American Society of Regional Anesthesia and Pain Medicine February 2018 - 33

distress, and religious or spiritual resources. Finding meaning and
purpose many not be about doing things differently but rather
seeing familiar things in new ways.12
Spiritual care services provides the APS team, including resident
anesthesiologists, and pain clinic staff with information and
didactics to help broaden their understanding of spiritual care.
Spiritual care providers round together with the entire APS team
(and independently), providing oral and written communication
to increase the team's awareness of patients' spiritual distress,
connection to pain, and inner resources.
Spiritual care aims to empower patients to discover, claim, and
rely on their inner religious or spiritual resources as integral and
valid treatment interventions as part of a multimodal plan of care.
For example, a patient was admitted for a complex infection; the
patient was alone, in distress, and had high pain management
needs. As spiritual care engaged in the patient's story, it became
apparent that the patient was suffering from unresolved grief (the
loss of a loved one a year prior). The patient's unresolved grief was
interwoven with his discomfort and limited his ability to cope with
acute pain. As the patient's grief was addressed and supported, the
patient's physical discomfort decreased, and the patient was better
able to cope through the duration of his hospital stay.
In another example, a patient came to the pain clinic for a presurgical
consultation for back surgery. The patient was feeling apprehensive
about having another surgery because of her history of chronic back
pain and previous back surgeries. Spiritual care was able to meet
with the patient in the pain clinic and listen to the patient's anxiety,
concerns, and hopes for her upcoming surgery and long-term health.
Spiritual care was able to assess the patient's spiritual resources
and draw on them during her subsequent hospital stay to help
her cope through discomfort and anxiety while being hospitalized.
Upon hospital discharge and pain clinic follow-up, the patient was
appreciative of the holistic support she received from the APS team
throughout her medical care and procedure.
SUMMARY
It has been our experience that integration of spiritual care in an
APS has demonstrated an increase in building of essential trust,

rapport, and patient engagement in plans of care. The focus of
pain service treatment has deepened and broadened to include
reinforcement of spiritual resources and greater empathy for how
grief and spiritual distress affect patients. When patients feel
heard and understood and believe that their spiritual needs have
been addressed, providers report decreased need for opioid pain
medications. Affirming and assisting patients in reframing their
connection to meaning, purpose, and spiritual resources establishes
hope for transformation. It has also created opportunity to draw on
nonpharmacologic resources as tools to assist with effective pain
management.
REFERENCES
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Puchalski C, Ferrell B, Virani R, et al. Improving the quality of spiritual care as a
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2.

Pargament K. Spiritually Integrated Psychotherapy. New York, New York: The
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Bai M, Dixon JK. Exploratory factor analysis of the 12-item functional
assessment of chronic illness therapy-spiritual well-being scale in people newly
diagnosed with advanced cancer. J Nurs Meas 2014;22(3):404-420.

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Mundle R. A narrative analysis of spiritual distress in geriatric physical
rehabilitation. J Health Psychol 2015;20(3):273-285.

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Cassel EJ. The nature of suffering and the goals of medicine. N Engl J Med
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Rohr R. Things Hidden: Scripture as Spirituality. Cincinnati, Ohio: Franciscan
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Groves RF, Klauser HA. The American Book of Living and Dying: Lessons in
Healing Spiritual Pain. Berkeley, California: Celestial Arts; 2009.

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Nouwen H. Can You Drink This Cup? Notre Dame, Indiana: Ave Maria Press;
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Puchalski C. The role of spirituality in health care. Proc (Bayl Univ Med Cent)
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10. Association of American Medical Colleges. Report III: Contemporary issues
in Medicine: Communication in Medicine. Medical School Objectives Project.
1999:25-26. https://members.aamc.org/eweb/upload/Contemporary%20
Issues%20In%20Med%20Commun%20in%20Medicine%20Report%20III%20.
pdf. Accessed December 12, 2017.
11. Hilsman GJ. Spiritual Care in Common Terms: How Chaplains Can Effectively
Describe the Spiritual Needs of Patients in Medical Records. London, United
Kingdom: Jessica Kingsley Publishers; 2017.
12. Remen RN. My Grandfather's Blessing: Stories of Strength, Refuge, and
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Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine February 2018
