title: A systematic review of spiritual and religious variables in Palliative Medicine, American Journal of Hospice and Palliative Care, Hospice Journal, Journal of Palliative Care, and Journal of Pain and Symptom Management.
abstract: OBJECTIVE
  There has been increasing recognition and acceptance of the importance of addressing existential and spiritual suffering as an important and necessary component of palliative medicine and end-of-life care in the United States. This paper seeks to. empirically and systematically examine the extent to which there is an adequate scientific research base on spirituality and its role in palliative care, in the palliative care and hospice literature.
  
  
  METHODS
  We sought to locate all empirical studies published in five palliative medicine/hospice journals from 1994 to 1998. The journals included: American Journal of Hospice and Palliative Care, Journal of Palliative Care, Hospice Journal, Palliative Medicine, and The Journal of Pain and Symptom Management. Journal contents were searched to identify studies that included spiritual or religious measures or results. Case studies, editorials, and theoretical or descriptive articles were not included in the search.
  
  
  RESULTS
  During the years 1994-1998, 1,117 original empirical articles were published in the five journals reviewed. Only 6.3% (70 articles) included spiritual or religious variables. This percentage, while low, was better that the 1% previously reported in an examination of studies published in Journal of the American Medical Association, The Lancet, and New England Journal of Medicine.
  
  
  CONCLUSIONS
  While researchers in the field of palliative care have studied spiritual/religious variables more than other areas of medicine, the total percentage for studies is still a low 6.3%. To move the field of palliative medicine forward so appropriate guidelines for spiritual care can be developed, it is critical that good research be conducted upon which to base spiritual care in an evidence-based model. Recommendations are made for future studies on spiritual care in palliative medicine.
authors.affiliation: George Washington Institute for Spirituality and Health (GWish), George Washington University, 2300 K Street N.W., #303, Washington, DC 20037, USA. hcsmp@gwumc.edu
authors.forename: Christina M
authors.initials: CM
authors.lastname: Puchalski
authors.forename: Shelley Dean
authors.initials: SD
authors.lastname: Kilpatrick
authors.forename: Michael E
authors.initials: ME
authors.lastname: McCullough
authors.forename: David B
authors.initials: DB
authors.lastname: Larson
mesh_terms: D015706:Bibliometrics; D017051:Hospice Care; D006801:Humans; D010166:Palliative Care; D010506:Periodicals as Topic / Q000706:statistics & numerical data*; D012068:Religion and Medicine; D012106:Research; D029181:Spirituality; D014481:United States