1. The Spiritual Side
of Patient Care
Dan Taylor, PhD
Volunteer Chaplain, USA Children’s and Women’s Hospital
Adjunct Assistant Professor of Medicine, USA College of Medicine
Departments of Internal Medicine and Surgery
2. Outline
1. Review what we teach medical students and
physicians.
2. Review medical literature regarding patient views of
spiritual discussions with physicians.
3. Discuss your role in the medical community.
4. Offer suggestions for relating to hospital staff while
addressing the spiritual needs of patients and family
members.
4. Williams M, Rodning C. Vitruvian Man: Metaphor of a “compleat” physician.
Pharos 1997;60(3):22-27. Emotional
So
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Phy Your patient
The physician
balance between
balance between
science
body and soul
and
humanitarianism
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da Vinci’s Vitruvian Man
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a medical metaphor
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“Remember to cure the patient as well as the disease.”
Psychological
Alvan L. Barach (1895–1977), U.S. physician.
5. “For many people spirituality forms the basis of
Did you notice their definition of healing …
meaning and purpose in life. The profoundly
disturbing effects of illness can call into question a
person’s purpose in life and work…. Healing, [the
[the restoration of wholeness as opposed to
restoration of wholeness as opposed to mainly
mainly technical healing] answers to these
technical healing], requires
questions.”
Foglio PR and Brody H. Religion, Faith, and Family Medicine. Journal of Family
Practice. 1988 Nov; 27(5):473-74.
6. Francis Peabody, MD 1847-1936
The treatment of a disease may be entirely impersonal; the care of a
patient must be completely personal . . .
What is spoken of as a “clinical picture” is not just a photograph of a
man sick in bed, it is an impressionistic painting of the patient
surrounded by his home, his work, his relations, his friends, his joys,
sorrows, hopes, and fears.
7. “The great physicians sit down, relax, and listen to the
patient's story. They care (or least seem to care) about the
patient's problems, and the context of those problems. I
suspect they truly care, because listening is hard work.”
Centor RM. Seek first to understand. Philos Ethics Humanit Med. 2007; 2: 29.
8. “Pain is not just physical suffering. Suffering also involves
psychosocial issues, loss of work, family functioning, financial
concerns, fear of death and spiritual issues.” “We miss the
boat when we think to take care of suffering we’ll just give a
medication of some type.
There is no medication for suffering.”
Ann Berger, MD. The NIH Record, Vol. 56, No. 10, May 11, 2004
Chief of the Pain and Palliative Care Service at NIH
10. Patients’ attitudes regarding whether or not
physicians should address spirituality
MD should consider pt’s spiritual needs 77% (King)
Want MD to ask about spiritual needs 33-70%
MD should pray with patient 33-78%
Would like MD to pray with them 67% (Oyama)
[MDs who say pts would not want prayer] 63% (Koenig)
11. Patients’ attitudes regarding whether or not
physicians should address spirituality
Physician should know their spiritual
beliefs because those beliefs would
influence their medical treatment 83% (McCord)
Important for physician to inquire about
a patient’s spiritual beliefs 84% (Hamilton)
Physician’s inquiry about spiritual beliefs
would strengthen their trust in the physician 81% (Hamilton)
Hamilton J, Levine J. Neo-pagan patients’ preferences regarding
physician discussion of spirituality. Family Medicine 2006;38(2):83-4.
12. Hospital Patient Satisfaction
Data analysis gathered from 1.7 million hospitalized
patients between January and December, 2001 revealed a
strong relationship between the “degree to which staff
addressed emotional/spiritual needs” and overall patient
satisfaction.
Clark P, Drain M, Malone M. Addressing Patients’ Emotional and Spiritual
Needs. Joint Commission Journal on Quality and Patient Safety. 2003;29(12):659-70.
13. Hospital Patient Satisfaction
Gallup poll of hospitalized patients conducted in 2002.
1. How satisfied were you with how well the staff was able to meet
your spiritual needs?
2. How satisfied were you with how well the staff was able to meet
your spiritual and emotional needs?
Analysis of the data revealed that overall patient
satisfaction was highly correlated with “meeting spiritual
needs” and “meeting spiritual and emotional needs.”
Blizzard R. Praying for Patient Satisfaction. Gallup Poll 2002.
http://www.gallup.com/poll/11116/Praying-Patient-Satisfaction.aspx?
14. Importance of religious/spiritual beliefs
USA Departments of General and Orthopedic Surgery
Agree or strongly agree
Spiritual beliefs are important to me. 93%
I have relied on spiritual beliefs to guide 85%
me through a major illness or other
medical condition.
15. Physician inquiry into patient’s
religious/spiritual beliefs
Agree or strongly agree
Surgeon should be aware of my 82%
spiritual beliefs.
Surgeon should obtain a spiritual 63%
history. Gen 75%
Ortho 56%
16. Physician inquiry into patient’s religious/spiritual
beliefs would increase trust
Agree or strongly agree
If my surgeon inquired about my 64%
religious/spiritual beliefs, my trust Gen 74%
in him/her would increase.
Ortho 57%
17. Assessing a Patient’s Spiritual Beliefs
Yogi Berra said,
“You can observe a lot by watching.”
“You can learn a lot by asking [and observing]!”
18. Take a spiritual history
to assess a patient’s spiritual beliefs
Introduce the subject before taking a spiritual history:
1. Minimize patient concerns. “You’re doing fine…”
2. Respect for patient autonomy. “Many patients rely on
personal spiritual beliefs to help them cope with stress
or illness. Would you mind if I asked you several
questions about your spiritual beliefs?”
“I routinely inquire about the spiritual beliefs of my
patients, would you mind if I asked you several
questions about your spiritual beliefs?”
19. Assessing a Patient’s Spiritual Beliefs
F Do you have a faith that provides peace and
comfort during times of stress and difficulty?
How important is your faith to you? How would
I your faith impact your medical decisions?
C Do you belong to a community of faith and are
they supportive of you?
A How would you like for me to address your
spiritual needs during this hospitalization?
21. Meeting the Spiritual Needs
of Hospital Patients
1. Many patients seek to understand their illness, and
find comfort through the lens of their
religious/spiritual beliefs.
2. Many hospitals do not have chaplains, or have
limited pastoral care staff.
3. Healthcare providers often feel inadequate regarding
spiritual care and welcome your participation.
4. You play a vital role in meeting the needs of
hospitalized patients.
22. Yogi Berra said,
“If the people don’t want to come out to
the ballpark, nobody’s going to stop
them.”
If you don’t want to partner with hospital staff
when meeting the spiritual needs of patients,
nobody’s going to stop you.
24. Points to consider
1. HIPAA (confidentially).
2. Understand hospital healthcare workers.
Busy
Trained as scientists (especially physicians)
May or may not possess a dynamic faith
Want you to be a partner in patient care
25. Meeting the Spiritual Needs
of Hospital Patients
3. Patient Visitation
Infection control
Honor signs
Don’t undermine hospital staff
4. Develop relationships with hospital staff and be
alert to ministry opportunities with other patients
and staff.
26. “I want to thank you for making this
day necessary.”
Yogi Berra
27.
28. The Spiritual Side
of Patient Care
Dan Taylor, Ph.D.
Chaplain, USA Medical Center and USA Children’s and Women’s
Adjunct Assistant Professor of Medicine, USA College of Medicine
Departments of Internal Medicine and Surgery
