|Year : 2017 | Volume
| Issue : 1 | Page : 50-52
Concepts of spirituality prevailing among undergraduate medical students in Delhi
Shantanu Sharma, Panna Lal
Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
|Date of Web Publication||13-Feb-2017|
No. 87, Manak Vihar, Trans Yamuna, New Delhi - 110 092
Source of Support: None, Conflict of Interest: None
Background: Spirituality is considered one of the determinants of health. Various studies have documented its role in the management of psychological illnesses such as schizophrenia, and anxiety disorders. Doctors often lack skills to do spiritual assessment of the patients. Aim: The current study was conducted among the 1st year undergraduate medical students to find out their ideas and thoughts about spirituality using self-administered questionnaire. Methodology: This was a college based cross sectional study wherein 168 students were interviewed using semistructured, self administered questionnaire. Ethical clearance was obtained from Institutional ethical committee.Results: Most of the students (93.5%) believed in spirituality, but only about half (49%) of them had complete knowledge about it. Only psychological disorders and chronic diseases were labeled by students who need spirituality as a modality of treatment. Girls linked spirituality with God more than boys. A formal training in spirituality is not essential according to 43% of the subjects. Conclusion: The undergraduates need to understand the importance of this dimension of health. A mere gain in knowledge about spiritual strength available in some of the textbooks would not be able to orient doctors sufficiently to apply it in their practice. Future Direction: Skill building and practicing the culture of spiritual counseling among health workers is the need of hour.
Keywords: Belief, health, medical students, spirituality
|How to cite this article:|
Sharma S, Lal P. Concepts of spirituality prevailing among undergraduate medical students in Delhi. Indian J Soc Psychiatry 2017;33:50-2
|How to cite this URL:|
Sharma S, Lal P. Concepts of spirituality prevailing among undergraduate medical students in Delhi. Indian J Soc Psychiatry [serial online] 2017 [cited 2019 Mar 23];33:50-2. Available from: http://www.indjsp.org/text.asp?2017/33/1/50/200088
| Introduction|| |
Spirituality is the search for “transcendent meaning” – can be expressed in religious practice or… expressed “exclusively in their relationship to nature, music, the arts, a set of philosophical beliefs, or relationships with friends and family.” It is an important determinant of physical, social, and emotional health. Studies have emphasized on the role of spirituality in culminating morbidity in geriatric population  and in patients with schizophrenia, major depressive and anxiety disorders, suicidal tendencies, smoking cessation, and many other psychiatric disorders. Several studies show that the majority of patients want their physicians to acknowledge their religious issues and address their spiritual needs.,, They appreciate it if the physician inquires about the patient's religious beliefs , and considers patients' spiritual needs. A study from America reported that medical students responsible for treating substance abuse are significantly less religiously and spiritually oriented than the patients they treat, and that the students do not indicate that spirituality is an important component in the care of patients. There is a need for health staff skilled in spiritual assessment and promotion for the benefit of their patients. There are lacunae in data regarding the knowledge of general practitioners and also the skills and attitudes to do the spiritual assessment and provide spiritual care in India. The present study was aimed at addressing these lacunae by studying the concepts regarding spirituality among the 1st year undergraduate medical students in New Delhi.
| Methodology|| |
This cross-sectional study was conducted in Maulana Azad Medical College in New Delhi where about 180 undergraduate medical students including both males and females are enrolled every year in MBBS course. They represent different religious and cultural backgrounds as well. A total of 168 1st year students present on the day of survey were approached. First-year undergraduates were undertaken to assess the baseline spiritual knowledge of medical graduates before the impact of medical books. Twelve students denied to participate, since they considered it as unimportant and irrelevant. The information was collected using semi-structured, self-administered questionnaire in English. The response sheet was kept anonymous to maintain confidentiality. Ethical clearance was obtained from the Institutional Ethics Committee. The purpose of the study was explained to the participants before they were included in the study. The participants were assured about privacy and confidentiality of the information provided by them. Data analysis was done using SPSS version 17 (USA Chicago II).
| Results|| |
Among 156 students enrolled in the study, there were 82 boys and 74 girls. Majority of the study subjects belonged to the age group of 17–19 years (94%) and believed in spirituality (93.5%). Among the nonbelievers, most were boys (90%). The spirituality was defined correctly by 110 (70%) students as a belief in God, oneself, and meditation by 57.5% students followed by others defining it as essence of life (5.4%); a state of physical, mental, and social development (8%, 5.4%); to focus in the right direction (0.7%) and to see good toward all (0.7%). Girls linked spirituality with God more than the boys. Approximately, half (49%) of the subjects did strongly agree with the concept that spirituality is essential for health in day-to-day life followed by those who were moderately or slightly agreed with its importance (47%). Only 4.4% did not agree at all. Around 50% of the students believed spirituality helped in curing diseases and almost all of them did correctly mention the diseases where it is helpful [Table 1]. When study subjects were questioned on whether spirituality contributes to health, 54% of the students replied yes, among whom majority (69%) defined contribution as a means of rehabilitation [Table 2]. The study subjects could not find the role of spirituality in building better communication and improving doctor–patient relationship. A formal training of health workers in spirituality was also emphasized by 57.7% of the students.
| Discussion|| |
Spirituality refers to a person's or a group's relationship with the transcendent. In the present study, nearly half of the students did not find spirituality as an essential element for health, yet among believers most claimed spirituality a means to treat mainly psychological disorders. Contrary to our results, in a study  of physician preferences regarding spiritual behavior conducted in North Carolina, Vermont, and Florida in 2003, it was observed that about 85% of physicians believed that they should be aware of the patients' spirituality. Study in the same areas in 2003 by Maugans et al. revealed that 64% of doctors believed in God. Many studies ,,, have reported positive association between religious commitment and health outcomes such as prevention of illness including depression, substance abuse, physical illness, mortality, and recovery from illness. Spirituality was found beneficial in 60–90% of diseases, including angina pectoris, asthma, herpes simplex, and duodenal ulcer.
The complete definition and concept of spirituality in the present study were lacking among most of the students. These results are congruent with that of another study conducted in Brazil in 12 medical schools in 2010 and 2011. In this study from Brazil, the majority of medical students (71.2%) believed that spirituality has an impact on patients' health and that this impact was positive (68.2%). The majority also wanted to address spirituality in their clinical practice (58.0%) and considered it relevant (75.3%), although 48.7% of them felt unprepared to do so. In the study conducted among family physicians of Illinois (n = 210), the study subjects believed that strong religious convictions positively affect older patients' mental health (68%) and physical health (42%), physicians' should pursue spiritual issues at patients' request (88%) and especially when patients faced bereavement or impending death (66%). Similarly, Missouri family physicians (n = 231) affirmed that spiritual well-being is an important health component (96%) and that hospitalized patients with spiritual concerns should be referred to chaplains (86%) to address their spiritual needs. More physicians (58%), however, felt that they should personally address patients' spiritual questions.,
| Conclusion|| |
Although physician is capable of curing physical ailments through medical treatment, they cannot ignore the emotional and spiritual needs of a patient. Hence, physicians need to be attentive to patients' emotional and spiritual elements. As revealed from the current study, medical students lack complete knowledge about spirituality and also the proven benefits and importance in the management of chronic diseases. They should be given an opportunity at the beginning of their career to understand this spiritual part of the treatment for their patients, which is still not being taught formally under the existing prescribed medical curriculum. Being empathetic helps a doctor communicate better with the patient and address his spiritual needs if trained very well.
| Limitations|| |
The smaller sample size of the current study limits its external validity. The universe was limited to undergraduates of one medical college. The survey was short and rapid in which in-depth indicators of knowledge about spirituality could not be assessed.
| Future Directions|| |
Spirituality is intangible something that transcends physiology and psychology. Hence, there is a need to address this issue by giving due importance not only in few lines of a chapter in the book, but also a practical application while taking case histories, examinations, and prescribing medications to patients. Counseling, which forms an important part of management for any disease, should be formulated in the manner to involve the essence of spirituality.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Astrow AB, Puchalski CM, Sulmasy DP. Religion, spirituality, and health care: Social, ethical, and practical considerations. Am J Med 2001;110:283-7.
Hassed C. The role of spirituality in medicine. Aust Fam Physician 2008;37:955-7.
Lucchetti G, Lucchetti AG, Badan-Neto AM, Peres PT, Peres MF, Moreira-Almeida A, et al.
Religiousness affects mental health, pain and quality of life in older people in an outpatient rehabilitation setting. J Rehabil Med 2011;43:316-22.
Shah R, Kulhara P, Grover S, Kumar S, Malhotra R, Tyagi S. Contribution of spirituality to quality of life in patients with residual schizophrenia. Psychiatry Res 2011;190:200-5.
Rasic D, Robinson JA, Bolton J, Bienvenu OJ, Sareen J. Longitudinal relationships of religious worship attendance and spirituality with major depression, anxiety disorders, and suicidal ideation and attempts: Findings from the Baltimore epidemiologic catchment area study. J Psychiatr Res 2011;45:848-54.
McFadden D, Croghan IT, Piderman KM, Lundstrom C, Schroeder DR, Hays JT. Spirituality in tobacco dependence: A Mayo Clinic survey. Explore (NY) 2011;7:162-7.
Hayden D. Spirituality in end-of-life care: Attending the person on their journey. Br J Community Nurs 2011;16:546, 548-51.
Maugans TA, Wadland WC. Religion and family medicine: A survey of physicians and patients. J Fam Pract 1991;32:210-3.
Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med 1999;159:1803-6.
King DE, Bushwick B. Beliefs and attitudes of hospital inpatients about faith healing and prayer. J Fam Pract 1994;39:349-52.
Goldfarb LM, Galanter M, McDowell D, Lifshutz H, Dermatis H. Medical student and patient attitudes toward religion and spirituality in the recovery process. Am J Drug Alcohol Abuse 1996;22:549-61.
Monroe MH, Bynum D, Susi B, Phifer N, Schultz L, Franco M, et al.
Primary care physician preferences regarding spiritual behavior in medical practice. Arch Intern Med 2003;163:2751-6.
Matthews DA, Larson DB. The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects: Enhancing Life Satisfaction. Vol. III. Washington: Institute for Healthcare Research; 1995.
Larson DB, Sherrill KA, Lyons JS, Craigie FC Jr., Thielman SB, Greenwold MA, et al.
Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978-1989. Am J Psychiatry 1992;149:557-9.
Benson H, Friedman R. Harnessing the power of the placebo effect and renaming it “remembered wellness”. Annu Rev Med 1996;47:193-9.
Brody H. Placebo response, sustained partnership, and emotional resilience in practice. J Am Board Fam Pract 1997;10:72-4.
Lucchetti G, de Oliveira LR, Koenig HG, Leite JR, Lucchetti AL; SBRAME Collaborators. Medical students, spirituality and religiosity – Results from the multicenter study SBRAME. BMC Med Educ 2013;13:162.
Koenig HG, Bearon LB, Dayringer R. Physician perspectives on the role of religion in the physician-older patient relationship. J Fam Pract 1989;28:441-8.
Ellis MR, Vinson DC, Ewigman B. Addressing spiritual concerns of patients: Family physicians' attitudes and practices. J Fam Pract 1999;48:105-9.
[Table 1], [Table 2]