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Treating the whole patient: integrating spirituality and healthcare

Treating the whole patient: integrating spirituality and healthcare

In the highly scientific field of healthcare, the concept of spirituality can be uncertain and uncomfortable territory for a practitioner. Not only does the term have several definitions, but often healthcare providers don’t know if, how or when to bring up the concept, let alone integrating spirituality in to a care plan.

And yet when the uncertainty around how to address spirituality is overcome, the potential for improved patient care is dramatic. In fact, “researchers in the emerging field of spirituality in medicine argue that science alone cannot meet the needs of aging populations who increasingly suffer from depression, social isolation and chronic diseases.”1 If we expand the scope of care by tuning in to a patient’s spiritual needs, we can then address some of the root causes of stress-related illnesses, while potentially reducing healthcare costs and most certainly improving patient outcomes.

Increasingly, we are seeing the topic of spirituality integrated into the education of health professionals. While many Canadian schools have yet to make courses in spirituality prerequisite to obtaining a degree, we are seeing an increase in the incorporation of spiritual healthcare into course content.2

Image removed.Here in the Queen’s Faculty of Health Sciences, spirituality is woven into the curriculum of our three schools. I asked Dr. Mary Ann McColl, Professor in Occupational Therapy, School of Rehabilitation Therapy, to comment on why we are exposing our students to a concept that has traditionally been isolated from patient care. Mary Ann teaches three sessions on spirituality, and her book, Spirituality and occupational therapy is required reading in most OT programs in the English-speaking world.

Mary Ann says, “one of the main reasons I think it is important to talk to health sciences students about spirituality is to help them to think about the many unknowns and unknowables in health care. They are often inclined towards a positivist approach to thinking about health and illness, death and pain, and this approach has its limits. By talking to them about spirituality, I hope they leave understanding something about the mystery and wonder of being human and working with human beings at their most private and personal level. I think it is important for them to have some way of thinking about times when we are clearly ‘not in charge’ – we don’t necessarily need to be able to say who or what is, but we need to have thought about the fact that it is not always humans who are in control of things.”

In the School of Nursing, spirituality is integrated in to all aspects of the core curriculum. Students learn about how spirituality and cultural norms play into an individual’s life, and how to incorporate this knowledge into a patient’s care.

In the School of Medicine, Dr. Peter O’Neill lectures on the topic of spirituality to all first year medical students. Peter presents students with a Spiritual Assessment Tool, designed to equip students with the very language that can be difficult or hard to find when working with a patient. The tool, using easy-to-remember acronyms, walks the practitioner through a series of specific questions that serve to uncover a patient’s ‘spiritual history’ and help the practitioner to understand how they can best address this in the healthcare that they provide.

In Mary Ann’s book, while she states that there are three ways to understand the spirit: religious, sacred and secular, she concedes that even the act of defining spirituality can be approached in a variety of ways.3 Thus, with patient care in mind, what is most important is that we equip our graduates with a language with which they can talk to their patients about spirituality. By simply opening the discussion, practitioners can offer better, more specialized care. It’s a patient-centered approach, and as the research is showing, it works.4

Do you think that incorporating spirituality in to patient care is important? How should it be done? Share your thoughts by commenting on the blog, or better yet, please drop by the Macklem House, my door is always open.

I would like to thank Jen Valberg for her assistance in preparing this blog.

  1. http://www.theglobeandmail.com/life/health-and-fitness/health/reclaiming-medicines-spiritual-roots-treating-people-not-just-diseases/article21704383/
  2. http://www.cmaj.ca/content/185/1/E35.full
  3. McColl, MA (2011) Spirituality and occupational therapy (2nd), Ottawa, ON: CAOT Publications.
  4. http://www.ncbi.nlm.nih.gov/pubmed/24084250

Sherri McCullough

Fri, 06/30/2017 - 12:49

Thank you Richard for this wonderful article. As you know this is a big component in Catholic Health Care. Very gratifying to see.
Sherri McCullough Chair Board of Directors Hotel Dieu Hospital

Sherri McCullough

Thanks for your comment Sherri. Indeed, the incorporation of spirituality is already in practice in many ways in some institutions, and I am glad to say that we are teaching the next generation of nurses, therapists and physicians to do continue with this integration.
Richard

Richard Reznick

Ray Viola, MD, Palliative Medicine

Fri, 06/30/2017 - 12:49

Exploring patients’ spiritual dimension is a core component of palliative care. Although I lack advanced skills, I make my attempt and include colleagues with training and insights into this important aspect of personhood in the care of patients facing life-threatening illnesses. KGH has a very active and effective Department of Spiritual and Religious Care, whose participation I always seek and value. Peter O’Neill brings to the bedside the unique combination of both medical and spiritual training in a single professional.

Ray Viola, MD, Palliative Medicine

Hi Ray,
I agree that exploring spirituality should play a critical role in palliative care. Thank you for sharing your thoughts.
Richard

Richard Reznick

Dr Karen Smith

Fri, 06/30/2017 - 12:50

I have been privileged to work with Dr McColl and with many patients and families who have helped me understand the importance and the power of this dimension of patient care. Thank you Dr Reznick for highlighting it.

Dr Karen Smith

David Andrew

Fri, 06/30/2017 - 12:50

As we discuss in our course `Controversies in Neuroscience` (NSCI 499/899*), spirituality appears to be hard-wired into our brain because there have been numerous survival advantages to being religious as our tribal brain has evolved.

The irony is that while our brain gives us the unlimited intellectual potential to rule over all we see, it also drives our illusion of servitude to a supreme power of undetermined origin and location.

David Andrew

eter O'Neill MD MDIV

Fri, 06/30/2017 - 12:51

The spirituality session with the Medical students has evolved over the past four years has several goals.
The first goal is affirm, for the medical students who have a religion, that all religious backgrounds that teach compassion will help in a medical career. The second goal is to make the students be aware of the religious diversity in their own classroom. The third goal is to determine if the worldview of the students will be a barrier in their learning medical care, and how their worldview might shape their career. The last goal is to make the students aware of the Chaplains at Queen’s, and in our hospitals.
Many of our students have worked hard at the sciences to get into Queen’s Medical School. In return we at Queen’s want them continue to pay attention to their academic health, but also to their physical, mental and spiritual health.

eter O'Neill MD MDIV

Dear Peter,
Thank you for sharing. It is a very interesting approach, and one that our students benefit from greatly.
Richard

Richard Reznick

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