Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: a qualitative study

摘要

Background Spirituality has received increased attention in the psychiatric literature; however, it remains underexplored on a global level. Knowledge about spirituality of persons with schizophrenia is often hampered by positive and negative symptoms, which limit their expression of spiritual needs and shift mental-health professionals’ focus from spiritual care to symptom control. Differences in the ways that the two parties understand spirituality may create different expectations and further hinder the provision of high-quality holistic care. This study investigated the meaning and roles of spirituality from the perspectives of persons with schizophrenia and mental-health professionals. Methods A qualitative design with semi-structured individual interviews was adopted. The analysis was based on data collected from interviews with 18 clients diagnosed with schizophrenia and 19 mental-health professionals from public hospitals and mental-health community rehabilitation centres in Hong Kong. Data were collected and analysed based on grounded theory principles. Results Both clients and professionals regarded spirituality as an inherent part of a person’s well-being, clients’ rehabilitation, and their lives in general. At the personal level, the clients’ descriptions were more factual, concrete, short term, and affective, whereas the professionals’ descriptions were more , complex, and cognitive. At the communal level, both parties had a similar understanding of spirituality but different interpretations of its role in recovery from mental illness. The clients regarded spirituality as a source of giving and receiving love and care, whereas the professionals regarded it as a means of receiving support and managing symptoms. Conclusions Building a?common understanding on the concept of spirituality and the significant role it plays?in rehabilitation between clients and mental-health professionals is an essential first step to support clients’ spiritual health. Clients tend to seek?for stability, peace, and growth rather than an existential quest; while?professionals hold a more pathological perspective, viewing spirituality as a means to relieve symptoms, increase social acceptance, and cope with illness experiences. The differential understanding of the two perspectives provides insight and perhaps a roadmap for developing spiritual assessments and holistic care in the psychiatric context.