The religious and spiritual beliefs of cancer patients may influence decision making

1. Overall, the influence of religion and spirituality on treatment decision making was both active and passive.

2. Though there were differences relative to rate and ethnicity, the impact of religion and spirituality was more pronounced among black patients.

Evidence Rating Level: 2 (Good)

Religious and Spirituality (R&S) forms a component of the World Health Organization’s definition of health. Unfortunately, the R&S needs of many patients go unmet, especially in patients with cancer. There is a current gap in how R&S influence cancer treatment decision making. As a result, the objective of the present systematic review was to evaluate the influence of R&S on treatment decision making among patients and providers in cancer care.

From 311 screened studies, 32 were included from 1997-2020. Articles were included if they explicitly discussed the relationship between R&S and treatment decision making. Articles were excluded if they focused on meditative practices and interventions such as mindfulness and yoga. Study outcomes focused on study demographics, R&S influence on providers and patients, and decision-making context.

Results showed that overall, the influence of religion and spirituality on treatment decision making was both active and passive, where some patients wanted more direct integration of their R&S beliefs. In contrast, patients with passive beliefs may want providers to be aware of their R&S preferences yet not want to discuss these topics explicitly. Furthermore, though there were differences relative to rate and ethnicity, the impact of religion and spirituality was more pronounced amongst black patients. The present study was limited by the greater representation on patient R&S topics rather than provider R&S relative to treatment decision making. However, these results suggest the need for providers to be aware of the impact of R&S on treatment decision making.

Click to read the study in Medical Decision Making

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