Spiritual History-Taking Amongst Southeast Asian Immigrants and Refugees

<h3>Context:</h3> Efforts to understand patient spirituality and implement spiritual history-taking tools have yet to consider the specific needs of refugee populations. For example, many Burmese immigrants and refugees have faced religious persecution, which may affect the process of spiritual history-taking for enhancing patient care. While positive attitudes of US patients towards spiritual history-taking are well-documented, evidence is needed to evaluate and validate the use of spiritual history-taking tools with this unique population. <h3>Objective:</h3> To document and analyze Burmese immigrant and refugees’ beliefs about the intersection of spirituality and health, as well as their attitudes towards giving a spiritual history in a primary care setting. <h3>Study Design and Analysis:</h3> Mixed-methods study utilizing an in-person survey. Survey results were coded and analyzed using quantitative and qualitative (grounded theory) methods. <h3>Setting/Dataset:</h3> FQHC serving refugees in Dallas, Texas. Surveys were conducted in the exam room immediately before or after an appointment with a provider. <h3>Population:</h3> Immigrants from Burma who speak Rohingya, Hakha-Chin, Burmese, or Karen, and immigrated within the last 5 years (n=31). <h3>Intervention/Instrument:</h3> Open Invite spiritual history tool, with additional survey questions developed to assess participants’ attitudes towards the spiritual history questionnaire. <h3>Outcome Measures:</h3> Patients’ perceptions of the relationship between their faith and their health; their attitudes towards being asked about religion/spirituality in a primary care setting. <h3>Results:</h3> 67% of participants believed their spiritual health affects their physical health. 65% agreed it is beneficial for their doctor to know about their religion, despite 74% having never been asked. At the same time, only 48% of patients said they feel positively about healthcare providers asking about their spiritual health. Finally, 80% of participants stated they did not feel differently if the provider taking the spiritual history was of a different faith tradition. <h3>Conclusion:</h3> Providers who take spiritual histories must consider specific practical (e.g., dietary restrictions), theological (e.g., patient’s belief regarding the interplay of spirituality and physical health), and sociopolitical (e.g., religious persecution) dimensions of patients’ spiritual lives. These unique concerns should also be taken into account in the development of spiritual history tools.