Indispensability of Spiritual Assessment of Patients

Spiritual Assessment

The Joint Commission on Accreditation of Healthcare Organization (JCAHO, 2008; JCAHO, n.d.) recognizes the importance of the spiritual component of a patient's evaluation. It covers his ways of coping, prayer life and religious practices, which make his life meaningful. This component, therefore, becomes an indispensable aspect of his total health care (JCAHO, JCAHO).

Part of the chosen spiritual assessment of the sample patient is composed of the following questions:

How does the patient visualize his spiritual life?

Is the patient contented or happy with his spiritual reputation?

How does he cope with a sense of guilt?

What is his and his wife's spiritual status in the community?

What is his spiritual dilemma that creates psychosomatic symptoms?

Assessment Findings

The male patient will be 54 years old in three months' time, a second-highest ranking official in the largest private coconut-growing coconut entity in Florida. He has worked at this company for 23 years and climbed the ladder to his current post with sustained efficiency and sense of duty. He is an agriculture graduate who prepared for his position. His wife and their only son, now 20 years old, are as educationally equipped as he. Three months ago, he consulted with a general practitioner in a hospital near his residence for a strange-looking mole right beside his right nostrils. A biopsy revealed a malignancy and it was immediately removed on outpatient basis. But a month later, he complained of vague uneasiness, mental lapses, insomnia and general malaise, which robbed him of sleep and his usual energy at work for successive days and nights. An executive check-up showed that he was relatively in good health, except for a fluctuating blood pressure and blood sugar level, which are now subjected to medication. The overall condition of infirmity has persisted.

Discoveries

The patient is described by fellow managers and employees as a fun-loving person. He is also an active leader is a spiritual fellowship organization in his locality. He and his wife are greatly admired in these places. He described his prayer life as regular and that they are born-again Christians. The male patient confided that he is very careful about his image in his organization and in his community. He and his wife are regarded as an ideal couple. But receiving much assurance of confidentiality, he intimated that he had met a woman at their office who conducted a research on a graduate paper on coconuts. He found her very attractive and felt a deep desire for her, which he could not keep to himself. They talked for some time and at another time, they went out to dinner. In that dinner, they confessed to having a deep desire for each other.

What Went Well?

The patient is not the type who expresses himself spontaneously. He does not make the first move. He has a sense of superiority because of his professional achievement and reputation in the business and in his community. The high level of spirituality attributed to him and his wife as regular church goers and avid donors in church gives him the feeling of being spiritually superior.

What Would You Do Differently in the Future?

A patient's spiritual evaluation heavily leans on his belief in immortality, in God and the life hereafter. His conduct is shaped by these beliefs. If his conduct violates them, he develops conflict, which medicines and medical procedures cannot correct. In diagnosing a patient in the future, his spiritual convictions should be included and used as guide in his overall progress and prognosis.

Barriers to the Assessment Tool

The patient's huge attraction for the girl, who at first, was innocent of his interest and resisted it, violated his professed spiritual convictions about fidelity and holiness. When he suddenly decided to break off with the girl out of a sense of guilt, she went into depression. But he constantly refused to see her or even reply to her calls and mobile messages. He felt a need to regain the self-respect and self-image he greatly enjoyed. But at the same time, he was also bothered not only by the awareness of her depression but also by the attraction for her, which remains in him.

How to Address These Better as Future Challenges

The patient should be encouraged to confront his dual sense of guilt in the most authentic way possible. His awareness and that of future patients should be raised to a realistic level. They will be advised that true spirituality consists in facing the truth and being kind to others. The girl has the right to be told and her feelings should be considered. One's inner peace is far more important than outside reputation. If un-addressed, it can make a person sick and imbalanced.