Lecture on Spirituality and Healing shared with Caregivers

            I want to thank everyone for coming today.  I know many of you may be wondering if this presentation’s subject has any relevance for you.  Concerning this issue of relevance, I know that there are some here who would consider tuning me out because they view themselves as an atheist, and that spirituality and religion have no part in their lives and therefore they do not need to listen to any of this material.  I would argue that this material may be most important for someone who is not coming from a position of faith.  If you maintain this perspective in your bedside manner, then you run the risk of building a separation between you and your patient.  

This concept is not because of antiquated data.  Even recent studies have shown that Americans are still a very spiritual people.  In fact, 57% of Americans pray at least daily (GSS, 2013).  If we as caregivers ignore the spiritual life of our patients, then we risk greatly limiting our relationship with them as well as the opportunity to help them leverage their faith in the development of their overall wellbeing.  I am not pushing for you to accept someone else’s beliefs.  However, I am encouraging you to find the means to be able to respect reasonable aspects of religion, spirituality, and faith in the lives of your patients.

            We should pause a moment to recognize that there are some differences between religion and spirituality.  One view of spirituality is that it is more of a personal search for answers to the questions of life and typically involves a relationship with the sacred (Lucchetti, Lucchetti, & Koenig, 2011).  On the other hand, religion has more to do with specific systems or ideas of beliefs, rituals, and practices designed to aid in a connection to the sacred (Lucchetti, et al, 2011).  What this means for us as caregivers is that we need to be attuned to the difference in order to be able to support and encourage our patients in the best possible way.

For example, studies have shown us that the US is becoming much more diverse in its approach to religion and the spiritual.  In fact, researchers are recognizing that 72% of younger adults consider themselves to be spiritual, but not religious (Vieten, Scammell, Pilato, Ammondson, Pargament, & Lukoff, 2013).  This means that they are not as focused on rituals as much as they are on opportunities to understanding different means toward connecting with the sacred (Lucchetti, et al, 2011).  Labeling someone who views themselves as “spiritual” as “religious” will often offend them.  We must manage the opportunity for connection with our patients because it can go badly if we are not wise.

            The next question related to this subject then would be what the role of our staff should be related to a patient’s religion or spirituality?  As one study publsihed in 2011 put it in their title, “It depends” (Balboni, Babar, Dillinger, Phelps, George, Block, Kachnic, Hunt, Peteet, Prigerson, VanderWeele, & Balboni, 2011).  In this study, researchers found that although patients, doctors, and nurses all thought that patient-initiated prayer was appropriate at least occasionally, 80% of patients viewed caregiver-initiated prayer as supportive spiritually (Balboni, 2011).  This means, that if you as a caregiver are willing to pray with your patients, the majority of them will welcome your offer to do so.  I would point out again that this does not need to be a realm in which you fake a level of personal spirituality.  If you are not a personally religious or spiritual person, do not feel like you have to create a false persona of religiosity.  However, prayer is one of the more common aspects across a multitude of faith backgrounds.  It is a simple means by which to connect with the spiritual aspect of our patients.  Again, respect is the foundational idea when supporting patients with faith.  The religion may be different, but it does not need to be oppositional. 

            That brings me to an additional aspect of this issue, what part does your own religious or spiritual background play in relating to the needs of your patient?  As noted, researchers recognize that history is rich with caregivers caring for others from a foundation of faith and spirituality (Duncan, Barbara, & Dusek, 2013).  Although 90% of American adults state that they believe in God, their view of God is quite possibly different than yours (NCI, 2012).  This is especially true when we consider the melting pot of cultures that is the US.  Your own spiritual background may be drastically different than the background of your patient (Lun, & Bond, 2013).  However, when the differences are handled respectfully, religion and spirituality become an additional way for caregivers to relate to their patients.

            Although we often wait to discuss spirituality only when a patient is facing some sort of life-threatening condition, this is too late.  If anything, it risks frightening the patient.  If instead, we broach the subject early in the relationship, then there is already an understanding concerning the patient’s background.

One way to spark conversation is to ask the patient if there is any specific faith background that they practice?  This allows the caregiver to understand if there are any potential culture or faith related concerns that the patient may have (Williams, Meltzer, Arora, Chung, & Curlin, 2011).  One way to connect with a patient is to share with them of our own background.  Therefore, sharing of our own faith background, while respecting the patient’s faith can be very useful.  If you are not that familiar with a particular religion or spiritual practice, do not be afraid to ask them about it.  This may be a means to help the patient connect with their own background as they reach back to a source of personal strength (Murphy & Fitchett, 2009). 

The internal, personal strength that comes from faith and spirituality has been shown to powerfully aid in health and recovery (Lucchetti, et al, 2011).  As caregivers we can help our patients tap into those resources.  With this foundation set, if you then feel comfortable, simply asking if you could pray with them is a natural next step (Balboni, et al, 2011).

            Ultimately, if for whatever reason, you do not feel comfortable further developing the spiritual side of your patient and your relationship, or if they do not seem comfortable discussing faith with you, then you have plenty of other resources.  The most accessible is the chaplain's office.  The hospital chaplain's job to try to be available and knowledgeable in order to assist our patients and our staff (Balboni, et al, 2011).  It is understandable if you struggle with a particular faith tradition.  Chaplains are here to support you.  However, I strongly encourage you to still make the attempt to reach out to the patient concerning faith.   You may be able to develop a strong sense of relationship and trust with your patients through that practice (Vieten, et al, 2013).

            An additional resource, that we should always consider with the patient’s permission, is any local laity or clergy for their particular faith group (Lucchetti, et al, 2011).  These can be strong relationships for support and healing.  Reseach is finding that faith, prayer, religion, and spirituality help not just with mental and emotional issues, but also other health concerns (Murphy, & Fitchett, 2009).  In fact, the level at which spirituality can possibly extend life is equivalent to getting your patients to eat the proper amounts of fruits and vegetables (Lucchetti, et al, 2011).

Conclusion

            Although Linus from Peanuts fame would tell us to not talk to people about politics and religion, in our work we should maybe limit his guidance to just the politics (Schulz, 1966).  Religion, spirituality and faith are areas that we as healthcare providers should be willing and able to discuss with our patients.  Surveys have shown us that the majority of patients desire to have such a discussion with their caregivers (Balboni, 2011).  Studies have shown us that spirituality and prayer can be powerful instruments toward healing (Lucchetti, et al, 2011).  Therefore, if we avoid this aspect of our patients not only to we limit the service that we give, we equally risk a level of disservice.  I challenge you to consider this aspect of the people to whom we have been called to care.  Thank you.

References

Balboni, M., Babar, A., Dillinger, J., Phelps, A., George, E., Block, S., Kachnic, L., Hunt, J., Peteet, J., Prigerson, H., VanderWeele, T., & Balboni, T. (2011). Original Article: “It Depends”: Viewpoints of Patients, Physicians, and Nurses on Patient-Practitioner Prayer in the Setting of Advanced Cancer.  Journal of Pain and Symptom Management, 41(5), 836-847. doi:10.1016/j.jpainsymman.2010.07.008  http://www.sciencedirect.com.proxy1.ncu.edu/science/article/pii/S0885392410010225

Breslin, M. J., & Lewis, C. (2008). Theoretical models of the nature of prayer and health: A review. Mental Health, Religion & Culture, 11(1), 9-21.  http://xt6nc6eu9q.search.serialssolutions.com/?genre=article&atitle=Theoretical+models+of+the+nature+of+prayer+and+health%3a+A+review.&title=Mental+Health%2c+Religion+%26+Culture&issn=14699737&isbn=&volume=11&issue=1&date=20080101&aulast=Breslin%2c+Michael+J.&spage=9&pages=9-21&rft.sid=EBSCO:PsycINFO:2007-19918-002

Duncan, C., Barbara, L., & Dusek, J. (January 2013).  Prayer.  Retrieved from http://www.csh.umn.edu/Integrativehealingpractices/prayer_rlo__sq.php?runningtitle=Prayer&runningtitle=Prayer&AUD=CSH&QUIZ=1&PREVIEW=NO&SCORE_REPORT_URL=http%3A//www.csh.umn.edu/free-online-learning-modules/index.htm

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Koenig, H. (2009). Research on Religion, Spirituality, and Mental Health: A Review. Canadian Journal of Psychiatry, 54(5), 283-291.  http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=313cdd06-f9dd-4b84-afe6-6ccdb66d2ba8%40sessionmgr4004&vid=8&hid=4111

Lucchetti, G., Lucchetti, A., & Koenig, H. (2011). Clinical article: Impact of Spirituality/Religiosity on Mortality: Comparison With Other Health Interventions. Explore: The Journal of Science And Healing, 7(4), 234-238. doi:10.1016/j.explore.2011.04.005  http://www.sciencedirect.com.proxy1.ncu.edu/science/article/pii/S1550830711001029

Lun, V., & Bond, M. (2013). Examining the Relation of Religion and Spirituality to Subjective Well-Being Across National Cultures. Psychology of Religion and Spirituality, doi:10.1037/a0033641  http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=7baea346-4119-4910-889b-8cb55fe9b360%40sessionmgr110&vid=3&hid=110

Murphy, P. E., & Fitchett, G. (2009). Belief in a concerned God predicts response to treatment for adults with clinical depression. Journal of Clinical Psychology, 65(9), 1000-1008. doi:10.1002/jclp.20598  http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=14d6fce8-462f-4d46-a68f-05aa9de0266b%40sessionmgr115&vid=4&hid=110

National Cancer Institute (NCI). (2012, Sept 20). Spirituality in Cancer Care.  Retrieved from http://www.cancer.gov/cancertopics/pdq/supportivecare/spirituality/healthprofessional/

Schulz, C. (1966).  It’s the Great Pumpkin, Charlie Brown.  Cited by http://sharperiron.org/2006/05/17/what-did-the-author-really-mean-charlie-brown

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University of Minnesota Center for Spirituality & Healing. (2013, November 25).  Wellbeing at Our Core.  Retrieved from http://www.csh.umn.edu/index.htm

Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (2013). Spiritual and religious competencies for psychologists. Psychology of Religion and Spirituality, 5(3), 129-144. doi:10.1037/a0032699  http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=7baea346-4119-4910-889b-8cb55fe9b360%40sessionmgr110&vid=5&hid=110

Williams, J. A., Meltzer, D., Arora, V., Chung, G., & Curlin, F. A. (2011). Attention to inpatients’ religious and spiritual concerns: Predictors and association with patient satisfaction. Journal Of General Internal Medicine, 26(11), 1265-1271. doi:10.1007/s11606-011-1781-y  http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=313cdd06-f9dd-4b84-afe6-6ccdb66d2ba8%40sessionmgr4004&vid=4&hid=4113