A Physician’s Guide to Incorporating Patient Spirituality in Practice

Understanding cultural differences can help physicians better treat a diverse range of patients. In particular, having knowledge of a patient’s spiritual beliefs can help a physician tailor interventions to the individual patient while providing a deeper level of respect for their patients.

Spiritual or compassionate care should serve the whole patient, including their physical, emotional, and social facets. Various studies^1-3 have found that patients want their physicians to understand their spiritual beliefs in order to better understand them as individuals and to understand their decision-making process.

Spirituality has been found to have an impact on patients in a variety of ways. It can affect how they view their disease, how they make decisions about care, and how they cope.

One way a physician can help incorporate spiritual beliefs into their practice is through the Health Belief Model (HBM).¹ With this model, physicians can use their understanding of spiritual beliefs to frame targeted interventions:

• HBM factor: Perceived severity (“How serious is this illness?”)
• Spiritual Belief(s):
  • I’ll pray that it gets better
  • Use of spiritual remedies
• Intervention: Engage patients in dialogue about their beliefs and provide information about treatments
• HBM factor: Perceived susceptibility (“What is the risk of contracting illness?”)
• Spiritual Belief(s)
  • God is in control.
  • Everything happens for a reason.
• Intervention: Provide information about health risks in faith-based communities and for the individual patient
• HBM factor: Perceived benefits (“Is treatment feasible? Effective?”)
• Spiritual Belief(s)
  • My body is a temple
  • I want to live longer
  • God helps those who help themselves
  • My church values health
• Intervention: Use faith-based promotional materials; refer patient to faith-based organizations to promote healthy practices
• HBM factor: Perceived barriers
• Spiritual Belief(s)
  • My beliefs prevent me from engaging in certain health practices
• Intervention: Engage in dialogue that allows patients to express concerns; refer patients to faith-based organizations that can help them make decisions
• HBM factor: Self-efficacy (ability to execute behavior)
• Spiritual Belief(s)
  • Higher power gives me the power to do anything
  • God is in control
  • Do my spiritual beliefs support what I want?
• Intervention: Partnering with community faith organizations can help promote healthy behaviors and engagement with primary care facilities. Physicians may also provide workshops for these organizations in order to increase health awareness.
• HBM factor: Cues to action
• Spiritual Belief(s)
  • Announcements about other church members who are ill
  • Preexisting health conditions
• Intervention: Partnering with community faith organizations can help promote healthy behaviors and engagement with primary care facilities. Physicians may also provide workshops for these organizations in order to increase health awareness.
• HBM factor: Sociopsychological variables
• Spiritual Belief(s)
  • Social support in church.
• Intervention: Partnering with community faith organizations can help promote healthy behaviors and engagement with primary care facilities. Physicians may also provide workshops for these organizations in order to increase health awareness.

Using the HBM, physicians can become more informed about patient spirituality and allow that to inform interventions. Incorporating spirituality into a practice doesn’t have to be challenging. By practicing compassion, taking a spiritual history, and incorporating spiritual practices and the help of community faith organizations into the patient’s care as necessary, physicians can treat the whole patient in a more meaningful way.

References

1. Issac K, Hay J, Lubetkin E. Incorporating spirituality in primary care. J Relig Health. 2016;55(3):1065-1077.
2. McCord G, Gilchrist VJ, Grossman SD, et al. Discussing spirituality with patients: a rational and ethical approach. Ann Fam Med. 2004;2(4):356-361
3. Puchalski CM. The role of spirituality in health care. Proc (Bayl Univ Med Cent). 2001;14(4):352-357.