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Don’t neglect spiritual care, doctors told

12 May 2023

Denmark study suggests spirituality is important to patients


A STUDY of patients in Denmark suggests that spiritual concerns remain important to patients — and might currently be neglected by health-care professionals.

The study, which is published in the medical journal The Lancet Regional Health (Europe), is described as “a challenge to those who assume that ‘faith is dead’ in our modern world” in an independent commentary by Dr Andrew Tomkins, a member of the Joint Learning Initiative on Faith and Health, the Christian Medical Fellowship UK, and the International Christian Medical and Dental Association.

Dr Tomkins continues: “It has important implications for all governments and health-care workers with responsibility for planning health services for those facing serious or terminal illness.

“It might be uncomfortable for secular health planners to admit that spiritual care is widely wished for, could be provided in forms which provide helpful support for patients coping with illness or impending death, and may even be clinically effective. But whose interests are more important ­— our patients’ welfare, or own preconceptions?”

The Danish study was the largest study of spiritual needs to date in Denmark. It was based on a random population-based sample of 104,137 adults (aged 18 or above), 26,678 of whom responded. Of these, 19,507 (81.9 per cent) reported at least one strong or very strong spiritual need in the past month.

‘‘It's OK, Mrs Gribble: the Government has expanded the list of what we can prescribe. How many prayers do you want?’’

Four types of spiritual need were defined: religious (including prayer, turning to a higher presence, or participating in a religious ceremony); existential (for example, to be forgiven or to forgive someone, or to talk about the possibility of life after death); inner peace (such as finding a place of quiet, or talking to someone about fears and worries); and generativity needs (such as being assured that one’s life was meaningful and of value).

The Danes scored highest on inner peace needs (68.7 per cent), followed by generativity (63.3 per cent), existential (41.5 per cent), and, lastly, religious needs (17.9 per cent). Those who identified themselves as religious or spiritual, and those who pray or meditate regularly, were more likely to identify a spiritual need — as were those who were experiencing poor health, or lower life-satisfaction. Increasing age was generally associated with increased spiritual needs, except for the area of inner peace, which was more prevalent in the young.

“Our data provides evidence that, though predominantly non-religious, most Danes experience spiritual needs,” the authors of the study write.

“These findings have important implications for public health policies and clinical care,” they conclude. “Care for the spiritual dimension of heath is warranted as part of holistic, person-centred care in what we term ‘post-secular’ societies.”

An editorial in The Lancet calls for the findings of the Danish study to be taken seriously, and integrated into health care elsewhere in Europe, including care in the NHS. “Providing spiritual care to patients with serious illness has been associated with better end-of-life outcomes, and unmet spiritual needs can be associated with poorer patient quality of life and wellbeing,” it says.

“Despite these findings, spiritual needs of patients with serious illness are frequently unaddressed within medical care — estimates of patients not receiving spiritual care range from 49 to 91 per cent.”

Part of this is due to a lack of consensus around understanding what spirituality is, the editorial suggests; spirituality is often considered taboo. “Spiritual matters are rarely addressed in health care and are not considered as a critical pillar of holistic health care.”

The editorial suggests that small changes — such as taking a spiritual history in a clinical setting — could make a significant difference to patients. “This approach can then lead to referrals to a spiritual-care specialist, if needed. It is also important to understand that spiritual care can be provided despite the providers’ personal beliefs (religious, spiritual, atheist, etc.) and whether the provider shares the same beliefs as their patient or not.”

The editorial concludes: “Care for the spiritual dimension of health is warranted along with the physical, mental, and social aspects that are included under the core umbrella of the health-care system.”

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