The beliefs of cancer care providers regarding the role of religion and spirituality within the clinical encounter

Purpose: To characterize cancer care provider perceptions of the role of religion and spirituality (R&S) within the clinical encounter.

Methods: A cross-sectional survey was administered to healthcare professionals (defined as someone who is authorized to diagnose and/or treat physical or mental health disorders) currently employed at The Ohio State University Comprehensive Cancer Center. Beliefs around the role of R&S within the clinical encounter were assessed using four adapted subscales/dimensions (D1-D4) from the Religion and Spirituality in Medicine: Physicians' Perspectives measure: God actively intervenes in patient health (D1), R&S is beneficial for patient mental health (D2), provider inquires about (D3) and discusses (D4) R&S in the clinical encounter. Logistic (D1) and linear (D2-D4) regression were performed using SAS v9.4 to determine the relationship between provider type and each subscale while controlling for gender, race, relationship status, education, and R&S identity.

Results: Among 340 participants, most participants were female (82.1%) or Caucasian (82.6%) and the median age was 35 years (IQR 31-48). Providers included physicians (17.9%), nurses (64.7%), and "other" (17.4%). Most participants identified as religious (57.5%), followed by spiritual (30.2%) and neither religious nor spiritual (12.3%). Nurses and other providers were more likely than physicians to believe that God intervenes in patient health (physician 41.7% vs. nurse 61.8% vs. other 60.3%; p = 0.02). All providers were equally as likely to believe that R&S is beneficial for patient mental health and to discuss R&S with patients within the clinical encounter (both p > 0.05). In contrast, nurses more frequently reported inquiring about R&S (median 1.7; IQR 0.9-2.0) compared with physicians (median 1.0; IQR 0.9-2.0) or other providers (median 1.4; IQR 1.0-2.1) (p < 0.001).

Conclusions: There were differences between providers in beliefs regarding the role of R&S in the clinical cancer encounter. Of note, nurses and other provider types were more likely than physicians to inquire about R&S with patients. Understanding variations in these beliefs will help determine how to best incorporate R&S support for patients during their cancer care.