Background & Aims

The spiritual dimension of chronic pain is often left unaddressed. Similarly, spiritual pain is a condition that is difficult to diagnose, measure and manage. The abstract refers to chronic pain patients attending a charitable hospital with spiritual, cultural and traditional aspects to its service. Chronic pain patients report spiritual distress and concerns and seek spiritual meaning for their pain and suffering in such a facility.
In view of the nature of this health facility, a clinical audit was carried out to note occurrence of spiritual distress, and other spiritual concerns, spiritual needs in chronic pain patients. The audit will help in improving quality care of chronic pain patients by addressing the spiritual dimension.

Methods

This is a clinical audit to examine the records of consecutive patients attending the Jagadguru Kripalu Charitable Chikithsalaya, a hospital in the holy city of Vrindavan, India and providing free health care, consultations, investigations and medications to those who seek healthcare. Over a period of a year 1026 people sought help. The records were perused to identify the frequency and nature of spiritual concerns in patients reporting chronic pain and if any had spiritual pain. Their clinical diagnosis according to International Classification of Diseases, ICD 10 were recorded, along with the relevant demographic variables.

Results

Of the 1026 persons, 58% were women and 42% men; 60% were between the ages of 18-45 years, 21% between 46-60 years and 11% above 61 years. Somatoform disorders were diagnosed in 18%, depressive disorders in 15%, anxiety disorders in 13%, 11% had obsessive compulsive disorders, and 5% had dissociative disorders.
Headache, backache, multiple bodily aches were the common presenting symptoms in patients diagnosed with these disorders.
Common spiritual themes noted were spiritual anxiety, spiritual conflict, spiritual distress, and spiritual dissociative symptoms in 22 of the pain patients. Two patients believed their pain to be a spiritual pain. Some patients who had OCD reported headaches due to continuous and/or repetitive spiritual thoughts going through their mind and had to resort to compulsions to mitigate the obsessions.

Conclusions

Spiritual distress, conflict and concerns occur in some patients reporting chronic pain with comorbid depression, anxiety, dissociation or obsessive-compulsive conditions. Spiritual aspects should be probed in chronic pain patients and suitable spiritual based interventions provided for complete and holistic pain management.

References

Chaturvedi SK. Editorial: The spirit of pain. NIMHANS. Journal, 17, 191-192, 1999.
Chaturvedi SK. Spirituality issues at the end of life. Indian Journal of Palliative Care. 13, 48-52, 2007.
Kandasamy A, Chaturvedi SK, Desai G. Spirituality, distress, depression, anxiety and quality of life in patients with advanced cancer. Indian J Cancer. 48 (1), 55-59, 2011.
Simha S, Noble S, Chaturvedi SK. Spiritual concerns in Hindu cancer patients undergoing palliative care: a qualitative study. Indian Journal Palliative Care, 19, 99-105, 2013
Gielen J, Bhatnagar S, Chaturvedi SK. Prevalence and Nature of Spiritual Distress among Palliative Care Patients in India. J Relig Health. 56(2):530-544, 2017.

Presenting Author

Santosh Kumar Chaturvedi

Poster Authors

Santosh Kumar Chaturvedi

MD (Psychiatry), FRCPsych

Jagadguru Kripalu Chikithsalaya, Vrindavan, India

Lead Author

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Topics

  • Assessment and Diagnosis