FICA is an acronym that can be used to remember what is asked in a spiritual history. It includes:

F: Faith or Beliefs
I: Importance or influence
C: Community
A: Address

Specific questions you can use to discuss these issues are:

F: What is your faith or belief?

  • Do you consider yourself spiritual or religious?
  • What things do you believe in that give meaning to your life?

I: Is it important in your life?

  • What influence does it have on how you take care of yourself?
  • How have your beliefs influenced your behavior during this illness?
  • What role do your beliefs play in regaining your health?

C: Are you part of a spiritual or religious community?

  • Is this of support to you and how?
  • Is there a person or group of people you really love or who are really important to
  • you?

A: How would you like me, your healthcare provider, to address these issues in your healthcare?

General recommendations when taking a spiritual history include:

  1. Consider spirituality as a potentially important component of every patient’s physical well being and mental health.
  2. Address spirituality at each complete physical examination and continue addressing it at follow-up visits if appropriate. In patient care, spirituality is an ongoing issue.
  3. Respect a patient’s privacy regarding spiritual beliefs; don’t impose your beliefs on others.
  4. Make referrals to chaplains, spiritual directors, or community resources as appropriate.
  5. Be aware that your own spiritual beliefs will help you personally and will overflow in your encounters with those for whom you care to make the doctor-patient encounter a more humanistic one.

© 1999 Christina Puchalski, M.D. Reprinted with permission from Christina Puchalski, M.D.