Discussing Spirituality With Patients: A Rational and Ethical Approach

Article Figures & Data

Table 1.

Demographic Profile of Respondents (N = 921).

Characteristic	No.	Percent
* Medians are reported for age and times to the doctor in the past year because the distributions were not normal.
Sex
Male	221	24.0
Female	699	76.0
Race
White	695	76.0
Black	189	20.7
Asian/Pacific Islander	4	0.4
Hispanic	11	1.2
Mixed black/white	3	0.3
Other	12	1.3
Marital status
Single	297	32.5
Married	434	47.4
Divorced	114	12.5
Separated	14	1.5
Widowed	54	5.9
Partner	2	0.2
Education
Less than high school	50	5.5
High school	317	34.7
Some college	276	30.2
College grad	217	23.8
Tech school	53	5.8
Site
Private practice	270	29.3
Residency sites	651	70.7
Respondent
Patient	798	86.6
Adult companion	123	13.4
	Mean (SD)	Range
Age, years (median 39 y)*	41.2 (16.57)	18–90
SF-12 Physical Health Score	47.0 (10.90)	14–65
SF-12 Mental Health Score	48.0 (11.05)	14–65
Times to doctor in past year(median 3)*	5.7 (6.67)	0–52

Table 2.

Ranking of Situations Where Spiritual Discussion Is Welcome

	Respondents Who Wanted to Talk
Situations	Percent Yes*	Total Percent^†
*Percentage of respondents among those that sometimes/always wanted to discuss spirituality with their physician.
† Percentage of all respondents including the 17 that never wanted to discuss spirituality with their physician.
Very seriously ill with the possibility of dying	94	77
Suffering from an ongoing, long-term, serious illness	91	74
Just diagnosed with a serious illness	90	73
Suffering from grief over the loss of a loved one	87	70
Recovering from a serious illness	83	66
Admitted to hospital	75	58
Victim of sexual abuse	72	55
Addiction to drugs or alcohol	72	55
Victim of domestic violence	71	54
Suffering from chronic pain	62	45
Discuss during medical history on initial visit to doctor	60	43
Discuss during routine physical or check-up	24	7
Visit for a minor medical problem	22	5

Table 3.

What Respondents Want Physicians to Do With Spiritual/Religious Information

	Percent of Patients
Reason for Wanting Discussion	Yes*	Total^†
Note: Choices are not mutually exclusive. Respondents were free to mark all that apply. Eighty-eight percent of those desiring spiritual discussion marked at least 1 item.
* Percentage of respondents among those that sometimes/always wanted to discuss spirituality with their physician.
† Percentage of all respondents including the 17 that never wanted to discuss spirituality with their physician.
So that the doctor can understand how your beliefs influence how you deal with being sick	87	68
So that the doctor can understand you better	85	65
So that the doctor would understand how you make decisions	83	64
So that the doctor can provide compassion, encourage realistic hope	67	50
So that the doctor can better advise you on how to take care of yourself when sick	66	49
So that the doctor would change how you are being treated Medically	62	45
So that the doctor can refer you to a spiritual advisor if you think you need it	51	34
So that the doctor would pray with you	33	16
Just so the doctor will listen	22	5

Table 4.

Predictors of Respondents That Always or Sometimes Want Their Physicians to Know About Their Beliefs

Variable	Coefficient	SE	PValue	OR	95% CI
OR = odds ratio; CI = confidence interval.
* On a range from 1 to 5, with 1 = not spiritual at all, to 5 = extremely spiritual.
Intercept	0.405	0.375	.2810
Beliefs give patient hope during times of illness	0.752	0.141	<.0001	4.503	2.588–7.836
Patient has spiritual beliefs that would influence a health care decision	0.553	0.151	.0002	3.025	1.676–5.461
30 to 64 years of age	0.360	0.105	.0006	2.054	1.363–3.096
Personal rating of spirituality*	0.283	0.108	.0091	1.327	1.073–1.641

Supplemental Appendix

Patient Attitudes Concerning Spirituality Questioning by Physicians.

Files in this Data Supplement:

Supplemental data: Appendix - PDF file, 4 pages, 1.17 MB
The Article in Brief

Most patients want doctors to ask about their spiritual beliefs in at least some circumstances; however, openness to such questions depends on the situation. Discussion of spirituality is most welcome in cases of serious or life-threatening illness or following the death of a loved one. Patients are interested in discussing spirituality so that their doctors can better understand them and their decisions, and provide compassion, hope and advice.