Spiritual Care Engagement Tool for Inter-Professional Staff

Section 1 – Community[1]

  • … Help me to learn about, “What supports you?” First, tell me,is there a person, group or community of people you really love or who are really important to you? Name them. Regarding each …
  • Are they currently supporting and/or helping you? How?
  • [Struggles, part 1:] Are there aspects of the relationship that, in your current situation, are not so helpful?
  • Is there disagreement (between you and them) about how to think, believe or make decisions?
  • Do feel trusting toward them?
  • Do you feel abandoned?

If the answer to any of these questions indicates struggle, provide “Summary” feedback; and consider a referral to “Spiritual and Religious Care” and/or to Social Work.

Section 2 – Meaning & Hope[2]

  • Next, tell me “deep inside” what are your personal sources of strength, meaning, hope, comfort and peace? Or, to ask another way,
  • What do you ‘hold onto’ during difficult times?, and
  • What sustains you and keeps you going?
  • For some people, certain practices are important towards strength and resilience; things like artistic expression, artistic appreciation, communing with nature, physical activity, meditation, prayer, reading scripture, studying religious/cultural tradition(s), attending religious services, and/or relationships within faith or cultural community; is this true for you?
  • If “Yes”, then,“What is on your list of such practices? … Your list is what we together are going to call, and think about, as your ‘spiritual practices’.”
  • For some people, their religious or spiritual beliefsare important resources; is this true for you?
  • If “Yes”, then,“Describe (or name), for me, your religious or spiritual community or tradition.”
  • If “No” for both the previous two questions, thenomitSection3and proceed to Section 4.

Section 3 – Personal Spirituality / Religious practices1

  • Is there something from your list of “spiritual practices”[Section 2, question 2] that you are ‘most missing’ because of your (medical) situation?
  • Can some of your “spiritualpractices” be done here?
  • Is there anything you need ‘from us’ to do so?
  • What influence do your faith/belief/spiritual practiceshave, in general, on how you take care of yourself? And how have theyshaped your thinking-and-feelings-and-actions during this illness?
  • Are you worried about any conflicts between your beliefs-and-practices on the one hand and your medical situation/care/decisions on the other?
  • Are there any specific religious or spiritual restrictions we should know about in providing your medical care (e.g., dietary restrictions, use of blood products, …)
  • [Struggles, part 2:] Are any of the following statements currently true, for you?...
  • I am having doubts about my faith/beliefs/practices.
  • I am not sure what I believe anymore.
  • I somehow keep doing other than what-I-know-I-ought-to-be-doing.
  • I feel guilty about the way I think, feel or act.

If the answer to any of these questions is “Yes”, provide “Summary” feedbackand consider a referral to “Spiritual and Religious Care”.

Section 4– Struggles[part 3][3]

  • In the midst of your current (medical) situation …
  • Does it sometimes seem to you like you are being “punished”?
  • [If so, by what?, or whom?]
  • Do you feel angry for what is happening to you?
  • Do you feel alone?
  • Does it feel like you’ve let someone (or something) down?
  • Do you wrestle with whether-or-not you“measure up” and are loved?
  • Do you ever think that ‘evil’ is somehow involved?
  • Do you ever ask, “Why?”; or, in other words, “What is the meaning or purpose of this (medical) situation?”

If the answer to any of these questions is “Yes”, provide “Summary” feedback; and consider a referral to “Spiritual and Religious Care”.

______

  • If the patient is palliative: How do your way of thinking and your normal life-practices affect the kind of care you want to receive from now till your end-of-life?

______

  • Having pondered all these questions, would it be useful to speak with a spiritual care specialist (i.e. someone on our staff here)?, or (if you have one) with a leader of your own religious/spiritual/cultural community?

If so, then please forward the patient’s self-referral.

Niagara Health System – Rev. Bob BondMarch 26 2015Page 1

[1]Adapted from Anandarajah and Hight (see footnote 2) and Pargament (see footnote 3) plus Puchalski and Romer, “Taking a Spiritual History Allows Clinicians to Understand Patients More Fully”, Journal of Palliative Medicine, vol 3, No 1, 2000, pp 129-137

[2]Adapted from Anandarajah and Hight, “Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment”, American Family Physician, Vol 63, No 1, January 2001, pp 81-88. The HOPE Tool itself is copyrighted © 2001 by the American Academy of Family Physicians.

[3]Adapted from Kenneth I. Pargament, Spiritually Integrated Psychotherapy: Understanding and Addressing the Sacred (The Guilford Press, 2007), pp. 211-219