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Keep the faith: Why the role of spiritual care in health care is critical 

Jung Kwak, PhD, MSW and Rev. Brian Hughes
Conditions
January 3, 2023
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This time of year, advice abounds on how to develop New Year’s resolutions that last. Some assert the need for resolutions and goals that reflect the deep desire for meaning-making, living life to the fullest extent possible, and establishing healthier, fuller lives moving forward.

Spiritual care is an essential part of any health care resolution.

Some describe a recent Journal of the American Medical Association study as “the most rigorous and comprehensive systematic analysis of the modern-day literature regarding health and spirituality to date.”

This study concludes that addressing spirituality improves patient outcomes among the seriously ill and explicitly calls for more directly incorporating spiritual care into the medical care of patients with serious illnesses, and addressing spiritual care needs through specialty practitioners of spiritual care.

One of the lead authors of the JAMA article declares spiritual care is a human right.

Spirituality profoundly influences health and how people cope with serious illnesses of their own and their loved ones. Spirituality influences how individuals perceive and attribute meaning to illness, communicate needs, and seek and access care.

Research shows that the practice of spirituality and a sense of faith can reduce risks for serious health conditions such as cancer, heart failure, and even mortality.

In our recent systematic review of the connection between spirituality and health, we found that religiosity and spirituality positively impact cognitive and mental health and coping in persons with dementia.

For families of patients with serious illnesses, religious and spiritual beliefs are important sources of guidance for surrogate decision-making and help family caregivers cope with caregiving challenges and responsibilities, as in the case of dementia caregivers we studied.

In our study with over 580 health care chaplains who facilitated serious illness conversations with patients, patients’ concerns were often existential and spiritual, even without explicit, verbal expression or use of the words “spirituality” or “faith.”

Chaplains reported that the patients’ hopes and fears involved how to live fully in the present, how to live and die peacefully and avoid suffering as much as possible. Patients expressed they desired to be connected with their loved ones, to consider and seek the sacred and meaning-making, and to contemplate the great unknown.

Another study of 196 critical illness survivors with ICU visits found that over half of patients reported major serious concerns. Over one-third needed more support than their family or friends could provide. Yet, many clinicians reportedly shy away from broaching the subject of spirituality or religion because of a lack of familiarity and training, anticipating questions or concerns that they may not be comfortable addressing. They report they do not wish to open up Pandora’s Box and be left without knowing how to best respond.

One solution is for clinicians to consider themselves spiritual care generalists, giving themselves permission to ask how a patient’s or family’s deeply held values may impact their care plan. And then listen to the response.

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If it gets complex, then call in the spiritual care specialist, often the board-certified chaplain. In the same way that a generalist medical provider inquires about many different symptoms and diseases, a spiritual care generalist can inquire about a patient’s or family’s values and beliefs, and seek to incorporate them into their care, and refer if and when the needs become beyond the scope of practice of the inquiring clinician.

When practitioners and leaders in health care place spiritual care in a place of resolute importance and priority, it infuses health care with humanity. The practice invites patients and families to bring deeply held values, beliefs, and worldviews into the collective field of vision in order to co-create better outcomes. It also becomes a more meaningful journey and facilitates connection and community.

Jung Kwak is a gerontologist. Brian Hughes is a chaplain.

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