Addressing spiritual concerns of patients family - Physicians' attitudes and practices

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.