Recent international and Australian surveys have shown that there is a need to incorporate the spiritual and religious dimension of patients into their management.
By keeping patients’ beliefs, spiritual/religious needs and supports separate from their care, we are potentially ignoring an important element that may be at the core of patients’ coping and support systems and may be integral to their wellbeing and recovery.
A consensus panel of the American College of Physicians has suggested four simple questions that physicians could ask patients when taking a spiritual history.
Doctors and clinicians should not “prescribe” religious beliefs or activities or impose their religious or spiritual beliefs on patients. The task of in-depth religious counselling of patients is best done by trained clergy.
In considering the spiritual dimension of the patient, the clinician is sending an important message that he or she is concerned with the whole person. This enhances the patient–physician relationship and is likely to increase the therapeutic impact of interventions.
Doctors, health care professionals and mental health clinicians should be required to learn about the ways in which religion and culture can influence patients’ needs and recovery.
- 1. Osler W. The faith that heals. BMJ 1910; I: 1470-1472.
- 2. Narayanaswamy A. A review of spirituality as applicable to nursing. Int J Nurs Stud 1999; 36: 117-125.
- 3. Dyson J, Cobb M, Forman B. The meaning of spirituality: a literature review. J Adv Nurs 1997; 26: 1183-1188.
- 4. Hassed CS. Depression: dispirited or spiritually deprived? Med J Aust 2000; 173: 545-547. <MJA full text>
- 5. Yawar A. Spirituality in medicine: what is to be done? J R Soc Med 2001; 94: 529-532.
- 6. Lamotte E. The Buddha, his teachings and his Sangha. In: Bechert H, Gombrich R, editors. The world of Buddhism. London: Thames and Hudson, 1984: 41-58.
- 7. Wig NN. Mental health and spiritual values: a view from the East. Int Rev Psychiatry 1999; 11: 92-96.
- 8. Foucault M. Madness and civilization: a history of insanity in the age of reason. New York: Random House, 1965.
- 9. Porter R. Madness: a brief history. Oxford: Oxford University Press, 2002.
- 10. Turpin J. Historical perspective: California mental health during the past 40 years [online]. Sierra Sacramento Valley Med 2004; 55(4). http://www.ssvms.org/articles/0407tupin.asp (accessed Apr 2007).
- 11. D’Souza R. Do patients expect psychiatrists to be interested in spiritual issues? Australas Psychiatry 2002; 10: 44-47.
- 12. Mathai J, North A. Spiritual history of parents of children attending a community child and adolescent mental health service. Australas Psychiatry 2003; 11: 172-175.
- 13. De Beer WA. “The religiosity gap”: a New Zealand perspective. Proceedings of the 35th Annual Congress of the Royal Australian and New Zealand College of Psychiatrists; 2000 April 27–30; Adelaide, SA.
- 14. May C, Mead N. Patient-centeredness: a history. In: Dowrick C, Frith L, editors. General practice and ethics: uncertainty and responsibility. London: Routledge, 1999: 76-90.
- 15. Gordon J. Medical humanities: to cure sometimes, to relieve often, to comfort always. Med J Aust 2005; 182: 5-8. <MJA full text>
- 16. Cassell EJ. The healer’s art. Cambridge, Mass: MIT Press, 1985.
- 17. Koenig HG, McCullough M, Larson D. Handbook of religion and health. New York: Oxford University Press, 2000: 7-14.
- 18. Koenig HG, Cohen H, Blazer D, et al. Religious coping and depression among elderly, hospitalized medically ill men. Am J Psychiatry 1992; 149: 1693-1700.
- 19. Koenig HG, George L, Peterson B. Religiosity and remission of depression in medically ill older patients. Am J Psychiatry 1998; 155: 536-542.
- 20. Koenig HG. Religion, spirituality and medicine: application to clinical practice. JAMA 2000; 284: 1708-1709.
- 21. Hummer R, Rogers R, Nam C, Ellison C. Religious involvement and US adult mortality. Demography 1999; 36: 273-285.
- 22. Twycross R. Introducing palliative care. 3rd ed. Oxford: Radcliffe Medical Press, 1999.
- 23. Qureshi B. Transcultural medicine. 2nd ed. Lancaster: Kluwer Academic, 1994.
- 24. D’Souza R, Heady A. Spirituality and religiosity: has it a place in psychiatric assessment and management? Proceedings of the Annual Scientific Meeting of the Australasian Society for Psychiatric Research; 2000 Dec 7–8; Adelaide, SA.
- 25. D’Souza R, Heady A, Rich D. Spiritual needs in psychiatric practice. Proceedings of the 36th Congress of the Royal Australian and New Zealand College of Psychiatrists; 2001 May 21–24; Canberra, ACT.
- 26. D’Souza R, Rich D. An open randomised controlled trial using spiritually augmented cognitive behavioural therapy in demoralisation and depression. Proceedings of the Annual Scientific Meeting of the Australasian Society for Psychiatric Research; 2001 Dec 6–7; Melbourne, VIC.
- 27. D’Souza R, Rodrigo A. Spiritually augmented cognitive behavioural therapy. Australas Psychiatry 2004; 12: 148-152.
- 28. D’Souza R. An open randomised controlled study using a spiritually augmented cognitive behavioural therapy for demoralisation and treatment adherence in patients with schizophrenia. Proceedings of the 11th Biennial Winter Workshop on Schizophrenia; 2002 Feb 24–Mar 1; Davos, Switzerland.
- 29. D’Souza R. Incorporating a spiritual history into a psychiatric assessment. Australas Psychiatry 2003; 11: 12-15.
- 30. Lo B, Quill T, Tulsky J. Discussing palliative care with patients. Ann Intern Med 1999; 130: 744-749.
- 31. Kinnersley P, Stott N, Peters TJ, Harvey I. The patient-centeredness of consultations and outcome in primary care. Br J Gen Pract 1999; 49: 711-716.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.