Methods: Hospitalized patients older than 18 years and who provided consent were asked to complete a questionnaire. The questionnaire collected information on patient’s age, gender, and race and included following two validated tools a Daily Spiritual Experience Survey (DSES) and a validated patient satisfaction tool for hospitalized patients (TAISCH). Patient satisfaction was further assessed using an internally developed 5-question satisfaction tool. The scores on three tools were rescaled such that the change in satisfaction scores represented percentage change in scores for one percentage change in DSES score. Mixed linear regression models were created to examine the effect of spirituality on patient satisfaction to account for correlation in observations due to group of patients seen by the same physician. All analyses were performed in R 3.1.1 using ‘lme4’ package.
Results: Of the 469 patients, 260 (55%) were females and 55 (11.7%) were African Americans. Mean (SD) age of the patients was 52.3 (19) years. These patients were seen by 170 physicians (range = 1 to 16 patients per physician). In unadjusted analysis, we found strong but negative association of patient satisfaction with DSES score (Figure). A low DSES score correlates with high spirituality. After adjusting for patient’s age, sex, and race, mean DSES score remained significantly associated with patient satisfaction on both questionnaires. Each one percent increase in DSES score was associated with -0.13% (95% CI = -0.22% to -0.04%; P = 0.005) decrease in TAISCH score and -0.20% (95% CI = -0.31% to -0.10%; P <0.001) decrease in internally developed 5-question satisfaction tool.
Conclusions: We found a statistically significant inverse association between DSES score and patient satisfaction with physicians during hospitalization. Our study is an important step towards understanding how to address a patient’s spiritual needs. These findings will add to the current research developing different methods of training physicians in confronting spiritualty. Our results suggest that addressing spiritual needs of patients during hospitalization may improve satisfaction with their physicians.