Many people
encounter ill-health occasion-ally and when serious,
anxiety is often provoked and both the person that is
ill as well as the relatives and friends become very
worried. In most cases, the early thoughts are centered
around the medications that will be useful, who will
properly recommend the right medications and where the
medications can be obtained. In Africa today, patients’
realities and the pursuit of remedies to their
ill-health are moving toward a new alignment.
The interest in both
spirituality and the use of medicines is growing,
with their inclusion in both daily life and in health
care. This editorial highlights how spirituality
and medications can harness each other to create a
better healthy experience for the sick.
Although the importance of considering an individual’s spirituality
in the use of medicines has been emphasized over the
past decade, a clear definition of spirituality
in this respect has been difficult. The Oxford English
Dictionary defines it as “of the spirit or soul;
religious, divine, inspired; refined, sensitive”.
Nevertheless, spirituality has been defined as “a
set of conscious/unconscious beliefs and values
underlying the motivation and reasons for undertaking
any task or occupation”1-3. The word
“connectiveness” has often been used when discussing the
concept of spirituality. According to Tansi3,
“connectiveness relates to the relationships we share
with ourselves, others, nature and/or God and “gives
meaning to life, thereby inspiring and motivating
individuals to achieve their optimal being”.
Furthermore, both vertical and horizontal components of
spirituality have been identified4.
The vertical component involves a person’s relationship
with a higher power (experiencing God as a transcendent
and/or personal being), while the horizontal component
is one’s relationship with self, others and environment
– often referred to as humanistic values and beliefs.
However, spirituality may be defined as the
search for meaning and purpose in life, which may or may
not be related to a belief in God, or some form of
higher power.
In health care delivery system, pharmacotherapy is the treatment
of diseases with the use of medicines5. A
critical aspect of pharmacotherapy is adherence
to medications. Adherence (compliance) here refers to
the degree to which a patient follows a treatment
regimen. It requires that the prescription is obtained
promptly and the medicines prescribed are taken as
prescribed in terms of dose, dosing interval, and
duration of treatment. It is known that only about 50
percent of patients who leave a physician's office with
a prescription take their medicines as directed. The
most common reasons for not adhering to treatment
(non-adherence) include frequent dosing, denial of
illness, poor comprehension of the benefits of taking
the medicine, and cost.
The separation between spirituality and physical
and mental health as well as pharmacotherapy has
been shrinking for years.
Just as certain
thinking patterns may lead to disease symptoms (by
giving a distorted picture of what is going on in the
person’s life, thereby causing anxiety, depression or
anger), spirituality
has both social and psychological dimensions. It plays a
role not only in medication adherence but in
the recognition and acceptance of ill-health6.
There is increasing evidence that spirituality
can help people prevent and recover from mental and
physical ill-health. The results of the
evaluation of over 1,600 studies and reviews7-8
have revealed that the relationship between
spirituality and religion to health and well-being
are threefold – it aids prevention, speeds recovery and
fosters composure in the face of ill-health.
The concept of
spirituality and pharmaco-therapy has a
certain synergy as they both espouse a view of the world
that recognizes the importance of the whole person.
Increasingly, people who are sick want their values and
beliefs attended to, perhaps, choosing a therapy as a
pathway to nourish their sense of the spiritual9.
They want the appropriate health professionals to help
them define honest and realistic expectations10.
Also, the nature of the health professional-client
relationship has been found to account for up to about
45 percent of the effectiveness of therapy.
In a holistic way,
therefore, the pharmacist and other health care
professionals need to acknowledge the spiritual
dimension of ill-health and well-being in order to
provoke a holistic and person-centred intervention,
maximize the effectiveness of medications and achieve a
desired therapeutic outcomes.
In
conclusion therefore, spirituality is implicit to
management of ill-health11 and
pharmacotherapy. Addressing the spiritual needs of
patients can enhance their adherence to medications and
recovery from illness. Nevertheless, the appropriateness
of addressing spiritual issues should be based on the
prevailing situation – let the patient/ client bring it
up. All health professionals should respect their
patients/clients’ cultures and beliefs. Respect, someone
to listen, rights of dignity and choice, sensitivity of
staff to culture, lifestyle or religion, space, and
recognition of personal beliefs and values are
imperative in acknowledging a patient/client’s
spirituality requirement12.
References
1.
Meyers
C. Spirituality. Naidex, 2008. Available at http://www.naidex.co.uk/page.cfm/link=154.
Accessed 20 August 2008
2. Mueller
PS, Plevak DJ, Rummans TA. Religious involvement,
spirituality and medicine: implications for clinical
practice. Mayo Clinic Proceedings. 2001; 76(12):
1225-1235.
3.
Tanyi
RA. Towards clarification of the meaning of
spirituality. J Adv Nursing. 2002; 39(5): 500-509.
4.
Stoll R.
The essence of spirituality. In: Carson V (ed).
Spiritual Dimensions of Nursing Practice. WB Saunders,
Philadelphia, USA, 1989.
5.
http://medical-dictionary.thefreedictionary.com/
pharmacotherapy.
6. Lewis
LM. Spirituality
and medication adherence in older african american
adults diagnosed with hypertension: A qualitative study.
Circulation.
2007; 116:II_675.
7.
Koenig
HK, McCullough ME, Larson DB. Handbook of Religion and
Health. Oxford University Press, 2001.
8. Mueller
PS, Plevak DJ, Rummans TA. Religious involvement,
spirituality and medicine: implications for clinical
practice. Mayo Clinic Proceedings. 2001; 76(12):
1225-1235.
9.
Foster
RNE. The spiritual encounter within a complementary
therapy treatment.
Complement Therapies Clin Pract.
2006; 12(2): 163-169.
10. Scott
JG, Cohen D, DiCicco-Bloom B, Miller WL, Stange KC,
Crabtree BF.
Understanding Healing Relationships in Primary Care. Ann
Fam Med 2008; 6: 315-322. DOI: 10.1370/afm.860.
11.
Egan M,
DeLaat MD. The implicit spirituality of occupational
therapy practice. Can J Occupation Ther. 1997; 64(1):
115-121.
12.
Udell L,
Chandler C. The role of the occupational therapist in
addressing the spiritual needs of clients. British J
Occupation Ther. 2000; 63(10): 489-494.
