Wednesday, June 3, 2009

Faith and Healthcare

Many people claim that spirituality within the context of healthcare is mumbo jumbo and does not deserve to be part of the conversation. I think it is arrogant to assume that we have enough knowledge to discount the obvious benefits of including faith and spirituality in the healthcare dialogue. Reading through American Family Physician a peer reviewed journal of the American Academy of Family Physicians, along with other journals and research results, can give some insight into this thorny issue.

Attending to the spiritual dimension of the patient provides the physician with a deeper understanding of the patient and his or her needs. The provider might use a variety of spiritually informed therapeutic tools that could greatly facilitate the patient's coping ability, thus enhancing well being. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process.

Barbara Apgar, M.D., M.S. in an article in American Family Physician discusses research on the significance of intercessory prayer for the sick, referencing the study by Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. The authors conclude that supplementary, remote, blinded, intercessory prayer produced a measurable improvement in the medical outcomes of critically ill patients in the CCU. Clinical trials on the Effects of Meditation on Mechanism of Coronary Heart Disease seem to bear out the same conclusion. Prayer and meditation are very effective tools in the fight against disease and valuable to promote healing and wellness.

Walter L. Larimore, M.D., reports that 99% of surveyed family physicians believe that religious beliefs can heal, 75% believe other people’s prayers (i.e., intercessory prayer) can promote healing. Based on his own clinical practice and dialogue with other family physicians Larimore suggests that “infrequent religious attendance or “poverty of personal faith” should be regarded as a risk factor that is nearly equivalent to tobacco and alcohol abuse.

The impact of spiritual practices and disciplines such as prayer are obvious.  While issues of faith and beliefs and how to implement those in medical care, such as through prayer, are controversial they should not be ignored. In light of some of the research on spirituality in healthcare we can not dismiss prayer as a possible viable intervention. And since the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), requires the administration of a spiritual assessment then it will be good to include standard templates for these assessments in an Electronic Health Record to be used for quality reporting. A good template for spiritual assessment and review of the JCAHO requirements and guidelines for implementation by Hodge can help social workers being called on to conduct spiritual assessments.

I am firm believer in technology enabled healthcare - but I also am absolutely certain that we should not try to push God out of the healthcare arena.