Spirituality in Cancer Care - Screening and Assessment of Spiritual Concerns
The following are semistructured interviewing tools designed to facilitate an exploration, by the physician or other health care provider, of religious beliefs and spiritual experiences or issues. The tools take the spiritual history approach and have the advantage of engaging the patient in dialogue, identifying possible areas of concern, and indicating the need for provision of further resources such as referral to a chaplain or support group. These approaches, however, have not been systematically investigated as empirical measures or indices of religiousness or of spiritual well-being or distress.
The SPIRITual History. The SPIRIT is an acronym for the six domains explored by this tool: S, spiritual belief system; P, personal spirituality; I, integration with a spiritual community; R, ritualized practices and restrictions; I, implications for medical care; T, terminal events planning. The 6 domains are covered by 22 items, which may be covered in as little as 10 or 15 minutes or integrated into general interviewing over several appointments. A strength of this tool is the number of questions pertinent to managing serious illness and to gaining an understanding of how patient religious beliefs may bear on patient care decisions.
Faith, Importance/Influence, Community, and Address (FICA) Spiritual History. FICA is an acronym for Faith, Importance/Influence, Community, and Address, with a set of questions to explore each area (e.g., What is your faith? How important is it? Are you part of a religious community? How would you like me as your provider to address these issues in your care?). Although developed as a spiritual history tool for use in primary care settings, it would lend itself to any patient population. The relative simplicity of the approach has led to its adoption by many medical schools.
Table 1. Assessment of Religion and Spirituality in Cancer Patients
Two factors: Spiritual Growth and Spiritual Decline
Forty items. Unique to assessing change in spiritual experience post-cancer diagnosis.
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