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Cited by 124Palliative Care and End-of-Life IssuesReligion, Spirituality, and PsychologyEthics and bioethics in healthcare

End-of-life decisions in HIV-positive patients: the role of spiritual beliefs

Kaldjian, Lauris C., Jekel, James F., Friedland, Gerald·1998·AIDS
DOI 10.1097/00002030-199801000-00012
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Abstract

OBJECTIVE: To describe the role of spiritual beliefs in HIV-positive patients' end-of-life decisions. DESIGN: Inperson, cross-sectional survey. SETTING: An HIV/AIDS floor of an urban, university teaching hospital. PATIENTS: Ninety hospitalized HIV-positive patients. MAIN OUTCOME MEASURES: Prior discussions about advance directives, possession of a living will (written advance directive), fear of death, professions of hope and purpose in life, religious beliefs and practices, guilt about HIV infection, and perception of HIV as punishment. RESULTS: Of 104 eligible patients, 90 agreed to be interviewed. Twenty-four per cent of patients had discussed their resuscitation status with a physician and 17% possessed a living will; 44% of patients felt guilty about their HIV infection, 32% expressed fear of death, and 26% felt their disease was some form of punishment. Prior discussions about resuscitation status were less likely in those who perceived HIV as punishment (P=0.009) and more likely in those who believed in God's forgiveness (P=0.043). A living will was more common in those who prayed daily (P=0.025) and in those whose belief in God helped them when thinking about death (P=0.065). Fear of death was more likely in those who perceived HIV as punishment (P=0.01) or felt guilty about having HIV (P=0.039), and less likely in those who read the Bible frequently (P=0.01) or attended church regularly (P=0.015). Outcome measures did not vary significantly according sex, race, HIV risk factors, or education level. CONCLUSIONS: In this HIV-positive population, spiritual beliefs and religious practices appeared to play a role in end-of-life decisions. Discussions about end-of-life decisions may be facilitated by a patient's belief in a forgiving God and impeded by a patient's interpretation of HIV infection as punishment. Health-care providers need to recognize patients' spiritual beliefs and incorporate them into discussions about terminal care.

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  • There are many practical reasons why addressing spiritual issues in clinical practice is important.

    “There are many practical reasons why addressing spiritual issues in clinical practice is important. Here are eight reasons [578] (and these are not exhaustive).”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [578]

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Authors
Kaldjian, L. C., Jekel, J. F., & Friedland, G.
Affiliations
Yale University (US)
ORCID
Kaldjian, Lauris C.
Venue
AIDS
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-01
Volume
12
Issue
1
Pages
103-107
ISSN
0269-9370 (ISSN-L)
DOI
10.1097/00002030-199801000-00012
OpenAlex
W2091137900
Cited by
124
References
10
Citations by year
2026: 2 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 7 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 7 · 2012: 5
FWCI
10.71
Type
journal article
Language
en
Open access
closed
Locations
  • AIDS (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
Yale University
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
end-of-life decisions, people living with HIV, spiritual beliefs, religious practice, advance directives, living wills, fear of death, end-of-life care, prayer, Bible reading, church attendance
MeSH terms
Cross-Sectional Studies, Death, Decision Making, Educational Status, Fear, Female, Guilt, Hospitalization, Hospitals, University, Humans, Male, Punishment, Religion, Religion and Psychology, Risk Factors, Sex Factors, HIV Infections, Living Wills, Resuscitation Orders, Spirituality, Advance Care Planning, Vulnerable Populations

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