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Screening the soul: Communication regarding spiritual concerns among primary care physicians and seriously ill patients approaching the end of life

Department of Anthropology, History, and Social Medicine, University of California at San Francisco, San Francisco, California

Michael W. Rabow, MD

Department of Medicine, University of California, San Francisco, San Francisco, California

Suzanne L. Dibble, RN, DNSc

Institute for Health and Aging, University of California, San Francisco, San Francisco, California

The purpose of this study was to explore the spiritual concerns of seriously ill patients and the spiritual-care practices of primary care physicians (PCPs). Questionnaires were administered to outpatients (n = 65, 90 percent response rate) with end-stage illness and to PCPs (n = 67, 87 percent response rate) in a diverse general medicine practice. Most patients (62 percent) and PCPs (68 percent) considered it important that physicians attend to patients’ spiritual concerns. However, few patients reported receiving such care, and most (62 percent) did not think it was the PCP’s job to talk about spiritual concerns. Although both seriously ill outpatients and PCPs assert the importance of spiritual concerns, PCPs often do not provide spiritual care. Appropriate provision of spiritual care within a diverse population of seriously ill outpatients is complex, necessitating appropriate and attentive screening.

Key Words: doctor-patient relationship • end-of-life care • spirituality • communication

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