Assessment of Religious Beliefs about End-of-Life Medical Care
Tracy Balboni, MD, MPH, Associate Professor Radiation Oncology, Harvard Medical School
Michael J. Balboni PhD, MDiv, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Andrea C. Enzinger, MD, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Paul K. Maciejewski, PhD, Center for Research on End-of-Life Care, Weill Cornell Medical College, New York, NY
Holly G. Prigerson PhD, Center for Research on End-of-Life Care, Weill Cornell Medical College, New York, NY
Tyler J. VanderWeele PhD, Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA
Background: Studies postulate that certain religious beliefs about medical care, e.g., God could perform a miraculous cure, play a role in advanced cancer patients’ end-of-life (EOL) medical decision-making and care. There is presently no way to assess the extent and the influence of such beliefs. Here we introduce and evaluate the Religious Beliefs about EOL Care (RBEC) scale, a new measure designed to assess the extent to which advanced cancer patients’ view EOL medical care in explicitly religious terms.
Methods: The RBEC scale consists of seven items developed to reflect religious beliefs about EOL care. Psychometric properties of the scale were evaluated in a sample of advanced cancer patients (N=275) from Coping with Cancer II, an NCI-funded, multi-site, longitudinal, observational study of communications processes and outcomes in EOL cancer care.
Results: The RBEC scale was found to be unidimensional, internally consistent (Cronbach’s=0.81), positively associated with other indicators of patients’ religiousness and spirituality (establishing its construct validity), and inversely associated with patients’ illness understanding (establishing its criterion validity). Most patients (87%) reported some (‘somewhat’, ‘quite a bit’ or ‘a great deal’) endorsement of at least one RBECC item and a majority (62%) endorsed three or more RBECC items.
Conclusions: The RBEC scale is a reliable and valid tool assessing religious beliefs about end-of-life medical care, beliefs that are frequently endorsed and inversely associated with terminal illness understanding.
Michael J. Balboni PhD, MDiv, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Andrea C. Enzinger, MD, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Paul K. Maciejewski, PhD, Center for Research on End-of-Life Care, Weill Cornell Medical College, New York, NY
Holly G. Prigerson PhD, Center for Research on End-of-Life Care, Weill Cornell Medical College, New York, NY
Tyler J. VanderWeele PhD, Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA
Background: Studies postulate that certain religious beliefs about medical care, e.g., God could perform a miraculous cure, play a role in advanced cancer patients’ end-of-life (EOL) medical decision-making and care. There is presently no way to assess the extent and the influence of such beliefs. Here we introduce and evaluate the Religious Beliefs about EOL Care (RBEC) scale, a new measure designed to assess the extent to which advanced cancer patients’ view EOL medical care in explicitly religious terms.
Methods: The RBEC scale consists of seven items developed to reflect religious beliefs about EOL care. Psychometric properties of the scale were evaluated in a sample of advanced cancer patients (N=275) from Coping with Cancer II, an NCI-funded, multi-site, longitudinal, observational study of communications processes and outcomes in EOL cancer care.
Results: The RBEC scale was found to be unidimensional, internally consistent (Cronbach’s=0.81), positively associated with other indicators of patients’ religiousness and spirituality (establishing its construct validity), and inversely associated with patients’ illness understanding (establishing its criterion validity). Most patients (87%) reported some (‘somewhat’, ‘quite a bit’ or ‘a great deal’) endorsement of at least one RBECC item and a majority (62%) endorsed three or more RBECC items.
Conclusions: The RBEC scale is a reliable and valid tool assessing religious beliefs about end-of-life medical care, beliefs that are frequently endorsed and inversely associated with terminal illness understanding.