FICA and HOPE in Clinical Care: A Narrative Review Comparing 2 Spiritual Screening Tools Used by Physicians

This review aims to compare the FICA (faith, importance/influence, community, address in care) and HOPE (sources of hope, organized religion, personal spirituality/practices, effects on care) spiritual screening tools across multiple domains, including clinical utility, implementation feasibility, and psychometric properties, in order to synthesize evidence and provide guidance to health care practitioners and educators regarding the relative strengths and limitations of the 2 tools. This review of published literature involved a structured search in PubMed, CINAHL, Embase, and PsycINFO, from which 2 reviewers independently screened, extracted, and synthesized data using predefined criteria. The studies included in the review assessed the use of the FICA and/or HOPE tools with adult patient populations and health care professionals in multiple countries, primarily within academic and hospital-based settings. FICA was more frequently used in clinical and educational settings and was noted for its structured format and integration into serious illness care. Meanwhile, HOPE was noted for its open-ended format and greater flexibility in exploring personal spirituality, particularly among patients identifying as spiritual but not religious. Although there does not seem to be research validating or using psychometric resources to analyze these tools, qualitative studies indicated their perceived value in enhancing holistic care. Both FICA and HOPE are valuable frameworks for initiating spiritual screenings in clinical practice. FICA may be more suitable in fast-paced environments because of its concise structure, whereas HOPE offers greater depth and personalization. Further research should focus on developing validated outcome measures and examining the impact of spiritual screenings on patient care.