Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA.
Department of Health Services Research and Administrative, University of Nebraska Medical Center, Omaha, Nebraska, USA.
J Pain Symptom Manage. 2018 Mar;55(3):897-905. doi: 10.1016/j.jpainsymman.2017.10.015. Epub 2017 Nov 1.
There has been a sustained debate in the medical literature over whether physicians should engage with patients' religious and spiritual concerns.
This study explores what physicians believe about the relative importance and appropriateness of engaging with patients' spiritual concerns and physicians' choices of interventions.
In 2010, a questionnaire was mailed to 2016 U.S. physicians with survey items querying about the relative importance of addressing patients' spiritual concerns at the end of life and the appropriateness of interventions in addressing those concerns. The survey also contained an experimental vignette to assess physicians' willingness, if asked by patients, to participate in prayer.
Adjusted response rate was 62% (1156/1878). The majority of physicians (65%) believe that it is essential to good practice for physicians to address patients' spiritual concerns at the end of life. Physicians who were more religious were more likely to believe that spiritual care is essential to good medical practice (odds ratio: 2.76, 95% CI 1.12-6.81) and believe that it is appropriate to always encourage patients to talk to a chaplain (odds ratio: 5.71, 95% CI: 2.28-14.3). A majority of the physicians (55%) stated that, if asked, they would join the family and patient in prayer. Physicians' willingness to join ranged from 67% when there was concordance between the physician's and the patient's religious affiliation to 51% when there was discordance.
The majority of U.S. physicians endorse a limited role in the provision of spiritual care, although opinions varied based on physicians' religious characteristics.
医学文献中一直存在着关于医生是否应该关注患者的宗教和精神关切的持续争论。
本研究探讨了医生对关注患者精神关切的相对重要性和适当性以及医生选择干预措施的看法。
2010 年,向 2016 名美国医生邮寄了一份问卷,调查项目包括在生命末期解决患者精神关切的相对重要性以及解决这些关切的干预措施的适当性。该调查还包含一个实验案例,以评估医生在患者提出要求时是否愿意参与祈祷。
调整后的回复率为 62%(1156/1878)。大多数医生(65%)认为,医生在生命末期解决患者的精神关切是良好实践的必要条件。宗教信仰更虔诚的医生更有可能认为精神关怀是良好医疗实践的必要条件(优势比:2.76,95%置信区间:1.12-6.81),并且认为始终鼓励患者与牧师交谈是适当的(优势比:5.71,95%置信区间:2.28-14.3)。大多数医生(55%)表示,如果被要求,他们会与家人和患者一起祈祷。医生的参与意愿从与医生宗教信仰一致时的 67%到不一致时的 51%不等。
大多数美国医生认可在提供精神关怀方面扮演有限的角色,尽管医生的宗教特征不同,意见也有所不同。