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Spiritual Care in Healthcare was the subject addressed by Richard Egan, Associate Professor at the Department of Preventative and Social Medicine at the University of Otago. He has qualifications in Theology, English Literature, Religious Studies, and Public Health. Richard stated that spirituality is implicitly present in healthcare and that it is timely to make it more explicit.

He was raised a Roman Catholic, and spent time in a seminary until he fell in love and needed to leave. These days he says he is more spiritual than religious, and has been teaching medical students about spirituality in the clinic for the past three years. In the past healthcare has often been medicalised and dehumanising, but there is now a movement towards an holistic care approach which is patient- and whanau-centred. The 2018 census showed that 48% of people in Aotearoa had no religion while 37% stated they were Christian. Secularization can be defined as having the choice to believe what you like. These days dying can take a long time, and consideration of spirituality is an important part of the process.

Since 2000 hauora/health in Aotearoa has been based on Te Whare Tapa Whā, the four houses which were developed as a model of wellbeing by Sir Mason Durie. They encompass physical, mental, spiritual, and social wellbeing, with a fifth (land/roots) added more recently.

Interestingly Treasury uses He Ara Waiora, which can be seen as Te Whare Tapa Whā version 2.0.

At this point Richard invited us to share with our neighbours one to three words which describe spirituality to us. My word was connections. We were then told that the most common definitions of spirituality in global research are connectedness and meaning of life/purpose.

Unaddressed spiritual needs can affect the patient’s quality of life, and integration of spirituality may result in more patient-centered care. Meaningful Ageing Australia is an organisation which is working in this area. Spiritual care is about enabling the person to access their own spiritual resources. Sadly in Aotearoa only 0.25% of the health budget is spent on spiritual care. However spirituality is increasingly becoming part of health policy, and healthcare providers are cultivating compassionate presence, which need not take a great deal of time. In pairs we discussed ways in which this policy might be put into practice.

It was acknowledged that many health providers are short of time to simply sit with patients. In Hospices the staff to patient ratio is one to three or four, whereas in hospitals it is one to twenty. Richard acknowledged the importance of having an Advance Care Plan, which is a place where you can specify your spiritual needs. It was noted that continuity of care is important, e.g. having a relationship with a particular G.P. Hospital chaplains are often Christian Ministers, but there is a trend to include non-Christians, and the title of Chaplain could possibly be changed to Spiritual Care Practitioner.

It’s something that needs to be there
the spiritual side of care

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