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Objective: The aim of our research was to determine the current situation at Praguean hospitals and hospitals of the Central Bohemia Region regarding the replenishing of spiritual needs in patients with infaust (unfavorable) prognosis. Design: Pilot study. Original Article 80 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 8 No. 4 2017 Introduction The multi-dimensional constitution of humans includes also spirituality. Replenishing their spiritual needs is at high demand in different kinds of personal struggles especially in patients with infaust prognosis. It is found, that many people experience spirituality as an important support aid while trying to cope with a chronic or life-threatening disease (1). Palliative Medicine should not only be used to suppress physical pain, but also discomfort, anxiety, and other disease-related problems. Individually perceived loss of personal dignity; sense of life or hope can be reasons for giving up and the desire to die soon. Awareness of finitude; of one ́s mortality does not inevitably have to lead to minimization of the meaning of remaining life. According to Baars, it relativizes cultural idols and poses the question of what life as a whole is really about (2). Ensuring the best possible quality of life for infaust patients is mainly helped by psychological, social and spiritual support (3). Keenan states, that by enhancing spiritual security, the professional can reduce the patient ́s/service user ́s spiritual vulnerability, risk and distress (4). Border issues in both Christian Pastoral Care and Clinical Psychology are concerned with in Pastoral Psychology (5). The National Health Service Scotland has differentiated between spiritual care and religious care suggesting that, “spiritual care is usually given in a one to one relationship, is completely person-centered and makes no assumptions about personal conviction Participants: The criteria for selection of respondents were age (people over the age of 65), diagnosed with chronic disease with complications, infaust prognosis of their health condition and hospitalization in a healthcare facility in Prague and the Central Bohemia Region. Methods: Investigation and evaluation of the current situation regarding this research problem was conducted using the FICA questionnaire, a tool of spiritual assessment that helps to discover personal spiritual history and provides guidelines for pastoral care in clinical practice. The research was conducted in hospitals in Prague and the Central Bohemia Region. Results: During the research, we identified that the satisfaction of spiritual needs is at an insufficient level, and this deficit leads to a deterioration of the mental state of the patients. Conclusion: In line with the research, the authors describe the appropriate forms of spiritual care that can be provided in the context of health care. Conflict of interest: The authors of this article certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, or other equity interest), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. 81 Original Articles Clinical Social Work and Health Intervention Vol. 8 No. 4 2017 or life orientation”; it could be provided by all health care staff, by carers, families, and other patients. In contrast, “religious care is given in the context of shared religious beliefs, values, liturgies and life style of a faith community“ (6). Academic Medical Centers, Medical and Nursing Schools, residency programs, and hospitals in the USA began to recognize the role of spiritual care as a dimension of palliative care in the early 1990s. Puchalski et al. came to a conclusion, that principles of spiritual care can be applicable across all phases and settings for seriously ill, without regard to culture, religious tradition, or spiritual frames of reference. They have defined spirituality as the aspect of humanity that refers to the way individuals seek and express meaning and purpose; the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred. The most recognized models of spiritual care were considered as a bio-psycho-social-spiritual model of care and an inter-professional spiritual care model (7). However, so far, attention for the spiritual needs of patients and dying in the Czech Republic has been implemented in health care facilities unsystematically and very diversely (8). In order to satisfy the spiritual care in the conditions of the Czech health care system, we refer to the Act on Health Services: Act No. 372/2011 Coll., where it is stated in detail that the patient is entitled in the provision of health services: “To receive spiritual care and spiritual support in medical facility at the patient department or daycare facilities from spiritual leaders of churches and religious societies registered in the Czech Republic or from persons charged with performing spiritual activities in accordance with the internal order and in a way that does not violate the rights of other patients and regarding their health status“ (9). As we can see, there is no distinction between the spiritual and the religious care in Czech legislation, as mentioned above regarding Scotland. Patients and Methods Investigation and evaluation of the current situation regarding our research issue was made upon the questionnaire FICA, spiritual assessment tool developed by Dr. Christina Puchalski and a group of Primary Care Physicians. It helps to discover any personal spiritual history and the guidelines for the Pastoral Care in clinical praxis. The FICA questionnaire is the only validated screening questionnaire, which was also described in the Czech Republic. Health professionals can, using this tool deal with patients with spiritual issues that are important to them. According to the author of the Puchalski Questionnaire, the method of asking FICA questions is applicable across different cultures. In all, 318 respondents aged 65 to 91 were involved in the survey. To comply with ethical considerations and to protect the rights of participants, the authors obtained permission; introduced themselves to participants; explained objectives of the study; obtained their informed consent; assured them of confidentiality of data; emphasized that they could withdraw from study as and when they wished. They were also assured that their names w not be disclosed.

Replenishing the Spiritual Needs in Patients with Infaust Prognosis in Praguean and the Central Bohemian Region´s Hospitals (Research Note)