Advertisement

Journal of Religion and Health

, Volume 44, Issue 2, pp 137–146 | Cite as

Spiritual Beliefs and Barriers Among Managed Care Practitioners

  • Jeanne Mccauley
  • Mollie W. Jenckes
  • Margaret J. Tarpley
  • Harold G. Koenig
  • Lisa R. Yanek
  • Diane M. Becker
Article

Abstract

Purpose: Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Methods: Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Findings: Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient’s spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician’s role. Ninety-five percent of our managed care group noted ‘8lack of time’ as an important barrier, ‘lack of training’ was indicated by 69%, and 21% cited ‘fear of response from administration’. Conclusions: Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients’ expressed needs regarding spirituality and beliefs.

Keywords

communication barriers managed care spirituality in medicine training 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bertram, C.A. (2003). Managed care: Solution or problem? http://www.medicineuptotheminute.com/mgdcare.htm (16 October 2003).Google Scholar
  2. Brady, M.J., Peterman, A.H., Fitchett, G., Mo, M., Cella, D. 1999A case for including spirituality in quality of life measurement in oncologyPsychooncology8417428Google Scholar
  3. Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., Dold, K.H., Targ, E. 1999Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancerPsychooncology8429438Google Scholar
  4. Daaleman, T.P., Frey, B. 1999Spiritual and religious beliefs and practices of family physicians: National surveyThe Journal of Family Practice4898104Google Scholar
  5. Daaleman, T.P., Nease, D.E.,Jr. 1994Patient attitudes regarding physician inquiry into spiritual and religious issuesThe Journal of Family Practice39564568Google Scholar
  6. Ehman, J.W., Ott, B.B., Short, T.H., Ciampa, R.C., Hansen-Flaschen, J. 1999Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely illArchives of Internal Medicine15918031806Google Scholar
  7. Ellis, M.R., Vinson, D.C., Ewigman, B. 1999Addressing spiritual concerns of patients: Family physicians’ attitudes and practicesThe Journal of Family Practice48105109Google Scholar
  8. Ellison, C.G., Levin, J.S. 1998The religion-health connection: evidence, theory, and future directionsHealth Education & Behavior25700720Google Scholar
  9. Gallup, G. (1990). Religion in America. Princeton, NJ: Princeton Religious Research Center. Cited by Matthews, D.A. et al. (1998). In religious commitment and health status. Archives of Family Medicine 7, 118–124. Google Scholar
  10. Goldbourt, U., Yaari, S., Medalie, J.H. 1993Factors predictive of long-term coronary heart disease mortality among 10.059 male Israeli civil servants and municipal employees: A 23-year mortality follow-up in the Israeli ischemic heart disease studyCardiology82100121Google Scholar
  11. Hebert, R.S., Jenckes, M.W., Ford, D.E., O’Connor, D.R., Cooper, L.A. 2001Patient perspectives on spirituality and the patient–physicians relationshipJGIM16685692Google Scholar
  12. Herzinger, R.E. (2003). Consumer driven health care. http://www.managedcaremag.com/sup plements/0309_colloquy1/0309.colloquy1.pdf (16 October 2003).Google Scholar
  13. King, D.E., Bushwick, B. 1994Beliefs and attitudes of hospital inpatients about faith healing and prayerThe Journal of Family Practice39349352Google Scholar
  14. Koenig, H.G., George, L.K., Hays, J.C., Larson, D.B., Cohen, H.J., Blazer, D.G. 1998aThe relationship between religious activities and blood pressure in older adultsInternational Journal of Psychiatry in Medicine28189213Google Scholar
  15. Koenig, H.G., George, L.K., Peterson, B.L. 1998bReligiosity and remission of depression in medically ill older patientsThe American Journal of Psychiatry155536542Google Scholar
  16. Koenig, H.G., Meador, K.G., Parkerson, G. 1997Religion index for psychiatric researchThe American Journal of Psychiatry154885886Google Scholar
  17. Maugans, T.A., Wadland, W.C. 1991Religion and Family Medicine: A survey of physicians and patientsThe Journal of Family Practice32210213Google Scholar
  18. McCullough, M.E., Larson, D.B. 1999Religion and depression: A review of the literatureTwin Research2126136Google Scholar
  19. Miller, W.R. 1998Researching the spiritual dimensions of alcohol and other drug problemsAddiction93979990Google Scholar
  20. Moore, R.D., Mead, L., Pearson, T.A. 1990Youthful precursors of alcohol abuse in physiciansThe American Journal of Medicine88332336Google Scholar
  21. Mueller, P.S., Plevak, D.J., Rummans, T.A. 2001Religious involvement, spirituality, and medicine: Implications for clinical practiceMayo Clinic Proceedings7612251235Google Scholar
  22. Nunally, J.C. 1978Psychometric Theory.McGraw-HillNew York, NYGoogle Scholar
  23. Oxman, T.E., Freeman, D.H., Manheimer, ED,Jr. 1995Lack of social participation or religious strength and comfort as risk factors for death after cardiac surgery in the elderlyPsychosomatic Medicine57515Google Scholar
  24. Oyama, O., Koenig, H.G. 1998Religious beliefs and practices in family medicineArchives of Family Medicine7431435Google Scholar
  25. Riley, B.B., Perna, R., Tate, D.G., Forchheimer, M., Anderson, C., Luera, G. 1998Types of spiritual well-being among persons with chronic illness: Their relation to various forms of quality of lifeArchives of Physical Medicine and Rehabilitation79258264Google Scholar
  26. Tarpley, M.J. (2003). Attitudes toward spirituality and health care. http://www.vuspiritmed.com/info.html (17 October 2003).Google Scholar

Copyright information

© Blanton-Peale Institute 2005

Authors and Affiliations

  • Jeanne Mccauley
    • 1
  • Mollie W. Jenckes
    • 1
    • 6
  • Margaret J. Tarpley
    • 2
  • Harold G. Koenig
    • 3
  • Lisa R. Yanek
    • 5
  • Diane M. Becker
    • 4
  1. 1.Department of MedicineJohns Hopkins UniversityBaltimore
  2. 2.Department of SurgeryVanderbilt University Medical CenterNashville
  3. 3.Duke UniversityDurham
  4. 4.Department of MedicineJohns Hopkins UniversityBaltimore
  5. 5.Center for Health Promotion, Division of Internal MedicineJohn Hopkins University School of MedicineBaltimore
  6. 6.Johns Hopkins School of MedicineBaltimoreUSA

Personalised recommendations