How and how much is spirituality discussed in palliative care consultations for advanced cancer patients with and without a question prompt list?
Abstract
Objective Patients want to discuss spirituality more with their doctors but feel disempowered. Question prompt lists (QPLs) assist conversations. This study assessed the impact of a QPL on spirituality discussions in Palliative Care (PC). Methods This was a sub-study of a trial in which PC patients were randomised to either receive a QPL prior to a consultation or not, to see whether its provision influenced advanced cancer patients'/caregivers' questions and discussion of topics relevant to end-of-life care during consultations with a PC physician. Consultations were recorded and transcribed. Transcriptions were analysed to examine the frequency and content of spirituality discussions. We conducted logistic regression to investigate the impact of the QPL and other predictors. Results 174 patients participated. Spirituality was discussed in half the consultations. Patients receiving a QPL discussed spirituality 1.38 times more than controls. This finding did not reach statistical significance. First PC consultation and being asked about their concerns by the doctor were significant predictors of a spiritual discussion. Conclusion Patients are more likely to discuss spirituality in their first PC consultation, and when their doctor asks them about their concerns. Practice implications Doctors caring for patients at the end of life should routinely raise spiritual issues.
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A randomized clinical trial with palliative care patients showed that patients who were asked directly about their R/S concerns, especially during the first consultation, were much more likely to discuss spirituality than those who were not.
“A randomized clinical trial with palliative care patients showed that patients who were asked directly about their R/S concerns, especially during the first consultation, were much more likely to discuss spirituality than those who were not.34”
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- Authors
- Best, M., McArdle, M. B., Huang, Y.-J., Clayton, J., & Butow, P.
- Affiliations
- The University of Sydney (AU)
- Dartmouth College (US)
- Corresponding author
- Best, Megan
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 102
- Issue
- 12
- Pages
- 2208-2213
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W2951451006
- Cited by
- 25
- References
- 28
- Citations by year
- 2026: 4 · 2024: 8 · 2023: 8 · 2022: 3 · 2020: 2
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- Cancer Institute NSW
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- spirituality, palliative care, advanced cancer, question prompt list, physician-patient communication, end-of-life care, patient empowerment, caregivers
- MeSH terms
- Adult, Aged, Aged, 80 and over, Communication, Female, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Patient Participation, Physician-Patient Relations, Referral and Consultation, Terminal Care, Reminder Systems, Outcome Assessment, Health Care, Terminally Ill, Spirituality
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