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Religion and Spirituality

Religion and spirituality are important aspects of some patients' cultural background. These patients use prayer to help them cope and feel hopeful.

Obtaining a spiritual history may be helpful for some patients, but not all. You may use what you are comfortable with for individual patients. You might ask them:

HOPE:

H Hope, what are your sources of hope, strength, and comfort?
O Organized religion, do you consider yourself part of an organized religion?
P Personal practices, do you have spiritual beliefs? Do you believe in God?
E Effects on medical care, do you have any specific practices that I should know about?

Anandarajah G, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician. 2001 Jan 1;63(1):81-9. http://www.aafp.org/afp/20010101/81.html

FICA:

F Faith or belief -- What is your faith or belief?
I Importance and influence -- Is it important in your life? How?
C Community -- Are you part of a religious community?
A Awareness and addressing -- What would you want me, as your physician, to be aware of? How would you like me to address these issues in your care?

SPIRIT:

S Spiritual belief system -- What is your formal religious affiliation?
P Personal spirituality -- Describe the beliefs and practices of your religion or spiritual system that you personally accept/do not accept.
I Integration within a spiritual community -- Do you belong to a spiritual or religious group or community? What importance does this group have for you?
R Ritualized practices and restrictions -- Are there specific practices that you carry out as part of your religion/spirituality (e.g., prayer and meditation)? What significance do these practices or restrictions have to you?
I Implications for medical care -- What aspects of your religion/spirituality would you like me to keep in mind as I care for you?
T Terminal events planning -- As we plan for your care near the end of life, how does your faith impact on your decisions?

Maugans TA: The SPIRITual history. Arch Fam Med 1996; 5:11-16.

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