Spirituality in Healthcare

A 2022 study published in JAMA by researchers from Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital reviewed the best available evidence on the role of spirituality in serious illness and overall health. The researchers wanted to know how taking spirituality into account could help guide the way health care is delivered and improve health outcomes

Spirituality was defined broadly as the ways people seek meaning, purpose, and connection, which may or may not involve religious practice. The team conducted two systematic reviews of thousands of studies published between 2000 and 2022, one on serious illness and one on health outcomes. Only research with validated measures of spirituality and low to moderate risk of bias was included. Eligible serious illness studies had at least 100 participants and eligible health outcome studies had at least 1,000 participants or were large randomized trials. From 371 serious illness studies and 215 health outcome studies, a multidisciplinary panel synthesized findings and ranked practical implications.

In serious illness, strong evidence showed that:

• Spirituality is important to most patients with serious illness.
• Spiritual needs are common but often go unmet in medical care.
• Patients frequently desire spiritual care and such care is associated with better quality of life and end-of-life outcomes.
• Addressing spiritual needs can influence medical decision-making.

In health outcomes, the evidence demonstrated that:

• Frequent participation in religious or spiritual community activities is linked to lower mortality, healthier behaviors, better mental health, and higher quality of life.
• These associations often show a dose–response relationship, meaning that more frequent participation in spiritual activities or communities is linked to greater health benefits.
• In adolescents, frequent participation is associated with lower rates of risky behaviors, substance use, depression, and suicidal thoughts or actions.

The authors concluded that incorporating spirituality into both serious illness care and public health strategies is an essential part of person-centered care, with clear links to better outcomes. They recommend that health systems routinely integrate spiritual care into the treatment of patients with serious illness, ensure that the members of interdisciplinary care teams receive training in this area, and include trained spiritual care specialists such as chaplains in patient care.

For broader health promotion, they advise recognizing the protective benefits of participation in religious or spiritual communities when designing patient-centered and population health initiatives, increasing awareness among health professionals about this evidence, and formally treating spirituality as a social factor that influences health in research, community assessments, and program development.