The SPIRITual history

Spirituality can be defined as a belief system focusing on intangible elements that impart vitality and meaning to life's events. Often spirituality is expressed through formalized religions. Recently, the interplay of spirituality, religion, and health care has been explored in the medical literature. Spiritual belief systems impact on the incidences, experiences, and outcomes of several common medical problems. Unfortunately, there is little recent literature addressing the process of conducting a medically oriented spiritual history. One approach to assisting the physician in spiritual history taking, a mnemonic, SPIRIT, is presented as a guide to identifying important components of the spiritual history. This article addresses the issues of when and whom to interview, as well as specific professional and ethical issues related to this topic. Two case examples from my practice are presented to illustrate the utility of the SPIRITual history.