Conducting the Spiritual Assessment

Before conducting a spiritual assessment, physicians should consider their personal faith
tradition, beliefs and practices, positive and negative experiences, attitudes on faith and
healing, and comfort and ability to participate in another's spirituality or share their own.
Some physicians may not consider themselves spiritual, may not wish to discuss
spirituality, or may vary in their level of ease or capability in discussing spiritual concerns.
Rather than a coercive responsibility, conducting a spiritual assessment and offering
spiritual support are similar to eliciting a social history and empathizing after the delivery
of a negative diagnosis. They provide yet another way to understand and support patients
in their experience of health and illness.

Several tools exist to help physicians conduct a spiritual history. The FICA Spiritual History
Tool (Table 130) uses an acronym to guide health professionals through a series of
questions designed to elicit patient spirituality and its potential effect on health care.
Starting with queries about faith and belief, it proceeds to ask about their importance to the
patient, the patient's community of faith, and how the patient wishes the physician to
address spirituality in his or her care.
FICA Is An Acronym That Can Be Used To Remember What Is
Asked In A Spiritual History. It Includes:
F: Faith or Beliefs
I: Importance or influence
C: Community
A: Address

Specific Questions You Can Use To Discuss These Issues Are:

F: What is your faith or belief?
• Do you consider yourself spiritual or religious?
• What things do you believe in that give meaning to your life?

I: Is it important in your life?

• What influence does it have on how you take care of yourself?
• How have your beliefs influenced your behavior during this illness?
• What role do your beliefs play in regaining your health?

C: Are you part of a spiritual or religious community?

• Is this of support to you and how?
• Is there a person or group of people you really love or who are really important to
you?

A: How would you like me, your healthcare provider, to address these issues in
your healthcare?

General Recommendations When Taking A Spiritual History

Include:
1. Consider spirituality as a potentially important component of every patient’s
physical well being and mental health.
2. Address spirituality at each complete physical examination and continue addressing
it at follow-up visits if appropriate. In patient care, spirituality is an ongoing issue.
3. Respect a patient’s privacy regarding spiritual beliefs; don’t impose your beliefs on
others.
4. Make referrals to chaplains, spiritual directors, or community resources as
appropriate.
5. Be aware that your own spiritual beliefs will help you personally and will overflow in
your encounters with those for whom you care to make the doctor-patient encounter
a more humanistic one.

© 1999 Christina Puchalski, M.D. Reprinted with permission from Christina Puchalski, M.D.
FICA adalah akronim yang dapat digunakan untuk mengingat apa yang ditanyakan dalam
sebuah riwayat rohani, yaitu:
F : Iman atau Keyakinan
I : Kepentingan atau pengaruh
C : Komunitas
A : Penempatan

Pertanyaan khusus yang dapat anda gunakan untuk membahas masalah-masalah ini adalah:
F : Apa keyakinan atau kepercayaan Anda?
• Apakah Anda menganggap diri Anda beragama atau religius?
• Hal-hal apa yang Anda yakini yang memberi arti bagi hidup Anda?

I : Apakah itu penting dalam hidup Anda?

• Apa pengaruhnya terhadap cara Anda menjaga diri sendiri?
• Bagaimana kepercayaan Anda memengaruhi perilaku Anda selama mengidap penyakit ini?
• Apa peran kepercayaan Anda dalam mendapatkan kembali kesehatan Anda?

C : Apakah Anda bagian dari komunitas rohani atau agama?

• Apakah ini mendukung Anda dan bagaimana?
• Adakah seseorang atau sekelompok orang yang benar-benar Anda cintai atau yang benar-
benar penting bagi Anda?

A : Bagaimana Anda ingin saya, penyedia layanan kesehatan Anda, untuk menempatkan
hal-hal yang berhubungan dengan keagamaan ini dalam perawatan Anda?

Rekomendasi umum saat mencatat riwayat rohani:

1. Pertimbangkan spiritualitas sebagai komponen yang berpotensi penting bagi kesehatan
fisik dan mental setiap pasien.
2. Sampaikan pesan keagamaan/spiritualitas pada setiap pemeriksaan fisik lengkap dan terus
menyampaikannya pada kunjungan tindak lanjut jika sesuai. Dalam perawatan pasien,
spiritualitas adalah masalah yang berkelanjutan.
3. Hormati privasi pasien mengenai kepercayaan spiritualnya; jangan memaksakan keyakinan
Anda pada orang lain.
4. Buat rujukan ke pendeta, pemuka agama, atau sumber daya komunitas jika perlu.
5. Sadarilah bahwa keyakinan spiritual Anda sendiri akan membantu Anda secara pribadi dan
akan meluap dalam pertemuan Anda dengan orang-orang yang Anda sayangi untuk
membuat pertemuan dokter-pasien menjadi lebih humanistik.