A study of views of spiritual care among junior doctors at a district general hospital

Results and discussion

There is a lack of awareness of local chaplaincy services among the junior doctors, and spiritual support is perceived as unimportant in caring for patients with advanced cancers.

Thirty-five patients (17 male and 18 female) with advanced cancer were admitted over the 1-month period. Thirty-six admissions (17 in oncology, 19 in medical wards) were recorded, with one patient being admitted twice to the oncology ward. Thirty-three of the patients were white British, one was Indian and one was Romanian. Average hospital stay was 13 days.

Patients were admitted for pain control (n=11), weakness, falls and not coping at home (n=8), general deterioration from disease progression (=5), jaundice (n=4), breathlessness (n=3), nausea and vomiting (n=1), seizures (n=1) and shingles (n=1). Two patients were repatriated to Lincoln following resections of brain tumours.

Twenty-two patients had a religious belief (18 Church of England, one Catholic, one Orthodox, one Spiritualist, one Hindu); 13 were atheists or had no religion. All except the Romanian patient spoke English.

Two patients were deemed to lack mental capacity during admission (one with an advanced brain tumour, one with acute delirium secondary to infection). No one had dementia. Two patients were started on the end-of-life care pathway during admission, and eight were seen by the palliative team while in hospital. Only one patient was documented to have been offered spiritual support by the medical team.

Chaplaincy received 14 referrals from both general medical wards and the oncology ward over the 1-month period. Referrals were mainly made by relatives and nurses, and none by a medical doctor.