over 18 years of age and were properly informed about the purpose and nature of the study. Further, they were advised that their participation was voluntary, of which their consent was asked prior to their acceptance as respondents. They were also guaranteed the privacy and confidentiality of the data gathered. Anonymity was observed in the use of pseudonyms of the participants and location of the research.

Instruments
The data gathering for the study utilized the adopted Perceived Stress Scale (PSS) 53 , the Religiosity/Spirituality Scale 54 and the GS instrument 55 . The questionnaires used for this study contained two parts. Part 1 included the personal data of the participants. This contained information regarding participants' sex, age, educational attainment, length of incarceration, status of case and religious affiliation. Part II of the questionnaire solicited information regarding their perceived stress, GS and spirituality. Information on their most stressful experience and stress coping mechanism was also included. The vernacular version of the questionnaire was also provided.

Perceived Stress Scale:
This study utilized the adopted Perceived Stress Scale 53 to assess the inmate level of incarceration stress. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomology, utilization of health services, and social anxiety. The scale consists of 10 items and requires the respondents to choose the option that best fits how he/she feels and how things have been going with them during the last month. Each item is answered on a 5-point Likert scoring system, ranging from almost never (1) to almost always (5). Item 4, 5, 7 and 8 are positively stated and scores are obtained by reversing. The test was scored by adding the encircled numbers and interpreted by means of the following scale: 4.10 -5.00, Extremely stressed; 3.10 -4.00, Stressed; 2.10 -3.00, Fairly stressed; 2.00 and below,. Not stressed.
Spirituality Scale: To gather the data for the level of spirituality of male inmates, the researcher used the 25 items slightly modified adopted Religiosity /Spirituality Scale 54 . The number of items were selected/reduced in the instrument with corresponding vernacular language translations in order to fit with prison inmates' context. The measure demonstrated strong internal consistency, and test-retest reliability data, as well as good preliminary validity. The scale consists of 25 items and requires the respondents to rate how often they do each activity or much they believe each item to be true. Each item is answered on a 5-point Likert scoring system, ranging from almost never to almost always (5). The measure was scored by adding the encircled numbers and interpreted by means of the following scale: 4.10 -5.00, Very spiritual; 3.10 -4.00, Moderately spiritual; 2.10 -3.00, Slightly spiritual; 2.00 and below, Not at all.

Geopathic Stress Scale:
To gather the data for GS the researcher utilized the 15 items adopted GS instrument 55 and required the respondents to encircle the numerical weight corresponding to the selected responses based on the frequency of occurrence from Almost Never/Strongly Disagree (1) to Almost Always/Strongly Agree (5). The test is scored by adding all the scores together and interpreted by means of the following scale: 4.10 -5.00, Extremely Experiencing GS; 3.10 -4.00, Have substantial GS feeling/ Experiencing GS, 2.10 -3.00, Have some strong feelings of GS; 2.00 and below, Have few feelings of GS.

Procedure
The permit to conduct the study among inmates during SY 2019-2020 was sought from the office the Campus Administrator, University President, authorities of Rehabilitation Center and BJMP respectively. The purposive and convenient sampling method was employed in the selection of the respondents who comprised the sample for this study. Only those inmates who are literate in answering questionnaire (at least elementary graduate), willing and available during the conduct of the study are qualified to be respondents. These participants were given the final forms of the questionnaire and likewise assisted by the researchers in the filling up of questionnaires. The researchers personally distributed the questionnaires to the concerned inmates, assist and explain if needed and retrieved the same. Upon retrieval of the questionnaires, accomplished copies were tallied, classified, statistically treated, and interpreted.

Statistical Tools
The data gathered for the study were subjected to certain computer analysis using the Statistical Package for the Social Sciences (SPSS) software. The percentage analysis, mean, standard deviation, Mann-Whitney U test, and Kruskall Wallis H test with probability level set at 0.05 alpha.

Profile of the Respondents
The respondents of the research study covered 144 purposively and conveniently selected male inmates of certain city Rehabilitation Centre in the Philippines, during the third quarter of fiscal Year 2019. The respondents were classified according to their age, educational attainment, length of incarceration, and status of case. Of the 144 male inmates, 77 (53.47%) were young (30 years old and below) and 67 (46.53%) were old (over 30 years of age); 48 (33.33%) were elementary, 68 (42.22%) were high school, and 28 (19.45%) were college; 105 (79.92%) were short (3 years and below) and 39 (27.08%) were long (over 3 years); and 94 (65.28%) were with pending and 50 (34.72%) were with convicted. Figure 1 shows the graphical presentation.

Religious Affiliation
Generally, the male inmates were all (100%) Christians. When classified as to religious affiliation, 123 or 85.42% were Roman Catholic, 9 or 6.25% were Baptist or Protestant, 6 or 4.17% were Iglisia ni Kristo, 5 or 3.47 were Born Again, and 1 or .69% was Jehovah Witness. In other words, the respondents were Christians and majority were members of Roman Catholic Church religious organization. Figure 2 shows the graphical presentation.  Figure 3 shows the graphical presentation.  Figure 4 shows the graphical presentation.

Extent of Geopathic Stress
Generally, nearly twenty (20%) of male inmates were affected by GS (experiencing and extremely experiencing

Differences in the Perceived Level of Stress Grouped as to Certain Categories
The Mann Whitney results showed that the male inmates did not differ significantly in their level of perceived stress when they were grouped according to their age (U=.332, p=.740), educational attainment (U=.660, p=.716) and status of case (U=1.389, p=.165). However, a significant difference was noted in inmates perceived stress when they were grouped as to their length of incarceration (U=1.989, p=.047). Those inmates with longer length of incarceration had higher level of perceived stress than those with shorter length of incarceration. On the other hand, a statistically significant difference (H=13.289, p=.001) existed in the inmates level of perceived stress when grouped as to their level of GS. Results of the Mann Whitney pair wise comparison, revealed that the inmates who have some strong feelings of GS had higher perceived level of stress compared with those with few feelings of GS (U=2.316, p=.021) and those who are experiencing GS had higher perceived level of stress compared with those who had some strong feelings of GS (U=2.188, p=.029).

Differences in the Level of Spirituality Grouped as to Certain Categories
The Mann Whitney results showed that the male inmates did not differ significantly in their level of spirituality when they were grouped according to their age (U=.332, p=.740), length of incarceration (U=.702, p=.483), and status of case (U=.714, p=.475). In other words, the religiousity or spirituality among male inmates is not a factor of age, length of incarceration, and status of case. Likewise, results in the Kruskal Wallis H-test revealed that the inmates did not differ significantly in their level of spirituality when grouped according to their educational attainment (H-2.828, p=.243) and level of GS (H=1.830, p=.400). In other words, being spiritual is not all about ones' educational attainment and level of GS.

Relationships of Male Inmates Perceived Stress, GS, and Spirituality
Results of the Spearman's Rho revealed a negative and significant relationship between male inmates level of perceived stress and spirituality (r=-.175, p=.036) and a positive and significant relationship existed between inmates level of GS and perceived stress (r=.327, p=.000). The findings imply that inmates' level of stress is influenced by their level of spirituality and level of GS. The higher the levels of inmates' spirituality the lower the corresponding level of stress. However, a positive but no significant relationship was noted between inmates' level of GS and spirituality (r=.051, p=.546). In other words, spirituality is not influenced by GS.

Discussion and Conclusion
This descriptive-correlational study examined the level and the relationships that exist among inmates perceived stress, GS and spirituality of male inmates in one of the city rehabilitations center in the Philippines.
The results of the study showed that majority of the male inmates were young, high school graduate, shorter length of incarceration, with pending status of case, and Roman Catholic religious beliefs. They were fairly stressed and had a moderate level of spirituality. This prevailing moderate level of stress and spirituality may indicate the positive impact of the Therapeutic Community stress reduction program of BJMP. The BJMP claimed that they actively practiced the Therapeutic Community Modality Program (TCMP), a set-up policy from the National Bureau of Jail Management and Penology (BJMP) in adherence to the recommendation of the UN released resolution on the reformation of prison services through education 50  bible study, worship service and other religious-spiritual activities sponsored by different religious organizations, vocational trainings, sports, exercises and other activities for them to cope with the stressful life in prison. There is some evidence that religiousness helps inmates cope with the prison experience 56 . Those who have strong faith tend to have a more positive outlook on life 72 and feel hopeful about their abilities and their future are generally happy individuals 57 . As affirmed, having a greater number of daily spiritual experiences and not feeling abandoned by God were associated with better emotional health 59 . Likewise, participating in sports can be a helpful way of reducing stress levels and increasing feelings of physical and mental well-being 60 . A regular exercise should be a part of everyone's regular stress-management routine due to its numerous physical and mental rewards. Thus, the result suggests the positive impact of inmates' participation in religious-spiritual, sports, exercises, and other stress reduction activities among inmates while in prison. In particular, spirituality played a big part among male inmates in coping with stressful prison life. For example, in cultivating their spirituality help them to uncover what's most meaningful in their life so that they can focus less on the unimportant things and eliminate stress. Staying connected to their inner spirit and the lives of those around can enhance their quality of life, both mentally and physically.
The results revealed that inmates with longer length of incarceration had higher level of perceived stress than those with shorter length of incarceration. Research revealed that those inmates who are new to prison, but anticipate serving long sentences in prison, experience the most stress 61 . As affirmed 62 , stressors are assumed to be conditions or circumstances that are considered threatening or demanding, or go beyond a person's capacity to handle. When an individual is open to a stressor, he/she will exhibit a stress reaction; for this study perceived longer stay in prison served as stressor. Long period stress includes the sympathetic nervous system, the innate immune system and the hypothalamic-pituitary-adrenal axis (also known as the HPA). The strength of the reaction to stress is reliant upon how a person recognizes the stressor; if the stressor is seen as highly intimidating, then the response will be strong, and opposite. In the present study, the perceived long stay in prison induced the boredom of imprisonment and desire for liberty and longing to be with their family all adds to the stress of incarceration Thus, the finding suggest of the negative impact of perceived long incarceration on male inmates level of stress. The diagnostic and statistical Manual Disorders (DSM-5) utilized by physicians and other healthcare professionals is recommended to provide the details and classification of mental disorders for the diagnosis and treatment 63 .
It is worth noting that nearly 20 percent of inmates were experiencing by GS. As reported, GZ are placed on the surface of the earth that can cause serious and longterm illnesses and psychological conditions for people who stay over them for a long period of time [24][25][26][27][28][29][30] . The earth is crisscrossed with invisible grid lines 64 that rise vertically from the ground like invisible radioactive wall, to a distance of 220 km 65 and such intersection are considered to create one of the most stressful zones 64 . These energies from earth at specific location (known as GS in the present study) have the ability to change the normal body function 64 and wherever it crosses (where GS zone is located) are seen to be the source of potential problems 27 and detrimental to the health of human body 66 . A negative spin/energy that causes a harmful effect in the body creates a high level of stress 67 and disturbances in the immune system, behavioural pattern and cell structure of a person 68 . If a person stayed always by sleeping for 7-8 hours a night, and also working on a GS zone for long period of time can have unpleasant experience 67 . However, it has been always ignored because most of the people are unaware of its occurrence and its harmful effects 24,26 . Thus, the finding suggests that those inmates affected by GS were most likely staying over within a GS zone for a long period of time and were not aware of the existence and harmful effect of GS on their health. A survey if inmates were staying over within GS zone is suggested. Likewise, the findings revealed that the inmates who have some strong feelings of GS had higher perceived level of stress compared with those with few feelings of GS and those who are experiencing GS had higher perceived level of stress compared with those who had some strong feelings of GS. In other words, the levels of ones perceived stress positively corresponds to the level of their GS. The finding suggests the possible connection between ones level of GS and stress. It was affirmed 25 that certain location on the surface of the earth can indeed induce stress. Such zones might cause distress ("malignant stress") even when staying at a short period of time. However, if present for an extended period of time, eustress may in a little time change to distress and thereby weaken the immune system. Because of the active suppression of the immune and other bodily systems, it appears most likely that in some persons, the development of more complex diseases is increased when individual kept on staying for longer times at GS zones (e.g., if stayed at their sleeping area, or at the area where their working chair is frequently placed). Impacts on overall health, therapeutic processes (e.g. in hospitals or recovery homes), on good sleeping, and also on personal relationships, especially in communication with partners (e.g. aggression), and also performance at work are possible negative impact of location-dependent stress. Those people who are at the early stages of ill health may become more sensitive to various kinds of disease when staying longer within GS zone, as well as observe that recovery may take longer than normal. In the later stage, it could be thought that chronic stress caused by GS may finally even lead to the development of malignant disease. Moreover, it was explained that the disturbed zones (known as GS zone in the present study) could no matter if in animals, plants or humans, weaken the immune system by causing stress 27 . Thus, the results suggest that GS induces distress and suppress immune system, lead to chronic stress and development of various diseases. A challenge is made to all health-care professionals who are dedicated to the development of holistic care to further their understanding and awareness of this phenomenon.
Finally, the finding demonstrates a negative association between inmates' levels of spirituality and level of perceived stress. The highly spiritual the inmates, the less likely for them to experience stress. Previous study revealed a negative correlation between spiritual care and depression, anxiety, stress, aggression, and obsession 69 . Those individuals who attend religious service regularly, perform religious behaviors such as prayer and scripture reading, and feel that religion is a very important part of their lives suffer less from depression and anxiety and score higher on measures of general mental well-being than their nonreligious counterparts 70,71 . Likewise, it was affirmed 72 that spiritual well-being is considered as an internal resource that helps an individual to cope well with stress. Furthermore, research revealed that prisoners who practice transcendental meditation twice a day might experience less stress and fewer mental health issues than fellow inmates who don't meditate, a small U.S. 73 . Thus, the finding suggests the important role of spirituality as an internal resource that helps male inmates to cope well with stress. People who consider themselves spiritual may be better able to cope with stress and may experience health benefits. A spiritual approach to prison life can shorten the time in which one experience seeming moments of pressure or tension. When one is connected with his spirituality, there is such a huge reservoir of support and help that one's worries in life seem inconsequential. When inmates get in touch with their spirituality, the ways to deal with stress will naturally fade away. Thus, strengthening of spiritual activities and prison inmates is hereby recommended.
Finally, an assessment of stress and other behavioral and mental illness using non-invasive like questionnaires is hereby recommended. This type of assessment may help the policymakers to assess the problems of the society timely and make necessary recommendations.

Study Limitations
It is important to consider certain limitations of the present study. The survey was founded on Likert type questionnaire, which could lead to intentional or unintentional dishonesty from participants, sometimes respondents may misunderstand the questions asked and give wrong feedbacks leading to skewed results, because in some cases someone might not be available to explain. Survey question answer options could lead to unclear data because certain answer options may be interpreted differently by respondents considering that some of the inmates-respondents are less literate in answering research questionnaire. Furthermore, the social desirability bias and pressure from being observed during the filling out during the survey might lead to disruption and partiality. The later limitation the study establishes the initial relationship among GS, spirituality and perceived stress. Usually, relationship does not suggest causation; being less stressed does not necessarily mean that a person is highly spiritual, and more geopathically stressed does not make a person is more stressed based to the results presented in this research. Despite these limitations, the results of this study expand the knowledge we currently have about the influence of spirituality and GS among male inmates perceived stress, in general, and its impact on their mental and physical health conditions.
In the last month, how often have you felt that you were unable to control the important things in your life? Sa mga nagligad nga bulan, daw pila ka beses nga makabatyag nga indi mo mokontrol ang mga importane nga butang sa imo kabuhi?`1 In the last month, how often you felt nervous and "stressed"? Sa mga nagligad nga bulan daw pila ka beses nga nakabatyag sang kahadlok ukon indi mapahamtang kag ginastress?
In the last month, how often have you felt confident about your ability to handle your personal problem? Sa mga naligad nga bulan, daw pila ka beses nga nakabatyag nga masarangan mo nga sulbaron ukon atobangon ang imo mga problema sa kabuhi?
In the last month, how often have you felt that things were going your way? Sa mga nagligad nga bulan, daw pila ka beses nakabatyag nga ang mga butang nga nagkahalanabo nagasanto sa imo kagustuhan.
In the last month, how often have you found that you could not cope with all the things that you had to do? Sa mga nagligad nga bulan, daw pila ka beses makita ukon nabal-an nga indi mo masarangan nga himoon ang mga butang nga dapat mo himoon.
In the last month, how often that you have been able to control irritations in your life? Sa mga nagligad nga bulan, daw pila ka beses nga nabatyagan nga masarangan kontrolon ang pagka-iritar ukon kaakig sa imo kabuhi?
In the last month, how often you felt that you were on top of things? Sa mga nagligad nga bulan, daw pila ka beses nakabatyag sang pagkahamtang sang imo kaiisipan sa mga butang nga nagkahalatabo?
In the last month, how often you been angered because of things that were outside of your control? Sa mga nagligad nga bulan, daw pila ka beses nagapangakig sa mga butang nga indi mo makontrol ukon mapunggan?
In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? Sa mga nagligad nga bulan, daw pila ka beses mo nabatyagan nga ang nagaabot nga mga kabudlayan daw indi mo masarangan?

Interview Questions (See separate copy -Example of Answers)
I. What was the most stressful thing for you to deal with while in prison/incarceration? Please check the only number that best describe your most stressful experience and further explain the situation.

Almost Always
Halos Wala 1