Ehman J W, Ott B B, Short T H, Ciampa R C, Hansen-Flaschen J
Department of Pastoral Care, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Arch Intern Med. 1999;159(15):1803-6. doi: 10.1001/archinte.159.15.1803.
Recognizing that many Americans draw on religious or spiritual beliefs when confronted by serious illness, some medical educators have recommended that physicians routinely ask about spirituality or religion when conducting a medical history. The most appropriate wording for such an inquiry remains unknown.
To examine patient acceptance of including the following question in the medical history of ambulatory outpatients: "Do you have spiritual or religious beliefs that would influence your medical decisions if you become gravely ill?"
Self-administered questionnaires were completed by 177 ambulatory adult patients visiting a pulmonary faculty office practice at a university teaching hospital in 1997 (83% response rate).
Fifty-one percent of the study patients described themselves as religious and 90% believe that prayer may sometimes influence recovery from an illness. Forty-five percent reported that religious beliefs would influence their medical decisions if they become gravely ill. Ninety-four percent of individuals with such beliefs agreed or strongly agreed that physicians should ask them whether they have such beliefs if they become gravely ill. Forty-five percent of the respondents who denied having such beliefs also agreed that physicians should ask about them. Altogether, two thirds of the respondents indicated that they would welcome the study question in a medical history, whereas 16% reported that they would not. Only 15% of the study group recalled having been asked whether spiritual or religious beliefs would influence their medical decisions.
Many but not all patients surveyed in a pulmonary outpatient practice welcome a carefully worded inquiry about their spiritual or religious beliefs in the event that they become gravely ill.
认识到许多美国人在面对严重疾病时会借鉴宗教或精神信仰,一些医学教育工作者建议医生在进行病史询问时常规询问患者的精神或宗教信仰情况。然而,此类询问最合适的措辞仍不明确。
研究门诊患者对在病史中加入以下问题的接受度:“你是否有精神或宗教信仰,若你身患重病,这些信仰会影响你的医疗决策吗?”
1997年,177名到大学教学医院肺科门诊就诊的成年患者自行填写了问卷(回复率为83%)。
51%的研究患者称自己有宗教信仰,90%的患者认为祈祷有时可能影响疾病康复。45%的患者表示若身患重病,宗教信仰会影响他们的医疗决策。94%有此类信仰的患者同意或强烈同意医生应该询问他们若身患重病是否有此类信仰。45%否认有此类信仰的受访者也同意医生应该询问。总体而言,三分之二的受访者表示他们会欢迎在病史中加入该研究问题,而16%的受访者表示不会。研究组中只有15%的人记得曾被询问过精神或宗教信仰是否会影响他们的医疗决策。
在肺科门诊接受调查的许多但并非所有患者都欢迎在他们身患重病时,以精心措辞询问其精神或宗教信仰情况。