A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points

Background: Spiritual beliefs and spiritual support from clinicians can affect medical decision-making and coping during times of serious illness. Research Question: How do religion and spirituality affect the critical illness experience of Black and White family caregivers of patients who are criti...

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Main Authors: Oluwatumilara F. Akeke, MPH, Dingyue Wang, BSN, Deborah Ejem, PhD, Kimberly S. Johnson, MD, Sharron L. Docherty, PhD, RN, Christopher E. Cox, MD, MPH, Katelyn Dempsey, MPH, Laura Fish, MPH, PhD, Sirajbir Sodhi, BS, Devika Shenoy, BS, Nidhi Charan, BS, Muhammed S. Bah, BA, Deepshikha C. Ashana, MD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:CHEST Critical Care
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949788424000674
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author Oluwatumilara F. Akeke, MPH
Dingyue Wang, BSN
Deborah Ejem, PhD
Kimberly S. Johnson, MD
Sharron L. Docherty, PhD, RN
Christopher E. Cox, MD, MPH
Katelyn Dempsey, MPH
Laura Fish, MPH, PhD
Sirajbir Sodhi, BS
Devika Shenoy, BS
Nidhi Charan, BS
Muhammed S. Bah, BA
Deepshikha C. Ashana, MD
author_facet Oluwatumilara F. Akeke, MPH
Dingyue Wang, BSN
Deborah Ejem, PhD
Kimberly S. Johnson, MD
Sharron L. Docherty, PhD, RN
Christopher E. Cox, MD, MPH
Katelyn Dempsey, MPH
Laura Fish, MPH, PhD
Sirajbir Sodhi, BS
Devika Shenoy, BS
Nidhi Charan, BS
Muhammed S. Bah, BA
Deepshikha C. Ashana, MD
author_sort Oluwatumilara F. Akeke, MPH
collection DOAJ
description Background: Spiritual beliefs and spiritual support from clinicians can affect medical decision-making and coping during times of serious illness. Research Question: How do religion and spirituality affect the critical illness experience of Black and White family caregivers of patients who are critically ill? Study Design and Methods: Twenty-one semistructured interviews were conducted with Black and White family caregivers of patients admitted to ICUs in a southeastern United States health system between January 3, 2023, and May 11, 2023. Eligible family caregivers either reported unmet spiritual needs or a high degree of importance of spirituality in their lives. Participants were asked how spirituality affected medical decision-making and coping while their loved ones were seriously ill. Coders were masked to participant race during thematic analysis. Results: Of 21 family caregivers, 9 caregivers (42.9%) were Black and 12 caregivers (57.1%) were White. Black and White family caregivers generally were middle-aged (mean [SD]: 50.6 [13.6] years and 61.7 [10.7] years, respectively) and female (n = 7 [77.8%] and n = 9 [75.0%], respectively). We observed that clinicians showed less engagement about spirituality with Black compared with White family caregivers in this sample. Black family caregivers felt more comfortable discussing their spirituality with members of their community, such as pastors or friends. A common belief among all family caregivers in this sample was that God, rather than the medical team, was in control of their loved one’s outcome. This was accompanied by a shared desire for accessible spiritual spaces in the ICU and proactive clinician engagement in their spirituality. Interpretation: Although spirituality served as an important coping mechanism for all family caregivers in this sample, racial differences in spiritual support offered to family caregivers were identified. Ensuring that multidisciplinary critical care teams are prepared to deliver culturally competent spiritual care is a priority.
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spelling doaj-art-973b0cdf01984891a9f81bbff2de5c962025-08-20T02:15:28ZengElsevierCHEST Critical Care2949-78842025-03-013110011310.1016/j.chstcc.2024.100113A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home PointsOluwatumilara F. Akeke, MPH0Dingyue Wang, BSN1Deborah Ejem, PhD2Kimberly S. Johnson, MD3Sharron L. Docherty, PhD, RN4Christopher E. Cox, MD, MPH5Katelyn Dempsey, MPH6Laura Fish, MPH, PhD7Sirajbir Sodhi, BS8Devika Shenoy, BS9Nidhi Charan, BS10Muhammed S. Bah, BA11Deepshikha C. Ashana, MD12School of Public Health, University of North Carolina at Chapel Hill, Chapel HillSchool of Nursing, Duke University, Durham, NCSchool of Nursing, University of Alabama at Birmingham, Birmingham, ALDepartment of Medicine, Duke University, Durham, NC; Geriatrics Research Education and Clinical Center, Durham Veterans Affairs Health Care System, Durham, NCSchool of Nursing, Duke University, Durham, NCDepartment of Medicine, Duke University, Durham, NCDepartment of Medicine, Duke University, Durham, NCBehavioral Health and Survey Research Core, Duke University, Durham, NCSchool of Medicine, Duke University, Durham, NCSchool of Medicine, Duke University, Durham, NCPhiladelphia College of Osteopathic Medicine, Philadelphia, PADepartment of Population Health Sciences, Duke University, Durham, NCDepartment of Medicine, Duke University, Durham, NC; CORRESPONDENCE TO: Deepshikha C. Ashana, MDBackground: Spiritual beliefs and spiritual support from clinicians can affect medical decision-making and coping during times of serious illness. Research Question: How do religion and spirituality affect the critical illness experience of Black and White family caregivers of patients who are critically ill? Study Design and Methods: Twenty-one semistructured interviews were conducted with Black and White family caregivers of patients admitted to ICUs in a southeastern United States health system between January 3, 2023, and May 11, 2023. Eligible family caregivers either reported unmet spiritual needs or a high degree of importance of spirituality in their lives. Participants were asked how spirituality affected medical decision-making and coping while their loved ones were seriously ill. Coders were masked to participant race during thematic analysis. Results: Of 21 family caregivers, 9 caregivers (42.9%) were Black and 12 caregivers (57.1%) were White. Black and White family caregivers generally were middle-aged (mean [SD]: 50.6 [13.6] years and 61.7 [10.7] years, respectively) and female (n = 7 [77.8%] and n = 9 [75.0%], respectively). We observed that clinicians showed less engagement about spirituality with Black compared with White family caregivers in this sample. Black family caregivers felt more comfortable discussing their spirituality with members of their community, such as pastors or friends. A common belief among all family caregivers in this sample was that God, rather than the medical team, was in control of their loved one’s outcome. This was accompanied by a shared desire for accessible spiritual spaces in the ICU and proactive clinician engagement in their spirituality. Interpretation: Although spirituality served as an important coping mechanism for all family caregivers in this sample, racial differences in spiritual support offered to family caregivers were identified. Ensuring that multidisciplinary critical care teams are prepared to deliver culturally competent spiritual care is a priority.http://www.sciencedirect.com/science/article/pii/S2949788424000674caregiverscritical illnesshealth equityICUmedical decision-makingreligion
spellingShingle Oluwatumilara F. Akeke, MPH
Dingyue Wang, BSN
Deborah Ejem, PhD
Kimberly S. Johnson, MD
Sharron L. Docherty, PhD, RN
Christopher E. Cox, MD, MPH
Katelyn Dempsey, MPH
Laura Fish, MPH, PhD
Sirajbir Sodhi, BS
Devika Shenoy, BS
Nidhi Charan, BS
Muhammed S. Bah, BA
Deepshikha C. Ashana, MD
A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
CHEST Critical Care
caregivers
critical illness
health equity
ICU
medical decision-making
religion
title A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
title_full A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
title_fullStr A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
title_full_unstemmed A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
title_short A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family CaregiversTake-Home Points
title_sort descriptive qualitative study of religion and spirituality s role in critical illness decision making among black and white family caregiverstake home points
topic caregivers
critical illness
health equity
ICU
medical decision-making
religion
url http://www.sciencedirect.com/science/article/pii/S2949788424000674
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