Spirituality is “the aspect of humanity that refers to the way individuals seek and express their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Puchalski et al., 2009, p.887).
The recent pandemic has increased the awareness of the important role spirituality may play for individuals confronted by health crises and how as healthcare providers we can provide care and support around spirituality.
However, I wonder whether when we consider the term spirituality it naturally turns us to thinking we are talking about religion. Such thinking may in turn lead us to believe to talk about spirituality would alienate our colleagues and patients/service users. As a result, it might prevent services from providing spiritual care due to lack of understanding and for fear of offending.
The NHS Education for Scotland defined spiritual care as, “that care which recognises and responds to the needs of the human spirit when faced with trauma, ill-health or sadness and can include the need for meaning, for self-worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener” (2006, p.6). This describes spiritual care as a core aspect of holistic, person-centred care.
Dr Anita Rose
As a person of faith, I am fully aware of the benefits of spirituality in my own life and the support it has, and does give me, in times of health crises, significant illness and daily living. And, as a healthcare professional working neurorehabilitation, which is a person centred and holistic driven process, I recognise that spiritual care can often be overlooked. This is also the case in the research literature in the field of neurorehabilitation where there is a paucity of research on the role spirituality can play.
I reviewed the literature that is available and noted it highlighted spiritual well-being was closely associated with better adjustment and coping in people who had sustained a neurological injury. The studies have documented clear associations between spiritual well-being, higher quality of life, life satisfaction and resilience, lower levels of depression and anxiety. This correlates with research on the relationship between spirituality and health in the broad field of healthcare.
This review led me then to think about how, in neurorehabilitation, we already provide care which is akin to this description of spiritual care, “person-centred care which helps to seek people (re)discover hope, resilience and inner strength in times of illness, injury, transition and loss” (NHS Education for Scotland, 2013).
So if we acknowledge we are providing care in line with the description in the previous paragraph how can we take the step to spirituality? Do we understand spirituality, what are our personal perceptions as healthcare professionals, do we need spiritual care training in our services, as in palliative care, and do we need external spiritual support as standard?
As a clinical neuropsychologist, I am comfortable in working with my patients and families to ask about their faith and spiritual thoughts as part of my initial holistic assessment period. I will use the demographic template around religion (as this has to be completed) however will broaden this to spirituality more generally using the definition I mentioned at the beginning of this article. This enables me to look at spiritual care needs and support.
However, I am aware that such conversations may be difficult for others. Maybe this is because spirituality is confused with religion, staff maybe be uncomfortable in raising this topic with patients, the perception it is a private matter and therefore should not be discussed, and maybe the lack of knowledge or skills in talking about spirituality.
Therefore, understanding staff perceptions and providing spiritual care training may support and increase knowledge regarding spirituality and spiritual care, and increase their confidence and comfort in assessing spiritual care needs and providing spiritual care. This would ensure our neurorehabilitation would be truly person-centred holistic care.
So, what about external spiritual services? A few years ago, I introduced a chaplaincy service in one of our hospitals at Renovo Care Group. This came about due to a number of our staff and residential service users regularly attending a local church and the church approached the senior team offering support to the inpatient service.
In recognising the importance of providing spiritual support to our patients we developed a chaplaincy team made up of different ministers of faiths and they would visit the site to meet with staff and patients and their families providing the fullness of spiritual care including person-centred support helping our patients rediscover hope and inner strength both through faith support and sensitive listening.
Having the external faith community involved was a very positive addition to both the neurorehabilitation process for the patient and staff care. They became part of the team. Having learnt from that experience we are looking to replicate in our newly opened neurorehabilitation hospital.
To end this reflection, I would agree with the title of one of the research articles I read – “Spirituality is Everybody’s Business” and as such I do believe there is a role for developing a clear role for spirituality in neurorehabilitation from training to implementation. After all, neurorehabilitation is a holistic process developed around the physical, cognitive, psychological, social and cultural dimensions and lifestyle of both the patient and their family and this cannot be truly holistic if we do not consider spirituality in all its rich diversity.
