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Am Fam Physician. 2022;106(4):415-419

Related Letter to the Editor: The Importance of Inclusivity During the Spiritual Assessment

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

The spiritual assessment offers the opportunity to enhance the patient-physician relationship and incorporate patient views that may have a significant impact on clinical decision-making. Multiple studies have demonstrated that patients' expectations of spiritual discussions in the health care setting are not being met. Perceived barriers reported by physicians include lack of time, training, and experience. There is a variety of physician approaches to assess and incorporate spirituality in the health care setting. A spiritual assessment is recommended when a patient is admitted to the hospital, has a significant clinical decline while in the hospital, is receiving psychosocial services for the treatment of substance use disorder, or when addressing palliative care. Tools for spiritual assessment include the Open Invite mnemonic, which initiates the topic and relies on a conversational approach, and the HOPE questions, which offer a structured approach to determine the relevance of spirituality to the patient's overall health and assist with the development of an individualized care plan. Although physicians should respect the right of patients who do not want to discuss this topic, multiple studies demonstrate significant relationships between spiritual interventions and improved mental and physical health outcomes.

The physician-patient relationship is at the foundation of every interaction in family medicine. Understanding a patient's spirituality significantly impacts this relationship as well as clinical decision-making. Patients often view their health care with spirituality in mind, particularly at the end of life. Spiritual assessment is a component of the holistic or biopsychosocial-spiritual approach of caring for the patient.1

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