Evaluation of a Spiritual History with Elderly Multi-Morbid Patients in General Practice—A Mixed-Methods Study within the Project HoPES3

Background: The “Holistic Care Program for Elderly Patients to Integrate Spiritual Needs, Social Activity and Self-Care into Disease Management in Primary Care” (HoPES3) examines the implementation of a spiritual history (SH) as part of a multifaceted intervention in German general practices. While the effectiveness of the interventions was evaluated in a cluster-randomized trial, this article investigates the patients’ views concerning the acceptability of the SH and its effects. Methods: A mixed-methods study was conducted in which 133 patients of the intervention group filled in a standardized questionnaire after the intervention. Later, 29 of these patients took part in qualitative semi-standardized interviews. Results: According to the survey, 63% (n = 77) of patients found the SH helpful. In the interviews, however, many indicated that they either kept the conversation brief or declined the offer to talk about spirituality. Contents of longer conversations referred to difficult life events, personal sources of strength, and experiences with religious institutions. Many patients who had a longer conversation about spirituality reported that their relationship with their general practitioner (GP) had improved. Almost all patients recommended integrating a personal conversation of this kind into primary care. Conclusions: The SH seems to be a possible ‘door opener’ for a trusting doctor-patient relationship, which can then be built upon.

Spiritually and culturally sensitive evidence-based approaches to taking a spiritual history

Given the demonstrated relationship between religion and spirituality (R/S) and mental health, clinicians are faced with the decision of how to integrate R/S into clinical care. The first, most basic step to inform this decision is to ascertain a spiritual history. A skillful spiritual history can help the clinician to understand not only the patient’s R/S and whether they would like R/S involved in his clinical care, but also key mental health information, aiding in diagnosis and treatment planning. Studies have shown that patients want clinicians to ask about R/S, and that taking a spiritual history can correlate with improved patient treatment adherence, trust, and well-being. While many mental health professionals consider patient R/S to be important, few discuss R/S with patients in practice, and few training programs include guidance on the spiritual history. This chapter includes practical tools and considerations to consider when taking a spiritual history in various clinical and cultural scenarios. Basic tenets of taking a spiritual history are reviewed, along with the details of a few published tools for taking the spiritual history. The chapter concludes with a discussion of nuances in the spiritual history and a summary of areas for future study.

The Contribution of Ss. Cyril and Methodius to Culture and Religion

The Byzantine mission of saint brothers Cyril and Methodius had a major impact on the spiritual history of Great Moravia. In the centuries that followed, their works paved the way for the political and historical development of the Slavic nations, mainly in South-East and East Europe. The mission, which reached Great Moravia in 863, had several dimensions. The most important were evangelism and the cultural and civilizational dimensions. Translations of the Gospel and liturgical texts into Old Church Slavonic intensified the religious life of our ancestors and laid the foundations of literature and culture for almost the entire Slavic world. From this point of view, research should be focused on the role and reflection of this historical and cultural heritage in the ecclesiastical and spiritual, national and cultural life of the Slavic nations. The aim of this article is to assess the significance of Christian and Byzantine cultural values in terms of the collective Slavic identity. The Cyrillo-Methodian idea manifests itself in the history of the Slavic world as a complex but solid foundation, capable of renewing the sleeping or inhibited energy and values in the areas of faith, culture, literature, arts, education, upbringing, as well as national consciousness.

Spirituality, Religion, and Humanism

As a humanistic, patient-centered approach to medicine becomes more accepted, physicians are moving from a purely objective, systematic approach to medicine toward a more holistic approach adapted to individual patients and their values and beliefs. While doctors are often uncomfortable discussing religion and spirituality with patients, some patients may actually benefit from the integration of these beliefs into the treatment process. While the terms are often used interchangeably, “religion” and “spirituality” have different meanings; religion refers to an organized system of beliefs, while spirituality relates to how individuals seek and express meaning in life through their connections to the self, others, nature, and the sacred. Religion or spirituality can improve treatment outcomes by providing patients with a more positive perspective, a greater sense of purpose, and healthier coping strategies. Prayer and meditation can inspire the relaxation response, which can improve many health indicators. The HOPE Questions for Spiritual Assessment and the FICA Spiritual History Tool are two methods that can be used to assess patients’ attitude toward the spiritual and how treatment should acknowledge these beliefs. Medical humanism encompasses many of these practices, because it is based on the idea that the physician should focus on the whole patient, including patients’ religious or spiritual beliefs.

Dlaczego w koncepcji Jaspersa postać Jezusa znajduje się poza „czasem osi”?

Karl Jaspers’s concept of the Axial Age (German: Achsenzeit), or the unprece- dented age of the highest rise of the human spirit, shows the kinship of people belonging to such different civilizations as Greek, Jewish, Hindu and Chinese. The Axial Age is not only the subject of research for many scholars dealing with the past, but also a possible foundation for the future realization of the peaceful unity of people of the whole Earth. The article focuses on the figure of Jesus, considered by Jaspers as one of the four paradigmatic individuals (German: die maßgebenden Menschen), i.e. people with the greatest influence in the spiritual history of humanity. Therefore, the presence or absence of Jesus in the Axial Age will bring serious consequences. The article presents Jaspers’s arguments for recognizing the period between the 8th and 2nd century BC as the Axial Age, and the possibility of expanding it.

The Dialectics of Affect

Initially influenced by Schelling’s lectures on positive philosophy (1841–1842), Kierkegaard ultimately withdrew from his lectures, devoting his attention exclusively to the redaction of Either/Or. The Concept of Anxiety was written in the shadow of that work under a uniquely anonymous pseudonym. Of course, anxiety in his deformalization of late idealism was not a concept; it belonged and did not belong to the understanding. Indeed, it precedes human actions under the sign of inherited “sinfulness” and as sheer possibility. If Kierkegaard aligned freedom with a leap, then anxiety was the affect precursive to it. Anxiety was the prethetic knowing that we are able to do. . . X. Tracing the “spiritual” history of the human race which carries the sins of the fathers even as it freely enacts sin, Kierkegaard urged that the more spiritual the culture, the more anxious it was. No longer the adjuvant of reason as in Hegel, anxiety belonged to the irreducible condition of a living subject. Over the five years that separated the Concept of Anxiety from Sickness onto Death, Kierkegaard’s mood of “Angest” will intensify as it is approached from his new perspective of Coram Deo (“before God”). Within the new perspective, the status and the meaning of the self is altered, showing a clearer relation to infinity. For the task of Kierkegaard’s philosophy—learning to become the nothing that one is—had attained a new stage in his existential dialectic. His arguments influenced Heidegger’s recourse to anxiety as a passage toward the question of being.

PATRON SAINTS OF GEORGIA IN MODERN ORTHODOX WRITERS’ LITERATURE

Semantics and functions of images that represent Georgia’s patron saints are examined in this article as exemplified in the Georgian Rhapsody, a collection of stories by O. Nikolayeva, stories by M. Saradzhishvili (from the books Do not rush to condemn and Next to you), Exile, a short story by V. N. Lyalin, and Wonderful journey to Orthodox Georgia by O. Rozhneva. Referring to episodes from the hagiography of Georgian saints in the texts in question allow us to trace the spiritual history of Georgia since the time of adoption of Christianity. The detailed list of saints is present in the books of О. Nikolayeva and О. Rozhneva. Even though only particular periods of Georgia's history are reflected in the stories of М. Saradzhishvili and V. N. Lyalin, the country's patron saints participation in the life of their characters in Georgia’s recent past or present day is undeniable. For example, Saint Equal-to-the-Apostles Nina performs a guardian function and her appearance during the Soviet years provides spiritual support to the female character of V. N. Lyalin’s story. First and foremost, a patron in combat, Saint George the Trophy Bearer is also a patron of the family. Venerable David of Garedzha is both an example of humility and a patron of the hearth and home. With his gift of prophecy, Blessed Gabriel (Urgebadze), mentioned in the book by О. Rozhneva, also assists on the path of personal salvation. Whereas О. Rozhneva’s book is exclusively focused on depicting Orthodox Georgia and its saints, the work of О. Nikolayeva provides a more comprehensive image of Georgia, including a vast stratum of the country’s cultural characteristics. In О. Nikolayeva’s book the saints represent a significant facet of Georgia’s image.