Clint Maun, CSP
Health and spirituality are often an intimately linked pair. For many, achieving a state of well being is not solely tied to their physical being but also to their mental, emotional and social existence as well. While the medical field in recent decades has emphasized on science and technology, the spiritual dimension of healthcare is calling many professionals to treat patients in a broader sense. Put simply, spiritual issues matter to patients and healthcare professionals who can learn to treat patients as a whole person and not simply as a collection of systems and symptoms can take hold of a powerful tool.
Spirituality refers to a person's sense of meaning in life. It is the implicit responses to ultimate questions, such as "Who am I?" and "What is my purpose?" and new research is suggesting that many patients want their healthcare providers to connect with them on this special aspect of their lives. In fact, there is much supporting evidence that spiritual issues are something the healthcare establishment should take seriously:
- More than 260 research studies reflect positively on the association of faith with physical and mental health outcomes.*
- A survey of 296 family physicians at a meeting of the American Academy of Family Physicians revealed that 99 percent believe that religious beliefs can heal, and
- 75 percent believe that others' prayers can promote healing.**
- More than 75 percent of patients believe their physicians should address spiritual issues as a part of their medical care.
- More than 40 percent of patients actively want discussion of spiritual issues to take place. ***
Patients come from diverse cultures and spiritual traditions.
Make no mistake about it-religious and spiritual matters are complex. While a healthcare professional may have good intentions, a patient's or resident's inquiry about religious/spiritual concerns can initiate a complicated and lengthy discussion. Furthermore, the topic at hand could concern a religion or facet of spirituality unfamiliar to you. If this is the case, it's good to have a prepared response that gives the patient some options and more importantly, won't offend them. For example, you could say, "I'm not familiar with that topic. I know it's important to you, so I don't want to give you any incorrect information concerning the matter. Perhaps it's better if I refer you to our facility's chaplain, who can then point you in the right direction." Above all, professionals certainly must not encourage patients to convert to another religion or give the impression that their faith is superior to that of the patient's.
It's a sensitive subject to many.
Some healthcare professionals and patients worship together in a local faith community and know each other well enough that spiritual conversations are appropriate. However, problems can arise when a personal faith or religious belief is "pushed" on a patient who is opposed to discussing this topic.**** If patients indicate that they are not interested in questions about their personal religion or faith, the subject should not be pursued.
Claims and outcomes can not be completely substantiated.
While initial research indicates a positive link between spirituality/religion and health outcomes, much additional research and exploration is necessary. As a healthcare professional, it's important to be conscious that in regard to spiritual matters, nothing is completely conclusive.
Balancing patients' wishes for spiritual guidance with the standards and ethics of medical practice is no easy task for any healthcare professional. However, there are many things you can do that won't compromise your credibility and can help your patients through times of need. One approach is to simply inform patients that healthcare professionals are becoming more aware of the importance spiritual beliefs can play in healthcare and then to inquire if they would like to discuss their own beliefs. Such an approach allows patients to decide for themselves if this is an area they would like to discuss with their healthcare professional.
You can also help create a "spirituality friendly" atmosphere by making sure patients and residents are aware of HIPPA and how it effects whether their minister, priest, rabbi etc. can be notified by your organization and allowed to see them. In accordance to HIPPA, if a patient is admitted to a hospital, and they say 'no' to a visit from the clergy, they are not allowed to visit. If possible, get the word out to churches, synagogues and other places of worship. Encourage them to publish information in bulletins and newsletters, telling their congregations how HIPAA works and explaining how they can notify clergy in case of a hospitalization. This kind of service is above and beyond the call of duty, but patients, family, and clergy will greatly appreciate it.
Lastly, for many people, prayer is an integral component of spirituality. Prayer allows people to express themselves during crisis and emotional turmoil. Nothing in federal law prohibits you from praying with a patient who requests prayer. Nurses and other healthcare professionals may use prayer with patients to positively influence how patients cope with anxiety relative to illness.
Remember, spiritual concerns are often at the heart of patients' understanding and acceptance of illness. It's important that your organization acknowledge this critical component and continually look to enhance all aspects of the care you provide. Not only will this better serve your patients, but it may also help you and other healthcare professionals better understand your calling and capabilities, and better appreciate your limits and life's work.
* Anandarajah G, Hight E. Spirituality and medical practice: using a practical tool for spiritual assessment. Am Fam Physician 2000:62;000-000.
** Waring N. Can prayer heal? Hippocrates 2000; 14:22-4.
*** Maugans TA, Wadland WC. Religion and family medicine: a survey of physicians and patients. J Fam Pract 1991;31:210-3.
**** Ellis MR, Vinson DC, Ewigman B. Addressing spiritual concerns of patients: family physicians' attitudes and practices. J Fam Pract 1999;48:105-9.