Incorporation of Spiritual Needs into Patient Care

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After spiritual needs have been identified, the physician may incorporate the results of the assessment into patient care.

The most basic thing a physician can do is to listen compassionately. Regardless of whether patients are devout in their spiritual traditions, their beliefs are important to them. By listening, physicians signal their care for their patients and recognition of this dimension of their lives. Empathetic listening may be all the support a patient requires.

 

Another way to incorporate the spiritual assessment is to document the patient's spiritual perspective, background, stated impact on medical care, and openness to discussing the topic.

Physicians may find this information helpful when readdressing the subject in the future or during times of crisis when sources of comfort and meaning become crucial.

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An additional way to incorporate the assessment is to consider how different traditions and practices may affect standard medical practice.

For instance, patients of the Jehovah's Witness tradition tend to refuse blood transfusion; believers in faith healing may delay traditional medical care in hopes of a miracle; and Muslim and Hindu women tend to decline sensitive (and sometimes general) examinations by male physicians.

Patients with certain beliefs may experience substantial psychological duress if they believe a condition is caused by a lack of belief or transgressions on their part.

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Physicians also need to consider how practices may influence acute or chronic health states.

For example, many Muslims fast during Ramadan, which may affect glucose control and other physiologic factors in the ambulatory and inpatient settings.

Persons of some faiths observe strict dietary codes, such as halal and kosher laws, which may require physicians to alter traditional nutrition counseling.

It is important to remember, however, that patients may not adhere to each specific belief or practice of their faith. Physicians should avoid making assumptions when asking patients how their particular practices may affect their medical care.

 

The spiritual assessment also allows patients to identify spiritual beliefs, practices, and resources that may positively impact their health. Helpful questions include, “Do you have spiritual practices, such as praying, meditating, listening to music, or reading sacred text, that you find helpful or comforting?” and “Are you part of a faith community? If so, does it have resources such as a home visitation program, a food pantry, or health screening?” Physicians can reinforce positive coping behaviors and, with the patient's permission, offer to contact the patient's spiritual community to mobilize community faith resources as appropriate.

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Finally, there may be some instances in which physician and patient faith traditions coincide. In these cases, if the patient requests, the physician may consider offering faith-specific support. This may include patient-or physician-led prayer.

Given the variety of spiritual practices followed in multicultural societies, it is best not to assume that a physician's spirituality mirrors that of his or her patients. Prayer should not be a goal of a spiritual assessment, and physicians should not attempt to get patients to agree with them on specific faith issues.

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Potential Benefits in the Physician-Patient Relationship

 

Assessing and integrating patient spirituality into the health care encounter can build trust and rapport, broadening the physician-patient relationship and increasing its effectiveness.

Practical outcomes may include improved adherence to physician-recommended lifestyle changes or compliance with therapeutic recommendations.

Additionally, the assessment may help patients recognize spiritual or emotional challenges that are affecting their physical and mental health. Addressing spiritual issues may let them tap into an effective source of healing or coping.

 

For physicians, incorporating patient spirituality brings the potential for renewal, resiliency, and growth, even in difficult encounters.

Sometimes physicians have few medical solutions for problems that cause suffering, such as incurable disease, chronic pain, grief, domestic violence, and broken relationships. In these situations, providing comfort to patients can increase professional satisfaction and prevent burnout.(Koenig HG, 2007).