Background and Purpose. Most physical therapists recognize that spirituality and religion can influence health and patient outcomes, providing hope and tools for coping with pain, chronic illness, and aging. However, they are hesitant to include religion and spirituality in physical therapy patient care. Barriers to exploring spiritual issues with patients include lack of time, lack of training in addressing spiritual issues, and discomfort with the spiritual domain. The purpose of this study was to explore physical therapist students' perceptions of spirituality and religion relative to patient care and to identify their comfort level in addressing these issues with patients.
Subjects. Students (n = 186) from a physical therapist education program in the Midwest United States.
Methods. A survey was distributed to 3 cohorts of physical therapist students. Data analysis included descriptive statistics (demographics) and frequencies (survey item reporting). Comparisons between groups were analyzed through analysis of variance (ANOVA) and point-biserial correlation.
Results. With 92% responding, participants agreed that spirituality and religion could provide a patient with hope (> 95%), and could help patients cope with injury, illness, and pain (> 80%). There was less agreement in regard to the roles of spirituality (86.5%) and religion (52.7%) in overall health. Knowledge of patient's spiritual or religious needs was identified as having positive effects on patient-therapist relationship (> 85%). Self-reported religious/ spiritual orientation demonstrated a weak, but significant, correlation with comfort in addressing spiritual needs of patients. The older student cohort expressed more comfort than the youngest cohort in talking with patients about hope and accepting differing beliefs.
Discussion and Conclusion. Students perceived religion as having less influence than spirituality on health, helping a patient cope with injury, illness and pain, and potentially strengthening the patient-therapist relationship. They agreed that both spirituality and religion can provide a patient with hope. The percentage of students who were unsure of their comfort level in some aspects of spiritual care suggested that they may not have the knowledge to apply these beliefs to patient care at this time. Students in the older cohort reported increased comfort in talking with patients about hope and in accepting beliefs different from their own compared to the youngest cohort. The results of this study seem to indicate that students may require formal training in recognizing and addressing the spiritual needs of patients and clients.
Key Words: Spirituality, Religion, Physical therapist students, Spiritual domain, Patients.
BACKGROUND AND PURPOSE
Spirituality and religious beliefs can influence overall health and patient outcomes.1-5 The mechanisms by which spirituality and religion influence patient outcomes are not clear, though it appears that spirituality and religion- as components of the spiritual domain-are useful tools for patients/clients attempting to cope with pain, chronic illness, and aging.4,6-16
Physical therapy patients experience a range of health challenges including temporary, chronic, and permanent states of pain and disability. These challenges may relate to the ability to participate in desired work and leisure activities, perform activities of daily living, or continued independent living. Physical therapists seeking the best outcome for individual patients use a variety of approaches and select the tools most appropriate for each case, which may include addressing spirituality and religion with a patient as a component of cultural competence. The importance of incorporating spirituality in patient care has been recognized by the Joint Commission on the Accreditation of Healthcare Organizations17 and the value of incorporating a patient's customs and beliefs as part of a physical therapy patient care is addressed in the (Atide to Physical Therapy Practice18 and the Blueprint for Teaching Cultural Competence in Physical Therapy Education. …