Discussing spiritual health in primary care and the HOPE tool - a survey of social prescribers.

Résumé

BACKGROUND: Social prescribing aims to provide holistic care to patients and reduce health inequalities by meeting needs that expand beyond the biomedical model, as detailed in the National Health Service (NHS)'s Long Term Plan. While holistic care includes spiritual health, understanding of social prescribers' attitudes towards discussing spiritual health with their patients is limited. This study aimed to (1) explore social prescribers' views on discussing spiritual health with patients; and (2) identify key barriers and facilitators to incorporating spiritual health within their practice, including the potential for using a structured tool (the HOPE tool) to support discussions.METHOD: We developed, piloted and administered a bespoke online survey for social prescribers working within primary care in the UK over two months, 1st August to 30th September 2024. This was based on our previous work with UK family doctors (general practitioners or GPs) on the topic of spiritual health and use of spiritual history-taking tools. The acceptability of the HOPE tool was investigated using patient vignettes drawn from clinical practice.RESULTS: One hundred seventy-one social prescribers responded. One hundred and twenty (70%) reported that they felt comfortable asking patients about their spiritual health. A similar proportion (71%) felt that the HOPE tool was beneficial. Those who were uncomfortable with the topic did not appear to have their comfort affected by learning about the HOPE tool. Attitudes towards spiritual health fell into categories of embracing, pragmatic, guarded and rejecting. Barriers and facilitators to discussion of spiritual health included: a perceived need for patient cues and training; fear of causing offence or upset; and pre-existing practitioner attitudes towards and/or interest in the topic.CONCLUSIONS: Social prescribers are positive about discussing spiritual health with patients and feel comfortable with the topic. The HOPE tool may be helpful where social prescribers are already happy to discuss spiritual health, but other approaches will be needed for those who are reluctant to broach the topic. If social prescribers are more comfortable with the topic of spiritual health than GPs, they may hold the answer to an area of unmet need. Training needs are highlighted for further research.