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Schouten, Esther (2016): Viewpoints and motives on religion and spirituality of professionals in perinatal medicine: a survey among midwives, nurses, obstetricians and neonatologists.. Dissertation, LMU München: Medizinische Fakultät



Introduction Pregnancy and childbirth are unique experiences in a family’s lifetime. They are time periods of highest emotional sensitivity. Also, they may constitute substantial health risks for both the mother and the infant. With the advent of modern neonatal intensive care, ethical dilemmas have arisen more often in perinatology. Decisions on intensive vs. compassionate care for critically ill infants may have long-term emotional and mental health effects on parents. A questionnaire among parents of deceased newborns after delivery room resuscitation showed that predictions of morbidity and mortality were not central to their decision-making. However, religion, hope, spirituality and compassion were mentioned as being most valuable guidance to decision-making regarding delivery room resuscitation. Little is known about German professionals’ views regarding the role of religion and spirituality in perinatology. We therefore administered a cross sectional survey to medical professionals (midwives, nurses, obstetricians and neonatologists) who are working in perinatal medicine in Germany. Our study aims were to evaluate their perspectives on religion / spirituality and health as well as their personal religious and spiritual characteristics. Methods A modified version of a questionnaire on “religious characteristics of U.S. physicians” that was developed by Curlin et al. was used. The questionnaire was translated, adapted and validated. The questionnaire contained 47 items divided over three sections that evaluated personal perspective on religion/spirituality and health, personal religious and spiritual characteristics of the respondents and demographic characteristics. Results and conclusion Four study centers were enrolled in the study. There were 374 eligible participants, 296 medical professionals participated (78% response rate). Among these 296 professionals, 21 chose not to fill out the entire questionnaire. They used an abbreviated version of the questionnaire. This resulted in 275 active survey participants: 45 midwives (16%), 121 neonatal intensive care nurses (44%) and 109 physicians (neonatologists, obstetricians) (40%). The median age of all participants was 36 years (minimum 23, maximum 64, between center - range 41). 30% said to have no religious affiliation, 47% reported to be Roman Catholic, 18% Protestant and 5% indicated other religious affiliations. 10% reported to be very religious and 16% to be very spiritual, 47% reported to be moderately religious and 46% moderately spiritual, 21% slightly religious and 26% slightly spiritual and 22% reported to be not religious at all and 12% not spiritual at all. 96% of the survey participants think that R/S has an influence on health. They valued R/S mainly as something positive, that gives patients hope and helps to cope with and endure illness. Although the medical professionals valued R/S mainly as something positive only 50% of the medical professionals ever inquired about R/S issues. They were more likely to inquire about R/S issues when the clinical situation is more severe. Furthermore, medical professionals likelyhood to inquire about R/S issues seems related to their own spirituality and religious affiliation, those who are more spiritual are more likely to inquire about R/S issues. 40% of the participants noted that they experience barriers that discouraged them from discussing R/S issues with patients. Most frequently mentioned barriers were lack of time and training as well as general discomfort speaking about R/S issues and fear to offend patients. The study results suggest that educational programs should be made available to overcome such barriers. This study should encourage medical professionals in perinatal care to bring up religious and spiritual issues in patient care.