Spiritual Assessment

Clinic A/P, adults, Hospital A/P, Adults, Hospital A/P, Peds

-ICD -10 Code: Z71.81 Spiritual or Religious Counseling
-Use a trusted tool like the FICA Spiritual History Tool or HOPE Questions for Spiritual Assessment.
-“A recent review of more than 1,200 studies of religion and health reported that at least two-thirds of the studies evaluated had shown significant associations between religious activity and better mental health, better physical health or lower use of health services.” AFP 2001
-The spiritual assessment can be performed by the physician.

 

 

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Pearls
The Joint Commission for Hospital Accreditation now requires a patient spiritual assessment upon hospital admission.

“Physicians should be aware of the role that religion plays in how patients cope with illness. Anxiety, depression, and loss of hope may complicate the course of many diseases, interfering with compliance, self-care activities and motivation toward recovery. Scientists are only now beginning to discover the powerful effects that the mind and social relationships can have on physiologic processes, especially cardiovascular, neuroendocrine and immune function.3,4Religious beliefs and practices are one method that patients use to modulate emotional distress during illness.” AFP 2001

HOPE questions

The HOPE concepts for discussion are as follows:

  • H—sources of hope, strength, comfort, meaning, peace, love and connection;
  • O—the role of organized religion for the patient;
  • P—personal spirituality and practices;
  • E—effects on medical care and end-of-life decisions.

Another method for doing a spiritual assessment is the FICA questions.

FICA Questions

  • F–Faith, Belief, Meaning. Do you have spiritual beliefs that help you cope with stress? What gives your life meaning?
  • I–Importance and Influence. Do your beliefs influence how you take care of yourself when you are ill?
  • C–Community. Are you part of a spiritual/religious community? Does this community support you? If so, how?
  • A–Address in care; Action in Care. How would you like me to address these issues in your health care?

 

References

  • Am Fam Physician. 2012 Sep 15;86(6):546-550. http://www.aafp.org/afp/2012/0915/p546.html (The Spiritual Assessment)

  • Am Fam Physician. 2006 Nov 15;74(10):1684-1685. http://www.aafp.org/afp/2006/1115/p1684.html

  • Am Fam Physician. 2006 Apr 15;73(8):1336-1337. http://www.aafp.org/afp/2006/0415/p1336.html (Religion, Spirituality, and Their Relevance to Medicine: An Update)
  • Am Fam Physician. 2001 Jan 1;63(1):81-89. http://www.aafp.org/afp/2001/0101/p81.html  (Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment)
  • Am Fam Physician. 2001 Jan 1;63(1):30-33. http://www.aafp.org/afp/2001/0101/p30.html (Spiritual Assessment in Medical Practice).
  • Spirituality and Faith on Familydoctor.org
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