Curlin Farr A, Chin Marshall H, Sellergren Sarah A, Roach Chad J, Lantos John D
Section of General Internal Medicine, The University of Chicago, Illinois 60637, USA.
Med Care. 2006 May;44(5):446-53. doi: 10.1097/01.mlr.0000207434.12450.ef.
Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients.
This study examines the relationship between physicians' religious characteristics and their attitudes and self-reported behaviors regarding R/S in the clinical encounter.
A cross-sectional mailed survey of a stratified random sample of 2000 practicing U.S. physicians from all specialties. Main criterion variables were self-reported practices of R/S inquiry, dialogue regarding R/S issues, and prayer with patients. Main predictor variables were intrinsic religiosity, spirituality, and religious affiliation.
Response rate was 63%. Almost all physicians (91%) say it is appropriate to discuss R/S issues if the patient brings them up, and 73% say that when R/S issues comes up they often or always encourage patients' own R/S beliefs and practices. Doctors are more divided about when it is appropriate for physicians to inquire regarding R/S (45% believe it is usually or always inappropriate), talk about their own religious beliefs or experiences (14% say never, 43% say only when the patient asks), and pray with patients (17% say never, 53% say only when the patient asks). Physicians who identify themselves as more religious and more spiritual, particularly those who are Protestants, are significantly more likely to endorse and report each of the different ways of addressing R/S in the clinical encounter.
Differences in physicians' religious and spiritual characteristics are associated with differing attitudes and behaviors regarding R/S in the clinical encounter. Discussions of the appropriateness of addressing R/S matters in the clinical encounter will need to grapple with these deeply rooted differences among physicians.
关于医生是否以及如何与患者探讨宗教/精神信仰(R/S)存在争议。
本研究探讨医生的宗教特征与其在临床诊疗中对R/S的态度及自我报告行为之间的关系。
对2000名来自美国各专业的执业医生进行分层随机抽样的横断面邮寄调查。主要标准变量为自我报告的R/S询问做法、关于R/S问题的对话以及与患者一起祈祷。主要预测变量为内在宗教信仰、精神信仰和宗教归属。
回复率为63%。几乎所有医生(91%)表示,如果患者提出相关问题,讨论R/S问题是合适的,73%的医生表示,当R/S问题出现时,他们经常或总是鼓励患者坚持自己的R/S信仰和做法。对于医生何时适合询问R/S(45%的人认为通常或总是不合适)、谈论自己的宗教信仰或经历(14%的人表示从不,43%的人表示只有在患者询问时才会说)以及与患者一起祈祷(17%的人表示从不,53%的人表示只有在患者询问时才会做),医生们的意见分歧更大。那些认为自己宗教信仰更强、精神信仰更强的医生,尤其是新教徒,在临床诊疗中更有可能认可并报告处理R/S的各种不同方式。
医生宗教和精神特征的差异与临床诊疗中对R/S的不同态度和行为相关。在临床诊疗中讨论处理R/S问题的适宜性时,需要应对医生之间这些根深蒂固的差异。