577: ADDRESSING PATIENT AND FAMILY SPIRITUAL NEEDS: A NATIONAL NEEDS ASSESSMENT OF PEDIATRIC FELLOWS

Abstract

Introduction: Spiritual care is an essential component of whole-person healthcare and becomes increasingly important in critical situations. Despite practice guidelines from the American College of Critical Care Medicine, studies have shown that adult critical care physicians rarely initiate conversations about patients’ and families’ spiritual needs and cite lack of training as a significant barrier. Little is known about the perspectives of pediatric physicians working in critical care settings as they relate to spiritual care. Methods: An IRB-approved survey was sent to 720 pediatric fellows training in critical care settings (165 Cardiology, 259 Critical Care, 296 Neonatology). Categorical data was compared using chi-squared test or Fisher’s exact tests. The Wilcoxon rank sum test was used to compare the percentage correct on ten multiple-choice questions about world religions. Written free text responses were independently reviewed and coded using inductive analysis by two research investigators. Results: 245 surveys were completed yielding a 34% response rate. 83% of fellows had never received prior spiritual care training and 72% of fellows indicated that they would be somewhat or very likely to incorporate spiritual care into their practice if they received training. Prior training was significantly associated with increased knowledge of a framework for taking a spiritual history (p < 0.001), the spiritual care resources at the fellow’s institution (p < 0.004), and spiritual practices that could influence medical care (p < 0.029). Prior training was significantly associated with frequency of taking a spiritual history (p < 0.0001), comfort taking a spiritual history (p < 0.0001), and referring patients/families to spiritual care resources (p < 0.016). Lack of time and training were the most commonly reported barriers to providing spiritual care in qualitative responses. Conclusions: Providing spiritual care for families is important in critical care. Pediatric fellows are open to incorporating spiritual care into their practice but lack the training to do so. Prior training is significantly associated with improved knowledge and skills in providing spiritual care. An opportunity exists to implement spiritual care training into pediatric training programs.