Physicians should be attentive to religious methods of coping
Andrea C. Phelps, M.D., from Beth Israel Deaconess Medical Center in Boston, and colleagues examined the association between religious coping and intensive life-prolonging care (defined as receipt of ventilation or resuscitation during the last week of life) at the end of life in 345 patients, predominantly Christian, with advanced cancer. Patients were interviewed about psychosocial, religious and spiritual preferences, advance care planning, and end-of-life treatment preferences, while religious coping was assessed by a 14-item questionnaire. The investigators found that 78.8 percent of patients reported that religion helped them cope to at least a moderate extent. After adjusting for age and race, patients with a high level of religious coping were more likely to receive mechanical ventilation (11.3 versus 3.6 percent, adjusted odds ratio 2.81) and intensive life-prolonging care during the last week of life (13.6 versus 4.2 percent, adjusted odds ratio 2.90), the researchers report. After further adjustment for other factors such as other coping styles and acknowledgement of terminal illness, a high level of religious coping remained significantly associated with receiving life-prolonging care at the end of life (adjusted odds ratio 2.90). The study "demonstrates that positive religious coping is associated with receipt of more intensive life-prolonging medical care at the end of life," Phelps and colleagues conclude. "These results suggest that clinicians should be attentive to religious methods of coping as they discuss prognosis and treatment options with terminally ill patients."
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