224 - Addressing the Spiritual Needs of Critically Ill Children and Their Families: A National Needs Assessment of Pediatric Fellows

Poster Number: 224
Publication Number: 224.332

Paige E. Stevens, Stanford University School of Medicine, Palo Alto, CA, United States; Caroline Rassbach, Stanford University School of Medicine, Palo Alto, CA, United States; Kevin Kuo, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Spiritual care is an essential component of whole-person healthcare and becomes increasingly important in critical situations. Despite practice guidelines from the American College of Critical Care Medicine highlighting the importance of spiritual care, studies have shown that critical care physicians rarely initiate conversations about patients’ spiritual needs citing lack of training as a significant barrier. Little is known about the perspectives of pediatric physicians working in critical care settings as they relate to spiritual care.

Objective: To understand the knowledge, attitudes, training, and experience of pediatric fellows as they pertain to spiritual care.

Design/Methods: An IRB-approved survey was sent to a purposeful sample of 720 pediatric fellows training in critical care settings (165 Cardiology, 259 Critical Care, 296 Neonatology). The survey assessed fellows’ prior training, experience, knowledge, and attitudes regarding spiritual care. Categorical data was compared using chi-squared test or Fisher’s exact tests. The Wilcoxon rank sum test was used to compare the percentage correct on ten multiple-choice questions about world religions. Written free text responses were independently reviewed and coded using inductive analysis by two research investigators.

Results: 245 fellows responded (34% response rate). 83% of fellows had never received prior spiritual care training and 72% of fellows indicated that they would be somewhat or very likely to incorporate spiritual care into their practice if they received training. Prior training was significantly associated with increased familiarity with a framework for taking a spiritual history (p < 0.001), the spiritual care resources at the fellow’s institution (p < 0.004), and increased knowledge regarding spiritual practices that might influence medical care (p < 0.029). Prior training was also associated with increased frequency and comfort in taking a spiritual history (p < 0.0001), increased referrals to spiritual care resources (p < 0.016), and increased comfort in leading a prayer with a patient/family if requested (p < 0.016). Lack of time and training were the most common barriers identified to providing spiritual care. Conclusion(s): Providing spiritual care for families is particularly important in critical care settings. Pediatric fellows are open to incorporating spiritual care into their practice but lack the training to do so. Prior training is significantly associated with improved knowledge and skills in providing spiritual care. An opportunity exists to implement spiritual care training into pediatric fellowship programs.
Table 1 - Page 1: Fellows’ Prior Training and Correlation with Knowledge, Attitudes, and Skills/Clinical Practice
Table 1 - Page 2: Fellows’ Prior Training and Correlation with Knowledge, Attitudes, and Skills/Clinical Practice