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Directions in research on spiritual and religious issues for improving palliative care

Published online by Cambridge University Press:  29 April 2003

BERNARD LO
Affiliation:
Program in Medical Ethics, the Center for AIDS Prevention Studies, and the Division of General Internal Medicine, University of California, San Francisco, California
VICKI CHOU
Affiliation:
Program in Medical Ethics, the Center for AIDS Prevention Studies, and the Division of General Internal Medicine, University of California, San Francisco, California

Extract

Spiritual and religious issues are often important to people with serious illnesses. Spiritual beliefs and religious ceremonies may help patients near the end of life find meaning and comfort. Comprehensive palliative care ought to address patients' spiritual and religious needs and concerns as well as their physical distress. Puchalski et al. (2003) document the paucity of studies that collect empirical data on spiritual and religious issues in palliative care. They argue convincingly that more studies are essential in order to develop evidence-based standards for appropriate ways to address patients' spiritual and religious needs at the end of life. Such research would help us better understand how spiritual and religious concerns, beliefs, practices, and interventions might impact outcomes of end-of-life care. For instance, routine inquiry by physicians about patients' spiritual and religious concerns might lead to such outcomes as better relief of physical symptoms or improved quality of life. Puchalski et al. (2003) call for more empirical research on these important topics and also the development of better measures. For example, they point out the need for measurements of religiousness that account for more than a patient's denomination. They also found that very few of the available scales had undergone evaluation for internal consistency or test–retest reliability. Moreover, many existing instruments concerning spirituality are not validated for patients near the end of life.

Type
EDITORIAL
Copyright
© 2003 Cambridge University Press

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References

REFERENCES

Curtis, R.C., Patrick, D.L., Engelberg, R.A., Norris, K., Asp, C., & Byock, I. (2001). A measure of the quality of dying and death: Initial validation using after-death interviews with family members. Journal of Pain and Symptom Management, 24, 1731.Google Scholar
Ehman, J.W., Ott, B.B., Short, T.H., Ciampa, R.C., & Hansen-Flaschen, J. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 18031806.Google Scholar
Elder, H. (1999). Stratagems for Spiritual Care. www.gomets.org/fireseeds/stratagems-sp99.html.
Ellis, M., Vinson, D., & Ewigman, B. (1999). Addressing spiritual concerns of patients: Family physicians' attitudes and practices. Journal of Family Practice, 48, 105109.Google Scholar
Fischer, G.S., Tulsky, J.A., Rose, M.R., Siminoff, L.A., & Arnold, R.M. (1998). Patient knowledge and physician predications of treatment preferences after discus-sions of advance directives. Journal of General Internal Medicine, 13, 447454.CrossRefGoogle Scholar
King, D.E. & Bushwick, B. (1994). Beliefs and attitudes of hospital inpatients regarding faith healing and prayer. Journal of Family Practice, 39, 349352.Google Scholar
Koenig, H.G., Bearon, L.B., Hover, M., & Travis, J.L. (1991). Religious perspectives of doctors, nurses, patients, and families. Journal of Pastoral Care, 45, 254267.CrossRefGoogle Scholar
Lo, B., Ruston, D., Kates, L.W., Arnold, R.M., Cohen, C.B., Faber-Langendoen, K., Pantilat, S.Z., Puchalski, C.M., Quill, T.R., Rabow, M.W., Schreiber, S., Sulmasy, D.P., & Tulsky, J.A. (2002). Discussing religious and spiritual issues at the end of life: A practical guide for physicians. Journal of the American Medical Association, 287, 749754.CrossRefGoogle Scholar
Maugans, T.A. & Wadland, W.C. (1991). Religion and family medicine: A survey of physicians and patients. Journal of Family Practice, 32, 210213.Google Scholar
Oyama, O. & Koenig, H. (1998). Religious beliefs and practices of family medicine. Archives of Family Medicine, 7, 431435.CrossRefGoogle Scholar
Patrick, D.L., Engelberg, R.A., & Curtis, J.R. (2001). Evaluating the quality of dying and death. Journal of Pain and Symptom Management, 22, 717726.CrossRefGoogle Scholar
Puchalski, C.M., Kilpatrick, S.D., McMullough, M.E., & Larson, D.B. (2003). A systematic review of spiritual and religious variables in Palliative Medicine, American Journal of Hospice and Palliative Care, Hospice Journal, Journal of Palliative Care, and Journal of Pain and Symptom Management. Palliative and Supportive Care, 1, 713.Google Scholar
Puchalski, C.M. & Larson, D.B. (1998). Developing curricula in spirituality and medicine. Academic Medicine, 73, 970974.CrossRefGoogle Scholar
Roter, D.L., Larson, S., Fischer, G.S., Arnold, R.M., & Tulsky, J.A. (2000). Experts practice what they preach: A descriptive study of best and normative practices in end-of-life discussions. Archives of Internal Medicine, 160, 34773485.CrossRefGoogle Scholar
Sloan, R.P., Bagiella, E., VandeCreek, L., Hover, M., Casalone, C., Jinpu Hirsch, T., Hasan, Y., Kreger, R., & Poulos, P. (2000). Should physicians prescribe religious activities? New England Journal of Medicine, 342, 19131916.Google Scholar
Steinhauser, K., Bosworth, H., Clipp, E., McNeilly, M., Christakis, N.A., Parker, J., & Tulsky, J.A. (2003). Initial assessment of a new instrument to measure quality of life at the end of life. Journal of Palliative Medicine. In press.Google Scholar
Teno, J. (2001). Toolkit. Providence, RI: The Center for Gerontology & Health Care Research. www.chcr.brown.edu/pcoc/toolkit.htm.
Tulsky, J.A., Chesney, M.A., & Lo, B. (1995). How do medical residents discuss resuscitation with patients? Journal of General Internal Medicine, 10, 436442.Google Scholar