Confirmatory Studies Regarding Spirituality Are Needed

Letters to the Editor Spirituality, Self-Care, and Social Activity in the Primary Medical Care of Elderly Patients—Results of a Cluster-randomized Interventional Trial (HOPES3) by Noemi Sturm, Dr. sc. hum. Johannes Krisam, Prof. Dr. med. Dipl. Soz. Joachim Szecsenyi, Martina Bentner, Prof. Dr. med. Eckhard Frick, Dr. rer. pol. Ruth Mächler, Dr. med. Friederike Schalhorn, Regina Stolz, M.A., Dr. med. Jan Valentini, Prof. Dr. med. Stefanie Joos, and Dr. med. Cornelia Straßner in issue 8/2022

In many definitions, spirituality encompasses a multitude of basic attitudes, which is why a statistical classification is difficult (1). The heterogeneity and lack of delimitation of the definition of spirituality must be classified as confounders in this article, too (2).

The spiritual or religious attitudes and convictions in the medical profession between the two groups are not very comparable. A patient’s knowledge of the GP’s personal attitude could influence religious people in their choice of doctor and thus distort the data obtained (3). The question of whether the interviewed patients know the personal attitude of the doctor remains open.

Within the intervention group, there is a significantly higher proportion of doctors who are not a member of a religious affiliation compared to the control group. This is accompanied by a significantly higher proportion in relation to the physician’s self-disclosure of the importance of religious beliefs. In the control group, there is a high proportion of doctors who identify as Christians with a significantly lower score on the importance of religious beliefs. These data may also be skewed by the two unequal groups in the medical profession. Spiritual belief seems to be more significant here than formal religious affiliation.

Furthermore, data validity is difficult to assess because the control group was not additionally interviewed by a medical assistant.

From a pastoral perspective, we can confirm the assessment, beyond the data, that religious-spiritual interventions achieve greater self-efficacy in patients who are open for them than in people with a rather negative attitude (4). The methodological limitations mean that the actual statements on the results can only be objectified to a limited extent. A focus on the spiritual aspects with the help of the available data would be desirable.

DOI: 10.3238/arztebl.m2022.0209

PD Dr. med. Dr. sc. hum. Kai Witzel
Institut für Kultivationswissenschaften in der Medizin, Hünfeld

Prof. Dr. theol. Tobias Hack
Lehrstuhl für Moraltheologie und Christliche Sozialethik, Theologische Fakultät Fulda

Dr. med. Sebastian Schiel
Zentrum für Palliativmedizin, Klinikum Fulda

References

1. Frick E, Riedner C, Fegg MJ, Hauf S, Borasio GD: A clinical interview assessing cancer patients‘ spiritual needs and preferences. Eur J Cancer Care (Engl) 2006; 15: 238–43

2. Sturm N, Krisam J, Szecsenyi J, et al.: Spirituality, self-care, and social activity in the primary medical care of elderly patients—results of a cluster-randomized interventional trial (HoPES3). Dtsch Arztebl Int 2022; 119: 124–31

3. Thangathurai D, Vitug S, Ravi V: Spirituality of physicians. South Med J 2019; 112: 619.

4. Steinhorn DM, Din J, Johnson A: Healing, spirituality and integrative medicine. Ann Palliat Med 2017; 6: 237–47