Original Article

Effects of a 12-Month Educational Intervention on Clinicians’ Attitudes/Practices Regarding the Screening Spiritual History

Authors: Harold G. Koenig MD, Kathleen Perno RN, CLC, Alaattin Erkanli PhD, Ted Hamilton MD


Objectives: Patients’ spiritual values, beliefs, and preferences are identified in outpatient medical settings by the taking of a screening spiritual history (SSH). We report the impact of an educational/training program on the attitudes/practices of physicians (MDs) and midlevel practitioners (MLPs).

Methods: A convenience sample of 1082 MDs or MLPs in outpatient practices was approached to participate in a 12-month educational/ training program in this single-group experimental study. Of the 1082 professionals, 48% (427 physicians, 93 MLPs) agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes/practices regarding the SSH. Changes in attitudes/practices over time were examined and baseline predictors identified using mixedeffects regression.

Results: Of the 520 participants completing questionnaires at baseline, 436 were assessed at 1 month (83.8%) and 432 were assessed at 12 months (83.1%). The belief that MDs should take a SSH did not significantly change over time (B = −0.022, standard error [SE] 0.028, P = 0.426). However, those who took an SSH often/always increased from 16.7% at baseline to 34.8% at 12-month follow-up (B = 0.328, SE 0.030, P < 0.0001), and perceived patient acceptance/appreciation increased from 72.1% to 80.5% (B = 0.074, SE 0.023, P = 0.001). Predictors of increased SSH taking across time among MDs were older age, female sex, family medicine specialty, prior training, and importance of religion; older age was the only predictor in MLPs.

Conclusions: Although attitudes toward taking an SSH were not affected, taking an SSH increased initially and was sustained over time, as did the sense that patients accepted/appreciated this practice. Educational programs of this type may be used to increase SSH taking by outpatient MDs and MLPs.

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