Attention to Inpatients’ Religious and Spiritual Concerns: Predictors and Association with Patient Satisfaction
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Little is known about how often patients desire and experience discussions with hospital personnel regarding R/S (religion and spirituality) or what effects such discussions have on patient satisfaction.
Objective, Design and Participants
We examined data from the University of Chicago Hospitalist Study, which gathers sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center.
Primary outcomes were whether or not patients desired to have their religious or spiritual concerns addressed while hospitalized, whether or not anyone talked to them about religious and spiritual issues, and which member of the health care team spoke with them about these issues. Primary predictors were patients’ ratings of their religious attendance, their efforts to carry their religious beliefs over into other dealings in life, and their spirituality.
Forty-one percent of inpatients desired a discussion of R/S concerns while hospitalized, but only half of those reported having such a discussion. Overall, 32% of inpatients reported having a discussion of their R/S concerns. Religious patients and those experiencing more severe pain were more likely both to desire and to have discussions of spiritual concerns. Patients who had discussions of R/S concerns were more likely to rate their care at the highest level on four different measures of patient satisfaction, regardless of whether or not they said they had desired such a discussion (odds ratios 1.4–2.2, 95% confidence intervals 1.1–3.0).
These data suggest that many more inpatients desire conversations about R/S than have them. Health care professionals might improve patients’ overall experience with being hospitalized and patient satisfaction by addressing this unmet patient need.
KEY WORDSpatient satisfaction physician/patient communication quality of care religion spirituality
We gratefully acknowledge Andrea Flores, Benjamin Vekhter, and Ainoa Mayo for their help with data cleaning and analysis, for which they did not receive compensation.
Financial support for this work was provided by the Agency for Healthcare Quality and Research through the Hospital Medicine and Economics Center for Education and Research in Therapeutics (CERT) (U18 HS016967-01, Meltzer, PI), a Midcareer Career Development Award from the National Institute of Aging (1 K24 AG031326-01, Meltzer, PI), and the Robert Wood Johnson Investigator Program, (RWJF Grant ID 63910 Meltzer, PI). Mr. Williams’ effort was supported by the Pritzker School of Medicine Summer Research Program through a grant from the Gold Foundation and a Ruth L. Kirschstein National Research Service Award Short-Term Institutional Research Training Grant (5T35AG029795, Meltzer, PI) from the National Institutes of Health, Bethesda, Maryland. Dr. Curlin is supported by a career development award from the national Center for Complementary and Alternative Medicine (1 K23 AT002749-01A1).
Please note that a poster presentation of a previous draft of the manuscript was made under the title Discussion of Inpatients’ Spiritual and Religious Concerns during Hospitalization on June 4, 2010, at the AAMC’s Integrating Quality Conference in Chicago, IL. An oral presentation of this current version of the manuscript was made at The Gerontological Society of America’s 63rd Annual Scientific Meeting on November 20, 2010, in New Orleans, LA.
Conflicts of Interest
We wish to make the following disclosures: Joshua Williams, David Meltzer, and Grace Chung have no potential conflicts of interest. Dr. Arora reports receiving funding from the National Institutes of Aging (NIA), the Agency for Healthcare Research and Quality (AHRQ), the ABIM Foundation, and the ACP Foundation. Dr. Curlin has no conflicts of interest relevant to this paper. In his only industry relationship, he was paid $6,700 by Boehringer-Ingelheim in 2008 to participate in an advisory board regarding religion and sexual dysfunction.
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