title: Whose role? Oncology practitioners' perceptions of their role in providing spiritual care to advanced cancer patients.
abstract: OBJECTIVE
  The purpose of this study is to determine how oncology nurses and physicians view their role in providing spiritual care (SC), factors influencing this perception, and how this belief affects SC provision.
  
  
  METHODS
  This is a survey-based, multisite study conducted from October 2008 to January 2009. All oncology physicians and nurses caring for advanced cancer patients at four Boston, MA cancer centers were invited to participate; 339 participated (response rate = 63 %).
  
  
  RESULTS
  Nurses were more likely than physicians to report that it is the role of medical practitioners to provide SC, including for doctors (69 vs. 49 %, p < 0.001), nurses (73 vs. 49 %, p < 0.001), and social workers (81 vs. 63 %, p = 0.001). Among nurses, older age was the only variable that was predictive of this belief [adjusted odds ratio (AOR) 1.08; 1.01-1.16, p = 0.02]. For nurses, role perception was not related to actual SC provision to patients. In contrast, physicians' role perceptions were influenced by their intrinsic religiosity (AOR, 1.44; 95 % CI, 1.09-1.89; p = 0.01) and spirituality (AOR, 6.41; 95 % CI, 2.31-17.73, p < 0.001). Furthermore, physicians who perceive themselves as having a role in SC provision reported greater SC provision to their last advanced cancer patients seen in clinic, 69 % compared to 31 %, p < 0.001.
  
  
  CONCLUSIONS
  Nurses are more likely than physicians to perceive medical practitioners as having a role in SC provision. Physicians' perceptions of their role in SC provision are influenced by their religious/spiritual characteristics and are predictive of actual SC provision to patients. Spiritual care training that includes improved understanding of clinicians' appropriate role in SC provision to severely ill patients may lead to increased SC provision.
authors: Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, 610 University Avenue, 5th floor, Toronto, ON, M5G 2M9, Canada, danielle.rodin@rmp.uhn.on.ca.
authors: Danielle
authors: D
authors: Rodin
authors: Michael
authors: M
authors: Balboni
authors: Christine
authors: C
authors: Mitchell
authors: Patrick T
authors: PT
authors: Smith
authors: Tyler J
authors: TJ
authors: VanderWeele
authors: Tracy A
authors: TA
authors: Balboni
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D009726:Nurses; D010465:Perception; D010820:Physicians; D012068:Religion and Medicine; D029181:Spirituality; D011795:Surveys and Questionnaires
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