HealthDay reports that hospitalized patients who are “able to talk about their religious and spiritual concerns are more satisfied with their care,” according to a study in the Journal of General Internal Medicine. Continue reading
Here’s an interview with me, from HCJB Global, about my teaching time at a large international medical conference in Quito, Ecuador, last month. Continue reading
This post is excerpted from my book, 10 Essentials of Happy, Healthy People: Becoming and staying highly healthy:
Finding a doctor and other health care team members who share your spiritual foundation and practices may be crucial for you—and thankfully it’s fairly simple. You can use a spiritual inventory.
Doctors are increasingly using spiritual inventories in their care of patients. In fact, when I make presentations at medical centers, medical schools, and professional meetings, the question I most often hear is, “How can doctors take useful spiritual inventories of their patients?”
In the same way a doctor can inquire about a patient’s spiritual beliefs, a patient should feel free to ask about how a doctor’s spiritual beliefs and practices relate to his or her medical care.
A winning health care provider should be perfectly willing to let you know where he or she stands on these issues.
Furthermore, when it comes to alternative or complementary care providers, these questions can be critical, because some have been known to use their therapy to actively recruit unsuspecting patients into spiritual belief systems I think are highly unhealthy. (You can read more about this in my best-selling book: Alternative Medicine: The Christian Handbook).
Here are a few questions you could ask at your interview of the prospective health care provider—or during your first official appointment. I’m sure you could come up with some of your own to add.
I’m aware that most people probably won’t follow my suggestion to ask a provider all the following questions—especially at a first meeting. However, if your spirituality is very important to you, and if you want a provider who shares your beliefs, then each question might by useful for you to discuss with your physician at some point.
- Are you willing to consider my spiritual preferences as you care for me?
- Are you open to discussion of the religious or spiritual implications of my health care?
- Are you willing to work with my spiritual mentors (pastor, priest, rabbi, elder) and other members of my health care team (family, friends, mentor, support group) in providing me with the best possible health care?
- Are you willing to pray with me—or for me—if I feel the need for prayer?
For those who are working to inflate and balance their spiritual wheel, asking questions 1, 2, 3, and 4 is perfectly reasonable—and, I would expect, acceptable to most physicians and providers. Some might consider the following questions to be too personal and intimate to ask of a total stranger. So if you’re not there—no problem.
- What does spirituality mean to you? How much is religion (and God) a source of strength and comfort for you?
- Have you ever had an experience that convinced you that God or a higher power exists?
- How strongly religious or spiritually oriented do you consider yourself to be?
- Do you pray? If so, how frequently?
- Do you attend religious worship times? If so, how often do you generally attend?
Even if you decide that asking these questions in an interview style is not comfortable, you may want to look for opportunities to talk informally during a visit. But at least consider asking the first four questions.
Frankly discussing this can strengthen all four of your health wheels, as well as your trust relationship with your health care provider.
This headline is likely not news to most of the readers of this blog — or likely to most people. We all seem to know intuitively that terminal diagnoses cause people to begin to think about spiritaul and eternal issues. HealthDay reports, “Addressing the spiritual needs of someone with advanced cancer could be just as important as taking care of their medical needs.” This is based upon a study appearing in the Journal of Clinical Oncology.
The study of 670 patients showed that 60 percent “said that their spiritual needs either hadn’t been met or were minimally supported,” even though patients ranked “pain control and being at peace with God” as the two most important factors “at the end of their lives.”
Patients who received “greater spiritual support from their medical team” said they had “a higher quality of life as they neared death.” Addressing the spiritual needs of someone with advanced cancer could be just as important as taking care of their medical needs, a new study suggests.
The take home for us healthcare professionals is that we all need to do a better job of taking a spiritual history on our cancer patients. In fact, the Joint Commission requires a spiritual history or assessment for all patients admitted to long-term care, home care, behavioral care, and hospital admission.
What should the assessment include? The Joint Commission says that it “should, at a minimum, determine the patient’s denomination, beliefs, and what spiritual practices are important to them.”
Why? They say, “This information would assist in determining the impact of spirituality, if any, on the care/services being provided and will identify if any further assessment is needed.”
The take home for the rest of us is to be sure that our family and friends who receive the diagnosis of cancer have the spiritual support upon which their health and well-being may depend.
The famous Johns Hopkins medical professor, Sir William Osler, writing in an editorial, titled “The Faith that Heals,” printed in the first edition of the British Medical Journal (BMJ 1910;1:470-2), wrote, “Nothing in life is more wonderful than faith … the one great moving force which we can neither weigh in the balance nor test in the crucible …” He wrote that faith is”… mysterious, indefinable, known only by its effects, faith pours out an unfailing stream of energy while abating neither jot nor tittle of its potence …”
Psychotherapist Arthur Kornhaber said, in a 1992 interview published in Newsweek magazine, “To exclude God from a medical consultation is a form of malpractice … spirituality is wonder, joy and shouldn’t be left in the clinical closet.”
I was the chief author of a systematic review (Annals of Behavioral Medicine 2002;24(1):69-73) that concluded, “The current evidence would encourage physicians, health-care providers and systems to learn to assess their patients’ spiritual health and to provide indicated and desired spiritual intervention. Clinicians should not, without compelling data to the contrary, deprive their patients of the spiritual support and comfort upon which their hope, health, and well being may hinge.”
Here’s the HealthDay report:
When asked what was important to them at the end of their lives, people dying of cancer ranked two factors highest: pain control and being at peace with God, the study found.
“Medicine tends to focus on the more scientific aspects of the person, and we’ve made wonderful strides in improving patient care, but there’s another important component of patient health: spirituality,” explained Dr. Tracy Anne Balboni, a radiation oncologist at the Dana-Farber Cancer Institute in Boston and the study’s lead author. “This is clearly an area where some important advancements can be made.”
The researchers discovered that people with advanced cancer were far more likely to choose hospice care when their spiritual needs had been addressed. And among those who were very religious, meeting spiritual needs increased the odds that a terminal patient would choose to forgo aggressive, yet often unsuccessful, medical treatments, the study found.
However, at least six of 10 people with advanced cancer reported that their spiritual needs were only minimally or not at all supported.
The new study involved 670 people with advanced cancer from seven treatment centers in the Northeast and Texas. The final analysis included information from 343 people who later died and whose caregivers completed a post-death interview. The average time between the start of the study and the person’s death was 116 days.
For purposes of the study, spiritual care was defined as patient-perceived support of their spiritual needs by their medical team and the receipt of pastoral care services.
Most people (60 percent) said that their spiritual needs either hadn’t been met or were minimally supported at the start of the study, and 54 percent had not received pastoral care visits. In the final week of life, 73 percent of the participants received hospice care, and 17 percent received aggressive care.
Those who had greater spiritual support from their medical team, including doctors, nurses, chaplains and more, reported a higher quality of life as they neared death than did those who felt unsupported spiritually.
People who felt they were getting better spiritual support were 3½ times more likely to receive hospice care. And among highly religious people, those whose spiritual needs were supported were five times more likely to receive hospice care and five times less likely to receive aggressive medical care, the study reported.
“We found that patients whose spiritual needs were well-supported seemed to transition to hospice more frequently and had a marked reduction in the use of aggressive care,” Balboni said.
Yet despite the findings, said Dr. Harold G. Koenig, co-director of the Center for Spirituality, Theology and Health at Duke University Medical Center, “few people are getting their spiritual needs met by the medical system.”
“Many doctors are uncomfortable discussing spirituality and haven’t been trained to do so,” he said. “And churches have a role, too. Although it’s not a popular topic, churches need to talk about the end of life in the pulpit. People don’t know theologically what they’re supposed to do.”
Religious people, Koenig said, are often left to think they should always have hope and should always “give God a chance to provide a miracle.” Hospice care, though, can often provide spiritual guidance and help people prepare for death, he said.
Doctors don’t need to actually provide spiritual care, Koenig said, but it’s important for physicians to acknowledge their patients’ spiritual needs and make sure they’re addressed by pastoral care or hospice. “The doctor does have to be the one to orchestrate this,” he said.
But if someone’s spiritual needs are not being met, Koenig and Balboni agreed that the person — or a friend or family member — needs to speak up. And if the patient’s doctor doesn’t feel qualified to discuss end-of-life spiritual issues, the doctor should be able to refer you to someone who can.
The better your spiritual health, the more likely you are to experience improved physical, mental, emotional, and relational health outcomes. Therefore, finding a healthcare professional that shares your spiritual foundation and practice can be critical. But, how can you do this?
My Take? Continue reading