Perceived Changes of Providers’ Religious and/or Spiritual Beliefs Over Their Medical Careers
Christopher Ho Kim, Cornell University, Ithaca, NY, Pellegrino Center for Clinical Bioethics, Washington, D.C. and Kim Overby, MD, Cornell University, Ithaca, NY
Background/Rationale: Much of the literature written about the relation between stakeholders’ religion and/or spirituality (R/S) have addressed how stakeholders’ beliefs influence their decision-making in medical contexts. This is true of providers (physicians, nurse practitioners, and physician assistants), as many studies have demonstrated that providers’ R/S influence their practice of medicine. However, less literature has been written in the other direction—how the practice of medicine influences providers’ R/S beliefs. Penderell and Brazil discussed the various ways that the practice of palliative medicine influenced spirituality, including having a level of emotional nourishment within a spiritual context and feeling a strong sense of spirituality (Penderell and Brazil 2010). Conferring with these themes, Seccareccia and Brown note that caring for dying patients and families impacts providers’ own sense of spirituality (Seccareccia and Brown 2009). However, further work must be done to understand providers’ experiences, as, in turn, those experiences influence their medical practices. No work has been done to study providers in rural settings, a typically marginalized area of healthcare. As such, this research is one of the first to explore how the practice of medicine affects providers' personal religious and/or spiritual beliefs, as they perceive it.
Methods: Data collection for this study is still ongoing. Nine in-depth, semi-structured interviews with providers at a local community hospital in rural Upstate New York have been conducted. The interviews discussed their clinical work and responsibilities, their own R/S beliefs, how R/S has informed their work, and how they had perceived their R/S to have changed over the course of their medical career. The interviews were transcribed and analyzed using a grounded theory approach. Following the completion of the study, interviews will be re-analyzed using interpretive phenomenological analysis.
Results: The inductive qualitative study, though ongoing, has generated a few themes: Use of language; Deepened, not completely changed; Challenging moments; and Geographical and political location of practice. 1) Use of language. Each provider was asked to define what “religion” and “spirituality” meant for them. Many stated that they viewed “spirituality” to be some form of connection to something greater than themselves and “religion” to be an organized set of practices and community that sustained those beliefs. A majority of providers viewed themselves as spiritual but not religious, even if they belonged to a religious community. 2) Deepened, not completely changed. Many providers indicated that if a R/S belief change occurred, it had done so outside of the medical context or before they began medical school (usually in college). Since they entered the medical field, their R/S beliefs have only deepened and not significantly changed. For the minority that stated a change happened over the course of their medical career, they attributed the change to outside of the medical context (e.g., divorce). 3) Challenging moments. If they had indicated some deppening of their R/S beliefs, providers were able to articulate specific moments in which their R/S beliefs were challenged and were thus deepened as a result. Some of these moments included working in NYC during the September 11 attacks, performing a third-trimester abortion, or witnessing death. 4) Geographical and political location of practice. Providers often referred to the rural and political nature of their current practices, comparing them to other healthcare contexts in which they had previously worked.
Conclusion: The R/S beliefs of providers have been shown to have an affect on their practice of medicine. The other directionality—how their practice of medicine affects their R/S—has not been extensively studied. Through this study, I was able to note how providers in a small rural community hospital in Upstate New York perceived their R/S beliefs to have changed over the course of their medical career, resulting in several themes. Further research in this field is warranted, as studying these processes will help providers understand their own R/S beliefs and the way that they interact with medicine.
Penderell, Adrienne, and Kevin Brazil. (2010). “The Spirit of Palliative Practice: A Qualitative Inquiry into the Spiritual Journey of Palliative Care Physicians.” Palliative and Supportive Care 8, no. 4: 415–20. https://doi.org/10.1017/s1478951510000271.
Seccareccia, Dori, and Judith Belle Brown. (2009) “Impact of Spirituality on Palliative Care Physicians: Personally and Professionally.” Journal of Palliative Medicine 12, no. 9: 805–9. https://doi.org/10.1089/jpm.2009.0038.
Methods: Data collection for this study is still ongoing. Nine in-depth, semi-structured interviews with providers at a local community hospital in rural Upstate New York have been conducted. The interviews discussed their clinical work and responsibilities, their own R/S beliefs, how R/S has informed their work, and how they had perceived their R/S to have changed over the course of their medical career. The interviews were transcribed and analyzed using a grounded theory approach. Following the completion of the study, interviews will be re-analyzed using interpretive phenomenological analysis.
Results: The inductive qualitative study, though ongoing, has generated a few themes: Use of language; Deepened, not completely changed; Challenging moments; and Geographical and political location of practice. 1) Use of language. Each provider was asked to define what “religion” and “spirituality” meant for them. Many stated that they viewed “spirituality” to be some form of connection to something greater than themselves and “religion” to be an organized set of practices and community that sustained those beliefs. A majority of providers viewed themselves as spiritual but not religious, even if they belonged to a religious community. 2) Deepened, not completely changed. Many providers indicated that if a R/S belief change occurred, it had done so outside of the medical context or before they began medical school (usually in college). Since they entered the medical field, their R/S beliefs have only deepened and not significantly changed. For the minority that stated a change happened over the course of their medical career, they attributed the change to outside of the medical context (e.g., divorce). 3) Challenging moments. If they had indicated some deppening of their R/S beliefs, providers were able to articulate specific moments in which their R/S beliefs were challenged and were thus deepened as a result. Some of these moments included working in NYC during the September 11 attacks, performing a third-trimester abortion, or witnessing death. 4) Geographical and political location of practice. Providers often referred to the rural and political nature of their current practices, comparing them to other healthcare contexts in which they had previously worked.
Conclusion: The R/S beliefs of providers have been shown to have an affect on their practice of medicine. The other directionality—how their practice of medicine affects their R/S—has not been extensively studied. Through this study, I was able to note how providers in a small rural community hospital in Upstate New York perceived their R/S beliefs to have changed over the course of their medical career, resulting in several themes. Further research in this field is warranted, as studying these processes will help providers understand their own R/S beliefs and the way that they interact with medicine.
Penderell, Adrienne, and Kevin Brazil. (2010). “The Spirit of Palliative Practice: A Qualitative Inquiry into the Spiritual Journey of Palliative Care Physicians.” Palliative and Supportive Care 8, no. 4: 415–20. https://doi.org/10.1017/s1478951510000271.
Seccareccia, Dori, and Judith Belle Brown. (2009) “Impact of Spirituality on Palliative Care Physicians: Personally and Professionally.” Journal of Palliative Medicine 12, no. 9: 805–9. https://doi.org/10.1089/jpm.2009.0038.