Clinical Case

This paper investigates the literature that is available on religious influences on the provision of healthcare. It entails an interaction between the student and the client to help understand the spiritual and/or religious dimensions of the client’s illness and experiences, in order to use this for the purpose of counseling. The student selects someone whose religious or spiritual issues impact on his or her counseling, how he or she has responded to the mental or medical care. In this paper, the chosen individual is of different religion. The client was interviewed by the student to have an understanding of the religious or spiritual issues which have an impact on the mental or medicinal care.

The impact of spirituality and religion on medical care has been an on-going debate in the medical world in the recent years. Research has established that there is a connection between the spirituality and medical health in terms of the outcomes. It is, therefore, very important to reflect on spirituality whenever one is carrying out the medical assessments. There are several instruments or methods that physicians or health practitioners can use when carrying out spiritual assessment, and these include: SAI (Spiritual Assessment Inventory), FICA and HOPE. FICA and HOPE are acronyms for the type of questions that these respective methods incorporate during the assessment (Willis, 1996).

This response uses the HOPE method of assessment which stands for: H- sources of Hope, O- role of organized religion, P- Personal spirituality practices and E-Effects on medical care. To fully understand the impact of spirituality on medical care, an interview was carried out in a well- known private hospital. The patient that was interviewed had cervical cancer. Due to patient’s confidentiality, she shall be referred to as Mrs. A in this report. Mrs. A is a Christian, belonging to the denomination of the Seventh Day Adventist church (S.D.A) (Berger, 1967).

Initially, Mrs. A and I got acquainted, and she gladly accepted to give information on this topic. She had been diagnosed with cervical cancer two months ago, and was undergoing chemotherapy. To begin with, I asked her how she took the news about her disease. She responded that she never thought she would have such a disease. That it was a very difficult and trying moment in her life. I further probed her on what gave her the strength to fight on. “My heavenly father,” she replied. ”I have three children, two in High School and my last born is in elementary-6th grade. I can’t die now. I have to see them graduating from college,” she added. Mrs. A also mentioned that her Christian faith in God was her primary source of strength and comfort (Berger, 1967).

Further, I asked her whether she belonged to any organized religion. She answered that she is a devout Christian, belonging to the Adventist denomination since her birth. Both of her parents were also Christian Adventists. Owing to this, I inquired on the aspects of her religion that she found helpful. Mrs. A responded that she was overwhelmed with the kind of support she got from her church. Apparently, once a week, the mothers in her church would visit her in hospital and keep her company. They would also encourage her with motivational scriptures and have praise and worship sessions of hymns, which she highly cherished. Back in her church, members had formed the prayer groups, and they would call each other at 3am in the night every day to pray for one another. Mrs. A belonged to a prayer group comprising of five church members, including her, and they also would pray every day at 3am in the morning. She acknowledged that the prayers were therapeutic to her. Interestingly, Mrs. A claimed that every time the church members came to visit her, she slept soundly and felt less pain that day. When I inquired whether there are certain elements in her religion that did not help her, she struggled to respond, and finally said that for the most part of her life being an Adventist, the folks there have been a delight. Mrs. A mentioned that the only thing that she did not find helpful was small-talk and church politics. She felt that this was their greatest undoing (Willis, 1996).

On the personal spiritual practices, Mrs. A pointed out that prayer and scripture reading have helped her greatly. In fact, on a light note, she joked that being hospitalized and diagnosed with cancer had made her a bible bookworm. She also informed me that she always prayed just before taking any medication. I probed her further on whether she had ever forgotten to pray before taking any drugs. “Not that I can remember,” she affirmed. Still on personal spirituality, I asked her on her relationship with God. Mrs. A confided that she was not as prayerful before her cancer diagnosis as she is presently. She added that in the past, she used to have a formal relationship with God, but nowadays she speaks to God as to a trusted friend and companion. “Anything that is on my mind, I would tell Him… anything,” she emphasized. Mrs. A also told me that every night after praying and just before going to bed she would listen to a hymn called “Rock of ages.” The hymn apparently gave her a sense of security and peace of mind just before sleeping. I asked her what the hymn was about, and before I had even finished inquiring, she started singing it. Her mood immediately brightened and she looked happier (Berger, 1967).

The last set of questions that I asked Mrs. A was whether the medical care that the hospital was providing to her was affecting her spiritual life in any way. She quickly admitted that what was affected most was fasting. Apparently, she was not allowed to fast, because of her frail health, and the doctors had particularly emphasized that she takes all the meals prescribed on a regular basis. Mrs. A informed me that before her diagnosis and hospitalization, she used to fast once a week every Wednesday. I then asked her, if any of the procedures or medical requirements conflicted with her spiritual beliefs. “If they did, I would not be here in the first place,” she told me. On religious constrains, particularly dietary that would affect the medical care, she told me that she did not eat meat or meat products because of her faith. It was her conviction that red meat, particularly pork and beef, were deleterious to any individual’s health (Willis, 1996).

With a great deal of honesty, I asked her about her future plans. She acknowledged that there is a possibility that she may not make it, since the doctors said her condition was worsening. However, she remained hopeful that the fear of dying was not in her mind, because she believed that she was going home to her heavenly father. Mrs. A, in a reprimanding tone then said that for the sake of her children, however small the window of hope was, she was not going to give up the fight for her life easily. With those words she requested that we conclude the interview, as she was drowsy from her medication (Berger, 1967).

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Spirituality and religion clearly have both a positive and negative impact on a patient’s mental and physical health. The following section attempts to analyze these influences, while citing the references from Mrs. A’s responses (Willis, 1996).

Patients who are religious are less prone to suffer from anxiety. Considering Mrs. A’s case, despite her terminal illness, she remained brave and attributed her strength to God. She demonstrated this at the end of the interview, when she assured me that she was not scared of dying, because of her belief in life after death. This gave her comfort and peace of mind, thus, making her less anxious (Berger, 1967).

Research has established that patients having religious beliefs show faster recovery rates and are less depressed. From Mrs. A’s point of view, religion and faith had been therapeutic. She claimed that the days which her church mates came to worship and pray with her, she would suffer less pain and sleep soundly. It also seems true that spiritual practices reduce the depression. This could be depicted clearly when Mrs. A started to sing the hymn “Rock of ages”, which cheered her up. She had formed a habit of listening to that hymn every day before she sleeps. Religion gives hope even when there is no chance of survival. Many religious people believe in the supernatural, and never rule out the possibility of a miracle happening. Hope is important, particularly for the mental health and wellness. Having a positive attitude is beneficial, especially to chronic illnesses, as it prevents someone from despairing. Suicide rates amongst religious patients have been shown to be minimal, as compared to the non-religious ones (Willis, 1996).

Undoubtedly, organized religions provide a lot of social support. As was evident in Mrs. A’s case, she reported that her church mates visit her every week to keep her company, motivate her and worship together with her. She claims that she drew a great strength from this, and actually looked forward to these visitations. Additionally, some members of her church had formed prayer groups, in order to petition one another’s problems to God. This kind of social support is very useful for patients. It gives them some kind of relief from their burdens, when they see that other people are concerned about them and are praying for them, as well as providing much needed company in dull hospital settings (Berger, 1967).

Even though many religious practices are helpful to patients, it is important to note that there are some negative impacts of religious and spiritual practices that could be detrimental. Fasting is a good example. Luckily, Mrs. A had agreed to put her weekly fasting on hold, since her physical health condition could not withstand a day without any meal. Some patients, however, remain adamant and disregard medical advice because of their faith. This has proved to be costly. Some religions surprisingly encourage their followers to desist from any form of modern medication on the basis that it is satanic. They use alternative medicines, such as herbs, and some even believe that prayer alone can suffice. This too has been proved to be costly, particularly for patients requiring urgent medical attention, such as blood transfusion or vital organ transplants. In such instances, religious beliefs are not useful (Berger, 1967).

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Other religious beliefs, particularly traditionalism, conflict with medicine. In many of the traditional religions, a number of diseases are associated with curses. The patients end up consulting sorcerers who in many cases give them concoctions that negate the effects of drugs given in the hospitals. Other religious beliefs simply impede decision-making in medical care. Usually, doctors and other healthcare practitioners provide patients with possible options to counter their ailments; recommend the best option, and then leave the patients to decide for themselves what they feel should be done. Religion has heavy influences in such crucial decision-making. A recently debate is about the abortion. In a case where continuation of the pregnancy could both endanger the mother and fetus’ life, doctors usually recommend the abortion. Some religions view this as murder without weighing the risks involved. Such patients end up choosing not to terminate pregnancy. Sadly, they wind up losing their lives (Willis, 1996).

In cases where religion influences ones diet, that is, what a patient should and should not eat, the patient’s health and chances of recovery are compromised. A case, where a patient has iron deficiency and the health practitioners recommend the patient to take liver, but he or she is vegetarian due to his or her faith, compromises on optimum healthcare. Some religions and spiritual beliefs encourage patients to take the certain herbs or substances to complement the medication provided in hospitals. These could result in drug-drug interactions or interfere with the detection of disease which would be to the patient’s disadvantage (Berger, 1967).

In conclusion, it is very significant for physicians and other healthcare providers to incorporate the spiritual information when taking patient’s history. The best kind of medical care is one that incorporates the entire patient’s concerns and preferences, and spirituality is one of them. This holistic approach has proved to have better outcomes in terms of the treatment and wellness. Consequently, spiritual history should be considered when probing patients during consultations, as it could impact either positively or negatively in mental and physical medical care.

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