Integrating Spirituality and

****answer need to be in APA and at least 2 references****

This week at clinical reminded me that health is indeed the whole being of a person, which includes the spiritual beliefs of a patient as well. In the acute care world I have had encounters with patient’s spiritual beliefs that have cause patient to refuse life saving interventions, like blood products or transplants. Today in primary care I encountered how a patient’s perception of God and faith can go on to have a negative impact on health as opposed to a positive one as it relates to health maintenance and disease progression. Studies show that 90% of patients strongly believe that spirituality is as important as physical health. At the same time, 40% of patients harness faith to cope with health challenges, and 25% rely heavily on prayer during ill health. Religious faith can also be a source of strength and comfort whenever patients face stressful and challenging health situations. In fact, 67% of patients believe that spirituality could enable medical practitioners to offer realistic hope on treatment outcomes, (“How to Respect Patient’s Religious Beliefs During Treatment,” 2017).

This week I met a patient who was following up on a wellness visit form last week to review her labs and to have continued in office blood pressure monitoring. The patient is a 67 year old female how was born in the Island of Jamaica and happens to be the wife of a Baptist minister. The patient just transferred care from her primary in her home city 2 hours away in leu for being treated at this practice because her daughter suggest she made the change to this practice being ran by old family friends and because, according to the patient, she felt her prior provider “is not able to bring my blood pressure down.” The patient has an history of hypertension, diabetes, high cholesterol, and renal disease. The patient is on several medications to treat her various conditions. Previous lab draw results from prior provider done 3 months ago showed last GFR at 25%. On arrival to the office this week the patient’s blood pressure was 198/100. The patient has decreased vision in the right eye caused by glaucoma and on assessment was found to be cloudy. The patient appeared anxious because she states she had been checking her blood pressure several times at home and it just kept climbing. The patient has been in care of the practice now for 2 weeks and completed a series of blood work drawn and resulted. The patient’s new GFR results shows 19% kidney function, indicating stage 5 kidney failure. On the patient’s initial visit it was found that the patient was not compliant with her medication regimen as she was only taking one of her 5 heart/blood pressure medications, stating she didn’t like how they made her feel and she was having near syncopal episodes. The patient was then convinced to try taking all except the beta blocker. On this visit the patient admitted she still wasn’t compliant and that she was praying about it. The patient was also apprised of her kidney function and told she would be referred to a nephrologist and she will need dialysis. The patient stated that with prayer and faith her functions will improve. Education was given to the patient, however the patient appears to not be ready to learn as she is still reluctant to take her medications as prescribed and unwilling to do dialysis because she is waiting for God to fix the problem, as opposed to thinking that these medical interventions are God’s way of relieving the problem that she is undoubtedly making worse. In cases like this the provider has to respect the patients belief and allow for autonomy and continue to deliver culturally competent care. If providers and health care systems are not working together to provide culturally competent care, patients may have untoward health consequences, receive poor quality care, and be dissatisfied with the care they receive, (Swihart, Yarrarapu & Martin, 2021).

Though medication non compliance and kidney failure is the primary reason for her unresolved htn. Differential diagnoses for this patient include congestive heart failure, anxiety, hyperthyroidism, portal hypertension.

References

Swihart, D. L., Yarrarapu, S.N., Martin, R.L.(2021), “Cultural Religious Competence In Clinical Practice,” StatPearls Publishing. Accessed June 2,2021 from https://pubmed.ncbi.nlm.nih.gov/29630268/

“How to Respect Patient’s Religious Beliefs During Treatment” (2017), Adventist University Academic Resource. Accessed June 2,2021 from https://progressivechristianity.org/resources/how-…