Physical Therapists' Perception of Spirituality and Patient Care: Beliefs, Practices, and Perceived Barriers

Article excerpt

Background and Purpose. Numerous studies have demonstrated a positive correlation between spirituality and treatment outcomes. Studies have shown that patients consider their spiritual health and physical health equally important and desire to have their physicians inquire about their spiritual needs. There is little information on what the role of the physical therapist is concerning the spiritual health of the patient. Therefore, the purpose of this study was to examine the perceptions of physical therapists (PTs) regarding the role of spirituality in patient care, their beliefs and practices, and perceived barriers to discussion of spiritual issues with patients.

Subjects. The CCCEs, directors, or any PT clinician working at the selected clinics were eligible to fill out the survey.

Methods. A non-random purposive sampling method was used in selecting clinics across the United States that participated in the clinical education program of the Andrews University Physical Therapy Department and clinics advertised in the American Physical Therapy Association's (APTA) Physical Therapy Journal. A total of 250 clinics were selected and surveys were sent out addressed to either the CCCE or director of the selected clinics. Of the 250 questionnaires that were sent out, 136 (56%) were received.

Results. A large majority (96%) of PTs felt that spiritual well-being is an important component of health; however, only 30% believed that spiritual concerns should be addressed by the PT. The most frequently identified barriers to discussion of spirituality with patients were lack of experience taking a spiritual history, uncertainty about how to manage spiritual issues, and lack of time.

Discussion and Conclusion. This study found that PTs are aware of the impact of spirituality on patient health but are not certain that spirituality issues with their patients should be addressed by them. A major barrier to the discussion of spirituality with patients is a lack of education in taking a spiritual history and how to manage spiritual issues. Clarification of a physical therapist's role in caring for the spiritual needs of a patient and providing training in the performance of a spiritual assessment may help deal with the uncertainty of addressing spiritual issues and how to manage them.

Key Words: Spirituality, Physical therapy, Health care, Religion.

BACKGROUND AND PURPOSE

Spirituality and religion have been found to be a strong influences on overall health and the outcomes of medical interventions.1,2 Mueller et al2 has shown that patients consider their spiritual health and physical health equally important and desire to have their physicians inquire about their spiritual needs.2 The literature supports a consensus among physicians,3,4 nurses,5 social workers,6,7 and occupational therapists8 on the importance of spirituality in patient care. However, in clinical practice and in the literature, the potential impact of spiritual issues has been overlooked. Ellis et al3 found that less than 20% of physicians reported addressing spiritual concerns and only 20% reported frequent referral of hospitalized patients to chaplains. Weaver et al9 examined 3 major journals from 1998-2000 for articles that made a reference to the role of spirituality or religion. The authors concluded that although religious variables were mentioned and found to be statistically significant in some of the studies, little attention seemed to be given to these issues.

The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) has recognized the significance of spiritual beliefs in patient care and, as of 2001, JCAHO has required the administration of a spiritual assessment for all patients.10,11 In certain settings, this responsibility often falls under the purview of the chaplains and nurses. However, JCAHO expects other caregivers to play an equally important role as spiritual assessments are being mandated in various settings, such as long-term care and home care. …