BACKGROUND: Communication about religious and spiritual issues is fundamental to palliative care, yet little empirical data exist to guide curricula in this area. The goal of this study was to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues. METHODS: We examined surveys of physician trainees (n=297) enrolled in an ongoing communication skills study at two medical centers in the northwestern and southeastern United States. Our primary outcome was self-assessed competence in discussing religion and spirituality. We used exploratory structural equation modeling (SEM) to develop measurement and full models for acquisition of self-assessed communication competencies. RESULTS: Our measurement SEM identified two latent constructs that we label Basic and Intermediate Competence, composed of five self-assessed communication skills. The Basic Competence construct included overall satisfaction with palliative care skills and with discussing do not resuscitate (DNR) status. The Intermediate Competence construct included responding to inappropriate treatment requests, maintaining hope, and addressing fears about the end-of-life. Our full SEM model found that Basic Competence predicted Intermediate Competence and that Intermediate Competence predicted competence in religious and spiritual discussions. Years of clinical training directly influenced Basic Competence. Increased end-of-life discussions positively influenced Basic Competence and had a complex association with Intermediate Competence. Southeastern trainees perceived more competence in religious and spiritual discussions than northwestern trainees. CONCLUSION: This study suggests that discussion of religious and spiritual issues is a communication skill that trainees consider more advanced than other commonly taught communication skills, such as discussing DNR orders.
BACKGROUND: Communication about religious and spiritual issues is fundamental to palliative care, yet little empirical data exist to guide curricula in this area. The goal of this study was to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues. METHODS: We examined surveys of physician trainees (n=297) enrolled in an ongoing communication skills study at two medical centers in the northwestern and southeastern United States. Our primary outcome was self-assessed competence in discussing religion and spirituality. We used exploratory structural equation modeling (SEM) to develop measurement and full models for acquisition of self-assessed communication competencies. RESULTS: Our measurement SEM identified two latent constructs that we label Basic and Intermediate Competence, composed of five self-assessed communication skills. The Basic Competence construct included overall satisfaction with palliative care skills and with discussing do not resuscitate (DNR) status. The Intermediate Competence construct included responding to inappropriate treatment requests, maintaining hope, and addressing fears about the end-of-life. Our full SEM model found that Basic Competence predicted Intermediate Competence and that Intermediate Competence predicted competence in religious and spiritual discussions. Years of clinical training directly influenced Basic Competence. Increased end-of-life discussions positively influenced Basic Competence and had a complex association with Intermediate Competence. Southeastern trainees perceived more competence in religious and spiritual discussions than northwestern trainees. CONCLUSION: This study suggests that discussion of religious and spiritual issues is a communication skill that trainees consider more advanced than other commonly taught communication skills, such as discussing DNR orders.
Authors: Renee D Stapleton; Dee W Ford; Katherine R Sterba; Nandita R Nadig; Steven Ades; Anthony L Back; Shannon S Carson; Katharine L Cheung; Janet Ely; Erin K Kross; Robert C Macauley; Jennifer M Maguire; Theodore W Marcy; Jennifer J McEntee; Prema R Menon; Amanda Overstreet; Christine S Ritchie; Blair Wendlandt; Sara S Ardren; Michael Balassone; Stephanie Burns; Summer Choudhury; Sandra Diehl; Ellen McCown; Elizabeth L Nielsen; Sudiptho R Paul; Colleen Rice; Katherine K Taylor; Ruth A Engelberg Journal: J Pain Symptom Manage Date: 2022-06 Impact factor: 5.576
Authors: Keith Zi Yuan Chua; Elaine Li Ying Quah; Yun Xue Lim; Chloe Keyi Goh; Jieyu Lim; Darius Wei Jun Wan; Simone Meiqi Ong; Chi Sum Chong; Kennan Zhi Guang Yeo; Laura Shih Hui Goh; Ray Meng See; Alexia Sze Inn Lee; Yun Ting Ong; Min Chiam; Eng Koon Ong; Jamie Xuelian Zhou; Crystal Lim; Simon Yew Kuang Ong; Lalit Krishna Journal: BMC Palliat Care Date: 2022-07-04 Impact factor: 3.113
Authors: Alison M Bays; Ruth A Engelberg; Anthony L Back; Dee W Ford; Lois Downey; Sarah E Shannon; Ardith Z Doorenbos; Barbara Edlund; Phyllis Christianson; Richard W Arnold; Kim O'Connor; Erin K Kross; Lynn F Reinke; Laura Cecere Feemster; Kelly Fryer-Edwards; Stewart C Alexander; James A Tulsky; J Randall Curtis Journal: J Palliat Med Date: 2013-11-01 Impact factor: 2.947