By Dr Attia Anwar
Being a doctor there is a question that haunts almost every compassionate doctor, where do biology, morality, literature, and philosophy intersect? A poet Walt Whitman tried to understand the physiological spiritual man in 1860. So it is an ancient concept and people have been trying to understand the complex interaction of factors that affect a patient’s health and symptoms for a long time. It is not very recent or new but it is as relevant today as then.
The biopsychosocial model of patient care is also not a new concept and is very important. We have been using it for quite some time. It describes the complex interaction of physiological, social, and emotional factors in the disease process and how it affects the patient. It enables us to understand the patient and the cause of his illness. It also helps us to manage the patient, as we have a clear concept of what the patient can do and what is difficult for him. But in this model, we miss an essential aspect of well-being, especially in seriously ill patients and that is spirituality. Both physician and patient steer away from this because they think they only believe in pure science and logic. However, this aspect can be thoughtfully and respectfully included in the consultation.
Many studies have documented spirituality will improve the outcome of patient
If you become comfortable about this aspect of life your patients healing and recovery are greatly improved. The bio-psychosocial model was made to have a comprehensive approach toward health and well-being. However recently we recognized that disease especially mental health is a complex interplay of genetic, physiological, social, environmental, and emotional aspects. If we do not include a spiritual aspect in it, it will not be a holistic model. Spiritual beliefs, experiences, and practices influence individual health and well-being. If we include this aspect, care will be more comprehensive and patient-centered. Many studies have documented spirituality will improve the outcome of patient in the face of adversity. It helps them to cope in a better way with disability. It improves healing and sometimes miracles can happen. It helps them to adjust to significant life changes. By acknowledging the spiritual dimension we can address the full spectrum of human experience. This approach will make sure that all aspects of care for the patients are considered. This model is a humanistic and holistic view of human beings.
It is a complete understanding of the complex interaction of biological, social, and psychological domains of a person’s life. To get all the benefits we have to make a therapeutic alliance with the patient. We should develop our rapport before asking sensitive personal questions. If we fail to do so, this can be counterproductive. It should be an ongoing process that continues to develop with multiple interactions. As I always stress about having your doctor. It will take some time to develop trust and bond before the patient wants to open up about all aspects of disease and well-being. The patient should be educated about the interaction of all factors and their wishes should be respected. As to some people, it seems to be invasive. It should be very carefully explained to the patient, the purpose of assessment and that should be supported by scientific facts. The needs of the patient should be given priority over the needs of anybody else.
We as a human are not one-dimensional. We are not just a set of separate compartments or separate systems. One thing happening in our body affects other things. It has been proved far from doubt now that our body is integrated and cannot be compartmentalized. That is why we need a holistic and integrated approach. We should know about the career situation, social context, belief system, stage of life, and biological health while dealing with the symptoms of patients. Biological health should be considered carefully because it is not sometimes all in your head situation. Patients having anxiety and depression can have thyroid problems or other hormonal disorders. It is important to know whether the patient is exercising or not if yes, which type of exercise are they doing. What do they do in their leisure time what are family dimensions? Do they have leisure time or not? What is their belief system? Belief systems can be detrimental to health in a few cases. In many cases, the same belief system can be a source of strength for patient and family. Doctors should have the ability to openly navigate the belief system without judging them.
Apart from religious activities, people can experience spirituality through relationships, nature, and art
It is particularly important in cases where they have tried everything and do not know what to do next. At this point, if the doctor is able to get some revelation, he can help the patient to find the root cause of symptoms and sometimes able to fix them. There is no disease-specific approach for caring for patients with serious illnesses. As far as spiritual needs are concerned they should be based on individual needs rather than type of disease.
Patients take prayer as a powerful tool for assistance and healing. Apart from religious activities, people can experience spirituality through relationships, nature, and art. This should be successfully integrated into patient care. Patients should be allowed to spend time with friends and family. Flexibility should be exercised in this domain rather than constraints like visiting hours. This domain of care is not the responsibility of only religious scholars. Every healthcare provider should understand the importance of mind-body connections. They should understand the power of healing touch. Spiritual care is not intended only for the person with specific religious beliefs, rather it should be universally for everyone. Each of us expresses our spirituality in our own unique way.it is about connecting with something bigger than ourselves. It brings meaning, purpose, and connection to our life. It buffers the effect of stress and fosters a sense of hope in our lives.
On the whole, it is backed by scientific research that people having spiritual connections in any way have better mental health. These practices increase well-being and happiness. People who are spiritually inclined will cope with stressful situations in a better way. Moreover, certain practices increase social connections and belonging. So if we can understand the value and practice in a balanced way we can enjoy its advantages.
The author Dr. Attia Anwar is a consultant family physician with a postgraduate degree from the Royal College of GP UK. She is a strong advocate of health and well-being and wants patient participation in decision-making regarding health.
