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Patients need spiritual help, report suggests

27 April 2018

In a survey of GPs, there was a debate over their ability to deal with questions other than health


DOCTORS are increasingly being seen as the “new clergy”, as patients come to them with spiritual demands and questions alongside physical and mental-health queries, new research suggests.

A report, published in the British Journal of General Practice last week, interviewed 19 GPs in Scotland to investigate the issue. It argues that family doctors need to become more  fully aware of spiritual issues and be better at dealing with them.

One of the authors of the report, Dr Alistair Appleby, who is also a practising GP, said that spirituality was “something that we would all benefit from talking about more openly, both in the health-care profession and in society more generally”.

Discussion of spiritual and mental-health issues, he said, had been held back by a reluctance to talk about them publicly.

The inspiration for the study came, Dr Appleby said, when “I felt I wasn’t meeting some patients’ needs. There were several occasions when I was with patients when it was fairly clear that I had not made the human connection that they hoped for.”

Some of those interviewed suggested that they did not feel that it was part of their job; others accepted that it was becoming a more essential part of their job.

One GP said: “I think so many of us reach for the prescription pad and prescribe when we ought to just be slowing down and looking at these deepest inner needs or spiritual needs, and accepting that we are the new, in some ways, the new clergy, the new priests that people come to, and embracing that because we’re good at it, but going that wee bit further into the spiritual issues.”

There were multiple reasons, Dr Appleby said, GPs would tackle spirituality with a patient. He said on Tuesday: “It is sometimes about approaching death, and realising that life is finite, or it is about the death of a relative or child. It can be to do with mental health: they can feel trouble or disturbed by their thoughts. Or it can be issues to do with guilt or shame, difficulty finding identity or significance, and locating affirmative relationships.

“Spirituality can also come up when you are trying to help patients reach some sense of self esteem, or when talking with a patient about negative religious or spiritual experiences, that is sometimes harming their mental health.”

Another of the doctors interviewed for the study said that, quite often, they would talk about issues of spirituality as a patient approached his or her death: “I want them to have every sense of support through that; so it is important that I would tap into their belief system, such as it is, and reinforce whatever beliefs they have regarding an almighty, eternal being, and that that is a being who seeks their best interest, and will be a source of help through this horrible, literally once-in-a-lifetime experience.”

Another participant in the study said, however: “I think the answer is, I don’t: I don’t go there [spiritually]. I don’t really understand the concept. Intellectually, I can get the fact that some people have spiritual crises, as they might be called, whereby they are doubting their beliefs, or are some way feeling that they’ve failed their God or whatever, and that’s a bit of a pity. But . . . there’s probably not much I can do about that.”

Dr Appleby said that medical professionals had found spirituality a “very difficult” subject to talk about openly together; so he hoped that the study would open it up. “It has been treated as something quite private . . . so, with this study, I’m allowing GPs to see into each other’s consulting rooms.

“What was most impressive to me [after undertaking the study] was GPs’ deep compassion for the patients, and their pragmatism in dealing with their spiritual issues. Generally, there is a positive, curious attitude towards finding out more about spirituality.”

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