Background:Spiritual health is an integral part of a person’s overall health. Literature supports a tie between poor spiritual health, suicide risk, and other negative health outcomes. A national shortage of mental health providers has led to an increased number of people are seeking mental health care in primary care settings. Barriers such as time and training have made it difficult for primary care providers to effectively screen for spiritual health.
Objective:The purpose of this project is to implement a focused screening and intervention program in primary care to improve spiritual health, perception of overall health, and reduce suicide risk.
Methods:The Functional Assessment of Chronic Illness Therapy-Spiritual Well Being (FACIT-Sp), which is an instrument validated for assessing spiritual distress in oncology and chronic pain management settings, was chosen to screen all same-day patients in a rural privately-owned family practice clinic. Individuals identified as experiencing spiritual distress were offered a systems-focused, multi-disciplinary intervention targeted towards reducing distress and improving health, and then followed for a period ranging from one week to two months to assess the impact of the intervention.
Results:Of the 172 patients screened 20% demonstrated scores indicating they were experiencing spiritual distress. While some individuals declined resources, 95% of those who received a targeted intervention and follow up plan reported an improvement in overall health, and the majority increased their total FACIT-Sp scores by 20% or more. Furthermore, nursing staff reported no negative impact on patient flow, and providers reported improved communication related to holistic health needs. Patient experience related to the screenings was mixed; while some patients were very grateful for being asked the information, others thought it was not an appropriate setting to be screened for spiritual distress, and a few patients reported feeling the questions were inappropriate or invasive.
Conclusion:Analysis of the improvement outcomes indicates that there is a need for routine screening for spiritual health status in primary care, but further research is necessary to develop the best approach for successful, time-efficient screening in the future.
Keywords:spiritual health, holistic, spiritual distress, primary care, systems-focused