Spirituality refers to the unique and universal component of human experience that originates from the inner subjective awareness of an individual (Seddigh, Keshavarz-Akhlaghi, & Azarnik 2016). Spirituality is distinct from religion in that religion deals with the pre-determined institutionalized system of attitudes, beliefs, and practices. Individuals are made up of both physical and spiritual dimensions. Spirituality provides a mechanism through which patients cope with and manage symptoms such as pain, anxiety, and depression.
Spiritual assessment refers to the process used by healthcare practitioners to identify a patient’s spiritual needs. This is important since it affects the healthcare outcome, decisions, and assists in the identification of barriers to the use of spiritual resources. A recent study estimated that about 86 percent of the patients in the USA believed in God while 78 percent considered religion as an important aspect of their life. Studies also indicate that 94 percent of the patients highly perceive the need for enhancing spiritual health. 40 percent of patients have been noted to rely on faith in dealing with illness with 25 percent of a patient using prayers for healing every year (Larimore, 2015). This paper will entail the analysis of a spiritual assessment interview of a patient using FICA spiritual assessment tool.
FICA Spirituality Assessment Tool
FICA tool is a feasible tool for carrying out a clinical assessment on spirituality. It offers a means through which clinicians can efficiently integrate open-ended questions when conducting a clinical assessment of spirituality (Vermandere, et al, 2012). The parts covered by the FICA tool include Faith, Importance & Influence, Community, and Address in care (LaRocca-Pitts, (2012).
For the interview, the patient suffered from kidney failure. Both of the patient’s kidneys are affected, thereby making dialysis a permanent treatment option. Doctors have recommended having a kidney transplant if a compatible donor is found.
Do you consider yourself spiritual or religious?
I consider myself as both religious and spiritual. I am a Christian and believe in God as the creator of the universe and sole provider.
Have your beliefs influenced you in how you handle stress?
I use the scriptures as the best component of my Christian beliefs and practices that help me deal with stressful situations. My favorite Biblical quote that I believe in and helps me overcome stress is 1 Peter 5:7 that states that, “Cast all your anxiety on Him, because He cares for you.”
On a scale of 0 (not important) to 5 (very important), how would you rate the importance of faith/belief in your life?
I would rate the importance of faith to me as a 5. My belief in this comes from the teachings of Jesus where He continuously taught that for the people that He healed, it was their faith that helped in their healing. It is faith that had made Peter walk on water but when he doubted, he started sinking.
Are you part of a spiritual religious community and how does it offer support to you?
I am a member of the First Baptist Church. The church community has been a great pillar through my journey of dealing with this disease. They have held prayer sessions with me, visited me while I was admitted to the hospital, contributed financial resources, and with some even offering to donate their kidney. I am grateful for all the support that they have offered me.
How would you like your healthcare provider to use this information about your spirituality as they care for you?
I would like the healthcare providers to use the information on my spiritual beliefs to influence the manner in which they offer realistic hope, provide medical advice, and change medical treatment. I would also want the healthcare providers to understand that based on my religious beliefs, euthanasia is not an option and should not even be recommended to either my family or myself.
What Went Well?
The use of open-ended questions as recommended by the FICA spiritual assessment tool was a very effective way of having the patient speak up and be open about their spiritual beliefs. The patient was able to provide comprehensive information about his spiritual beliefs. He was able to offer clarity on his personal mechanisms of dealing with stress. The questions helped the patient express himself freely concerning their beliefs based on Christianity.
What to Do Differently in Future
I felt that I might have limited the time to carry out the interview. In future, I may want to allocate more to time to ensure that the patient provides a comprehensive account of their spirituality. One thing that might help in bringing this out is to allow the patient to share the experiences that they had had in their spiritual journey. It is from such narrations that one may pick up important cues.
Barriers and challenges
Among the challenges that I encountered in conducting this interview was the tendency of the patient to get emotional during the discussion on religious issues and deviate from the topic of the question. This made me keep re-emphasizing and repeating the question to ensure that the patient offered the exact answer that was in line with the FICA spiritual assessment tool. This contributed to another barrier on time. Time scheduled for conducting the interview seemed to be limited as the patient had much to express and bring out about their spirituality aspect of life. Another challenge that I found when conducting this interview was on maintaining the conversation to be centered towards the patient. In a few occasions, I found myself carried away by discussions on religious matters and seemingly acted in a prejudiced manner based on my personal spiritual beliefs.
How to Address the Challenges in Future?
I believe that I can carry out the interview much better and in a manner that overcomes the barriers and challenges that I encountered. I would first ensure that I make every intentions and purpose of the interview clear to the patient. This would be helpful in maintaining the discussion on the course of spiritual assessment issues only. I would ensure that I inform the patient in advance the time allocated for the interview and the estimated time expected to be taken for each question. This would ensure that the interview is carried out in a seamless manner and with enough time granted to the patient to offer answers to their satisfaction. Avoiding prejudice would require me to handle the interview with an open mind and in full realization that is not just a discussion on the religious matter but rather an assessment meant to establish the spiritual status of the patient.
I was moved by the patient’s faith and reliance on the Biblical scriptures. He was able to recite a number of verses that cleared indicated his faith in God in dealing with such stressful situations. The patient sang a number of hymns, all based on the different scriptures. He was livened up to hear me sing along with him. This was clearly an effective way for the patient to calm down. During the interview, the patient indicated that he was prayerful and even requested that I lead in a word of prayer after the session. These were clearly the aspects of spirituality care, which the patient would have needed to attain spiritual health.
Ability of the Tools to Meet the Needs of the Patient
Using the FICA spiritual assessment tool, I was able to establish the patients’ spiritual needs. This point to the fact the tool was effective in meeting the needs of the patient. The questions from the tool made the patient open up and express their perception and foundation of spirituality. Through the tool, the patients also gave information that will be very helpful to the healthcare providers as they develop the care plan for the patient.
How did the Illness and Stress Amplify the Spiritual Concerns and Needs of the Interviewee?
The kidney failure that the patient suffered from seemed to help increase the patient’s faith in God. It was clear that the interviewee had the utmost trust in the healing power of God. It was clear that even the patient viewed life as a sacred gift from God as he emphasized his objection to euthanasia.
Notably, spirituality refers to the unique and universal component of the human experience that originates from the inner subjective awareness of individuals. It is essential that healthcare providers carry out the spiritual assessment to ascertain the spiritual health of the patients. FICA spiritual assessment tool is among the tools used for patients’ spiritual assessment. The parts covered by the FICA tool include Faith, Importance & Influence, Community, and Address in care. The use of open-ended questions as recommended by the FICA spiritual assessment tool was effective in helping the patient open up about their spirituality status. Through the interview, the patient emphasized his faith and trust that God would heal his disease. The patient also indicated that he valued life as a gift from God and was therefore against Euthanasia.
Larimore, W. (2015). Spiritual Assessment in Clinical Care. Christian Medical and Dental Associations. Christian Medical & Dental Associations. Retrieved from: https://www.cmda.org/resources/publication/tcd-spring-2015-spiritual-assessment-in-clinical-care-part-1
LaRocca-Pitts, M. (2012). FACT, a chaplain’s tool for assessing spiritual needs in an acute care setting. Chaplaincy Today, 28(1), 25-32.
Seddigh, R., Keshavarz-Akhlaghi, A. A., &Azarnik, S. (2016). Questionnaires Measuring Patients’ Spiritual Needs: A Narrative Literature Review. Iranian journal of psychiatry and behavioral sciences, 10(1), 1-8.
Vermandere, M., Choi, Y.-N., De Brabandere, H., Decouttere, R., De Meyere, E., Gheysens, E., … Aertgeerts, B. (2012). GPs’ views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study. The British Journal of General Practice, 62(603), e718–e725.
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