Spirituality linked with better health outcomes, patient care

Spirituality should be incorporated into care for both serious illness and overall health, according to a new study.

What the researchers say: “This study represents the most rigorous and comprehensive systematic analysis of the modern-day literature regarding health and spirituality to date,” said the lead author. “Our findings indicate that attention to spirituality in serious illness and in health should be a vital part of future whole person-centered care, and the results should stimulate more national discussion and progress on how spirituality can be incorporated into this type of value-sensitive care.”

“Spirituality is important to many patients as they think about their health,” said the study’s co-author. “Focusing on spirituality in health care means caring for the whole person, not just their disease.”

The study will be published online in JAMA.

According to the International Consensus Conference on Spiritual Care in Health Care, spirituality is “the way individuals seek ultimate meaning, purpose, connection, value, or transcendence.” This could include organized religion but extends well beyond to include ways of finding ultimate meaning by connecting, for example, to family, community, or Nature.

In the study, the researchers systematically identified and analyzed the highest-quality evidence on spirituality in serious illness and health published between January 2000 and April 2022. Of the 8,946 articles concerned with serious illness, 371 articles met the study’s strict inclusion criteria, as did 215 of the 6,485 articles focused on health outcomes.  

A structured, multidisciplinary group of experts, called a Delphi panel, then reviewed the strongest collective evidence and offered consensus implications for health and health care.

They noted that for healthy people, spiritual community participation—as exemplified by religious service attendance—is associated with healthier lives, including greater longevity, less depression and suicide, and less substance use. For many patients, spirituality is important and influences key outcomes in illness, such as quality of life and medical care decisions. Consensus implications included incorporating considerations of spirituality as part of patient-centered health care and increasing awareness among clinicians and health professionals about the protective benefits of spiritual community participation.  

The 27-member panel was composed of experts in spirituality and health care, public health, or medicine, and represented a diversity of spiritual/religious views, including spiritual-not-religious, atheist, Muslim, Catholic, various Christian denominations, and Hindu.  

According to the researchers, the simple act of asking about a patient’s spirituality can and should be part of patient-centered, value-sensitive care. The information gleaned from the conversation can guide further medical decision-making, including but not limited to notifying a spiritual care specialist. Spiritual care specialists, such as chaplains, are trained to provide clinical pastoral care to diverse patients—whether spiritual-not-religious or from various religious traditions. Chaplains themselves represent a variety of spiritual backgrounds, including secular and religious.

“Overlooking spirituality leaves patients feeling disconnected from the health care system and the clinicians trying to care for them,” the researchers concluded. “Integrating spirituality into care can help each person have a better chance of reaching complete well-being and their highest attainable standard of health.”

So, what? Spiritually is inbuilt in our DNA (there is no society on earth which does not have a set of spiritual practices as part of its norms and rituals)—and maybe in the genome of other animals as well, as some studies have suggested. It would seem obvious that something so fundamental to who we are should not be left out of the realm of medicine or healing generally.

Spirituality is essentially about connection, about support and about belonging. A football club gathering, a church or temple service, a walk in the woods with friends, being part of a high performing team, having a meal with someone you love, or with people who you believe are part of your support network are all essentially spiritual experiences. So is dying surrounded by loving family and friends. Each has a ritualistic component (sometimes unconscious) which provides commonality and a sense of trust and safety.