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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