Spiritual Needs and Perception of Quality of Care and Satisfaction With Care in Hematology/Medical Oncology Patients: A Multicultural Assessment.
CONTEXT
Assessment and response to patients' spiritual concerns are crucial components of high-quality supportive care. Better measures of spiritual needs across the cultural spectrum may help direct necessary interventions.


OBJECTIVES
The objective of this study was to assess spiritual needs in a racially/ethnically and religiously mixed sample of hematology and oncology outpatients and examine the association between spiritual needs and perception of quality of care and satisfaction with care.


METHODS
This is an observational study of 727 racially/ethnically and religiously diverse outpatients. Spiritual needs were measured using a validated, 23-item questionnaire, the Spiritual Needs Assessment for Patients. Scales were administered in four languages.


RESULTS
Forty-four percent were white, 13% Hispanic, 25% black, and 14% Asian. English was the primary language for 57%; 59% considered themselves "spiritual but not religious." At least one spiritual need was reported by 79%. Forty-eight percent were comfortable having their physician inquire about spiritual needs. Compared with English-speaking patients, Russian-speaking patients reported lower spiritual needs (P = 0.003). Patients who considered themselves "spiritual but not religious" (P = 0.006) reported a higher level of spiritual needs. Higher spiritual needs were associated with less satisfaction with care (P = 0.018) and lower perception of quality of care (P = 0.002).


CONCLUSION
Spiritual needs are common in an ethnically, religiously, and linguistically diverse cancer patient population but may differ by cultural background. High levels of spiritual need are associated with lower levels of satisfaction and diminished perception of quality of care. Training clinicians to address patients' spiritual concerns, with attention to cultural differences, may improve patients' experiences of care.
['Astrow|Alan B|AB|', 'Kwok|Gary|G|', 'Sharma|Rashmi K|RK|', 'Fromer|Nelli|N|', 'Sulmasy|Daniel P|DP|']
D003431:Cross-Cultural Comparison D005260:Female D006402:Hematologic Diseases D006801:Humans D008297:Male D008875:Middle Aged D009369:Neoplasms D010045:Outpatients D017060:Patient Satisfaction D010465:Perception D010817:Physician-Patient Relations D011787:Quality of Health Care D012068:Religion and Medicine D029181:Spirituality D011795:Surveys and Questionnaires
Spirituality spiritual needs quality of care satisfaction with care spiritual care