This article is reprinted with permission of the National Institute for Healthcare Research.

Do patients want their doctors to ask if they have spiritual or religious beliefs that would influence their medical decisions if they became gravely ill? A new University of Pennsylvania study, recently published in the Archives of Internal Medicine, found that a majority of patients would welcome this line of questioning. The study also found that being asked such a question would increase the amount of trust patients place in their doctor.

"Overall, 66% of respondents agree that a physician's inquiry about religious or spiritual beliefs would strengthen their trust in their physician," noted the research team.

Some 94% of the respondents who indicated they had religious or spiritual beliefs that would make a difference felt physicians should inquire about these beliefs. Also, as many as half of those without such beliefs thought doctors should at least inquire.

Overview of Results:

  • 51% of respondents described themselves as religious.
  • 90% believe that prayer may sometimes influence recovery from an illness.
  • 45% reported that religious or spiritual beliefs would influence their medical decisions if they became gravely ill.
  • 94% of patients with such beliefs agreed that physicians should ask about their spiritual or religious beliefs if they became gravely ill.
  • 45% of patients who denied having such beliefs also agreed that physicians should ask about them.
  • 66% would welcome a question about spiritual or religious beliefs in a medical history.
  • 15% reported being asked such a question.
  • 16% would find such a question unwelcome.
  • In contrast, only 15% of the study's patients recalled having been asked whether their religious or spiritual beliefs would influence their medical decisions--a large gap between the number of patients who would like to discuss it and the number of physicians who have invited them to.

    The study of 177 outpatients with respiratory disease at the University Hospital of Pennsylvania grew out of the recognition that many Americans draw on religious or spiritual beliefs when confronted by serious illness. The question put to the study population was simple: Do you have spiritual or religious beliefs that would influence your medical decisions if you become gravely ill?

    According to the study's authors, "Two-thirds of our respondents reported that the question we studied would increase their trust in a physician. How often might this question, or others like it, also lead to better medical decision making?"

    "This study's findings contribute to an understanding of how a physician might improve patients' medical care," commented Dr. David Larson, president of the National Institute for Healthcare Research (NIHR).

    "Tactful, sensitive questions about our patients' religion or spirituality may help physicians better respond to patients' preferences, especially among those who have a high likelihood of relying on religion, such as the severely or chronically ill," Dr. Larson noted.

    "Such questions could include, 'Is religion/spirituality helpful to you in handling your illness?' or 'What gets you through the tough times in your life?' For patients who answer, 'My faith, spirituality or religion helps me,' a doctor might respond, 'What can I do to support or address spiritual issues in your life?'" Larson suggested.

    The University of Pennsylvania research team noted that by asking the open-ended question featured in this study, a doctor shows openness regarding the patient's medically relevant religious or spiritual beliefs. Also, the team noted, such a question provides a "quick, unrevealing avenue of exit" if the patient has no desire to address this topic.

    However, in this survey, 16% responded that they would not welcome such a line of questioning. Although this was only a minority of the respondents, the research team suggested that "clearly more information is needed on the potential downside of asking questions about spirituality and religion in clinical practice."

    "Some younger or generally healthy individuals may be more concerned about a physician's unexpected inquiry about a grave illness than the invitation to talk about religious or spiritual beliefs," they suggested. The patient may wonder if the doctor might "know something I don't know" about his or her medical condition, and another type of question might be more appropriate.

    Ultimately, however, the researchers concluded that "the results of this study point to possible widespread patient acceptance of incorporating a carefully worded exploratory question about spiritual or religious beliefs within a routine medical history."

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