Health Medical Homework Help

Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:

1) The FICA Spiritual History Tool is one of several spiritual assessment tools available. It is designed to elicit patient spirituality and its potential effect on healthcare by having the healthcare provider ask a series of questions.

F: What is your Faith?

I: Have your beliefs Influenced how you take care of yourself in this illness?

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

A: How would you like me to Addressthese issues in your health care? (Saguil & Phelps, 2012). 

My assessment is on a 56-year-old Caucasian female that I saw in clinical that is suffering from adjustment disorder with depressed mood and with mixed disturbance of emotions and conduct. She is also suffering from end-stage multiple sclerosis. She is in long-term care due to the MS. She is depressed due to being confined to a wheelchair at a young age. She is starting to have some memory decline as well. She was just recently moved to the new long-term facility she is in now. Before she was in an assisted living but is no longer able to live unassisted. She has a history of depression. 

F: What is your faith? “I am a Christian. I believe in heaven and in God. But right now, I am a little angry because I am so sick. I know it’s not anyone’s fault, but it doesn’t make it any easier. I no longer go to church in person but do try to watch it online at least 2 times a month”

I: Have your beliefs influenced how you take care of yourself in this illness? “I usually pray more when I am sick, but I have not been praying as much as usual due to my mood.”

C: Are you part of a spiritual or religious community? “I used to go to church in Tampa, I don’t remember the name. Now I just try to find something online to watch. I don’t care what church it is as long as the message is good.”

A: How would you like me to address these issues in your health care? “I know that God is the ultimate healer. However, right now, I am upset. I want to get back into church so I can make peace with my situation.”

Assessment: DSM 5: V62.89 (ICD 10: Z65.8) Other Problem Related to Psychosocial Circumstances

Plan: Referral to a chaplain for religiously integrated cognitive behavioral therapy (RCBT). Religious beliefs and motivations incorporated into cognitive behavioral therapy processes that are used to encourage thought and behavior modifications is the definition of RCBT. The technique has been adjusted from Judith Beck’s cognitive behavior model to fit religious beliefs and sociocultural context. Utilizing strong religious beliefs, doctrines, and behaviors, therapists feel that patients can be trained to modify their bad beliefs, values, and behaviors to form a meaningful, hopeful, and optimistic view of the world. By utilizing RCBT, it is theorized that depression will be eliminated by giving the patient the meaningful, hopeful, and optimistic view of the world that they currently lack. The RCBT is performed by a therapist over 12 one-hour weekly sessions (Hosseini et al., 2017).

References

Hosseini, S. H., Rafiei, A., & Gaemian, A. (2017). Comparison of the effects of Religious cognitive behavioral Therapy (RCBT), cognitive behavioral Therapy (CBT) and Sertraline on depression in patients after coronary artery bypass Graft surgery: A randomized controlled trial. World Family Medicine Journal/Middle East Journal of Family Medicine, 15(10), 32–41. https://doi.org/10.5742/mewfm.2017.93135

Saguil, A., & Phelps, K. (2012, September 15). The Spiritual Assessment. American Family Physician. https://www.aafp.org/afp/2012/0915/p546.html.

2) Per Woodall (1996), the patient must be assessed holistically, which includes their spirituality. A patient’s spiritual beliefs can affect their perception of illness and their treatment decisions. Studies have shown that religious beliefs and practices can affect a person’s health experience (Woodall, 1996).

Dr. Todd Maugans created the mnemonic ‘SPIRIT’ as an interviewing tool to assist providers with spiritual history taking (Saguil & Phelps, 2012). As healthcare providers, we have a responsibility to make sure that patients are comfortable with their religious beliefs. However, we also have ethical responsibilities when it comes to communicating with them (Woodall, 1996).

My patient is an 71-year-old African-American female diagnosed of Major depressive disorder, Anxiety, Bipolar, and Dementia. She was brought in by emergency medical services for bizarre behavior. The patient is a widower and lives with her eldest daughter. Her youngest daughter, of two, comes over 2-3 times per week to check on her. The patient needs 24-hour supervision, care with her ADLs, and receives a monthly pension check. She has Medicare insurance and receives food stamps.

Subjective

S= Spiritual belief System: What is your religious affiliation? “I am of the Baptist faith. I am a member of a local church for over 25 years, but often misses church due COVID restrictions.”

P=Personal Spirituality: Describe the beliefs and practices of your religion. “I believe in the Father, the Son, and the Holy Spirit. Trust in God, for he will take care of it all.” 

I=Integration with a spiritual community: Do you belong to any spiritual or religious group? What is your role? “No, I don’t. I call my Pastor whenever I need prayer.”

R=Ritualized practices and Restrictions: Are there specific practices that you must carry out as a part of your religion or restrictions? “As Baptists, we do not have limitations. The Bible instructs us to live Christ-like.”

I=Implications for medical care: What aspects of your religion would you like me to keep in mind as I care for you? “I trust in God for all things.”

T=Terminal events planning: As we plan for your care near the end of life, how does your faith affect your decisions? “I have lived a good life on Earth. However, when the time comes, I want to be with my Father in heaven.”

Plan

According to Rindfleisch (2013), it is important to address spirituality with the patient often without overt projection of our beliefs. Moreover, I would maintain a record of all the persons authorized to discuss my patient’s condition.

References

Rindfleisch, J. (2013). Whole health: Change the conversation spiritual assessment tools clinical tool. Whole Health Library. http://projects.hsl.wisc.edu/SERVICE/index.php

Saguil, A. & Phelps, K. (2012, September 15). The spiritual assessment. American Family Physician, 86(6), 546-550.https://www.aafp.org/afp/2012/0915/p546.html

Woodall, H. (1996, January). The spiritual history. Archives of Family Medicine, 5(1):11-16. DOI: 10.1001/archfami.5.1.11. PMID: 8542049.