Abstract
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; Conclusion: 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.
Highlights
A paradox exists with regard to the discussion of spirituality by doctors and their patients, where spirituality refers to the way people engage with the purpose and meaning of human existence and shapes their personal values [1]
Spirituality should not be confused with religion, which is an organized form of spiritual expression and a subset of human spirituality as a whole
In order to do this, we interviewed doctors caring for patients at the end of life (EOL), a time known to be associated with increased spiritual need, about the challenges of discussing spirituality in the medical consultation [22]
Summary
A paradox exists with regard to the discussion of spirituality by doctors and their patients, where spirituality refers to the way people engage with the purpose and meaning of human existence and shapes their personal values [1]. The literature reflects a high level of patient interest in discussing spirituality in the medical consultation, but a low frequency of doctors raise the topic [2,3] This is despite several studies reporting that a majority of doctors believe that routine spiritual care (SC). Doctors’ discomfort and concerns regarding the appropriateness of SC provision in the face of high patient approval raises the possibility that some barriers are anticipated rather than experienced as problematic What is it that causes so much uneasiness for doctors contemplating the discussion of spirituality with their patients?. In order to do this, we interviewed doctors caring for patients at the EOL, a time known to be associated with increased spiritual need, about the challenges of discussing spirituality in the medical consultation [22]. It was not an a priori objective for the study
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