This CPD site is for Australian health professionals
image
Need an easy way to manage your CPD?

Sign up to Ausmed for Free to take control of your CPD

Spiritual Considerations in Healthcare

CPD
4m

Published: 11 August 2019

Cover image for article: Spiritual Considerations in Healthcare

In the wake of an illness or injury, the role of spirituality in a person’s life is likely to only intensify and make itself more apparent.

It is every person’s right to maintain their identity and to expect inclusive care throughout the patient journey. This article is intended to help you to navigate conversations and requests regarding your patient’s spiritual beliefs.

Spirituality Defined

Spirituality is distinct from religion. It is less an organised system of beliefs, and more of an intangible set of ideas that allow an individual to conceive of the world, and their place in it (Dossey & Keegan 2016).

Although for some, spirituality may be tied to their religion, many people do not express their spirituality within a religious tradition. Conversely, religious practices do not necessarily indicate a person’s spirituality.

Spirituality recognises that a person’s role and place in life has a greater value than what they do every day. It can relieve them from dependence on material things and help them to realise their life’s greater purpose (ReachOut 2019).

Why Does it Matter?

Broadly speaking, a primary goal of holistic care is to know and care for a patient in their complexity and wholeness.

Keep in mind, compassionate spiritual care involves serving not just the physical, but the emotional, social, and spiritual needs of a patient (Puchalski 2000).

How is Spirituality Linked to Health?

Studies conducted to explore the relationship between spirituality and health tend to connect spiritual belief to three major areas: mortality, coping and recovery.

1. Mortality

Observational studies have suggested that those who have regular religious and spiritual practices tend to live longer (Li 2016). This is attributed to the stress relief offered by spiritual coping mechanisms, the meditational qualities of prayer, and the social support and strength of personal values that are often associated with religion (Puchalski 2000).

2. Coping

One of the more obvious benefits of spiritual belief is that it may aid coping through an advanced or terminal illness. Spirituality is an essential part of the ‘existential domain’—which encompasses a meaningful personal existence, fulfilment of life goals, and a feeling that life to that point had been worthwhile. This is often correlated with a higher quality of life for patients with severe disease (Puchalski 2000).

3. Recovery

Spirituality is often linked to hope and positive thinking, which beyond clearing the mind, has also shown to have physical benefits. Meditation, for example, has been shown to have the potential to decrease blood pressure, increase pain tolerance, improve sleep, and decrease anxiety levels when practised for 10 to 20 minutes, twice a day (Thorpe 2017). Spirituality may be instrumental to a patient’s journey back to wellbeing (Puchalski 2000).

Where to Start

What does compassionate care look like in practice?

Healthcare staff should consider the following:

  • Practising compassionate presence—i.e. being fully present and attentive to your patients and being supportive to them in all of their suffering: physical, emotional, and spiritual.
  • Listening to patients' fears, hopes, pain and dreams.
  • Consider obtaining a spiritual history.
  • Being attentive to all dimensions of patients and their families: body, mind and spirit.
  • Incorporating spiritual practices as appropriate.
  • Consider involving chaplains as members of the interdisciplinary healthcare team.

(Puchalski 2000)

It goes without saying that throughout this process, your own professional boundaries are to be observed. It may not be appropriate for you to initiate or lead prayer, and this is best left to a specialist in that particular field.

It might be the case that the patient wishes you to be with them in silence while they pray—it is up to you to decide what you feel comfortable doing in this scenario.

Of course, it is important that a patient feels safe that by disclosing their spiritual practices they will be respected and not ridiculed (Puchalski 2000).

Key Strategies to Respecting and Observing Spirituality in Healthcare

Listening and intentional presence are key to exploring meaning associated with a patient’s spiritual journey.

Advanced communication skills facilitate the exploration of spiritual issues. Typically, broad, unassuming open-ended questions are useful. Consider asking questions and/or statements such as: “tell me more about that”, “help me to understand what you need”, and, “could you help me to understand what you are saying?”

These are useful for healthcare professionals to gain a deeper understanding of their patient's needs and are likely to be appreciated by the individual who will recognise your efforts to meet their particular spiritual needs (Dossey & Keegan 2016).

Steps You Can Take

Attempt to understand how strongly and what kind of role spirituality plays in a patient or client’s life, and how it relates to their healing processes.

Once sharing and open communication have occurred, consider what you as the health provider should do with the information the patient has provided. For example, it may be necessary for you to refer a chaplain, encourage meditation or yoga classes, or another spiritual resource (Puchalski 1996). Respect and, if appropriate, facilitate prayer, centreing, awareness, and meditation.

Letting your patient know that you will do your best to incorporate their spiritual needs into care may go a long way in reassuring them that their spirituality is acknowledged and respected by the healthcare team.

Consider Discussing the Following With Your Patient:

1. Purpose and meaning in life

The process of searching for or discovering events or relationships that provide a sense of worth, hope, or reason for existence (Dossey & Keegan 2016).

2. Innerness or inner resources

The process of striving for or discovering wholeness, identity, and a sense of empowerment, manifested in feelings of strength in times of crisis and calmness or serenity in dealing with uncertainty in life (Dossey & Keegan 2016).

3. Unifying interconnectedness

The feeling of relatedness or attachment to others, a sense of relationship to all life, a feeling of oneness with the universe (Dossey & Keegan 2016).

4. Transcendence

The ability to reach or go beyond the limits of usual experience; the capacity, willingness, or experience of rising above or overcoming body or psychic conditions; or the capacity for achieving wellness or self-healing (Dossey & Keegan 2016).

Collaboration

Healthcare workers should collaborate with clients and their families in:

  • Determining appropriate outcomes;
  • Developing a plan; and
  • Organising overall care to ensure the incorporation of each person’s selfhood, values and worldview.

(Dossey & Keegan 2016)

Healthcare professionals are able to facilitate this process when they promote an atmosphere that is encouraging of spiritual expression in its many and varied forms.

The Bigger Picture

If incorporating spiritual considerations into your practice feels daunting, it is likely you are not alone in this thought. A possible barrier to the incorporation of spirituality into care is the dearth of language within Western societies for discussing and expressing subject matter regarding the soul and/or spirit (Dossey & Keegan 2016).

Respect for the idea of the spirit should be a professional healthcare responsibility and an intrinsic part of holistic care. From the perspective of holistic care, providing spiritual care is an ethical obligation, which one could argue, if ignored, deprives patients of their dignity as human beings (Dossey & Keegan 2016).

Healthcare professionals who integrate spirituality into their care of others are able to recognise that although each person acts out of, and is informed by, their own spiritual perspective, acting from this foundation is not the same as imposing these beliefs and values on another (Dossey & Keegan 2016).

Conclusion

Spirituality can be an important device through which patients can navigate chronic illness, suffering, loss and life itself. Neglecting the spiritual considerations of your patients could be detrimental to their recovery, it could also weaken their trust in the practice, and create tension. Effective holistic care sets out to treat not just the physical illness but also the emotional and spiritual needs of every patient.

Additional Resources

Multiple Choice Questions

Q1. Which of the following is not credited as a benefit of meditation?

  1. Improved sleep.
  2. Reduced anxiety.
  3. Decreased stress.
  4. Increased muscle mass.

Q2. True or false: Spirituality can only be understood as an organised system of beliefs.

  1. True.
  2. False.

Q3. True or false: Asking open-ended questions is the correct approach when discussing matters of spirituality with patients.

  1. True.
  2. False.
References
  • Dossey, BM & Keegan, L 2013, Holistic Nursing: A Handbook for Practice, Jones & Bartlett Publishers, Burlington, MA.
  • Li, S, Stampfer, MJ, Williams, DR & VanderWeele, TJ 2016, ‘Association of Religious Service Attendance With Mortality Among Women’, JAMA Intern Med, vol. 176, no. 6, pp. 777–85.
  • Puchalski, CM 2001, ‘The Role of Spirituality in Health Care’, Proceedings (Baylor University. Medical Center), vol. 14, no. 4, pp. 352–7.
  • ReachOut 2019, What is Spirituality, ReachOut, viewed 9 August 2019, https://au.reachout.com/articles/what-is-spirituality
  • Thorpe, M, 2019, 12 Science-Based Benefits of Meditation, Healthline, viewed 9 August 2019, https://www.healthline.com/nutrition/12-benefits-of-meditation

(Answers: d, b, a)

Author

Portrait of Ausmed  Editorial Team
Ausmed Editorial Team Visit

Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date.

Related Learning Hubs

Learner Reviews

3.9

7 Total Rating(s)

Portrait of Rebecca Brown
Rebecca Brown
19 Aug 2019

I found it very inclusive and helpful. We need to be reminded of a patient's spiritual needs as well as physical and mental

Generic portrait
Pamela Boyd
17 Aug 2019

Excellent R/V of the importance of spirituality to enlarge our capacity to cope and of course our palliative care patient and their grieving family. Families can be so difficult, so needy and to add to the mix - be at logger-heads with each other. So we also need to be very mindful of their grief, do our duties quietly and respectfully and be very aware how a careless word can cause them pain.