BACKGROUND. Our goals were to assess family physicians' spiritual well-bein
g, identify their perceived barriers to discussing spiritual issues with pa
tients, and determine how often they have these discussions.
METHODS. We mailed a questionnaire to 231 Missouri family physicians (80 re
sidents, 43 faculty and 108 community physicians). The questionnaire includ
ed the Ellison Spiritual Well-being Scale (ESWS), as well as questions abou
t physicians' attitudes toward spirituality and the barriers to and frequen
cy of discussions of spiritual issues with patients.
RESULTS. The response rate was 74%. The mean ESWS score indicated that the
physician respondents had a high level of spiritual well-being. Nearly all
respondents (96%) considered spiritual well-being an important health compo
nent, 86% supported referral of hospitalized patients with spiritual questi
ons to chaplains, and 58% believed physicians should address patients' spir
itual concerns. Fear of dying was the spiritual issue most commonly discuss
ed, and less than 20% of physicians reported discussing other spiritual top
ics in more than 10% of patient encounters. Barriers to addressing spiritua
l issues included lack of time (71%), inadequate training for taking spirit
ual histories (59%), and difficulty identifying patients who want to discus
s spiritual issues (56%).
CONCLUSIONS. Family physicians in this survey had high spiritual well-being
scores. Most believed spiritual well-being is an important factor in healt
h. Despite this belief, however, most reported infrequent discussions of sp
iritual issues with patients and infrequent referrals of hospitalized patie
nts to chaplains. Lack of time and training were key barriers to spiritual
assessment.