Mental Health Patient

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The HOPE Model of Spiritual Assessment

Assessing a patient’s spirituality is just one aspect of a complete health assessment, but it is a very important one. It contributes to one’s total view of the person, and reinforces the notion of holistic care. Anandarajah & Hight (2001) proposed a model for spiritual assessment that uses the acronym HOPE.

HOPE Sample Questions

H = Sources of hope, meaning, comfort, strength, peace, love, and connection What is there in your life that gives you internal support? ________________________________

What are your sources of hope, strength, comfort, and peace? ____________________________ _______________________________________________________________________________

What do you hold on to in difficult times? ____________________________________________ What sustains you? _______________________________________________________________ For some people, religious or spiritual beliefs act as a source of comfort and strength: Is this true for you? __________________________________________

If answer is “Yes”, go on to O and P questions.

If answer is “No”, consider asking: Was it ever? If so, ask, What changed?

O = Organized religion Do you consider yourself part of an organized religion? __________________________________ How important is this to you? _______________________________________________________ What aspects of your religion are helpful, and not so helpful, to you? _______________________ ________________________________________________________________________________ Are you part of a religious or spiritual community? ______________________ Does it help you? __________________ How? __________________________________________



P = Personal spirituality and practice Do you have spiritual beliefs independent of organized religion? ___________________________ What are they? ___________________________________________________________________ Do you believe in God? _____________________________

What is your relationship with God? _________________________________________________ What aspects of your spiritual practices do you find most helpful? (e.g. prayer, meditation, reading scripture, music, communing with nature) ______________________________________________



E = Effects on medical care and end of life issues Has being sick affected your ability to do the things that usually help you spiritually? _____________ Is there anything that I can do to help you access the things that usually help you spiritually? ______ __________________________________________________________________________________ Are you worried about any conflict between your beliefs and decisions about medical care? _______ Would it help you to speak to a chaplain or community spiritual leader? ______________________ Are there any specific practices or restrictions that I should know about in providing your medical care? (e.g. dietary restrictions, use of blood products) __________________________________________



If patient is dying: How do your beliefs affect the kind of medical care you would like me to provide during the next few days / weeks / months?

Anandarajah, G. & Hight, E. (2001). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. American Family Physician, 63, 81-89.

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