Physicians' Religious Topic Avoidance during Clinical Interactions.

Melinda Villagran,Mollie Canzona,Christy Ledford,Brenda Macarthur,Lauren Lee

doi:10.3390/bs7020030

Abstract

Religious and spiritual (R/S) conversations at the end-of-life function to help patients and their families find comfort in difficult circumstances. Physicians who feel uncertain about how to discuss topics related to religious beliefs may seek to avoid R/S conversations with their patients. This study utilized a two-group objective structured clinical examination with a standardized patient to explore differences in physicians’ use of R/S topic avoidance tactics during a clinical interaction. Results indicated that physicians used more topic avoidance tactics in response to patients’ R/S inquiries than patients’ R/S disclosures; however, the use of topic avoidance tactics did not eliminate the need to engage in patient-initiated R/S interactions.

Highlights

Communication at the end of life often includes discussions with physicians about the physical, emotional, and spiritual needs of a dying loved one [1]
This study extends research on Religious and spiritual (R/S) conversations in healthcare [8,9] to explore religious topic avoidance tactics used by physicians during clinical interactions
A total of 57 topic avoidance tactics were employed by physicians in 28 objective standard clinical examinations (OSCEs) clinical interactions

Summary

Introduction

Communication at the end of life often includes discussions with physicians about the physical, emotional, and spiritual needs of a dying loved one [1]. Physicians who are not receptive to R/S discussions at the end of life use verbal and nonverbal tactics to avoid these discussions, even though addressing R/S topics could meet communicative needs of their patients [4,5]. In the case of R/S conversations at the end of life, physicians may employ topic avoidance tactics to limit challenging R/S discussions or avoid disclosing personal R/S beliefs due to a lack of perceived religious concordance with patients and their families. Shared R/S beliefs can bring confidence to the interaction, a perceived lack of R/S concordance may limit a physician’s ability to address patients’ R/S questions directly [7]

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Results

Discussion

Conclusion