Spiritual Care in PICUs: A U.S. Survey of 245 Training Fellows 2020–2021

Abstract

Objectives: To understand the perspectives of pediatric fellows training in critical care subspecialties about providing spiritual care. Design: Cross-sectional survey of United States National Residency Matching Program pediatric fellows training in critical care specialties. Setting: Online survey open from April to May 2021. Subjects: A total of 720 fellows (165 cardiology, 259 critical care, and 296 neonatology) were contacted, with a response rate of 245 of 720 (34%). Interventions: None. Measurements and Main Results: We assessed fellows’ survey responses about spiritual care in neonatal and pediatric critical care units. Categorical data were compared using chi-square test or Fisher exact tests. The Wilcoxon rank-sum test was used to compare the percentage correct on ten multiple-choice questions about world religions. Free-text responses were independently coded by two research investigators. A total of 203 of 245 (83%) responding fellows had never received training about spiritual care and 176 of 245 (72%) indicated that they would be likely to incorporate spiritual care into their practice if they received training. Prior training was associated with increased familiarity with a framework for taking a spiritual history (p < 0.001) and increased knowledge of spiritual practices that could influence medical care (p = 0.03). Prior training was also associated with increased self-reported frequency of taking a spiritual history (p < 0.001) and comfort in referring families to spiritual care resources (p = 0.02). Lack of time and training were the most reported barriers to providing spiritual care. Conclusions: Providing spiritual care for families is important in critical care settings. In 2020–2021, in the United States, 245 pediatric critical care fellows responded to a survey about spiritual care in their practice and reported that they lacked training in this subject. An opportunity exists to implement spiritual care curricula into pediatric fellowship training.