title: "It depends": viewpoints of patients, physicians, and nurses on patient-practitioner prayer in the setting of advanced cancer.
abstract: BACKGROUND
  Although prayer potentially serves as an important practice in offering religious/spiritual support, its role in the clinical setting remains disputed. Few data exist to guide the role of patient-practitioner prayer in the setting of advanced illness.
  
  
  OBJECTIVE
  To inform the role of prayer in the setting of life-threatening illness, this study used mixed quantitative-qualitative methods to describe the viewpoints expressed by patients with advanced cancer, oncology nurses, and oncology physicians concerning the appropriateness of clinician prayer.
  
  
  METHODS
  This is a cross-sectional, multisite, mixed-methods study of advanced cancer patients (n=70), oncology physicians (n=206), and oncology nurses (n=115). Semistructured interviews were used to assess respondents' attitudes toward the appropriate role of prayer in the context of advanced cancer. Theme extraction was performed based on interdisciplinary input using grounded theory.
  
  
  RESULTS
  Most advanced cancer patients (71%), nurses (83%), and physicians (65%) reported that patient-initiated patient-practitioner prayer was at least occasionally appropriate. Furthermore, clinician prayer was viewed as at least occasionally appropriate by the majority of patients (64%), nurses (76%), and physicians (59%). Of those patients who could envision themselves asking their physician or nurse for prayer (61%), 86% would find this form of prayer spiritually supportive. Most patients (80%) viewed practitioner-initiated prayer as spiritually supportive. Open-ended responses regarding the appropriateness of patient-practitioner prayer in the advanced cancer setting revealed six themes shaping respondents' viewpoints: necessary conditions for prayer, potential benefits of prayer, critical attitudes toward prayer, positive attitudes toward prayer, potential negative consequences of prayer, and prayer alternatives.
  
  
  CONCLUSIONS
  Most patients and practitioners view patient-practitioner prayer as at least occasionally appropriate in the advanced cancer setting, and most patients view prayer as spiritually supportive. However, the appropriateness of patient-practitioner prayer is case specific, requiring consideration of multiple factors.
authors.affiliation: Center for Psycho-Oncology and Palliative Care Research, Department of Psycho-Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts 02120, USA. michael_balboni@dfci.harvard.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Balboni
authors.forename: Amenah
authors.initials: A
authors.lastname: Babar
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dillinger
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Phelps
authors.forename: Emily
authors.initials: E
authors.lastname: George
authors.forename: Susan D
authors.initials: SD
authors.lastname: Block
authors.forename: Lisa
authors.initials: L
authors.lastname: Kachnic
authors.forename: Jessica
authors.initials: J
authors.lastname: Hunt
authors.forename: John
authors.initials: J
authors.lastname: Peteet
authors.forename: Holly G
authors.initials: HG
authors.lastname: Prigerson
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: VanderWeele
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Balboni
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001900:Boston / Q000453:epidemiology; D029221:Faith Healing / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000451:nursing*; D009723:Nurse-Patient Relations; D010166:Palliative Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D015995:Prevalence; D013727:Terminal Care / Q000706:statistics & numerical data*