Contrasting effects of religious/spiritual support from religious communities versus medical teams on advanced cancer patient end-of-life care
Carolyn Vachani, RN, MSN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: June 9, 2010
It will come of no surprise to patients and their families that religious and spiritual concerns are important to the majority (76-88%) of patients facing a life-threatening illness. Support of a patient’s religious or spiritual (R/S) needs by the medical team (nurses, physicians and chaplains) is associated with less aggressive care at the end of life and better quality of life near death. Guidelines from the National Consensus Project for Quality Palliative Care recommend that attention to R/S needs should be incorporated into medical care. However, these needs are often provided by religious communities rather than the medical team.
Aggressive care at the end of life is linked to a worse quality of death and less likelihood of dying in the place of the patient's choice, not to mention the cost of such care. This study looked to compare end of life care for cancer patients receiving R/S support provided by a religious community or the medical team. The researchers hypothesized that R/S care from either group would lead to lower rates of aggressive care at the end of life.
Patients who received R/S care from their medical team were more likely to receive hospice care, less likely to receive aggressive care and less likely to die in an ICU, when compared to a patient who did not receive R/S care. Interestingly, the exact opposite was true for those whose R/S care was provided by the religious community. This group were equally less likely to receive hospice care and more likely to receive aggressive treatment and die in an ICU.
There was no clear explanation as to why spiritual support from the religious community was associated with more aggressive care. Potential explanations may include lack of understanding about the patient’s prognosis and potential adverse effects of aggressive care, or inadequate communication with the medical team. The study highlights an important aspect of patient care that is often overlooked by medical teams and underscores the influence that patient religious/spiritual beliefs can have on treatment decisions near the end of life.
Form more information, please see Interpreting a Cancer Research Study.