Valuing the Spiritual

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Abstract

Identifying reforms that minimize US healthcare costs is imperative. This commentary explores one intervention with potential cost-saving implications that has received comparably minimal consideration: spiritual care provision. It highlights the staff and patient costing benefits of spiritual care in addressing spiritual distress and urges practical policy and research initiatives to maximize its impact.

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Most cited references 25

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Burnout and self-reported patient care in an internal medicine residency program.

Tait Shanafelt, Katharine A Bradley, Joyce Wipf … (2002)

Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Cross-sectional study using an anonymous, mailed survey. University-based residency program in Seattle, Washington. 115 internal medicine residents. Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made...errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non-burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P = 0.004). In multivariate analyses, burnout--but not sex, depression, or at-risk alcohol use--was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose-response relationship). Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.

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Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life.

John R. Peteet, C Lathan, Tracy A Balboni … (2007)

Religion and spirituality play a role in coping with illness for many cancer patients. This study examined religiousness and spiritual support in advanced cancer patients of diverse racial/ethnic backgrounds and associations with quality of life (QOL), treatment preferences, and advance care planning. The Coping With Cancer study is a federally funded, multi-institutional investigation examining factors associated with advanced cancer patient and caregiver well-being. Patients with an advanced cancer diagnosis and failure of first-line chemotherapy were interviewed at baseline regarding religiousness, spiritual support, QOL, treatment preferences, and advance care planning. Most (88%) of the study population (N = 230) considered religion to be at least somewhat important. Nearly half (47%) reported that their spiritual needs were minimally or not at all supported by a religious community, and 72% reported that their spiritual needs were supported minimally or not at all by the medical system. Spiritual support by religious communities or the medical system was significantly associated with patient QOL (P = .0003). Religiousness was significantly associated with wanting all measures to extend life (odds ratio, 1.96; 95% CI, 1.08 to 3.57). Many advanced cancer patients' spiritual needs are not supported by religious communities or the medical system, and spiritual support is associated with better QOL. Religious individuals more frequently want aggressive measures to extend life.

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Cost savings associated with US hospital palliative care consultation programs.

R Morrison (2008)

Hospital palliative care consultation teams have been shown to improve care for adults with serious illness. This study examined the effect of palliative care teams on hospital costs. We analyzed administrative data from 8 hospitals with established palliative care programs for the years 2002 through 2004. Patients receiving palliative care were matched by propensity score to patients receiving usual care. Generalized linear models were estimated for costs per admission and per hospital day. Of the 2966 palliative care patients who were discharged alive, 2630 palliative care patients (89%) were matched to 18,427 usual care patients, and of the 2388 palliative care patients who died, 2278 (95%) were matched to 2124 usual care patients. The palliative care patients who were discharged alive had an adjusted net savings of $1696 in direct costs per admission (P = .004) and $279 in direct costs per day (P < .001) including significant reductions in laboratory and intensive care unit costs compared with usual care patients. The palliative care patients who died had an adjusted net savings of $4908 in direct costs per admission (P = .003) and $374 in direct costs per day (P < .001) including significant reductions in pharmacy, laboratory, and intensive care unit costs compared with usual care patients. Two confirmatory analyses were performed. Including mean costs per day before palliative care and before a comparable reference day for usual care patients in the propensity score models resulted in similar results. Estimating costs for palliative care patients assuming that they did not receive palliative care resulted in projected costs that were not significantly different from usual care costs. Hospital palliative care consultation teams are associated with significant hospital cost savings.

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Author and article information

Contributors

Eric J. Hall:

ORCID: http://orcid.org/0000-0003-2530-1689

ejhall@healthcarechaplaincy.org , http://www.healthcarechaplaincy.org

Richard A. Powell: r.powell@imperial.ac.uk

Journal

Journal ID (nlm-ta): J Relig Health

Journal ID (iso-abbrev): J Relig Health

Title: Journal of Religion and Health

Publisher: Springer US (New York )

ISSN (Print): 0022-4197

ISSN (Electronic): 1573-6571

Publication date (Electronic): 21 February 2021

Pages: 1-6

Affiliations

[1 ]GRID grid.479350.c, ISNI 0000 0001 0170 6687, HealthCare Chaplaincy Network and Spiritual Care Association, ; 505 8th Ave, 9th floor, New York, NY 10016 USA

[2 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Department of Primary Care & Public Health, , Imperial College London, NIHR Applied Research Center Northwest London, ; Charing Cross Campus, The Reynolds Building, St Dunstan’s Road, London, England

Author information

Eric J. Hall http://orcid.org/0000-0003-2530-1689

Article

Publisher ID: 1206

DOI: 10.1007/s10943-021-01206-9

PMC ID: 7897417

PubMed ID: 33611680

SO-VID: 365a36b7-1188-4888-95fe-f0a9836b9d3f

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This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

Valuing the Spiritual

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Most cited references 25

Burnout and self-reported patient care in an internal medicine residency program.

Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life.

Cost savings associated with US hospital palliative care consultation programs.

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