Why do We Find It so Hard to Discuss Spirituality? A Qualitative Exploration of Attitudinal Barriers.
BACKGROUND
Despite known health benefits of spiritual care and high patient interest in discussing spirituality with their physicians, the frequency of spiritual discussions in the medical consultation is low. We investigated spiritual conversations for doctors caring for patients with advanced cancer; why these conversations so difficult; and what the underlying challenges are for discussing spirituality with patients;


METHODS
Participants were contacted through the Australian and New Zealand Society of Palliative Medicine and the Medical Oncology Group of Australia, including physicians from two secular countries. Semi-structured interviews were taped and transcribed verbatim. The text was analyzed using thematic analysis;


RESULTS
Thematic saturation was reached after 23 participants had been interviewed. The following themes were identified: (1) confusing spirituality with religion; (2) peer pressure; (3) personal spirituality; (4) institutional factors; (5) historical factors;


CONCLUSIONS
This study explored the underlying attitudes contributing to the reluctance doctors have to discuss spirituality in the medical consultation. Underlying confusion regarding the differences between religion and spirituality, and the current suspicion with which religion is regarded in medicine needs to be addressed if discussion of spirituality in the medical consultation is to become routine. Historical opposition to a biopsychosocial-spiritual model of the human being is problematic.
Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney 2006, Australia. megan.best@sydney.edu.au.
Megan
M
Best
Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney 2006, Australia. phyllis.butow@sydney.edu.au.
Phyllis
P
Butow
Division of Health Sciences, University of South Australia, Adelaide 5001, Australia. ian.olver@unisa.edu.au.
Ian
I
Olver
Neoplasms; communication barriers; physician-patient relations; qualitative research; religion; spirituality