Symposium IV

Doctor's Beliefs and Medical Practice: Findings from Switzerland

René Hefti & Stefan Rademacher

To assess doctors’ beliefs in Switzerland we used an adapted Curlin questionnaire (Curlin et al. 2005) adjusting the religiosity questions to the Religionsmonitor (2007). This enables us to compare religious profiles of the physicians with the general Swiss population.

We investigated 137 physicians of two religious organisations, the Swiss Association of Protestant Doctors and the Swiss Association of Catholic Physicians. 26.0% of the physicians considered themselves as protestant, 55.7% as evangelical and 18.3% as catholic. We wondered whether the three denominational groups differ in their understanding of how religion interacts with medicine and how religion should be implemented into medical practice. A second survey was done amongst medical students at the University of Bern also using the adapted Curlin questionnaire. Results of both cohorts will be presented at the symposium.

References:

Curlin FA, Lantos JD, Roach CJ, Sellergren SA, Chin MH: Religious characteristics of U.S. physicians: a national survey. J Gen Intern Med.2005.20:629-634.

Religionsmonitor 2008, Bertelsmann Foundation, Gütersloh (2007)

Slides:

Religion Associated Variations in Physicians' Responses to Basic Mental Health Concerns

Farr Curlin

Basic human questions underlie physicians’ responses to common mental and behavior health concerns. This study uses data from a national survey of United States physicians to assess their self-predicted practices regarding depression, anxiety, medically unexplained symptoms, and alcoholism, and to describe the extent to which differences in physicians’ practices are accounted for by differences in their religious characteristics. These data suggest that clinicians who are more religious tend to interpret common mental and behavioural problems as having spiritual dimensions and components, and they tend to encourage patients to make use of spiritual resources to address such problems.

Psychiatric Staff's Religious/Spiritual Belief and it's Influence on the Therapeutic Process

Eunmi Lee

By means of a representative study of German psychiatric staff (e.g. medical and nursing staff), this study aimed to find out 1) to what extent psychiatric staff values religiosity/spirituality in their own lives, 2) how psychiatric staff reacts to religious/spiritual issues in therapeutic process and 3) how psychiatric staff’s own attitude toward religiosity/spirituality influences their clinical practice. From October 2010 to February 2011 an anonymous study was distributed to the staff of psychiatry and psychotherapy departments at German university hospitals and confessional clinics. The response rate was 24.43 % (N =404 of 1654).

Using the Duke University Religion Index, a degree of spirituality m = 7.0 on a scale of 12.0 was shown. On a revised version of the Curlin et al. questionnaire on Religion and Spirituality in Medicine: Physicians’ Perspectives psychiatric staff indicated that they are open to religiosity/spirituality in the therapeutic setting, ready to listen and discuss religious/spiritual issues with their patients and also cooperate with chaplains. Moreover, there was significant moderate correlation between the staff’s own spirituality and their attitude toward religiosity/spirituality in therapeutic setting, that is: The more religious/spiritual psychiatric staff is, the more they believe that religiosity/spirituality is appropriate in the therapeutic process.

Interestingly chaplains working in psychiatric clinics responded that psychiatric staff is open to talk with patients about religious/spiritual topics, but psychiatric staff rated themselves more positively in this regard than chaplains. Moreover, chaplains affirmed that the personal religious/spiritual belief of psychiatric staff is an influencing factor on their attitude toward religiosity/spirituality in the clinical setting.

References:
Eunmi Lee (2014): Religiosität bzw. Spiritualität in Psychiatrie und Psychotherapie. Ihre Bedeutung für psychiatrisches Wirken aus der Sicht des psychiatrischen Personals anhand einer bundesweiten Personalbefragung. Würzburg: Echter Verlag
Eunmi Lee and Klaus Baumann (2013): German Psychiatrists’ Observation and Interpretation of Religiosity/Spirituality, in: Evidence-Based Complementary and Alternative Medicine (2013), http://dx.doi.org/10.1155/2013/280168

Slides:

Religiosity/Spirituality of German Doctors in Privat Practice and Likelihood of Adressing R/S Issues with Patients

Edgar Voltmer

This study examined the self-assessed religiosity and spirituality (R/S) of a representative sample of German physicians in private practice (n = 414) and how this related to their addressing R/S issues with patients. The majority of physicians (49.3 %) reported a Protestant denomination, with the remainder indicating mainly either Catholic (12.5 %) or none (31.9 %). A significant proportion perceived themselves as either religious (42.8 %) or spiritual (29.0 %). Women were more likely to rate themselves R/S than did men. Women (compared to men) were also somewhat more likely to attend religious services (7.4 vs. 2.1 % at least once a week) and participate in private religious activities (14.9 vs. 13.7 % at least daily), although these differences were not statistically significant. The majority of physicians (67.2 %) never/seldom addressed R/S issues with a typical patient. Physicians with higher self-perceived R/S and more frequent public and private religious activity were much more likely to address R/S issues with patients. Implications for patient care and future research are discussed.

The Role of Religion/Spirituality in Medical Management and Decission Making in Obstetrics and Neonatalogy: A Survey among Medical Professionals

Inga Wermuth & Andreas Schulze

There is evidence that family members of critically ill infants wish to have more integration of their R/S from medical professionals particularly during shared critical-decision making. The purpose of our study was to analyze the perspective of perinatologists (obstetricians, midwifes, neonatologists, neonatal nursing staff) on R/S in their professional environment.

1500 professionals from 20 German perinatal centers participated in an anonymous cross sectional survey. This accounts for 80% of all potential participants in these centers. The questionnaire was based on Curlin’s instrument and adapted to suit perinatal and European specifics. In our cohort Roman Catholics were overrepresented (about 45%), while Protestants and those without a religious denomination represented about one quarter each with a statistically negligible number of all other religious affiliations. The age of the participants ranged from 22 to above 60 with the mode located around 30 years. A majority rated the general impact of R/S on patients’ health as significant or moderate. Most of them felt that this influence is positive or could be positive as well as negative, while almost none felt that it is generally negative. The vast majority said that R/S has a role in coping during illness and suffering. Only about one third claimed that R aspects are sometimes or regularly addressed during a professional encounter with families. Less than 10% said that this never occurs. While almost all felt it to be appropriate to include R/S in counseling when parents bring such issues up, many participants were hesitant to actively introduce such themes without a parental request. About half of the respondents indicated that specific barriers may impair communication on R/S with parents. A prevalent concern was that such conversation might be perceived as intrusive.

We speculate that the high survey response rate among health care providers in perinatology may indicate by itself that communication on R/S during the professional encounter with parents is generally regarded as important. However, the survey also reveals that the current practice of counseling in perinatology does not reflect this rating.