Patient desire for spiritual assessment is unmet in urban and rural primary care settings

Joseph R. Fuchs,Jeffrey W. Fuchs,Marilyn E. Coors,Joshua M. Hauser

doi:10.1186/s12913-021-06300-y

Joseph R. Fuchs, Jeffrey W. Fuchs + Show 2 more

Open Access

https://doi.org/10.1186/s12913-021-06300-y

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Abstract

BackgroundIncorporation of patient religious and spiritual beliefs in medical care has been shown to improve the efficacy of medical interventions and health outcomes. While previous study has highlighted differences in patient desire for spiritual assessment based on patient religiosity, little is known about patient desire for spiritual assessment based on community type, particularly in urban compared to rural communities. We hypothesized that, given demographic trends which show a higher degree of religiosity in rural areas, patients in rural communities will be more likely to desire spiritual assessment.MethodsIn this cross-sectional study of 141 adult primary care patients in rural and urban Colorado at non-religiously affiliated clinics, we surveyed patient demographic information, measures of religiosity, patient desire for spiritual assessment, and frequency of spiritual assessment in practice. Univariate logistic regression analyses were used to compare the two populations.ResultsIn both Denver County (urban) and Lincoln County (rural) over 90% of patients identified as religious, spiritual, or a combination of the two. Thirty eight percent (38.3%) of patients in Denver County and 49.1% of patients in Lincoln desired spiritual assessment. Over 97% of patients in both areas reported rarely or never being asked about their R/S within the past year. For patients who have had five or more clinic visits in the past year, more than 91% in both areas stated they have never or rarely been asked about their beliefs.ConclusionsWhile the majority of patients in this study identify as religious or spiritual and many patients desire spiritual assessment, the majority of patients have never or rarely been asked about their spirituality within the past year. This demonstrates a significant gap between patient preference and provider practice of spiritual assessment in the primary care setting, which was similar in both rural and urban settings. This highlights the need for interdisciplinary focus on spiritual assessment and incorporation of patient R/S beliefs in medical care to provide holistic patient care and improve health outcomes.

Highlights

Incorporation of patient religious and spiritual beliefs in medical care has been shown to improve the efficacy of medical interventions and health outcomes
Recent research suggests that the incorporation of patient Religion and Spirituality (R/S) improves the efficacy of medical interventions and the integration of R/S beliefs in care leads to improved measures of patient hope and quality of life [6, 7]
The results of the study indicate that approximately 40% of patients in the outpatient general medicine settings in both an urban (Denver County) and rural (Lincoln County) location desire spiritual assessment

Summary

Introduction

Incorporation of patient religious and spiritual beliefs in medical care has been shown to improve the efficacy of medical interventions and health outcomes. Since the 1990s, the impact of Religion and Spirituality (R/S) on patient health has received increasing attention This is seen in the exponential growth in publications on the topic of religion, spirituality, and health over the past three decades [1]. Over this time period, more than one thousand studies have examined the impact of R/S on patient health and health outcomes [2, 3]. Recent research suggests that the incorporation of patient R/S improves the efficacy of medical interventions and the integration of R/S beliefs in care leads to improved measures of patient hope and quality of life [6, 7]

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