- Kenny Lin, MD
Since it became possible to post online comments on AFP content earlier this year, no single article has prompted as many comments as "The Spiritual Assessment," published in the September 15th issue. The range of comments thus far reflects family physicians' diversity of views on this topic. For example, while one reader opined that spiritual concerns have "little to do with improving the health of our patients," another countered, "I do not think this article goes far enough in promoting this type of spiritual health assessment." Another reader argued that the spiritual assessment should "not be elevated to the status of another vital sign we must always take." Some readers expressed concerns that physicians might seek to impose their religious beliefs on vulnerable patients, while another suggested that "many physicians seem to have more fear of [discussing] spiritual issues than the patients do."
In the article, Drs. Aaron Saguil and Karen Phelps suggest assessing older patients, hospitalized patients, and patients with worsening or terminal illness, who are more likely to be interested in sharing their spiritual or religious beliefs. Other patients may bring up their faith or spiritual practices without prompting in the course of a normal conversation. Since 80 percent of patients and family physicians perceive religion to be important, according to the authors, acknowledging and supporting spiritual beliefs is a key component of holistic, patient-centered care:
The spiritual assessment allows physicians to support patients by stressing empathetic listening, documenting spiritual preferences for future visits, incorporating the precepts of patients' faith traditions into treatment plans, and encouraging patients to use the resources of their spiritual traditions and communities for overall wellness. Conducting the spiritual assessment also may help strengthen the physician-patient relationship and offer physicians opportunities for personal renewal, resiliency, and growth.
We invite other readers to share their perspectives on the role of the spiritual assessment in family medicine by posting a comment on the article, posting a comment to this blog, or sending an e-mail to afpcomment@aafp.org.
Thursday, September 20, 2012
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21 September 2012
ReplyDeleteWhen I was in training 25 years ago, the AFP emphasized the "bio-psycho-social model" of health and illness.
Unless I misread the current proposal, AFP is now proposing a "bio-psycho-social-spiritual" model of health and illness.
Perhaps I am stating the obvious, but the latter model is a far more accurate metric than the former because it is more comprehensive.
Even for patients who claim to have no 'spiritual life', i.e. are atheistic in their beliefs, atheism is their personal subset of spirituality when spirituality is broadly defined.
The more comprehensive model is consistent with every religious faith including holding no religious faith at all.
To be more specific: I am religiously observant in the Jewish faith.
Anyone caring for me as a patient needs to be aware of this because it influences everything I think, say and do.
My thirteen-year-old budding scientist daughter currently considers herself an atheist. I told her that I was atheistic too at thirteen when I was a budding scientist. Her atheism currently influences everything that she thinks, says and does.
We ignore the faith component of our lives and our patients' lives at our peril, and by ignoring it we serve our patients poorly at every stage of life.
Mark Gary Blumenthal, MD, MPH
Knoxville, TN