Relationships Between Advance Care Planning Engagement, Patients' Religious Practices, and Spirituality.
Robyn M Axel-Adams, Emily Fox Ludden, James E Slaven and 6 others
PMID 42394147WHAT IT FOUND
Among older adults facing high mortality risk, greater religious practice or belief and self-described spirituality were linked to more advance care planning engagement.
Religious affiliation alone was not.
Key findings
01Greater religiosity, including organized and personal religious activity and intrinsic religious beliefs, was associated with higher overall advance care planning engagement scores after controlling for age, race, sex, education, health literacy, income comfort, and illness severity.
02Participants who identified as spiritual had mean overall advance care planning engagement scores of 3.93, compared with 3.52 for participants who did not identify as spiritual, on a 1 to 5 scale.
03Religious affiliation was not significantly associated with any advance care planning engagement domain or the overall score.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were mostly Black (35.4%) or White (62.1%), so results may not apply to other racial groups. About 92% identified as Protestant Christian or Catholic, and only about 2% identified with another religion, limiting generalizability to religiously unaffiliated adults or other faiths. The study did not ask how specific religious beliefs, such as God controlling life length or religious coping, relate to advance care planning decisions. The data were baseline associations collected before randomization, so they cannot show that religion or spirituality causes advance care planning engagement. The sample came from primary care clinics in two large health systems in a Midwestern US city, which may limit generalizability.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not conclude that religious or spiritual patients will engage more because of a nurse-led program. This analysis looked at baseline associations before randomization, not intervention effects.