Family Practice Vol. 17, No. 3, 230-232
© Oxford University Press 2000
Do doctors pay attention to the religious beliefs of their patients? A survey amongst Dutch GPs
Department of General Practice, University Medical Centre, Utrecht, The Netherlands.
WGE Kuyck, MD, Grensstraat 31-hs, 1091 SW Amsterdam, The Netherlands.
Kuyck WGE, de Wit NJ and Kuyvenhoven MM. Do doctors pay attention to the religious beliefs of their patients? A survey amongst Dutch GPs. Family Practice 2000; 17: 230–232.
Received 21 May 1999; Revised 10 December 1999; Accepted 21 December 1999.
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Abstract |
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Background. Patients' religious beliefs can offer support at times of illness and disease. Therefore religious beliefs of patients are important in doctor–patient interaction.
Objective. To assess to what extent GPs pay attention to religious beliefs of patients in their daily work.
Methods. A postal questionnaire was sent to 120 GPs. The questionnaire consisted of five clusters of items with precoded Likert-scale answer categories related to several clinical situations.
Results. Response rate was 72% (n = 87). Upon registration in the practice, 16% of the GPs paid attention to the religious beliefs of patients, while in situations concerning end-of-life decisions like terminal illness or requests for euthanasia most GPs pay attention to religious beliefs of patients (79%). In general GPs brought up in Protestant families tend to pay more attention to religious beliefs of patients than GPs with a Catholic background (65% vs 36%; 95% CI 5–51) and Protestant GPs pay more attention to these aspects than Catholic GPs (81% vs 47%; 95% CI 5–63).
Conclusions. Most GPs tend to pay attention to religion when their medical possibilities in patient care come to an end. GPs and trainees might be conscious of these aspects in patient management. Since most GPs are familiar just with Western religions, the increasing number of non-Western religious denominations might have consequences for patient care in general practitioners' work.
Keywords. General practitioners (GPs), patients, religious beliefs, (non-)Western religions.
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Introduction |
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Health care and religion have long been closely related to each other. In the early days of Western history, the priest and the doctor were one and the same person.1 The interrelationships between patients' religious attitudes and their experiences of disease and perception of health have been documented.1–4 For the practising doctor today, it is important to realize that patients can gain strength from their religious faith in cases of serious (somatic or psychiatric) illness and other major life events. However, it is not known whether GPs take into account religious beliefs, either of their patients or their own, in their daily work of cure and care.5 We therefore conducted a survey addressing two questions. (i) When, and to what extent do GPs in The Netherlands pay attention to the religious beliefs of patients? (ii) What individual characteristics of GPs are associated with paying attention to the religious beliefs of patients?
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Methods |
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All 120 GP vocational trainers attached to the Department of General Practice of Utrecht University were sent a questionnaire, addressing personal characteristics and asking questions regarding the importance of religious beliefs in routine clinical work and a number of ethical clinical situations (with five point Likert-type answer categories). The results were analysed while retaining the respondents' anonymity.
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Results |
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The response rate was 72%. The majority of respondents were male (93%) full-time workers (83%) aged between 30 and 50 years (71%) with practices of 2000–3000 patients (89%). Just over half (51%) of the GPs reported no religious affiliation, compared with 40% of the Dutch population. Those who did were predominantly Christian orientated: Catholic 19% (compared with 32% of the Dutch population), Protestant 24% (23%) and Ecumenical 2%.
The attention paid to religious beliefs varied: only 16% of the GPs enquired about patients' religion during registration at the practice; 25% enquired during routine consultations. Religious aspects were brought up more frequently in cases of 'bad news' (56%), requests for abortion (60%) or euthanasia (79%).
The association between GPs' answers to related questions, i.e. paying attention to religious beliefs of patients in different clinical situations, was high (Cronbach's alpha: 0.78). Based on the median of the sum score of these questions, two groups of GPs could be identified (Table 1
): attendants (n = 43, GPs who pay relatively more attention to religious beliefs of patients) and non-attendants (n = 44). Subsequently, the relationship to GPs' characteristics could be analysed.
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GPs with and without religious upbringing were represented equally in the two groups. GPs brought up in a Protestant family, however, were over-represented in the 'attendants' group, while the majority of GPs with a Catholic background did not pay attention to the religious beliefs of patients (Table 1
). Attention to religious background of patients was even stronger for GPs who actively professed Protestantism at the time of the study. Working full-time and having a practice size between 2000 and 3000 patients was associated with attention to religion, while the type of practice (rural/urban) and year of GP registration was not. Logistic regression analysis with relevant variables showed that being Protestant and having a larger list size were associated independently with paying attention to the religious beliefs of patients [practising Protestantism: adjusted odds ratio (OR) 4.9, 95% confidence interval (CI) 1.00–24.26; and list size: adjusted OR 7.1; 95% CI 2.04–24.86].
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Discussion |
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This survey showed that only limited attention is paid to patients' religious beliefs and attitudes in routine daily work in general practice. Most GPs do not register the religion of the patient. Religious motives become increasingly important in the management of major life events such as abortion, terminal illness or euthanasia. This confirms earlier work of Maugans in the USA,3 who reported that physicians are active concerning religious inquiries in situations such as counselling for terminal illness (69%), when the patients are near death (68%), and abortion counselling (52%). The personal existential thoughts of doctors probably become more important in clinical work in relation to the existential circumstances of the patient.
In our study group, which was a good representation of Dutch general practice, those brought up in and professing Protestantism (as opposed to Catholicism), in particular, paid attention to patients' beliefs. The majority also considered their own religion to play an important role in decisions on moral clinical issues. This is probably a reflection of religious developments in society in the past decades, and the changing influence of religions on ethical issues.
This survey did not address the question of to what extent patients expect physicians to explore a religious issue, nor did it explore the influence of this religious attention on the communication and quality of the work of the GP. With a growing number of patients leading an often non-Western religious life style, these are important subjects for future research.
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References |
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1 Hunt JH. Religion and the family doctor. Br J Gen Pract 1969; 18: 199–206.
2 Schreiber K. Religion in the physician–patient relationship. J Am Med Assoc 1991; 266:
3 Maugans TA, Wadland WC. Religion and family medicine: a survey of physicians and patients. J Fam Pract 1991; 32: 210–213.[Web of Science][Medline]
4 Craigie FC, Jr, Lui IY, Larson DB, Lyons JS. A systematic analysis of religious variables in The Journal of Family Practice, 1976–1986. J Fam Pract 1988; 27: 509–513.[Web of Science][Medline]
5 Daaleman TP, Naese DN, Jr. Patient attitudes regarding physician inquiry into spiritual and religious issues. J Fam Pract 1994; 39: 564–568.[Web of Science][Medline]
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