Original Article

Integrating Spirituality Into Outpatient Practice in the Adventist Health System

Authors: Harold G. Koenig, MD, Kathleen Perno, RN, CLC, Ted Hamilton, MD


Objectives: We examined Adventist Health System (AHS)–affiliated providers and staff regarding controversial spiritual practices such as praying led by a practitioner, sharing of personal religious beliefs, and encouraging patients’ religious beliefs for health reasons.

Methods: Approached were 1082 providers to participate in a project to integrate spirituality into outpatient care. Those who agreed were asked to identify staff in their practice to assist. Providers and staff were asked to complete a baseline questionnaire examining attitudes/practices concerning spiritual activities with patients. Regression models were used to identify predictors.

Results: Questionnaires were completed by 520 providers (83% physicians and 17% mid-level practitioners) and 217 nurses and other staff members. A significant proportion of providers and staff (29.6% vs 49.1%) indicated “often/very often” to a statement that healthcare professionals should pray with patients, should initiate an offer to pray (25.7% vs 49.1%), should pray if the patient initiates the request (72.2% vs 79.5%), and should encourage greater religious activity for health reasons (48.9 vs 48.1%). With regard to behaviors, 15.3% of providers and 8.8% of nurses and other staff members currently often or always prayed with patients, 24.2% and 25.1% shared their personal faith, and 28.2% compared with 22.0% encouraged patients to become more active in their religious faith; however, 93.3% had little or no training on how to do so. The strongest and most consistent predictor of religious activity with patients was self-rated religiosity of the health professional.

Conclusions: A significant proportion of Adventist Health System providers and staff favor engaging in spiritual practices with patients. Training is needed to engage appropriately and sensitively in these activities.


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