H O P E

At MUSC, we teach the HOPE method of taking a spiritual history because of its ease of use and the way it smoothly transitions from social support to spiritual topics (Anandarajah and Hight, Amer Fam Phys 2001). The HOPE questions, can be seen at on the web at www.aafp.org/afp/20010101/81.html, or summarized below:
H addresses the person’s basic spiritual resources, such as sources of Hope, without immediately focusing on religion or spirituality. Using this method allows for meaningful dialogue with patients of diverse backgrounds, including those whose spirituality lies outside the boundaries of traditional religion or those who have been alienated in some way from their religion. It also allows those for whom religion, God or prayer is important to volunteer this information.
O focuses on the importance of Organized religion in patients' lives.
P focuses on the specific aspects of their personal spirituality and personal religious practices. If patients relate meaningful experiences at this point, then the interviewer can proceed with more specific questions regarding religion and personal spirituality. If not, then one can ask open-ended follow-up questions to open the door for patients to discuss important spiritual concerns they may have.
E focuses on the Effects of a patient's spiritual and religious beliefs on medical care and end-of-life issues. These questions help re-direct the discussion back onto clinical issues and medical-decision-making.