Spirituality and health: an exploratory study of hospital patients’ perspectives
Julieanne Hilbers A D , Abby S. Haynes B and Jennifer G. Kivikko CA Diversity Health, Prince of Wales Hospital, McNevin Dickson Bldg, Avoca Street, Randwick, NSW 2031, Australia.
B Sydney Hospital and Sydney Eye Hospital, Sydney, NSW 2000, Australia.
C Department of Chaplaincy, Prince of Wales Hospital and Randwick Hospitals Campus Services, Sydney, NSW 2031, Australia.
D Corresponding author. Email: julieanne.hilbers@sesiahs.health.nsw.gov.au
Australian Health Review 34(1) 3-10 https://doi.org/10.1071/AH09655
Submitted: 30 May 2008 Accepted: 24 February 2009 Published: 25 March 2010
Abstract
The relationship between spirituality/religion and health is receiving increasing academic interest, but few studies have explored the experience of Australians. This paper presents data from an exploratory survey of patients and families in a public teaching hospital in Sydney. The findings show that the majority of hospital service users:
• believe there are links between spirituality/religion and health;
• believe that rituals and customs can help people when they are sick/suffering;
• have valued practices associated with their beliefs;
• feel it is helpful for health staff to know their patients’ beliefs;
• are willing to be asked about their beliefs; or
• want hospital staff to respect and support the beliefs and practices of all patients.
Spirituality and religion, and the beliefs and practices associated with them, were found to be eclectic, individualised and evolving in response to life events such as loss and health crises. This paper concludes that a person-centred framework of health practice includes attention to the religious/spiritual dimension of patients and their families.
What is known about the topic? There is a rapidly developing body of research that demonstrates an increasing awareness of the important links between religion and health, but is limited in Australian application.
What does this paper add? This paper provides contextually relevant qualitative and quantitative data on patient perspectives, including how patients wish to be treated by health staff in relation to their beliefs and practices. The Australian perspective also provides a valuable counterpoint to US-dominated research in the global community.
What are the implications for practitioners? The research findings indicate that practitioners need to recognise and respond to the role of religious and spiritual beliefs and practices in patients’ health journeys. The discussion suggests some practical ways of doing this which sit comfortably within the patient-centred approach.
Acknowledgements
We thank Dharmacari Ratnavyuha, participating investigator and member of the Spirituality and Health project team, and Ian Nivison-Smith who managed the database and data extraction. A grant of AU$8000 was provided by the South East Sydney Area Multicultural Health Unit to assist with data collection and analysis.
[1]
[2]
[3] Peach HG. Religion, spirituality and health: how should Australia’s medical professionals respond? Med J Aust 2003; 178(2): 86–8.
| PubMed |
[4] Bouma G. Globalization and recent changes in the demography of Australian religious groups: 1947 to 2001. People Place 2002; 10(4): 17–23.
[5]
[6]
[7] Larson JS. The conceptualization of health. Med Care Res Rev 1999; 56(2): 123–36.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[8] Johnson M. Faith, prayer and religious observances: diversity in medicine. Clin Cornerstone 2004; 6(1): 17–24.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] D’Souza R. The importance of spirituality in medicine and its application to clinical practice. Med J Aust 2007; 186(10): S57–9.
| PubMed |
[10] Williams DR, Sternthal MJ. Spirituality, religion and health: evidence and research directions. Med J Aust 2007; 186(10): S47–50.
| PubMed |
[11] Hebert RS, Jenckes MW, Ford DE, O’Connor DR, Cooper LA. Patient perspectives on spirituality and the patient-physician relationship. J Gen Intern Med 2001; 16(10): 685–92.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[12] Eckersley RM. Culture, religion, spirituality and health: looking at the big picture. Med J Aust 2007; 186(10): S54–6.
| PubMed |
[13] Higginbotham AR, Marcy TR. Spiritual assessment: a new outlook on the pharmacist’s role. Am J Health Syst Pharm 2006; 63 169–73.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[14] Rumbold BD. A review of spiritual assessment in health care practice. Med J Aust 2007; 186(10): S60–2.
| PubMed |
[15] Koslander T, Arvidsson B. Patients’ conceptions of how the spiritual dimension is addressed in mental health care: a qualitative study. J Adv Nurs 2007; 57(6): 597–604.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[16] Koenig HG. Religion and medicine II: religion, mental health, and related behaviors. Int J Psychiatry Med 2001; 31(1): 97–109.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[17] Larson D, Larson S. Spirituality’s potential relevance to physical and emotional health: a brief review of quantitative research. J Psychol Theol 2003; 31(1): 37.
[18] Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality and medicine: implications for practice. Mayo Clin Proc 2001; 76 1225–35.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[19] Clark PA, Drain M, Malone MP. Addressing patients’ emotional and spiritual needs. Jt Comm J Qual Saf 2003; 29(12): 659–70.
| PubMed |
[20]
[21]
[22] Koenig HG. Religion, spirituality and medicine in Australia: research and clinical practice. Med J Aust 2007; 186(Suppl. 10): S45–6.
| PubMed |
[23]
[24] George LK, Larson DB, Koenig HG, McCullough ME. Spirituality and health: what we know, what we need to know. J Soc Clin Psychol 2000; 19(1): 102–16.
| Crossref | GoogleScholarGoogle Scholar |
[25] Koenig HG, Idler E, Kasl S, Hays JC, George LK, Musick M, Larson DB, Collins TR, Benson H. Religion, spirituality and medicine: a rebuttal to skeptics. Int J Psychiatry Med 1999; 29(2): 123–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[26] Lauver DR. Commonalities in women’s spirituality and women’s health. ANS Adv Nurs Sci 2000; 22(3): 76–88.
| PubMed | CAS |
[27] Pargament KI, Smith BW, Koenig HG, Perez L. Patterns of positive and negative religious coping with major life stressors. J Sci Study Relig 1998; 37(4): 710–24.
| Crossref | GoogleScholarGoogle Scholar |
[28] Post SG, Puchalski CM, Larson DB. Physicians and patient spirituality: professional boundaries, competency, and ethics. Ann Intern Med 2000; 132(7): 578–83.
| PubMed | CAS |
[29] Ryan RM, Rigby S, King K. Two types of religious internalisation and their relations to religious orientations and mental health. J Pers Soc Psychol 1993; 65 586–96.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[30] Seeman TE, Dubin LF, Seeman M. Religiosity/spirituality and health: a critical review of the evidence for biological pathways. Am Psychol 2003; 58(1): 53–63.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[31] Selway D, Ashman AF. Disability, religion and health: a literature review in search of the spiritual dimensions of disability. Disabil Soc 1998; 13(3): 429–39.
| Crossref | GoogleScholarGoogle Scholar |
[32] Monroe MH, Bynum D, Susi B, Phifer N, Schultz L, Franco M, MacLean CD, Cykert S, Garrett J. Primary care physician preferences regarding spiritual behavior in medical practice. Arch Intern Med 2003; 163(22): 2751–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[33]
[34] Lo B, Ruston D, Kates LW, Arnold RM, Cohen CB, Faber-Langendoen K, Pantilat SZ, Puchalski CM, et al. Discussing religious and spiritual issues at the end of life: a practical guide for physicians. JAMA 2002; 287(6): 749–54.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[35]
[36]
[37]
[38]
[39] Kendler KS, Liu X-Q, Gardner CO, McCullough ME, Larson D, Prescott CA. Dimensions of religiosity and their relationship to lifetime psychiatric and substance use disorders. Am J Psychiatry 2003; 160 496–503.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[40] Jantos M, Kiat H. Prayer as medicine: how much have we learned? Med J Aust 2007; 186(10): S51–3.
| PubMed |
[41]
[42]
[43]
[44] Anandarajah G, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician 2001; 63(1): 81–9.
| PubMed | CAS |
[45] Galek K, Flannelly K, Vane A, Galek R. Assessing a patient’s spiritual needs: a comprehensive instrument. Holist Nurs Pract 2005; 19(2): 62–9.
| PubMed |
[46] Holt P. Role of questioning skills in patient assessment. Br J Nurs 1995; 4(19): 1145–6.
| PubMed | CAS |
[47] McSherry W, Ross L. Dilemmas of spiritual assessment: considerations for nursing practice. J Adv Nurs 2002; 38(5): 479–88.
| Crossref | GoogleScholarGoogle Scholar | PubMed |