Cadge Wendy, Ecklund Elaine Howard
Department of Sociology, Brandeis University, Waltham, MA 02454, USA.
South Med J. 2009 Dec;102(12):1218-21. doi: 10.1097/SMJ.0b013e3181bfac71.
Physicians and researchers have recently paid increased attention to prayer in physician-patient interactions. Research focuses more on attitudinal questions about whether physicians and/or patients think prayer is relevant than on actual data about when and how prayer comes up in the clinic and how physicians respond. We focus on pediatric physicians to investigate: 1) how prayer enters clinical contexts and 2) how physicians respond.
We examined in-depth interviews with 30 academic pediatricians and pediatric oncologists. All of these physicians were employed by the most highly ranked hospitals according to US News and World Report.
In close to 100% of cases when the subject of prayer came up in clinical contexts, it was patients and families who raised it. Patients and families mostly talked about prayer in response to a seriously ill or dying child. When it was raised, pediatric physicians responded to prayer by participating; accommodating but not participating; reframing; and directing families to other resources.
Physicians wanted to respect patients and families around the topic of prayer. They negotiated between patient/family requests, the specific situation, and their own comfort levels to respond in one of four ways. Their four responses allowed researchers to generate hypotheses about the independent variables that influence how pediatric physicians respond to prayer. Asking how prayer actually came up in clinical situations rather than how patients and/or physicians thought it should be raised, better informs ongoing conversations about the significance of prayer in physician-patient interactions.
医生和研究人员最近越来越关注医患互动中的祈祷行为。研究更多地集中在关于医生和/或患者是否认为祈祷相关的态度问题上,而不是关于祈祷在临床中何时以及如何出现以及医生如何回应的实际数据。我们聚焦于儿科医生来调查:1)祈祷如何进入临床情境;2)医生如何回应。
我们对30位学术儿科医生和儿科肿瘤学家进行了深入访谈。所有这些医生都受雇于《美国新闻与世界报道》评选出的排名最高的医院。
在临床情境中,几乎100%的情况下,是患者及其家属提出了祈祷的话题。患者及其家属大多是在面对重病或濒死的孩子时谈到祈祷。当祈祷话题被提出时,儿科医生通过参与、迁就但不参与、重新阐释以及引导家属寻求其他资源等方式来回应祈祷。
医生希望在祈祷话题上尊重患者及其家属。他们在患者/家属的请求、具体情况以及自身的舒适程度之间进行权衡,以四种方式之一做出回应。他们的四种回应方式使研究人员能够就影响儿科医生对祈祷回应方式的自变量提出假设。询问祈祷在临床情境中实际是如何出现的,而不是患者和/或医生认为应该如何提出,能为正在进行的关于祈祷在医患互动中的意义的讨论提供更充分的信息。