The video also reminded me of two different spiritual encounters with clinicians shared with me by some friends. The first happened recently. My husband and I were visiting a friend in the hospital when they shared this story with us. Her husband was in a coma but every morning she and her children would have devotions with him. There was one nurse who would be in the room during this time and she was usually silent and respectful during their worship times. One morning the family’s devotion time was focused on the story of Shadrach, Meshach, and Abednego and how they stood up to a King who was trying to force them to worship a god they didn’t believe in, even at the risk of death. 

The nurse listened silently to the story and each family member’s comments on the lesson of the story. To the family’s amazement, she shared her perspective on the story, which basically was that she was impressed that they trusted God even though they were very close to death. And without directly saying so, they felt that lesson was for them too, as my friend's husband was on life support and passed a few days later. My friend really appreciated her thoughts and that she expressed an interest in that personal aspect of their family life.  It seems that nurse was spiritually assessing the family during the previous worship times and calculated an appropriate time to talk about spirituality with them. I was impressed by this.

The next story happened some years ago, before the death of another friend’s father. He was in the hospital and his family had gathered to say goodbye to him. As they were doing so, among tears and feeling very sad, a nurse came in. She looked over the group and cheerily told them not to be sad because when he dies, he could still come to visit them. She then went on to share a story of how when her brother died, he started visiting her. My friend’s family was put off by her complete disregard for their pain and further, her beliefs on death and what happens when you die was at complete odds with what they believed. It’s important to be emotionally aware of your patients and to never impose your beliefs on them. You might feel you have words of healing but the timing or the context might not be appropriate. As clinicians/healthcare workers we should be observant to the cues our patients give us. 

“ God may indeed exist, and prayer may indeed heal; however, it appears that, for important theological and scientific reasons, randomized controlled studies cannot be applied to the study of the efficacy of prayer in healing. In fact, no form of scientific enquiry presently available can suitably address the subject. Therefore, the continuance of such research may result in the conducted studies finding place among other seemingly impeccable studies with seemingly absurd claims (Renckens et al.[42] 2002) ¹” .

Spirituality does not merely co-exist with our interactions and interventions. It is the background and the basis for who we are. Knowing, experiencing and gratitude, I feel would be much better measures ( if we may use such a term) of the boundless, than trying to box it in numericals and statistics.

References:

1)      Andrade C, Radhakrishnan R. Prayer and healing: A medical and scientific perspective on randomized controlled trials. Indian Journal of Psychiatry. 2009;51(4):247-253. doi:10.4103/0019-5545.58288.

 

While I would not agree that God is indifferent to humanity, I would agree that he transcends human limitations and is not subject to human processes.  I feel the study would be restricted if prayer was considered a process where humans dictated to God their desires with the full expectation that God would respond in each situation according to the will of man. 

 

“The aim of science is not to open a door to infinite wisdom but to set a limit to infinite error”. - Attributed to Galileo (Andrade & Radhakrishnan, 2009).

 

 

Andrade, C., & Radhakrishnan, R. (2009, Oct-Dec). Prayer and healing: A medical and scientific perspective on randomized controlled trials. Indian Journal of Psychiatry, 51(4), 247-253.

 

 

 

Informal spiritual assessment may be accomplished at any time during the medical encounter but the formal one has to be specified and asking specific questions during the medical assessment or first visit to determine if the patient has spiritual background could affect the health care plan and  outcome or not.

The informal spiritual assessment involves the listening carefully to the patient’s stories first regarding to the illness or live as a general then interpreting the spiritual issues, but for the formal one, the patient has to answer some questions in different formats for conducting a formal spiritual assessment.

Sometimes, there are some clues will reflect the struggling of the patient with spiritual issues such as search for meaning, feelings of connection versus isolation, hope versus hopelessness, fear of the unknown, this a kind of informal spiritual assessment findings.

 

I prefer the informal spiritual assessment first to figure out if my patient is willing to cooperate and interesting in conducting this kind of the assessment regarding to his/her religion of his/her spirituality , then if the patient feels comfortable and starts to open up to me, then the next step is the formal assessment to be easy for me as a medical provider and for him to feel comfort toward these kind of the questions related to the inner background of religions or spirituality.

And to these questions I found a witty but a sensible answer which is given below.

Of course God does value our beliefs as well as our merits, and God is definitely compassionate to treat us with love and shower his mercy upon those who ask for forgiveness. We should believe that God will do justice to all of us and without any hesitation we should put all our faith and trust in his eternal power.

I knew that meditation and prayer have health benefits, now its time to really focus on educating my patients on these areas with empathetic fashion. Take home message for me after watching that video was raising spiritual awareness by giving positive response to patients after carefully listening to them with good heart, try not to turn down their spiritual pain questions, putting the ball in patients court itself and focus on patient not on the pathology or diagnosis.

As we are in health care, how many of us know to meditate, I would assume very minimal. First of all, we should realize and feel the benefit to integrate in our practice. For this we need proper training in these areas. In modern medicine they call it as alternative medicine, I think everyone in health care should start integrating this in every day’s practice. As an example, we all knew that exercise and hypertensive medication in combination will help in reducing higher blood pressure, similarly Meditation also helps in reducing blood pressure, but how many of Physician encouraging meditation for their patients. My point here is due to lack of self-realization and efficient training on these areas costing a lot in chronic illness. 

After this spirituality class, for sure I will start going to temple as often as possible to teach my kid about religion and its core values, I hope that will bring inner peach in our life.

 

Seven techniques were presented that are helpful and healing. Spiritual healing incorporates: Intellectual awareness of spirituality by using restatement, openness, storytelling techniques; emotional awareness of spirituality by asking open questions about feelings and reflection of feeling; body awareness of spirituality using body listening and some religious practices. Human needs include meaning and purpose, the need to transcend self, healthy relationships, and being true to self.    

 

Healing techniques incorporates letting the patient talk with little interruption while trying not over talking or interjecting personal perspectives. The use of open questions allows the patient to clarify and explore thought or feeling. Use open question sparingly. Reflective feeling uses word like “I am disappointed or” maybe you feel like a flower that has not blossom”. Self-disclosure – do not disclose to gratify your needs but access why they are asking, i.e. always return the ball in the patent’s court. Keep disclosure short. Do not side step the patient’s issues, use story listeners – help patient connect to the present and privately consider questions that will help the patient. Taylor also encouraged the use religious practices using ethical guidelines. Understand your own wishes and beliefs and participate in the patient’s religious practice only if fits with your beliefs. Respect the patient’s wishes as JACHO mandates asking the patient spiritual questions in support with their religious practices. Summarize techniques to help patient gain awareness of their spirituality. Finally, remember that compassion can compensate for talking techniques and remember that there is a power greater than self that does the healing. 

 

Reference

Johnston-Taylor, E. (2007). Templeton Foundation Press 2007

Where does this leave us? God may indeed exist and prayer may indeed heal; however, it appears that, for important theological and scientific reasons, randomized controlled studies cannot be applied to the study of the efficacy of prayer in healing. In fact, no form of scientific enquiry presently available can suitably address the subject. Therefore, the continuance of such research may result in the conducted studies finding place among other seemingly impeccable studies with seemingly absurd claims (Renckens et al.[42] 2002). Whereas we have attempted to be scientifically and politically correct in our critique, other authors, such as Dawkins,[43] have been humorous, nay even scathing, in their criticism.

The aim of science is not to open a door to infinite wisdom but to set a limit to infinite error (attr., Galileo[44])."

Meditation on the other hand, has shown to reduce blood pressure, reduce heart rate and improve the immune system. It also helps reduce stress and depression. 

            One important thing from the video was to create a spiritual awareness in patients.

Inner peace can often be found in places where we find comfort. Temples are often seen as an architectural marvel, but they are also spiritual centres built in a way that one can connect the spiritual core as one with the God, becoming one with them.

I think incorporating HOPE assessment could be a great way of including spiritual assessment for appropriate patients.

                                     -Rebecca O'Donnell

Prayer is not demanding that God do for me what I will not do for myself (paraphrased from Thomas Merton- Catholic writer). Prayer is uniting my mind and heart to God. Koenig describes a positive correlation with religiousness and better cardiac markers. Maybe that’s the better question.

The article on prayer research revealed different results on the effectiveness of prayer. However the conclusions drawn from the study agrees with what Dr Anandarajah which says science cannot fully understand some things in spirituality. we should keep an open mind to research and explore more of the positive advantages that spirituality brings to health.