More than half of physicians believe that religion and spirituality have a significant influence on patients' health, according to a report in the April 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Physicians who are most religious are more likely to interpret the influence of religion and spirituality in positive ways.
The relationship between religion and health generates controversy in the medical world, according to background information in the article. "Consensus seems to begin and end with the idea that many (if not most) patients draw on prayer and other religious resources to navigate and overcome the spiritual challenges that arise in their experiences of illness," the authors note. "Controversy remains regarding whether, to what extent and in what ways religion and spirituality helps or harms patients' health."
Farr A. Curlin, M.D., and colleagues at the University of Chicago mailed a survey in 2003 to a random sample of 2,000 practicing U.S. physicians 65 years or younger from all specialties. The survey included questions to determine physicians' religious characteristics, general observations and interpretations of religion and spirituality and potential positive and negative influences of religion and spirituality.
The response rate was 63 percent (1,144 of 1,820) and the average age for respondents was 49. According to the study, two-thirds of U.S. physicians believe that experiencing illness often or always increases patients' awareness of religion and spirituality issues. A majority of physicians (56 percent) think that religion and spirituality has much or very much influence on health and 54 percent believe that at times a supernatural being intervenes. The majority of physicians (85 percent) believe that the influence of religion and spirituality is generally positive, but few (6 percent) feel that religion and spirituality changes medical outcomes.
The study also found that 76 percent of physicians believe that religion and spirituality helps patients cope, 74 percent believe that it gives patients a positive state of mind and 55 percent report that it provides emotional and practical support through religious community. Few physicians (7 percent) believe that religion and spirituality often causes negative emotions such as guilt and anxiety, 2 percent think it leads patients to decline medical therapy and 4 percent report that patients use it to avoid taking responsibility for their health, but about one-third believe it has these harmful influences sometimes.
Physicians' observations and interpretations are strongly influenced by their religious beliefs, according to the authors. "Physicians with higher intrinsic religiosity are much more likely to (1) report that their patients bring up religion and spirituality issues, (2) believe that religion and spirituality strongly influences health and (3) interpret the influence of religion and spirituality in positive rather than negative ways."
These findings lend support to recommendations that physicians recognize how their own beliefs influence how they provide care, the authors note. "Physicians' notions about the relationship between religion and spirituality and patients' health are strongly associated with physicians' own religious characteristics," they conclude. "Future studies should examine the ways physicians' religious (and secular) commitments shape their clinical engagements in these and other domains."
This study was funded by a grant from the Greenwall Foundation and by the Robert Wood Johnson Clinical Scholars Program. Dr. Curlin is also supported by a grant from the National Center for Complementary and Alternative Medicine of the National Institutes of Health.
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