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Debate & Analysis

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 and Stéfanie Monod
British Journal of General Practice 2019; 69 (678): 40-41. DOI: https://doi.org/10.3399/bjgp19X700613
Marc-Antoine Bornet
Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne; Platform Medicine, Spirituality, Care and Society, Lausanne University Hospital, Lausanne, Switzerland.
Roles: Internal Medicine Resident
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Naomi Edelmann
Platform Medicine, Spirituality, Care and Society, Lausanne University Hospital, Lausanne, Switzerland
Roles: Research Psychologist
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Etienne Rochat
Spirituality, Care and Society, Lausanne University Hospital, Lausanne, Switzerland.
Roles: Head of the Platform Medicine
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Jacques Cornuz
University of Lausanne, Lausanne, Switzerland.
Roles: Professor of Primary Care and Head of the Department of Ambulatory Care and Community Medicine
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Emmanuelle Poncin
Platform Medicine, Spirituality, Care and Society, Lausanne University Hospital, Lausanne, Switzerland.
Roles: Researcher
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Stéfanie Monod
Canton of Vaud, Lausanne, Switzerland.
Roles: Head of the Department of Public Health
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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)
    Page navigation anchor for Provision of spiritual care in general practice
    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)
    Page navigation anchor for Spiritual care is stagnating in general practice
    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...
    Show More
    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.
     
    Show Less
    Competing Interests: Lead for chaplaincy provision in Regent Gardens Medical Practice
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British Journal of General Practice: 69 (678)
British Journal of General Practice
Vol. 69, Issue 678
January 2019
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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
British Journal of General Practice 2019; 69 (678): 40-41. DOI: 10.3399/bjgp19X700613

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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
British Journal of General Practice 2019; 69 (678): 40-41. DOI: 10.3399/bjgp19X700613
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  • Article
    • INTRODUCTION
    • (NON-)EVOLUTION IN THE LITERATURE
    • EXISTING MODELS
    • SPIRITUALITY AND PRIMARY CARE REFORM
    • WHAT FUTURE?
    • CONCLUSION
    • Notes
    • REFERENCES
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More in this TOC Section

  • SAFER diagnosis: a teaching system to help reduce diagnostic errors in primary care
  • An Australian reflects on the Collings report 70 years on
  • GP home visits: essential patient care or disposable relic?
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