9067 Background: Religious practices and spiritual beliefs may affect end of life care decisions. Methods: Adult patients with advanced common cancers (Stages III, IV; lung, breast, prostate, colon) who were within one year of their diagnosis and were receiving active treatment in two community oncology practices, were interviewed (30 questions, 20–30 minutes) during an outpatient office visit to determine the major influences on end of life decisions. Specific attention was given to advance directives, influences on end of life decisions, discussions with family and physicians, and the role of religious practices and spiritual beliefs. 353 consecutive patients were invited to be interviewed and 339 patients (median age 66.2 yrs, 52.7% female, 57% married, 58% Caucasian, 30% African-American, 62% Christian, 61% high school education) completed the interview and were evaluable. Results: Fifty-one percent of the patients had an advance directive. The major influences on end of life decisions were family discussions (63%), quality of life (56%), personal experiences (50%), religious/spiritual beliefs (48%), financial burdens (41%), physician discussions (39%), and specific individuals (10%). Factors associated with having an advance directive were religious or spiritual affiliation, participating in regular religious or spiritual practices, and having discussed end of life decisions with their family or a physician. Patients had little knowledge of their religion's specific recommendations on end of life care and had few discussions with a religious professional on these issues. Conclusions: Health care providers need to recognize the influences on end of life decisions, as well as the role of patients’ religious practices and spiritual beliefs. No significant financial relationships to disclose.
Relationships among Health and Spiritual Beliefs, Religious Practices, and Congregational Support in Individuals with Cancer
