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Beliefs of Primary Care Residents Regarding Spirituality and Religion in Clinical Encounters with Patients: A Study at a Midwestern U.S. Teaching Institution

Luckhaupt, Sara E. MD; Yi, Michael S. MD, MSc; Mueller, Caroline V. MD; Mrus, Joseph M. MD, MSc; Peterman, Amy H. PhD; Puchalski, Christina M. MD; Tsevat, Joel MD, MPH

Research Report

Purpose To assess primary care residents’ beliefs regarding the role of spirituality and religion in the clinical encounter with patients.

Method In 2003, at a major midwestern U.S. teaching institution, 247 primary care residents were administered a questionnaire adapted from that used in the Religion and Spirituality in the Medical Encounter Study to assess whether primary care house officers feel they should discuss religious and spiritual issues with patients, pray with patients, or both, and whether personal characteristics of residents, including their own spiritual well-being, religiosity, and tendency to use spiritual and religious coping mechanisms, are related to their sentiments regarding spirituality and religion in health care. Simple descriptive, univariate, and two types of multivariable analyses were performed.

Results Data were collected from 227 residents (92%) in internal medicine, pediatrics, internal medicine/pediatrics, and family medicine. One hundred four (46%) respondents felt that they should play a role in patients’ spiritual or religious lives. In multivariable analysis, this sentiment was associated with greater frequency of participating in organized religious activity (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.20-1.99), a higher level of personal spirituality (OR 1.05, 95% CI 1.02-1.08), and older resident age (OR 1.11, 95% CI 1.02-1.21; C-statistic 0.76). In general, advocating spiritual and religious involvement was most often associated with high personal levels of spiritual and religious coping and with the family medicine training program. Residents were more likely to agree with incorporating spirituality and religion into patient encounters as the gravity of the patient's condition increased (p < .0001).

Conclusions Approximately half of primary care residents felt that they should play a role in their patients’ spiritual or religious lives. Residents’ agreement with specific spiritual and religious activities depended on both the patient's condition and the resident's personal characteristics.

Dr. Luckhaupt is a second-year preventive medicine resident at the University of Michigan, Ann Arbor, Michigan. At the time of the study, Dr. Luckhaupt was a research assistant, Department of Internal Medicine, University of Cincinnati Medical Center; Veterans Healthcare System of Ohio (VISN 10); and the Institute for the Study of Health, University of Cincinnati Medical Center, Cincinnati, Ohio.

Dr. Yi is assistant professor of internal medicine and pediatrics, Department of Internal Medicine, University of Cincinnati Medical Center; Institute for the Study of Health, University of Cincinnati Medical Center; and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Dr. Mueller is associate professor of internal medicine and pediatrics, Department of Internal Medicine, University of Cincinnati Medical Center; and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Dr. Mrus is assistant professor of internal medicine and pediatrics, Department of Internal Medicine, University of Cincinnati Medical Center, Institute for the Study of Health, University of Cincinnati Medical Center; and Cincinnati Children's Hospital Medical Center; and physician, Health Services Research and Development, Veterans Healthcare System of Ohio (VISN 10), Cincinnati, Ohio.

Dr. Peterman is director of research, Center on Outcomes, Research, and Education; and Institute for Health Services Research and Policy Studies, Northwestern University, Chicago, Illinois.

Dr. Puchalski is director of The George Washington Institute of Spirituality and Health, and associate professor of medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Tsevat is professor of medicine and director of outcomes research, Department of Internal Medicine, University of Cincinnati College of Medicine; research director, Center for Clinical Effectiveness, Institute for the Study of Health, University of Cincinnati Medical Center; and director of health services research and development, Veterans Healthcare System of Ohio (VISN 10), Cincinnati, Ohio.

For information about the authors, see the end of this report.

Some of the results of this study were presented in a poster session at the Annual Meeting of Pediatric Academic Societies, May 3, 2004, San Francisco, California.

Correspondence should be addressed to Dr. Luckhaupt, 2781 Page Avenue, Ann Arbor, MI 48104; telephone: (734) 973–6267; e-mail: 〈sluckhaupt@yahoo.com〉.

© 2005 Association of American Medical Colleges