Patient preference for physician discussion and practice of spirituality.
OBJECTIVE
To determine patient preferences for addressing religion and spirituality in the medical encounter.


METHODS
Multicenter survey verbally administered by trained research assistants. Survey items included questions on demographics, health status, health care utilization, functional status, spiritual well-being, and patient preference for religious/spiritual involvement in their own medical encounters and in hypothetical medical situations.


METHODS
Primary care clinics of 6 academic medical centers in 3 states (NC, Fla, Vt).


METHODS
Patients 18 years of age and older who were systematically selected from the waiting rooms of their primary care physicians.


RESULTS
Four hundred fifty-six patients participated in the study. One third of patients wanted to be asked about their religious beliefs during a routine office visit. Two thirds felt that physicians should be aware of their religious or spiritual beliefs. Patient agreement with physician spiritual interaction increased strongly with the severity of the illness setting, with 19% patient agreement with physician prayer in a routine office visit, 29% agreement in a hospitalized setting, and 50% agreement in a near-death scenario (P <.001). Patient interest in religious or spiritual interaction decreased when the intensity of the interaction moved from a simple discussion of spiritual issues (33% agree) to physician silent prayer (28% agree) to physician prayer with a patient (19% agree; P <.001). Ten percent of patients were willing to give up time spent on medical issues in an office visit setting to discuss religious/spiritual issues with their physician. After controlling for age, gender, marital status, education, spirituality score, and health care utilization, African-American subjects were more likely to accept this time trade-off (odds ratio, 4.9; confidence interval, 2.1 to 11.7).


CONCLUSIONS
Physicians should be aware that a substantial minority of patients desire spiritual interaction in routine office visits. When asked about specific prayer behaviors across a range of clinical scenarios, patient desire for spiritual interaction increased with increasing severity of illness setting and decreased when referring to more-intense spiritual interactions. For most patients, the routine office visit may not be the optimal setting for a physician-patient spiritual dialog.
MacLean
Charles D
CD
University of Vermont College of Medicine, Burlington 05401, USA. charles.maclean@vtmednet.org
Susi
Beth
B
Phifer
Nancy
N
Schultz
Linda
L
Bynum
Deborah
D
Franco
Mark
M
Klioze
Andria
A
Monroe
Michael
M
Garrett
Joanne
J
Cykert
Sam
S
D001741:Black or African American; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010817:Physician-Patient Relations; D012067:Religion; D029181:Spirituality; D011795:Surveys and Questionnaires