In addition, the faculty consensus group that produced the concept also developed teaching guidelines and learning objectives for these courses. One of the primary tenets of these courses is that concentrating on a patient's spiritual needs allows for more empathetic care.
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In conclusion, spirituality can have a significant role in how patients cope with chronic illness, pain, and loss. Physicians must address and be responsive to their patients' physical, emotional, and spiritual suffering. This is all part of providing compassionate care. I believe that if we can be compassionate, we can be better physicians and true partners in our patients' lives as they live and die: if we sincerely listen to their hopes, concerns, and beliefs, and include these beliefs into their therapy programs.
What is spirituality in medicine?
Michael and Tracy Balboni summarize their new book, Hostility Towards Hospitality: Spirituality and Professional Socialization within Medicine, in this issue's feature (Oxford University Press, 2019). Tracy, a physician, and Michael, a theologian, discuss how contemporary medicine overlooks, and may even be hostile to, the humanistic issues that are so important in spirituality and religion. “Both domains (medicine and religion) become more full through the light shed from the other,” the authors argue in their book. (vii)
Empirical research demonstrates an inextricable link between medicine and spirituality, which is broadly defined as the way people seek and express meaning and purpose, as well as sense connectedness to self, others, the significant or sacred.
Spirituality has an impact on patient well-being, contentment with care, medical decision-making, and medical care outcomes when it is experienced individually and/or within communal, religious forms. The medical industry, on the other hand, appears to mainly ignore the spiritual dimension of patient well-being and sickness, according to data. This evidence, taken together, calls for a rethinking of how medicine interacts with spirituality and religion. Following is a synopsis of our research into this issue, followed by four recommendations for how medicine might better respond to patients' spiritual experiences of sickness. Hostility to Hospitality: Spirituality and Professional Socialization in Medicine provides further evidence to corroborate our findings.
Patient Experience of Serious Illness
Take into account the evidence that most patients perceive serious illness as a spiritual experience. Patients significantly endorsed religious attitudes and practices, according to a poll of 542 hospital patients in North Carolina, with 65 percent attending religious services at least a few times each month. Another research of 100 terminally ill patients at the M.D. Anderson palliative care outpatient clinic in Houston, Texas, found that 80% of the patients identified as Protestant, with the majority expressing high levels of spirituality and religiousness. In a poll of cancer patients at the Saint Vincent's Comprehensive Cancer Center in New York, NY, 29 percent said they go to religious services on a weekly basis, and 66 percent said they are spiritual (but not religious). We did a research among Boston teaching hospitals that indicated 78 percent of patients felt spirituality and/or religion to be significant to their cancer experience, 73 percent reported being spiritual, and more than half considered themselves both spiritual and religious. Religion was essential to 68 percent of terminally ill patients in a multiregional sample of 230 patients, with the highest percentages among Blacks (89 percent) and Latinos (86 percent) (79 percent). While geographical differences in religiousness and spirituality influence religiousness and spirituality, overall, this data suggests that patients in the United States are extremely spiritual and religious. Many patients, according to data, view their sickness through a spiritual lens.
There is also evidence that religiousness and spirituality increase as people age and face acute disease.
As a result, general population surveys of spirituality/religiosity will always undervalue the relevance of spirituality and religion in the context of serious disease. Because there are no prospective studies that follow people as they transition from relative health to serious illness, the magnitude of any change cannot be calculated at this time. Patients with advanced cancer report significant changes in daily spiritual activities (e.g., prayer) after diagnosis (47 percent before vs. 61 percent after, p.0001). There is limited evidence that higher levels of stress are associated with increased religiousness, and patients with advanced cancer report significant changes in daily spiritual activities (e.g., prayer) after diagnosis (47 percent before vs. 61 percent after, p.0001). In a study of 108 women with gynecologic cancers, 49% said they were more religious after their diagnosis, while none said they became less religious. This is referred to as the “The “foxhole” effect refers to the saying that no atheists can be found in combat foxholes. This transition, according to Freud, occurs as a result of a direct confrontation with, or increased awareness of, one's fear of death or longing for immortality. This impact does not necessarily explain the origins of religion, as Sigmund Freud argued, but it is a dynamic that explains why religion and spirituality become more operational when physical health deteriorates.
A variety of spiritual demands occur in the context of significant sickness, ranging from dread of dying or being punished, to trouble finding purpose in disease, to seeking for God's presence. According to our poll of cancer patients at Boston teaching hospitals, 51% wanted help overcoming their worries, 42% wanted help finding hope, and 40% wanted help finding meaning. Another study found that 79 percent of 727 racially/ethnically and religiously diverse patients using Duke University Medical Center's general care, cardiology, and neurology services had at least one spiritual need. In a study at MD Anderson Cancer Center in Houston, 58 percent of advanced cancer patients said they were having trouble sleeping “Spiritual anguish.” Spiritual quality of life and self-perceived religiosity were significantly poorer in patients with spiritual suffering. In a Boston-based study, 85 percent of the participants recognized one or more spiritual concerns, with a median of four issues per patient among the 14 spiritual issues evaluated. Among the patients' most pressing spiritual concerns were: “Seeking a closer relationship with God or one's religion,” 54%; “seeking forgiveness (of oneself or others),” 47%; and “feeling abandoned by God,” 28%. Surprisingly, of the 22% of patients who stated religion or spirituality was important to them, “Two-thirds said spiritual concerns were “not crucial” to their cancer experience, and 40% said they had four or more spiritual issues. Only 7% of all patients were consistently non-religious and non-spiritual, according to our findings. The findings of these research imply that religious/spiritual requirements are common among patients confronting serious disease, and that spiritual needs are common even among patients who do not consider themselves religious/spiritual.
To cope with illness, the vast majority of patients turn to religion and spirituality.
Many people find new meaning and purpose as a result of their chronic illnesses, and some obtain practical assistance from sympathetic spiritual communities.
This data indicates the importance and prevalence of spirituality and religion in the context of serious disease. Do spiritual experiences of disease, on the other hand, establish a responsibility to bridge the gap between medicine and religion? We believe they do when paired with outcome measures. Next, we'll have a look at this.
Spirituality and Religion andMeasured Outcomes
Religion/spirituality is linked to quality of life metrics, satisfaction, and utilization outcomes, according to growing research acquired over the last two decades.
Patient Satisfaction with Care: According to a cross-sectional study based on data from the University of Chicago Hospitalist Study, patients who reported that their spiritual needs were not being met by medical staff were more likely to rate overall quality of care as poor and to be dissatisfied with their medical care.
Similarly, a Duke University Medical Center study of 542 individuals treated for depression found that those with higher spiritual demands had poorer evaluations of satisfaction with care and lower perceptions of care quality.
While these preliminary studies do not show causation, they do suggest a probable link that will require further investigation.
Making Decisions: Religious beliefs and opinions have been linked to a delay in getting treatment for serious illnesses.
Religious variables are also linked to patient and surrogate choice preferences, such as a desire for aggressive treatment and a desire to use all measures possible to prolong life.
Religious groups, according to studies, encourage medical decision-making based on religious views.,
End-of-Life Care: A prospective cohort study of 340 advanced cancer patients found that patients who reported high levels of spiritual support from their medical teams (e.g., doctors, chaplains, nurses) had a three-fold greater chance of transitioning to hospice care at the end of life than patients who reported low levels of spiritual support.
Patients with strong religious coping who had their spiritual needs met by the medical system were five times more likely to transfer to hospice and five times less likely to undergo aggressive care in their final week of life, according to the same study. As a result, while the Phelps et al study revealed that high religious copers are more likely to receive aggressive care at the end of life, further analyses suggest that spiritual support from the medical system reverses this trend. Spiritual care and medical care received at the end of life were found to have an impact on end-of-life medical costs in a follow-up report. In the final week of life, medical care for patients whose spiritual needs were badly met cost $2,441 more on average than for patients whose spiritual needs were properly met by the medical team.
These studies demonstrate that spiritual care in the medical setting, such as identifying and addressing patient spirituality/religion, has an impact on patient end-of-life outcomes. Religion and spirituality are not incidental to medical care; they have observable effects across multiple dimensions.
Medicine's Neglect of Spirituality
Evidence of spirituality's significance in sickness and patient outcomes should prompt the medical system to respond positively to patients' spirituality/religion as part of patient-centered and culturally sensitive care. According to studies, the majority of seriously sick patients regard spiritual inquiry and participation as vital, appropriate, and supportive within the patient-clinician interaction. Notably, 67 percent of patients treated in primary care wanted their physician to be aware of their spirituality/religion; but, the majority (78 percent) would not want talks of religion/spirituality if it meant less time spent discussing medical issues. The need for spiritual interaction among patients was also observed to grow as the severity of their sickness worsened. However, few clinicians connect spiritually with patients with serious illnesses.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Patients in Boston, for example, said they had rarely gotten spiritual care from their doctors (6 percent) or nurses (13 percent) during their cancer treatment.
Many patients and their families use a spiritual/religious framework of values and meaning to participate with the greater sickness experience, including medical decisions. In a multi-site survey of 275 advanced cancer patients, 87 percent said they believe in religious beliefs related to end-of-life medical care (e.g., sanctity of life, miracles), with 62 percent saying they believe in three or more. In a 2015 report from a multicenter prospective study of 249 audio-recorded family interactions with surrogate decision makers in the ICU, the medical team's frequent lack of recognition of this facet of the disease experience is illustrated. Despite the fact that most surrogates (78%) thought religion/spirituality was essential, just 16 percent of interactions discussed spiritual or religious themes, and 65 percent of those dialogues were initiated by the surrogate. Furthermore, fewer than 20% of physicians engaged further or asked follow-up questions after surrogates directly stated religious concerns regarding treatment decisions.
The separation model, in which medicine ignores and avoids spirituality/religion, is fostered by “plausibility structures,” as defined by Peter Berger.
These are unstated assumptions anchored in certain social processes that give socially held views and practices a matter-of-fact quality. At medicine, especially in academic medical schools and teaching hospitals, the belief that medicine and spirituality should be kept separate is often unchallenged. Clinicians are socialized to ignore or avoid patient spirituality and religion because of plausible frameworks.
- Hospitals are largely technological and curative institutions, rather than humanistic care organizations.
- Physicians see themselves first and foremost as scientists, then as health administrators, rather than as healers who care about the whole person.
- The human person is divided into material and spiritual parts; there is no direct relationship between body and soul on an anthropological level. Spiritual influences have no direct impact on physical health or sickness.
- Fear, finitude, and death are all subjective domains that are best handled by others, such as clergy and religious communities.
- Modern medicine is influenced by bureaucratic concerns as well as secular forces such as the economy, science, and technology. This method does not allow for spirituality or religion.
Engaging the Gap
As scientific evidence increases, medicine cannot continue to ignore spirituality and religion as the status quo. Simple distinctions between body and soul fail to account for patients' experiences with disease or how many individuals approach medical decisions. Dichotomous approaches are not patient-centered, and they are resulting in costly gaps in care for the seriously sick and those nearing the end of life, for both patients and the health-care system. So, how can medicine respond to patients' spiritual experiences of sickness in a productive and non-defensive manner? We have four quick responses for you.
1. Research: Clinicians should use empirical research as a vital tool to move forward with their replies. This necessitates collaboration and investment on the side of doctors, spiritual/religious specialists, and funding organizations in order to conduct thorough research investigations. Greater description of the patient experience of spirituality in various cultural and clinical contexts (e.g., pediatrics, psychiatry, internal medicine, etc.) as well as exploration of how these factors relate to important medical outcomes like quality of life and medical decision-making are among the research needs. In order to create and assess spiritual care therapies, further research is required. Hypothesis testing, increasingly sophisticated assessments, peer-reviewed research, and medical-religious alliances are all important steps in closing the gap in patient spirituality and religion. While the topic of spirituality and health is still in its early stages, data and clinical consequences are beginning to emerge.
2. Training: Spiritual care training for physicians and nurses must be incorporated as a significant structural change in the socialization of professionals. It has been proven that receiving spiritual care training is the most powerful predictor of physicians and nurses providing spiritual care to the seriously ill. Even non-religious people were considerably more inclined to provide spiritual care to gravely ill patients after being instructed. Even a rudimentary amount of mandated clinician training would undoubtedly aid in the removal of biases generated by systematic silence.
3. Concerns about patient-centeredness or professionalism: Patients and clinicians agree in polls that neither should be made to feel uncomfortable or compelled to participate in a spiritual/religious dialogue while receiving spiritual care. Furthermore, patients do not want clinicians to be accused of not being true to their own beliefs. Spiritual care should be patient-centered and tailored to the clinician's professional role and training. Clinicians should be expected to ask each patient if and how spirituality or religion may be essential to their disease as a minimum standard.
- If the patient states during the initial clinical history that spirituality and religion are not important to them, the physician moves on.
- If the patient appears to be spiritually distressed, the clinician would help coordinate a chaplaincy visit or, if appropriate, encourage the patient to see their local minister or other trusted community spiritual supporter, with the patient's permission.
- If the patient expresses a desire to include spiritual supports (e.g. clergy) in medical decision-making, the physician must consider how to appropriately address the spiritual aspects of those discussions.
There are numerous more aspects that influence how suitable patient-clinician spiritual involvement is at different times. The length of the relationship, the degree of training and comfort with spirituality and religion, and spiritual/religious concordance; the degree of mutually shared awareness of tradition, beliefs, and spiritual practices are all factors in determining appropriateness. There is no expectation that clinicians will go beyond a basic level of spiritual inquiry when dealing with serious sickness. However, when both the patient and the physician feel at ease, there are numerous more reasons to encourage further dialogue or shared practice.
4. Religious Partnership: Because the sickness setting is a combination of secular, holy, and humanistic aspects, medical practitioners and medical institutions will be most effective when they collaborate with local religious communities and religious clergy. In Hostility to Hospitality, we propose that future collaboration is crucial in caring for patients' bodies, minds, and spirits. Equally essential, we believe that as market, technological, and bureaucratic forces increasingly dominate health, equally powerful forces such as community spiritual/religious organizations will be required to maintain the personal and human qualities of compassion and care.
Follow the Evidence
Many years ago, one of our Harvard academic mentors, a self-described humanist and atheist, taught us a vital lesson. She showed us that following the evidence, no matter where it leads, is always the best course of action in medicine. Our mentor was a big supporter of the parts of our study that showed how spirituality and spiritual care might improve patient outcomes. She smiled and stated, “I was able to support that work despite my personal convictions,” when we asked her how she was able to do so “We follow the evidence for the sake of our patients.” Her words of wisdom inspired us to explore and publish scientific data that revealed religious influences had a negative impact on end-of-life outcomes at times. Spiritual and religious factors in illness are becoming easier to measure in research, and there is enough evidence to demand that medicine follow suit “follow the evidence,” and form collaborative relationships with the spiritual/religious resources of the patients, families, and communities it serves.
Michael Balboni is a Harvard theologian and social science scholar who also serves as a minister at Boston's Park Street Church. Tracy Balboni is an associate professor at Harvard Medical School and a radiation oncologist at Brigham and Women's Hospital and the Dana-Farber Cancer Institute. They lead Harvard's Initiative on Health, Religion, and Spirituality as codirectors.
Is medicine a spiritual practice?
Medicine has always been and always will be a spiritual practice. Those who have forgotten this are lost, and as a result, patients suffer and are traumatized.
It's understandable if you're a healer who considers medicine to be a spiritual discipline in today's health-care environment. We're giving of ourselves at a time when providing healing services is difficult. I've seen the pulsating, pounding heart of medicine collide with the cold hard steel of technical advancements and managed care constraints time and time again. I understand the difficulties that health-care practitioners have in trying to perform their professionand sure, no matter how much research we conduct, medicine is still more art than science.
How does spirituality affect mental health?
Religion and spirituality can both be beneficial to one's mental health. They have the same effect in certain respects. Religion and spirituality, for example, can both assist a person cope with stress by instilling calm, purpose, and forgiveness. However, due to their distinct natures, the benefits of the two often differ.
Is religion the same as spirituality?
Religion is a collection of organized ideas and behaviors that are usually shared by a community or group of people.
Spirituality: This is a more personal discipline that involves feeling at ease and having a sense of purpose. It also refers to the process of forming views about the meaning of life and one's connection to others in the absence of any predetermined spiritual principles.
Imagine a football game as a metaphor for the link between spirituality and religion. The rules, officials, other players, and field markings all serve as guides as you play the game, much like religion can help you uncover your spirituality.
Kicking a ball around a park, without needing to play on a field or follow all of the rules and regulations, can still provide fulfillment and fun while expressing the core of the game, comparable to spirituality in life.
You can identify as religious or spiritual in any combination, but being religious does not inherently make you spiritual, and vice versa.
What are some spiritual jobs?
One of the most rewarding aspects of my work as a lightworker is being able to share my message and light with the rest of the world through mentorship and guidance. If you, like me, enjoy assisting and guiding people in discovering their purpose, loving themselves, and living their best lives, you might consider pursuing a career in teaching, coaching, or divine instructing. These can be especially beneficial if you are a good communicator and have an intuitive side to you that allows you to connect with people on a deeper level. Consider becoming a: if your objective is to impact others by spiritual counseling, teaching, mentorship, or divine instruction.
What happens when you have a spiritual awakening?
As Kaiser argues, this is the start of your spiritual journey, as you begin to doubt everything you previously believed. You begin to purge certain aspects of your life (habits, relationships, and outdated belief systems) in order to make room for new, more meaningful experiences. You may sense that something is lacking, but you aren't sure what it is. It's common to feel disoriented, confused, and down during this time.
Does Jesus still heal today?
“At the cross, Jesus truly triumphed over sin, death, wickedness, poverty, illness, demonic powers, and so much more. He was victorious over both those things and the adversary who was behind them. We're supposed to gain from what He done for us.” Divine healing is one of these advantages. Today, Jesus continues to heal.
However, the Old Testament lays the groundwork for the remarkable level of miraculous healing that we read about in the New Testament.
“Praise the LORD, my soul, and don't forget all his blessings – who forgives all your sins and heals all your ailments…”
There are accounts of miraculous healings, such as Naaman's recovery from leprosy (2 Kings 5:1-19) and Hezekiah's recovery from a potentially fatal infection (2 Chronicles 32:24). Boys are raised from the dead by Elisha (2 Kings 4:11-37) and Elijah (1 Kings 17:17-24). This is just a small sample of the healing that may be found in this section of the Bible.
Healing with Jesus Christ
Jesus came into the world with certain goals in mind: to make God known (Matthew 11:27), to destroy the devil's works (1 John 3:8), and to bring salvation and redemption to the world (John 3:16). Everything that makes people sick or broken is the devil's work.
As a result, the four gospels are replete with instances of Jesus' healing. The atmosphere around Jesus is clearly described in Matthew 4:23: “went across Galilee, teaching in their synagogues, proclaiming the kingdom's good news, and curing everyone who was sick or sick.”
This miraculous healing power of Jesus is mentioned in Luke 6:19. “…And everyone tried to touch him because he was radiating strength and curing everyone.”
I could list verse after verse to establish Jesus Christ's healing work, but I believe most of us are aware that these texts exist. The problem is to believe that the events mentioned genuinely occurred before moving on to the next level. “It is written,” Jesus continued “I promise you that anybody who believes in me will do the same things I have done, and even more…” (Matthew 14:12-14) “, he explained “And those who believe will be accompanied by these signs…they will lay their hands on sick people and they will recover.” (Matthew 16:17)
What are some examples of spiritual health?
Finding meaning and purpose in life may be a lifelong process that changes over time as a result of unique circumstances, personal experiences, and global events. A person's level of spiritual wellness, like the other dimensions of wellness, varies throughout their life. It's common to feel a range of emotions on the route to spiritual healing, both positive and negative (hope, forgiveness, acceptance, joy) (doubt, fear, disappointment, conflict).
Spiritual wellbeing has the power to make our decisions and choices easier, to center us during times of change, and to provide us with the resiliency to face hardship with grace and inner peace. Having a spiritual component in our lives may even assist us in healing whether we are afflicted with a physical or mental ailment.
Personal Reflection
Take a moment to measure your spiritual well-being by answering the following questions.
- Do I make an effort to broaden my understanding of various ethnic, racial, and religious groups?
Practice Spiritual Wellness
When it comes to spiritual wellness, it's vital to identify the strategy and approach that works best for you; unlike the other dimensions of wellness, there is no “one size fits all” solution.
- Volunteering in your community, spending time in nature, and appreciating music and the arts are all good things to do.
In future articles regarding spiritual wellness, we'll look at ways to figure out what your meaning or purpose is, as well as activities that can help you maintain or improve your spiritual wellness.