The beliefs of cancer care providers regarding the role of religion and spirituality within the clinical encounter

Abstract

Purpose

To characterize cancer care provider perceptions of the role of religion and spirituality (R&S) within the clinical encounter.

Methods

A cross-sectional survey was administered to healthcare professionals (defined as someone who is authorized to diagnose and/or treat physical or mental health disorders) currently employed at The Ohio State University Comprehensive Cancer Center. Beliefs around the role of R&S within the clinical encounter were assessed using four adapted subscales/dimensions (D1-D4) from the Religion and Spirituality in Medicine: Physicians’ Perspectives measure: God actively intervenes in patient health (D1), R&S is beneficial for patient mental health (D2), provider inquires about (D3) and discusses (D4) R&S in the clinical encounter. Logistic (D1) and linear (D2–D4) regression were performed using SAS v9.4 to determine the relationship between provider type and each subscale while controlling for gender, race, relationship status, education, and R&S identity.

Results

Among 340 participants, most participants were female (82.1%) or Caucasian (82.6%) and the median age was 35 years (IQR 31–48). Providers included physicians (17.9%), nurses (64.7%), and “other” (17.4%). Most participants identified as religious (57.5%), followed by spiritual (30.2%) and neither religious nor spiritual (12.3%). Nurses and other providers were more likely than physicians to believe that God intervenes in patient health (physician 41.7% vs. nurse 61.8% vs. other 60.3%; p = 0.02). All providers were equally as likely to believe that R&S is beneficial for patient mental health and to discuss R&S with patients within the clinical encounter (both p > 0.05). In contrast, nurses more frequently reported inquiring about R&S (median 1.7; IQR 0.9–2.0) compared with physicians (median 1.0; IQR 0.9–2.0) or other providers (median 1.4; IQR 1.0–2.1) (p < 0.001).

Conclusions

There were differences between providers in beliefs regarding the role of R&S in the clinical cancer encounter. Of note, nurses and other provider types were more likely than physicians to inquire about R&S with patients. Understanding variations in these beliefs will help determine how to best incorporate R&S support for patients during their cancer care.

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Fig. 1

Data availability

The authors maintain full control of all primary data included in this article and are available from the authors on reasonable request.

References

  1. 1.

    Puchalski CM (2013) Integrating spirituality into patient care: an essential element of person-centered care. Pol Arch Med Wewn 123:491–497. https://doi.org/10.1016/j.ihj.2014.03.023

    Article  PubMed  Google Scholar 

  2. 2.

    Vincensi BB (2019) Interconnections: spirituality, spiritual care, and patient-centered care. Asia Pacific J Oncol Nurs 6:104–110. https://doi.org/10.4103/apjon.apjon_48_18

    Article  Google Scholar 

  3. 3.

    Astrow AB, Puchalski CM, Sulmasy DP (2001) Religion, spirituality, and health care: social, ethical, and practical considerations. Am J Med 110:P283–P287. https://doi.org/10.1016/S0002-9343(00)00708-7

    Article  Google Scholar 

  4. 4.

    Koenig HG (2012) Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry 2012:1–33. https://doi.org/10.5402/2012/278730

    Article  Google Scholar 

  5. 5.

    Pargament KI, Koenig HG, Tarakeshwar N, Hahn J (2004) Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study. J Health Psychol 9:713–730. https://doi.org/10.1177/1359105304045366

    Article  PubMed  Google Scholar 

  6. 6.

    Peteet JR, Balboni MJ (2013) Spirituality and religion in oncology. CA Cancer J Clin 63:280–289. https://doi.org/10.3322/caac.21187

    Article  PubMed  Google Scholar 

  7. 7.

    Mueller PS, Plevak DJ, Rummans TA (2001) Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc 76:1225–1235

    CAS  Article  Google Scholar 

  8. 8.

    Puchalski CM, Sbrana A, Ferrell B, Jafari N, King S, Balboni T, Miccinesi G, Vandenhoeck A, Silbermann M, Balducci L, Yong J, Antonuzzo A, Falcone A, Ripamonti CI (2019) Interprofessional spiritual care in oncology: a literature review. ESMO Open 4:1–12. https://doi.org/10.1136/esmoopen-2018-000465

    Article  Google Scholar 

  9. 9.

    Bickel KE, McNiff K, Buss MK et al (2016) Defining high-quality palliative care in oncology practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement. J Oncol Pract. https://doi.org/10.1200/jop.2016.010686

  10. 10.

    Puchalski CM (2001) The role of spirituality in health care. Proc (Baylor Univ Med Center) 14:352–357. https://doi.org/10.1080/08998280.2001.11927788

    CAS  Article  Google Scholar 

  11. 11.

    American Nurses Association, Health Ministries Association (2017) Faith community nursing: scope and standards of practice, 3rd edn. American Nurses Association, Inc., Silver Spring

    Google Scholar 

  12. 12.

    Puchalski CM, Lunsford B, Harris MH, Miller RT (2006) Interdisciplinary spiritual care for seriously ill and dying patients: a collaborative model. Cancer J 12:398–416. https://doi.org/10.1097/00130404-200609000-00009

    Article  PubMed  Google Scholar 

  13. 13.

    Field MJ, Cassel CK (2011) Approaching death: improving care at the end of life. Health Prog 19:344–345. https://doi.org/10.1016/s0197-4572(98)90125-2

    Article  Google Scholar 

  14. 14.

    Phelps AC, Lauderdale KE, Alcorn S, Dillinger J, Balboni MT, van Wert M, VanderWeele TJ, Balboni TA (2012) Addressing spirituality within the care of patients at the end of life: perspectives of patients with advanced cancer, oncologists, and oncology nurses. J Clin Oncol 30:2538–2544. https://doi.org/10.1200/JCO.2011.40.3766

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Post SG, Puchalski CM, Larson DB (2000) Physicians and patient spirituality: professional boundaries, competency, and ethics. Ann Intern Med 132:578–583. https://doi.org/10.7326/0003-4819-132-7-200004040-00010

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Puchalski CM, Vitillo R, Hull SK, Reller N (2014) Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med 17:642–656. https://doi.org/10.1089/jpm.2014.9427

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Stern RM, Rasinski KA, Curlin FA (2011) Jewish physicians’ beliefs and practices regarding religion/spirituality in the clinical encounter. J Relig Health 50:806–817. https://doi.org/10.1007/s10943-011-9509-1

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Mcsherry W, Jamieson S (2011) An online survey of nurses’ perceptions of spirituality and spiritual care. J Clin Nurs 20:1757–1767. https://doi.org/10.1111/j.1365-2702.2010.03547.x

    Article  PubMed  Google Scholar 

  19. 19.

    Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. https://doi.org/10.1016/j.jbi.2008.08.010

    Article  PubMed  Google Scholar 

  20. 20.

    Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J (1999) Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med 159:1803–1806. https://doi.org/10.1001/archinte.159.15.1803

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Hebert R, Zdaniuk B, Schulz R, Scheier M (2009) Positive and negative religious coping and well-being in women with breast cancer. J Palliat Med 12:537–545. https://doi.org/10.1089/jpm.2008.0250

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Puchalski CM (2012) Spirituality in the cancer trajectory. Ann Oncol 23:49–55. https://doi.org/10.1093/annonc/mds088

    Article  PubMed  Google Scholar 

  23. 23.

    Balboni TA, Paulk ME, Balboni MJ, Phelps AC, Loggers ET, Wright AA, Block SD, Lewis EF, Peteet JR, Prigerson HG (2010) Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 28:445–452. https://doi.org/10.1200/JCO.2009.24.8005

    Article  PubMed  Google Scholar 

  24. 24.

    McBrien B (2010) Nurses’ provision of spiritual care in the emergency setting - an Irish perspective. Int Emerg Nurs 18:119–126. https://doi.org/10.1016/j.ienj.2009.09.004

    Article  PubMed  Google Scholar 

  25. 25.

    Treloar LL (2000) Integration of spirituality into health care practice by nurse practitioners. J Am Acad Nurse Pract 12:280–285. https://doi.org/10.1111/j.1745-7599.2000.tb00305.x

  26. 26.

    Oxhandler HK, Parrish DE (2018) Integrating clients’ religion/spirituality in clinical practice: a comparison among social workers, psychologists, counselors, marriage and family therapists, and nurses. J Clin Psychol 74:680–694. https://doi.org/10.1002/jclp.22539

    Article  PubMed  Google Scholar 

  27. 27.

    Gilligan P, Furness S (2006) The role of religion and spirituality in social work practice: views and experiences of social workers and students. Br J Soc Work 36:617–637. https://doi.org/10.1093/bjsw/bch252

    Article  Google Scholar 

  28. 28.

    Zollfrank AA, Trevino KM, Cadge W, Balboni MJ, Thiel MM, Fitchett G, Gallivan K, VanderWeele T, Balboni TA (2015) Teaching health care providers to provide spiritual care: a pilot study. J Palliat Med 18:408–414. https://doi.org/10.1089/jpm.2014.0306

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Balboni MJ, Sullivan A, Amobi A, Phelps AC, Gorman DP, Zollfrank A, Peteet JR, Prigerson HG, VanderWeele TJ, Balboni TA (2013) Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. J Clin Oncol 31:461–467. https://doi.org/10.1200/JCO.2012.44.6443

    Article  PubMed  Google Scholar 

  30. 30.

    Lawrence RE, Curlin FA (2009) Physicians’ beliefs about conscience in medicine: a national survey. Acad Med 84:1276–1282. https://doi.org/10.1097/ACM.0b013e3181b18dc5

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Surbone A, Baider L (2010) The spiritual dimension of cancer care. Crit Rev Oncol Hematol 73:228–235

    Article  Google Scholar 

  32. 32.

    Curlin FA, Chin MH, Sellergren SA, Roach CJ, Lantos JD (2006) The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Med Care 44:446–453. https://doi.org/10.1097/01.mlr.0000207434.12450.ef

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the Intramural Research Program at The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

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Correspondence to Timothy M. Pawlik.

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The current study was performed in accordance with the ethical standards for the protection of research participants and complied with federal regulations, guidance, and state laws related to human subjects protection. Informed consent was obtained from all participants. The study protocol was approved by the institutional review board (no. 2019C0167).

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The authors declare that they have no conflict of interest.

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Palmer Kelly, E., Paredes, A.Z., Hyer, M. et al. The beliefs of cancer care providers regarding the role of religion and spirituality within the clinical encounter. Support Care Cancer (2020). https://doi.org/10.1007/s00520-020-05562-2

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Keywords

  • Spiritual care
  • Religion and spirituality
  • Cancer care
  • Patient-centered care