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Addressing religion and spirituality in the intensive care unit: A survey of clinicians

Published online by Cambridge University Press:  30 April 2018

Philip J. Choi ,
Farr A. Curlin  and
Christopher E. Cox
Philip J. Choi*
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University Hospital, Duke University Medical Center, Durham, NC
Farr A. Curlin
Affiliation:
Division of Palliative Care Medicine, Department of Medicine, Duke University Hospital, Trent Center for Bioethics, Humanities, and History of Medicine, Duke University Medical Center, Durham, NC
Christopher E. Cox
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University Hospital, Duke University Medical Center, Durham, NC
*
Author for correspondence: Philip Choi, Division of Pulmonary and Critical Care Medicine, DUMC Box 102355, Durham, NC 27710. E-mail: philip.choi@duke.edu
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Abstract

Objective

Studies have shown that when religious and spiritual concerns are addressed by the medical team, patients are more satisfied with their care and have lower healthcare costs. However, little is known about how intensive care unit (ICU) clinicians address these concerns. The objective of this study was to determine how ICU clinicians address the religious and spiritual needs of patients and families.

Method

We performed a cross-sectional survey study of ICU physicians, nurses, and advance practice providers (APPs) to understand their attitudes and beliefs about addressing the religious and spiritual needs of ICU patients and families. Each question was designed on a 4- to 5-point Likert scale. A total of 219 surveys were collected over a 4-month period.

Result

A majority of clinicians agreed that it is their responsibility to address the religious/spiritual needs of patients. A total of 79% of attendings, 74% of fellows, 89% of nurses, and 83% of APPs agreed with this statement. ICU clinicians also feel comfortable talking to patients about their religious/spiritual concerns. In practice, few clinicians frequently address religious/spiritual concerns. Only 14% of attendings, 3% of fellows, 26% of nurses, and 17% of APPs say they frequently ask patients about their religious/spiritual needs.

Significance of results

This study shows that ICU clinicians see it as their role to address the religious and spiritual needs of their patients, and report feeling comfortable talking about these issues. Despite this, a minority of clinicians regularly address religious and spiritual needs in clinical practice. This highlights a potential deficit in comprehensive critical care as outlined by many national guidelines.

Keywords

Religionspiritualitycritical carespiritual careend of life care
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 2 , April 2019 , pp. 159 - 164
Copyright
Copyright © Cambridge University Press 2018 

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References

Angus, DC (2005) Charting (and publishing) the boundaries of critical illness. American Journal of Respiratory and Critical Care Medicine 171(9), 938–939.Google Scholar
Astrow, AB, Wexler, A, Texeira, K, et al. (2007) Is failure to meet spiritual needs associated with cancer patients' perceptions of quality of care and their satisfaction with care? Journal of Clinical Oncology 25(36), 5753–5757.Google Scholar
Balboni, T, Balboni, M, Paulk, ME, et al. (2011) Support of cancer patients' spiritual needs and associations with medical care costs at the end of life. Cancer 117(23), 5383–5391.Google Scholar
Balboni, TA, Paulk, ME, Balboni, MJ, et al. (2010) Provision of spiritual care to patients with advanced cancer: Associations with medical care and quality of life near death. Journal of Clinical Oncology 28(3), 445–452.Google Scholar
Balboni, TA, Vanderwerker, LC, Block, SD, et al. (2007) Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology 25(5), 555–560.Google Scholar
Choi, PJ, Curlin, FA, Cox, CE (2015) “The patient is dying, please call the chaplain”: The activities of chaplains in one medical center's intensive care units. Journal of Pain and Symptom Management 50(4), 501–506.Google Scholar
Clarke, EB, Curtis, JR, Luce, JM, et al. (2003) Quality indicators for end-of-life care in the intensive care unit. Critical Care Medicine 31(9), 2255–2262.Google Scholar
Cook, D, Swinton, M, Toledo, F, et al. (2015) Personalizing death in the intensive care unit: The 3 Wishes Project: a mixed-methods study. Annals of Internal Medicine 163(4), 271–279.Google Scholar
Dzeng, E, Colaianni, A, Roland, M, et al. (2015) Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life. JAMA Internal Medicine 175(5), 812–819.Google Scholar
Ernecoff, NC, Curlin, FA, Buddadhumaruk, P, et al. (2015) Health care professionals' responses to religious or spiritual statements by surrogate decision makers during goals-of-care discussions. JAMA Internal Medicine 175(10), 1662–1669.Google Scholar
Ford, DW, Downey, L, Engelberg, R, et al. (2012) Discussing religion and spirituality is an advanced communication skill: An exploratory structural equation model of physician trainee self-ratings. Journal of Palliative Medicine 15(1), 63–70.Google Scholar
Lanken, PN, Terry, PB, Delisser, HM, et al. (2008) An official American Thoracic Society clinical policy statement: Palliative care for patients with respiratory diseases and critical illnesses. American Journal of Respiratory and Critical Care Medicine 177(8), 912–927.Google Scholar
Maciejewski, PK, Phelps, AC, Kacel, EL, et al. (2012) Religious coping and behavioral disengagement: Opposing influences on advance care planning and receipt of intensive care near death. Psycho-Oncology 21(7), 714–723. doi:10.1002/pon.1967.Google Scholar
Phelps, AC, Maciejewski, PK, Nilsson, M, et al. (2009) Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 301(11), 1140–1147.Google Scholar
Sloan, RP, Bagiella, E, Powell, T (1999) Religion, spirituality, and medicine. Lancet 353(9153), 664–667.Google Scholar
Steinhauser, K E, Christakis, NA, Clipp, EC, et al. (2000) Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284(19), 2476–2482.Google Scholar
Sulmasy, DP (2009) Spirituality, religion, and clinical care. Chest 135(6), 1634–1642.Google Scholar
Swinton, M, Giacomini, M, Toledo, F, et al. (2016) Experiences and expressions of spirituality at the end of life in the intensive care unit. American Journal of Respiratory and Critical Care Medicine 195(2), 198–204.Google Scholar
Wall, RJ, Engelberg, RA, Gries, CJ, et al. (2007) Spiritual care of families in the intensive care unit. Critical Care Medicine 35(4), 1084–1090.Google Scholar
Williams, JA, Meltzer, D, Arora, V, et al. (2011) Attention to inpatients' religious and spiritual concerns: Oredictors and association with patient satisfaction. Journal of General Internal Medicine 26(11), 1265–1271.Google Scholar
Zollfrank, AA, Trevino, KM, Cadge, W, et al. (2015) Teaching health care providers to provide spiritual care: A pilot study. Journal of Palliative Medicine 18(5), 408–414.Google Scholar