The association between religiosity and resuscitation status preference among patients with advanced cancer.
OBJECTIVE
The potential influence of patient religious and spiritual beliefs on the approach to end-of-life care and resuscitation status preferences is not well understood. The aim of this study was to assess the association between religiosity and resuscitation preferences in advanced-cancer patients.


METHODS
We performed a secondary analysis of a randomized controlled trial that evaluated the influence of physician communication style on patient resuscitation preferences. All patients completed the Santa Clara Strength of Religious Faith Questionnaire-Short Form (SCSRFQ-SF) and expressed their resuscitation preferences. We determined the frequency of resuscitation preferences and its association with intensity of religiosity.


RESULTS
A total of 78 patients completed the study. The median age was 54 years, with a range of 18-78. Some 46 (59%) were women; 57 patients (73%) were Caucasian, 15 (19%) African American, and 5 (7%) Hispanic. A total of 46 patients (56%) were Protestant and 13 (17%) Catholic. Some 53 of 60 patients who chose Do Not Resuscitate status (DNR) (88%) and 16 of 18 patients who refused DNR (89%) for a video-simulated patient were highly religious (p = 0.64). When asked about a DNR for themselves after watching the videos, 43 of 48 who refused DNR (90%) and 26 of 30 patients who chose DNR (87%) were highly religious (p = 0.08). The Spearman correlation coefficient for patients choosing DNR for themselves and intensity of religiosity was r = -0.16 (p = 0.16). Some 30 patients (38%) who chose DNR for the video patient refused DNR for themselves, and 42 who chose DNR for both the video patient and themselves (54%) were highly religious (p = NS).


CONCLUSIONS
There was no significant association between intensity of patient religiosity and DNR preference for either the video patient or the patients themselves. Other beliefs and demographic factors likely impact end-of-life discussions and resuscitation status preferences.
The University of Texas MD Anderson Cancer Center,Houston,Texas.
Marvin O
MO
Delgado-Guay
The University of Texas MD Anderson Cancer Center,Houston,Texas.
Gary
G
Chisholm
The University of Texas MD Anderson Cancer Center,Houston,Texas.
Janet
J
Williams
The University of Texas MD Anderson Cancer Center,Houston,Texas.
Eduardo
E
Bruera
D000293:Adolescent; D000328:Adult; D016223:Advance Directives / Q000523:psychology*; D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D010817:Physician-Patient Relations; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012068:Religion and Medicine; D016414:Resuscitation Orders / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*; D055815:Young Adult
Decision making; Religiosity; Resuscitation code status; Spirituality