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. 2019 Oct;113(4):787–891. doi: 10.5935/abc.20190204

Chart 9.3.

FICA and HOPE questionnaires for spiritual history

FICA questionnaire HOPE questionnaire
F - Faith/beliefs
Do you consider yourself religious or spiritual?
Do you have beliefs that help you deal with problems?
If not, what gives life meaning?
H - Are there sources of hope?
What are your sources of hope, comfort and peace?
What do you cling to in hard times?
What gives you support and makes you move forward?
I - Importance/influence
What importance do you give to faith and religious beliefs in your life?
Has faith or beliefs helped you cope with stress or health problems?
Do you have any beliefs that may affect medical decisions or your treatment?
O - Religious organization
Do you consider yourself part of an organized religion? Is this important?
Are you part of a community? Does it help?
In what ways does your religion help you?
Are you part of a religious community?
C - Community
Are you part of any religious or spiritual community?
Does it support you? How?
Are there any groups of people you really love or are important to you?
Is there any community (church, temple, support group) that supports you?
P - Personal spiritual practices
Do you have any spiritual beliefs that are independent of your organized religion?
Do you believe in God? What is your relationship with God?
What aspects of your spirituality or spiritual practice help you the most? (prayer, meditation, readings, attending religious services?)
A - Action in treatment
How would you like your doctor to consider the religiosity/spirituality question in your treatment?
Name any religious/spiritual leaders in your community.
E - Effects on treatment
Are there any spiritual resources you are missing?
Are there any restrictions on your treatment generated by your beliefs?