During the summer of 2019, I attended a 6-week training conference in Southern California aimed at educating graduate students in healthcare disciplines the importance of spiritual care. My perspective was exceedingly grown. Over the course of those 6 weeks, I learned just how much a person’s response to injury, motivation to continue with rehabilitation, and overall health is tied with their spiritual beliefs (or lack thereof). This appreciation grew substantially as I began to take care of patients during my clinical rotations. Physical Therapists have a unique opportunity to establish strong relationships with their patients due to the significant amount of time spent working together to achieve the patient’s goals. During this time of collaborative work for the patient’s betterment, it is our responsibility to coordinate the patient’s care with attention to the patient as a whole person.
I knew this was going to be the topic of my capstone after one afternoon in clinic. I was briefed by a nurse that this patient was very anxious, uncomfortable, and unwilling to work with any of the medical personnel. Upon the subjective examination, I asked this patient about the presence (or lack thereof) of a faith or belief system. This patient began to cry and informed me of a death in the immediate family that occurred the night before, and how hard that has been to reconcile that event with their belief system. Following that conversation, I noticed the patient’s heart rate and blood pressure decrease along with her discomfort, and the rest of the evaluation went much more smoothly.
After this patient interaction, I thought to myself, “people need to know about this.” My capstone project has been a labor of love for people and my desire for patients to know that whole person care is important. Specifically, that while they may have an ache, pain, or dysfunction in a body region (biological), the human person is a complex interplay of parts impacting each other. Caring for a person’s biological needs and their spiritual needs can have significantly positive impacts on the well-being of a whole person.
Statement of Need:
What sparked this interest in me and kept the flame burning was the desire expressed to me for this care by patients’ themselves. I can’t count the number of times a patient has said to me following a spiritual screening, “No doctor has every asked me those questions before” or “I wish my other doctors would ask me those questions.”
I think a lot of us (including myself) are unaware of how many people are struggling in a world of isolation, condemnation, and loneliness. This has certainly been amplified during the past 2-years of the COVID-19 pandemic. One patient told me at the end of the plan of care, “you’re the only person I’m able to talk to about these things.”
It is very possible to be physically cared for without feeling cared for; I think there is more of a need than we realize for this facet of care.
There’s been an excellent trend in Physical Therapy practice over the last decade with more emphasis on the whole person. The consideration of how a person’s emotional, mental, and social health impacts their physical health is important for all health care providers to keep in mind. These factors (such as anxiety, depression, etc) are a part of regular subjective screenings and are deemed “yellow flags.”
The primary purpose for my capstone is to advocate for “spiritual health” to be added to that list of independent variables – for Physical Therapists to include a “spiritual health” screening as part of their yellow flag screening during patient subjective examinations. By doing this, I think we will have a better awareness of the patient’s well-being and we will be practicing within the available evidence which supports the positive impacts on the patient’s overall health from spiritual assessment and care.
Throughout the formulation process of this presentation, I received feedback from my advisor committee on how to communicate this information most effectively to my audience. With the help of my committee, I designed this slideshow to present information about my topic in a way that acknowledges and addresses common counterarguments to why this form of care should not be implemented into practice. By doing this, I can succinctly present information in a way that doesn’t drag on and take up a long duration of time – losing the attention of my audience.
Additionally, I employed strategies to keep my audience engaged by not including excessive amounts of information on slides and by introducing myself at the beginning of the presentation to make it more personal.
For Physical Therapists, I created a VoiceThread presentation where I explain what spiritual care is, how to implement it, and why to implement it. Throughout the presentation, I analyze what current literature has to say about the impact of spirituality and spiritual assessment on patient health.
For Physical Therapists and patients, I developed a feasible, efficient spiritual care questionnaire that the patient can fill out at any point of the evaluation. This would serve as a substitute and/or complement to verbal spiritual care assessment to any Physical Therapist who deems it helpful.
Throughout the project, I utilized the expertise and suggestions from my committee, working with them to come up with products that are objective, purposeful, and useful to Physical Therapists.
For the purposes of feedback on my presentation and product, I created this feedback form for viewers to fill out after viewing my presentation/products.
Throughout the formation of this presentation, I received feedback from committee members and others who were concerned with spiritual care in relation to the scope of physical therapy practice. Additionally, concerns were voiced to me regarding the objectivity and nature of this project – whether it was to be informative/educational, or persuasive. My goals for this project were to be educational and persuasive, using objective data provided by research to persuade my audience into adopting this form of screening to their own evaluation “routine.” The bottom line, I want to share what I’ve found to be true about the spiritual needs and care of our patients as supported by the evidence and my own experiences.
This project taught me how to search for and analyze objective data in an effort to test my hypotheses and determine if there is support of this practice strategy. I also learned about effective strategies for presenting information to an audience on a topic that many deem controversial. The skills I learned throughout the creation of these products will help me navigate future situations that may be tense or uncomfortable, as well as developing my presentation/leadership skills for future endeavors.
To my primary advisor, Michael McMorris: Thank you for shepherding my vision and helping to turn it into a reality. Your honest feedback and desire to tell me what I need to hear, not necessarily what I want to hear is one of the main reasons this project exists.
To Bob Mason, the director of the Whole Person Care Preceptorship: Thank you for shining light and for igniting this passion within me.
To Daniel Alford: Thank you for allowing me to practice incorporating this form of care into my own clinical routines and for fostering an environment of mutual growth and respect throughout this process.