Incorporation of spiritual care as a component of healthcare and medical education: comparison of Sub-Saharan African and Northern European viewpoints

Main Article Content

David Bell
Timothy Atkinson
Christopher Philip Agnew
Mark Thomas Harbinson

Abstract

This study addresses cultural differences regarding views on the place for spirituality within healthcare training and delivery. A questionnaire was devised using a 5-point ordinal scale, with additional free text comments assessed by thematic analysis, to compare the views of Ugandan healthcare staff and students with those of (1) visiting international colleagues at the same hospital; (2) medical faculty and students in United Kingdom. Ugandan healthcare personnel were more favourably disposed towards addressing spiritual issues, their incorporation within compulsory healthcare training, and were more willing to contribute themselves to delivery than their European counterparts. Those from a nursing background also attached a greater importance to spiritual health and provision of spiritual care than their medical colleagues. Although those from a medical background recognised that a patient’s religiosity and spirituality can affect their response to their diagnosis and prognosis, they were more reticent to become directly involved in provision of such care, preferring to delegate this to others with greater expertise. Thus, differences in background, culture and healthcare organisation are important, and indicate that the wide range of views expressed in the current literature, the majority of which has originated in North America, are not necessarily transferable between locations; assessment of these issues locally may be the best way to plan such training and incorporation of spiritual care into clinical practice.

Article Details

How to Cite
Bell, D., Atkinson, T., Agnew, C. P., & Harbinson, M. T. (2015). Incorporation of spiritual care as a component of healthcare and medical education: comparison of Sub-Saharan African and Northern European viewpoints. The International Journal of Whole Person Care, 3(1). https://doi.org/10.26443/ijwpc.v3i1.100
Section
Empirical Studies
Author Biographies

David Bell, Centre for Medical Education The Queen's University of Belfast

Senior Lecturer in Therapeutics and Pharmacology/ Advisor of Studies (Medicine), Centre for Medical Education, QUB

Timothy Atkinson, UK National Health Service

Foundation Year 2 Doctor

Christopher Philip Agnew, UK National Health Service

Foundation Year 2 Doctor

Mark Thomas Harbinson, Centre for Medical Education The Queen's University of Belfast

Senior Lecturer in Cardiology/Consultant Cardiologist

References

WHO, 1946. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948 [Internet]. Available from: http://www.who.int/about/definition/en/

print.html.

Larson JS. The World Health Organization's Definition of Health: Social versus Spiritual Health. Social Indicators Research. 1996;38:181-92.

Department of Mental Health & Substance Dependence World Health Organization. WHOQOL-SRPB Field–test instrument [Internet]. Geneva, Switzerland; 2002 [cited 2012 Aug 6]. Available from: http://www.who.int/mental_health/media/en/622.pdf.

Speck P, Higginson I, Addington-Hall J. Spiritual needs in health care. BMJ. 2004;329:123–4.

Fisher JW. Spiritual health: its nature and place in the school curriculum. The University of Melbourne Custom Book Centre; 2011.

Sheldon M. What is whole person health care? [Internet]. England; 2008 [cited 2012 Sept 10]. Available from: http://www.wholecare.org/Other%20pages/wholeperson.html.

Anandarajah A, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment Am Fam Phys. 2001;63:81-9.

King DE, Bushwick B, Beliefs and attitudes of hospital in-patients about faith, healing and prayer. J Fam Pract. 1994;39:349-52.

MacLean CD, Susi B, Phifer N, Schultz L, Bynum D, Franco M et al. Patient preference for physician discussion and practice of spirituality. J Gen Intern Med. 2003;18:38-43.

Silvestri GA, Knittig S, Zoller JS, Nietert PJ. Importance of faith on medical decisions regarding cancer care. J Clin Oncol. 2003;21:1379–82.

Larimore WL, Parker M, Crowther M. Should clinicians incorporate positive spirituality into their practices? What does the evidence say? Ann Behav Med. 2002;24:69-73.

Luckhaupt SE, Yi MS, Mueller CV Mrus JM, Peterman AH, Puchalski CM et al Beliefs of primary care residents regarding spirituality and religion in clinical encounters with patients: a study at a midwestern U.S. teaching institution. Acad Med. 2005;80:560–70.

Goldfarb LM, Galanter M, McDowell D, Lifshutz H, Dermatis H. Medical student and patient attitudes toward religion and spirituality in the recovery process. Am J Drug Alcohol Abuse. 1996;22(4):549-61.

Abbott RB, Hui KK, Hays RD, Mandel J, Goldstein M, Winegarden B et al. Medical student attitudes toward complementary, alternative and integrative medicine. Evidence-Based Complementary and Alternative Medicine, vol. 2011, Article ID 985243, 14 pages, 2011. doi:10.1093/ecam/nep195.

Chibnall JT, Duckro PN. Does exposure to issues of spirituality predict medical students’ attitudes toward spirituality in medicine? Acad Med. 2000;75:661.

General Medical Council. Tomorrow’s Doctors: Outcomes and standards for undergraduate medical education. London; 2009.

Randall D, Goulding N. Centre for Excellence in Teaching and Learning, Barts and the London School of Medicine and Dentistry [Internet], 2007 [cited 2012 Sept 12]. Available from: http://www.cetl.org.uk/spiritual_project/Randall%20and%20Goulding.html.

Neely D, Minford EJ. Current status of teaching on spirituality in UK medical schools. Med Educ. 2008;42:176–82.

Bell D, Harbinson M, Toman G, Crawford V, Cunningham H. Wholeness of healing: an innovative student selected component introducing UK medical students to the spiritual dimension in healthcare. SOUTH MED J. 2010;103:1204-9.

Fegg M, L’Hoste S, Brandstatter M, Borasio GD. Does the working environment influence healthcare professionals’ values, meaning in life and religiousness? Palliative care units compared with maternity wards. J Pain Symptom Manage. 2014;48:915-23.

Anandarajah G, Roseman JL. A qualitative study of physician’s views on compassionate patient care and spirituality: medicine as a spiritual practice? Rhode Island Med J. 2014;17-22.

McEvoy M, Burton W, Milan F. Spiritual versus religious identity: a necessary distinction in understanding clinician’s behaviour and attitudes toward clinical practice and medical student teaching in this realm. J Relig Health. 2014;53:1249-56.

Lucchetti G, Lucchetti ALG, Puchalski CM. Spirituality in medical education: global reality? J Relig Health. 2012;51:3-19.

Graves DL, Shue CK, Arnold L. The role of spirituality in patient care: Incorporating spirituality training into medical school curriculum. Acad Med. 2002;77:1167.

Fortin AH, Barnett KG. Medical school curricula in spirituality and medicine. JAMA. 2004;291:2883.

Lie D, Rucker L, Cohn F. Using literature as the framework for a new course. Acad Med. 2002;77:1170.

Montgomery K, Chambers T, Reifler DR. Humanities education at Northwestern University’s Feinberg School of Medicine. Acad Med 2003;78:958-62.

Lypson ML, Hauser J. Talking medicine-a course in medical humanism. Acad Med. 2002;77:1169-70.

Anandarajah G, Craigie F, Hatch R. Kliewer S, Marchand L, King D et al. Toward competency-based curricula in patient-centered spiritual care: recommended competencies for family medicine resident education. Acad Med. 2010 Dec;85(12):1897-904. doi: 10.1097/ACM.0b013e3181fa2dd1.

Puchalski CM, Blatt B, Kogan M, Butler A. Spirituality and health: the development of a field. Acad Med. 2014;89:10-6.

Harbinson MT, Bell D. How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum? BMC Med Educ. 2015;15:96.

Northern Ireland Census Data: Religion [Internet]; 2011 [cited 2015 Feb 28]. Available from: http://www.ninis2.nisra.gov.uk/public/pivotgrid.aspx?dataSetVars=ds-2511-lh-44-yn-2011-sk-136-sn-Census%202011-yearfilter.

European Union: European Commission. Discrimination in the EU in 2012 [Internet].

Special Eurobarometer, 383; 2012 [cited 2015 Feb 28]. Available from: http://ec.europa.eu/

public_opinion/archives/ebs/ebs_393_en.pdf.

European Union: European Commission. Special Eurobarometer, biotechnology, page 204.

Fieldwork: Jan-Feb 2010 [cited 2015 Feb 28]. Available from: http://ec.europa.eu/public_opinion/

archives/ebs/ebs_341_en.pdf.

Guck TP, Kavan MG. Medical student beliefs: Spirituality’s relationship to health and place in the medical school curriculum. Med Teach. 2006;28:702-7.

General Medical Council. Guidance on personal beliefs and medical practice [Internet].

London; 2013 [cited 2015 Feb 28]. Available from: http://www.gmc-uk.org/static/documents/content/

Personal_beliefs_and_medical_practice.pdf.

Nick Constable. Nurse suspended for offering prayer gives her first interview [Internet]. Daily Mail; February 7, 2009 [cited 2015 Feb 28]. Available from: http://www.dailymail.co.uk/news/article-1138624/Exclusive-The-nurse-suspended-offering-prayer-gives-interview.html.

Daily Mail. Doctor who prescribed faith in Jesus fights for his job [Internet]. May 23, 2011 [cited 2015 Feb 28]. Available from: http://www.dailymail.co.uk/news/article-1389675/Christian-doctor-prescribed-faith-Jesus-fights-job.html.