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The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patients spirituality or religious commitment and health outcomes, and that patients would like physicians to consider these factors in their medical care. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patients spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process. The HOPE concepts for discussion are as follows: H-sources of hope, strength, comfort, meaning, peace, love and connection; O-the role of organized religion for the patient P-personal spirituality and practices; E-effects on medical care and end-of-life decisions. (Am Fam Physician 2001;63:81-8,89.)
Family medicine emphasizes medical care of the whole person, which includes an understanding of a patient's family and environment, as well as the social, cultural and psychologic situation. Over the past several years, it has been suggested that spirituality is another important, yet often neglected, factor in the health of patients.', Up to 77 percent of patients would like spiritual issues considered as part of their medical care,3 yet only 10 to 20 percent of physicians discuss these issues with their patients.3,4 Reports such as these have increased interest in the incorporation of spirituality into the practice of medicine. Nearly 50 medical schools currently offer courses in spirituality and medicine.5
Relationship Between Spirituality and Medicine
The evidence in the medical literature that suggests a strong relationship between spirituality and medicine is increasing (Table 1346-24). Polls of the U.S. population' have consistently shown that 95 percent of Americans believe in God. One study3 found that 94 percent of patients admitted to hospitals believe that spiritual health is as important as physical health, 77 percent believe that physicians should consider their patients' spiritual needs as part of their medical care, and 37 percent want their physician to discuss their religious beliefs more. However, 80 percent reported that physicians never or rarely discuss spiritual or religious issues with them.
One study4 of physicians and patients in an outpatient setting found that 91 percent of patients believe in...