Spiritual care is stagnating in general practice: the need to move towards an embedded model

Marc-Antoine Bornet; Naomi Edelmann; Etienne Rochat; Jacques Cornuz; Emmanuelle Poncin; Stéfanie Monod

doi:10.3399/bjgp19X700613

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Provision of spiritual care in general practice
Ian J. Hamilton

Published on: 05 January 2019
Spiritual care is stagnating in general practice
Gordon. W Macdonald

Published on: 05 January 2019

Published on: (5 January 2019)

Provision of spiritual care in general practice
Ian J. Hamilton, Researcher, Institute of Health and Wellbeing, University of Glasgow
I read with interest Bornet et al’s proposal for an embedded model of spiritual care in general practice offering whole-person care, interdisciplinary coordination of interventions, and integration of care settings.¹ There is an increasing awareness of the importance of spiritual care in holistic healthcare² and I would agree with the authors that GPs working in an integrated care setting with spiritual care providers and other health professionals would be better equipped to provide compassionate and optimised care to an increasingly ageing multimorbid population and to manage the long term follow up of patients with chronic diseases.

References

1. Bornet MA, Edelmann N, Rochat E, et al. Spiritual care is stagnant in general practice. Br J Gen Pract 2019, 69(678): 40-41.

2. Hamilton IJ, Morrison J, Macdonald S. Should GPS provide spiritual care? Br J Gen Pract 2017, 67(665): 573-574.

Competing Interests: None declared.
Published on: (5 January 2019)

Spiritual care is stagnating in general practice
Gordon. W Macdonald, GP, Regent Gardens Medical Practice
The embedded model suggested is currently functioning in several UK practices and being rolled out into local clusters. These practices have a chaplain fully integrated within their multidisciplinary teams providing spiritual care in line with the biopsychosocial-spiritual model¹ and modern maladies approach.²

Research has shown that such chaplaincy provision improves spiritual wellbeing to a similar extent as antidepressants whilst reducing GP consultations rates.^3,4 These results justify the place chaplaincy within our MDT's at this time of workload realignment.

Chaplaincy has also been shown to be responsive to multimorbidity and undifferentiated illness, both of which are core presentations the expert medical generalist encounters.⁴ Such generalists are ideally placed to refer on to the specialist chaplain within the MDT.

Snowden has developed a patient reported outcome measure (PROM) to both facilitate spiritual conversations and measure the impact of spiritual interventions.⁵

It is agreed that there is an ongoing need for training but the above evidence suggests the tide is turning on spiritual care and assessing its impact in general practice in the UK.

References

1. Griffin J, Tyrrell I. Human...
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The embedded model suggested is currently functioning in several UK practices and being rolled out into local clusters. These practices have a chaplain fully integrated within their multidisciplinary teams providing spiritual care in line with the biopsychosocial-spiritual model¹ and modern maladies approach.²

Research has shown that such chaplaincy provision improves spiritual wellbeing to a similar extent as antidepressants whilst reducing GP consultations rates.^3,4 These results justify the place chaplaincy within our MDT's at this time of workload realignment.

Chaplaincy has also been shown to be responsive to multimorbidity and undifferentiated illness, both of which are core presentations the expert medical generalist encounters.⁴ Such generalists are ideally placed to refer on to the specialist chaplain within the MDT.

Snowden has developed a patient reported outcome measure (PROM) to both facilitate spiritual conversations and measure the impact of spiritual interventions.⁵

It is agreed that there is an ongoing need for training but the above evidence suggests the tide is turning on spiritual care and assessing its impact in general practice in the UK.

References

1. Griffin J, Tyrrell I. Human givens-a new approach to emotional health and clear thinking. 2004. Chalvington: HG Publishing.

2. Hanlon P, Carlisle S, Hannah M, Reilly D, Lyon A. Making the case for a 'fifth wave' in public health. Public Health 2011; 125(1):30-36.

3. Macdonald G. The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with anti- depressants. Prim Health Care Res Dev 2017;18(4):354-365.

4. Macdonald G. Primary care chaplaincy: an intervention for complex presentation. Prim Health Care Res Dev 2018; 8:1-12.

5. Snowden A, Telfer I. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains. J Health Care Chaplain 2017;23(4):131-155.

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Competing Interests: Lead for chaplaincy provision in Regent Gardens Medical Practice