Evaluation of a Spiritual History with Elderly Multi-Morbid Patients in General Practice—A Mixed-Methods Study within the Project HoPES3

Abstract

Background: The “Holistic Care Program for Elderly Patients to Integrate Spiritual Needs, Social Activity and Self-Care into Disease Management in Primary Care” (HoPES3) examines the implementation of a spiritual history (SH) as part of a multifaceted intervention in German general practices. While the effectiveness of the interventions was evaluated in a cluster-randomized trial, this article investigates the patients’ views concerning the acceptability of the SH and its effects. Methods: A mixed-methods study was conducted in which 133 patients of the intervention group filled in a standardized questionnaire after the intervention. Later, 29 of these patients took part in qualitative semi-standardized interviews. Results: According to the survey, 63% (n = 77) of patients found the SH helpful. In the interviews, however, many indicated that they either kept the conversation brief or declined the offer to talk about spirituality. Contents of longer conversations referred to difficult life events, personal sources of strength, and experiences with religious institutions. Many patients who had a longer conversation about spirituality reported that their relationship with their general practitioner (GP) had improved. Almost all patients recommended integrating a personal conversation of this kind into primary care. Conclusions: The SH seems to be a possible ‘door opener’ for a trusting doctor-patient relationship, which can then be built upon.

In‐person interventions to reduce social isolation and loneliness: An evidence and gap map

“…Four studies were excluded for an incorrect study design (Fokkema & van Tilburg, 2007; Low et al, 2015; Mächler et al, 2022; Purewal et al, 2017). Fokkema and van Tilburg (2007) was a literature review of intervention to reduce loneliness that did not report using a systematic search.…”

“…Purewal et al (2017) was a systematic review of companion animal studies that looked at association as opposed to effectiveness. Mächler et al (2022) was a primary study that investigated the views of patients following participation in a holistic care program which aims to increase social activity instead of measuring effectiveness.…”

GPs´ Personal Spirituality, Their Attitude and Spiritual Competence: A Cross-Sectional Study in German General Practices

“…For more details, see the study protocol (Strassner et al, 2019 ). For more results of the project see Mächler et al ( 2022 ) and Sturm et al ( 2022 ).…”

Espiritualidade e religiosidade: desafios e possibilidades para prática médica

“…Outros estudos avaliados consideraram que o treinamento em E/R na prática clínica é um importante meio para evitar desconforto na sua abordagem, capacitando o profissional para considerar os pacientes que desejam ou não conversar sobre o tema e desenvolvendo aptidão para tratar o assunto de forma respeitosa, sem imposições de valores pessoais (Mächler, et al, 2022;Menegatti-Chequini, et al, 2019;Piscitello & Martin, 2020).…”

“…Em consonância a essa visão, Mächler, et al (2022) relata que grande parte dos pacientes também recomendam a integração da história espiritual na atenção primária, descrevendo a melhora da relação e aumento da confiança em seu médico, ao passo que essa oferta demonstra a abertura para tratar do tema e não gera prejuízo aos pacientes que não desejam sua abordagem. Torna-se necessário ainda tomar o devido cuidado para não misturar conceitos de espiritualidade com instituição religiosa, o que pode afastar alguns pacientes.…”