Skip to main content
Top
Published in: Supportive Care in Cancer 5/2019

01-05-2019 | Original Article

Using patient-reported religious/spiritual concerns to identify patients who accept chaplain interventions in an outpatient oncology setting

Authors: Petra J. Sprik, Kendall Walsh, Danielle M. Boselli, Patrick Meadors

Published in: Supportive Care in Cancer | Issue 5/2019

Login to get access

Abstract

Purpose

The goals of this study were to (1) describe the prevalence and correlates of patient-reported religious/spiritual (R/S) needs in outpatient oncology patients and (2) estimate the associations of R/S concerns with acceptance of an R/S intervention offered by phone.

Methods

This was a retrospective analysis of data collected from distress screenings and spiritual care interventions at an outpatient cancer center from March 1, 2017 to May 9, 2017. Patients (n = 1249) used a tablet to self-report the following R/S concerns: spiritual or religious concern, isolation, struggle to find hope/meaning in life, concern for family, fear of death, shame/guilt, and doubts about faith. Patients were also screened for anxiety, depression, and distress. A chaplain contacted patients that reported one or more R/S concerns to offer R/S interventions via telephone or in person.

Results

Approximately one third (29.9%) of surveyed patients indicated at least one R/S need. Younger age, female gender, anxiety, depression, and distress were associated with indication of specific R/S concerns. Fear of death (OR 1.64 [1.02, 2.66], p = 0.043), struggle to find meaning/hope in life (OR 2.47 [1.39, 4.39], p = 0.002), and anxiety (p = 1.003) were associated with increased odds of intervention acceptance.

Conclusion

Effective screening practices are needed for chaplains to prioritize patients most in need. This exploratory study suggests that screening for struggle to find meaning/hope in life, fear of death, and anxiety will help chaplains identify patients who have R/S concerns and will likely accept R/S interventions. Developing effective telehealth practices like this is an important direction for the field.
Appendix
Available only for authorised users
Literature
1.
go back to reference Smith A, Hyde YM, Stanford D (2015) Supportive care needs of cancer patients: a literature review. Palliat Support Care 13(4):1013–1017CrossRefPubMed Smith A, Hyde YM, Stanford D (2015) Supportive care needs of cancer patients: a literature review. Palliat Support Care 13(4):1013–1017CrossRefPubMed
2.
go back to reference Moadel A, Morgan C, Fatone A, Grennan J, Carter J, Laruffa G, Dutcher J (1999) Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology 8(5):378–385CrossRefPubMed Moadel A, Morgan C, Fatone A, Grennan J, Carter J, Laruffa G, Dutcher J (1999) Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology 8(5):378–385CrossRefPubMed
3.
go back to reference Pearce MJ, Coan AD, Herndon JE, Koenig HG, Abernethy AP (2012) Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer 20(10):2269–2276CrossRefPubMed Pearce MJ, Coan AD, Herndon JE, Koenig HG, Abernethy AP (2012) Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer 20(10):2269–2276CrossRefPubMed
4.
go back to reference Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG (2007) Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 25(5):555–560CrossRefPubMedPubMedCentral Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG (2007) Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 25(5):555–560CrossRefPubMedPubMedCentral
5.
go back to reference Astrow AB, Wexler A, Texeira K, He MK, Sulmasy DP (2007) Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol 25(36):5753–5757CrossRefPubMed Astrow AB, Wexler A, Texeira K, He MK, Sulmasy DP (2007) Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol 25(36):5753–5757CrossRefPubMed
6.
go back to reference Balboni TA, Paulk ME, Balboni M, Phelps A, Loggers ET, Wright A, Prigerson HG (2010) Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 28(3):445–452CrossRefPubMed Balboni TA, Paulk ME, Balboni M, Phelps A, Loggers ET, Wright A, Prigerson HG (2010) Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 28(3):445–452CrossRefPubMed
7.
go back to reference Balboni T, Balboni M, Paulk ME, Phelps A, Wright A, Peteet J, Prigerson HG (2011) Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer 117(23):5383–5391CrossRefPubMedPubMedCentral Balboni T, Balboni M, Paulk ME, Phelps A, Wright A, Peteet J, Prigerson HG (2011) Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer 117(23):5383–5391CrossRefPubMedPubMedCentral
9.
go back to reference Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Fernandes A, Shaw C (2017) Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods. BMJ Support Palliat Care, 1–14 Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Fernandes A, Shaw C (2017) Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods. BMJ Support Palliat Care, 1–14
10.
go back to reference Fitchett G, Peter MM, Burton LA (2000) Spiritual care in the hospital: who requests it? Who needs it? J Pastoral Care 54(2):173–186CrossRefPubMed Fitchett G, Peter MM, Burton LA (2000) Spiritual care in the hospital: who requests it? Who needs it? J Pastoral Care 54(2):173–186CrossRefPubMed
11.
go back to reference Epstein-Peterson ZD, Sullivan AJ, Enzinger AC, Trevino KM, Zollfrank AA, Balboni MJ, Balboni TA (2015) Examining forms of spiritual care provided in the advanced cancer setting. Am J Hosp Palliat Care 3(7):750–757CrossRef Epstein-Peterson ZD, Sullivan AJ, Enzinger AC, Trevino KM, Zollfrank AA, Balboni MJ, Balboni TA (2015) Examining forms of spiritual care provided in the advanced cancer setting. Am J Hosp Palliat Care 3(7):750–757CrossRef
12.
go back to reference Ledford CJW, Seehusen DA, Canzona MR, Cafferty LA (2014) Using a teaching OSCE to prompt learners to engage with patients who talk about religion and/or spirituality. Acad Med 89(1):60–65CrossRefPubMed Ledford CJW, Seehusen DA, Canzona MR, Cafferty LA (2014) Using a teaching OSCE to prompt learners to engage with patients who talk about religion and/or spirituality. Acad Med 89(1):60–65CrossRefPubMed
13.
go back to reference McEvoy M, Schlair S, Sidlo Z, Burton W, Milan F (2014) Assessing third-year medical students’ ability to address a patient’s spiritual distress using an OSCE case. Acad Med 89(1):66–70CrossRefPubMed McEvoy M, Schlair S, Sidlo Z, Burton W, Milan F (2014) Assessing third-year medical students’ ability to address a patient’s spiritual distress using an OSCE case. Acad Med 89(1):66–70CrossRefPubMed
14.
go back to reference Blanchard JH, Dunlap DA, Fitchett G (2012) Screening for spiritual distress in the oncology inpatient: a quality improvement pilot project between nurses and chaplains. J Nurs Manag 20(8):1076–1084PubMed Blanchard JH, Dunlap DA, Fitchett G (2012) Screening for spiritual distress in the oncology inpatient: a quality improvement pilot project between nurses and chaplains. J Nurs Manag 20(8):1076–1084PubMed
15.
go back to reference Vlasblom JP, Van der Steen JT, Knol DL, Jochemsen H (2011) Effects of a spiritual care training for nurses. Nursing Educ Today 31(8):790–796CrossRef Vlasblom JP, Van der Steen JT, Knol DL, Jochemsen H (2011) Effects of a spiritual care training for nurses. Nursing Educ Today 31(8):790–796CrossRef
16.
go back to reference Ford DW, Downey L, Engelberg R, Back AL, Curtis JR (2014) Association between physician trainee self-assessments in discussing religion and spirituality and their patients’ reports. J Palliat Med 17(4):453–462CrossRefPubMedPubMedCentral Ford DW, Downey L, Engelberg R, Back AL, Curtis JR (2014) Association between physician trainee self-assessments in discussing religion and spirituality and their patients’ reports. J Palliat Med 17(4):453–462CrossRefPubMedPubMedCentral
17.
go back to reference Best M, Butow P, Olver I (2015) Do patients want doctors to talk about spirituality? A systematic literature review. Patient Educ Couns 98(11):1320–1328CrossRefPubMed Best M, Butow P, Olver I (2015) Do patients want doctors to talk about spirituality? A systematic literature review. Patient Educ Couns 98(11):1320–1328CrossRefPubMed
18.
go back to reference Ellis MR, Vinson DC, Ewigman B (1999) Addressing spiritual concerns of patients: family physicians’ attitudes and practices. J Fam Pract 48(2):105–109PubMed Ellis MR, Vinson DC, Ewigman B (1999) Addressing spiritual concerns of patients: family physicians’ attitudes and practices. J Fam Pract 48(2):105–109PubMed
19.
go back to reference Balboni MJ, Sullivan A, Enzinger AC, Epstein-Peterson ZD, Tseng YD, Mitchell C, Balboni TA (2014) Nurse and physician barriers to spiritual care provision at the end of life. J Pain Symptom Manag 48(3):400–410CrossRef Balboni MJ, Sullivan A, Enzinger AC, Epstein-Peterson ZD, Tseng YD, Mitchell C, Balboni TA (2014) Nurse and physician barriers to spiritual care provision at the end of life. J Pain Symptom Manag 48(3):400–410CrossRef
20.
go back to reference Daaleman TP, Frey B (1998) Prevalence and patterns of physician referral to clergy and pastoral care providers. Arch Fam Med 7(6):548–553CrossRefPubMed Daaleman TP, Frey B (1998) Prevalence and patterns of physician referral to clergy and pastoral care providers. Arch Fam Med 7(6):548–553CrossRefPubMed
21.
go back to reference Smyre CL, Tak HJ, Dang AP, Curlin FA, Yoon JD (2017) Physicians’ opinions on engaging patients’ religious and spiritual concerns: a national survey. J Pain Symptom Manag 55(3):897–905CrossRef Smyre CL, Tak HJ, Dang AP, Curlin FA, Yoon JD (2017) Physicians’ opinions on engaging patients’ religious and spiritual concerns: a national survey. J Pain Symptom Manag 55(3):897–905CrossRef
22.
go back to reference Winter-Pfändler U, Flannelly KJ, Morgenthaler C (2011) Referrals to health care chaplaincy by head nurses: situations and influencing factors. Holist Nurs Pract 25(1):26–32CrossRefPubMed Winter-Pfändler U, Flannelly KJ, Morgenthaler C (2011) Referrals to health care chaplaincy by head nurses: situations and influencing factors. Holist Nurs Pract 25(1):26–32CrossRefPubMed
23.
go back to reference Fitchett G, Rasinski K, Cadge W, Curlin FA (2009) Physicians’ experience and satisfaction with chaplains: a national survey. Arch Intern Med 169(19):1808–1810CrossRefPubMed Fitchett G, Rasinski K, Cadge W, Curlin FA (2009) Physicians’ experience and satisfaction with chaplains: a national survey. Arch Intern Med 169(19):1808–1810CrossRefPubMed
24.
go back to reference Garcia SF, Cella D, Clauser SB, Flynn KE, Lad T, Lai J-S, Reeve BB, Wilder Smith A, Stone AA, Weinfurt K (2007) Standardizing patient-reported outcomes assessment in cancer clinical trials: a patient-reported outcomes measurement information system initiative. J Clin Oncol Off J Am Soc Clin Oncol 25(32):5106–5112CrossRef Garcia SF, Cella D, Clauser SB, Flynn KE, Lad T, Lai J-S, Reeve BB, Wilder Smith A, Stone AA, Weinfurt K (2007) Standardizing patient-reported outcomes assessment in cancer clinical trials: a patient-reported outcomes measurement information system initiative. J Clin Oncol Off J Am Soc Clin Oncol 25(32):5106–5112CrossRef
25.
go back to reference Seow H, Snyder CF, Shugarman LR, Mularski RA, Kutner JS, Lorenz KA, Dy SM (2009) Developing quality indicators for cancer end-of-life care: proceedings from a national symposium. Cancer 115(17):3820–3829CrossRefPubMed Seow H, Snyder CF, Shugarman LR, Mularski RA, Kutner JS, Lorenz KA, Dy SM (2009) Developing quality indicators for cancer end-of-life care: proceedings from a national symposium. Cancer 115(17):3820–3829CrossRefPubMed
26.
go back to reference Fitchett G, Murphy PE, Kim J, Gibbons JL, Cameron JR, Davis JA (2004) Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. Int J Psychiatry Med 34(2):179–196CrossRefPubMed Fitchett G, Murphy PE, Kim J, Gibbons JL, Cameron JR, Davis JA (2004) Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. Int J Psychiatry Med 34(2):179–196CrossRefPubMed
27.
go back to reference Galek K, Flannelly KJ, Vane A, Galek RM (2005) Assessing a patient’s spiritual needs: a comprehensive instrument. Holist Nurs Pract 19(2):62–69CrossRefPubMed Galek K, Flannelly KJ, Vane A, Galek RM (2005) Assessing a patient’s spiritual needs: a comprehensive instrument. Holist Nurs Pract 19(2):62–69CrossRefPubMed
28.
go back to reference Taylor EJ (2003) Spiritual needs of patients with cancer and family caregivers. Cancer Nurs 26(4):260–266CrossRefPubMed Taylor EJ (2003) Spiritual needs of patients with cancer and family caregivers. Cancer Nurs 26(4):260–266CrossRefPubMed
29.
go back to reference Kroenkie K, Spitzer RL, Williams JBW, Lowe B (2010) The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 32(4):345–359CrossRef Kroenkie K, Spitzer RL, Williams JBW, Lowe B (2010) The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 32(4):345–359CrossRef
30.
go back to reference Donovan KA, Grassi L, McGinty HL, Jacobsen PB (2014) Validation of the distress thermometer worldwide: state of the science. Psycho-Oncology 23(3):241–250CrossRefPubMed Donovan KA, Grassi L, McGinty HL, Jacobsen PB (2014) Validation of the distress thermometer worldwide: state of the science. Psycho-Oncology 23(3):241–250CrossRefPubMed
31.
go back to reference Pargament KL (2013) Searching for the sacred: toward a nonreductionistic theory of spirituality In Pargament, K. L (Ed.) APA handbook of psychology religion and spirituality: Vol 1 context, theory, and research. American Psychological Association Pargament KL (2013) Searching for the sacred: toward a nonreductionistic theory of spirituality In Pargament, K. L (Ed.) APA handbook of psychology religion and spirituality: Vol 1 context, theory, and research. American Psychological Association
32.
go back to reference National Public Radio (2016) Hospice chaplain reflects on life, death and the “strength of the human soul". Retrieved from NPR.org National Public Radio (2016) Hospice chaplain reflects on life, death and the “strength of the human soul". Retrieved from NPR.​org
34.
go back to reference Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17(8):1117–1128CrossRef Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17(8):1117–1128CrossRef
35.
go back to reference Lebel S, Beattie S, Area I, Bielajew C (2013) Young and worried: age and fear of recurrence in breast cancer survivors. Health Psychol 32(6):695–705CrossRefPubMed Lebel S, Beattie S, Area I, Bielajew C (2013) Young and worried: age and fear of recurrence in breast cancer survivors. Health Psychol 32(6):695–705CrossRefPubMed
36.
go back to reference Shinn EH, Taylor CLC, Kilgore K, Valentine A, Bodurka DC, Kavanagh J, Basen-Engquist K (2009) Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients. Palliat Support Care 7(3):299–306CrossRefPubMedPubMedCentral Shinn EH, Taylor CLC, Kilgore K, Valentine A, Bodurka DC, Kavanagh J, Basen-Engquist K (2009) Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients. Palliat Support Care 7(3):299–306CrossRefPubMedPubMedCentral
37.
go back to reference Aarts JWF, Deckx L, Van Abbema DL, Tjan-Heijnen VCG, Van den Akker M, Buntinx F (2015) The relation between depression, coping and health locus of control: differences between older and younger patients, with and without cancer. Psychooncology 24(8):950–957CrossRefPubMed Aarts JWF, Deckx L, Van Abbema DL, Tjan-Heijnen VCG, Van den Akker M, Buntinx F (2015) The relation between depression, coping and health locus of control: differences between older and younger patients, with and without cancer. Psychooncology 24(8):950–957CrossRefPubMed
38.
go back to reference Abu-Raiya H, Pargament KI, Krause N (2016) Religion as problem, religion as solution: religious buffers of the links between religious/spiritual struggles and well-being/mental health. Qual Life Res 25(5):1265–1274CrossRefPubMed Abu-Raiya H, Pargament KI, Krause N (2016) Religion as problem, religion as solution: religious buffers of the links between religious/spiritual struggles and well-being/mental health. Qual Life Res 25(5):1265–1274CrossRefPubMed
39.
go back to reference Chaar, E. A., Hallit, S., Hajj, A., Aaraj, R., Kattan, J., Jabbour, H., Khabbaz, L. R. (2018) Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Support Care Cancer, 1–10 Chaar, E. A., Hallit, S., Hajj, A., Aaraj, R., Kattan, J., Jabbour, H., Khabbaz, L. R. (2018) Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Support Care Cancer, 1–10
40.
go back to reference Pargament KI, Koenig HG, Tarakeshwar N, Hahn J (2004) Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study. J Health Psychol 9(6):713–730CrossRefPubMed Pargament KI, Koenig HG, Tarakeshwar N, Hahn J (2004) Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study. J Health Psychol 9(6):713–730CrossRefPubMed
41.
go back to reference Traeger L, Greer JA, Fernandez-Robles C, Temel JS, Pirl WF (2012) Evidence-based treatment of anxiety in patients with cancer. J Clin Oncol 30(11):1197–1205CrossRefPubMed Traeger L, Greer JA, Fernandez-Robles C, Temel JS, Pirl WF (2012) Evidence-based treatment of anxiety in patients with cancer. J Clin Oncol 30(11):1197–1205CrossRefPubMed
42.
go back to reference Piderman KM, Marek DV, Jenkins SM, Johnson ME, Buryska JF, Mueller PS (2008) Patients’ expectations of hospital chaplains. Mayo Clin Proc 83(1):58–65CrossRefPubMed Piderman KM, Marek DV, Jenkins SM, Johnson ME, Buryska JF, Mueller PS (2008) Patients’ expectations of hospital chaplains. Mayo Clin Proc 83(1):58–65CrossRefPubMed
43.
go back to reference Cooper RS (2011) Case study of a chaplain’s spiritual care for a patient with advanced metastatic breast cancer. Journal of Healthcare Chaplaincy 17(1–2):19–37CrossRef Cooper RS (2011) Case study of a chaplain’s spiritual care for a patient with advanced metastatic breast cancer. Journal of Healthcare Chaplaincy 17(1–2):19–37CrossRef
44.
go back to reference Stonelake-French H, Moos BE, Brueggen CM, Gravemann EL, Hansen AL, Voll JM, Dose AM (2018) Understanding distress in the hospital: a qualitative study examining adults with cancer. Oncol Nurs Forum 45(2):206–216CrossRefPubMed Stonelake-French H, Moos BE, Brueggen CM, Gravemann EL, Hansen AL, Voll JM, Dose AM (2018) Understanding distress in the hospital: a qualitative study examining adults with cancer. Oncol Nurs Forum 45(2):206–216CrossRefPubMed
45.
go back to reference Barney LJ, Griffiths KM, Jorm AF, Christensen H (2006) Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry 40(1):51–54CrossRefPubMed Barney LJ, Griffiths KM, Jorm AF, Christensen H (2006) Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry 40(1):51–54CrossRefPubMed
Metadata
Title
Using patient-reported religious/spiritual concerns to identify patients who accept chaplain interventions in an outpatient oncology setting
Authors
Petra J. Sprik
Kendall Walsh
Danielle M. Boselli
Patrick Meadors
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 5/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4447-z

Other articles of this Issue 5/2019

Supportive Care in Cancer 5/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine