Link between religious coping and aggressive treatment in terminally ill cancer patients.(Clinical report)

In a new study of terminally ill cancer patients, researchers at Dana-Farber Cancer Institute found that those who draw on religion to cope with their illness are more likely to receive intensive, life-prolonging medical care as death approaches uu treatment that often entails a lower quality of life in patients' final days (see also Dana-Farber Cancer Institute).

Previous research has shown that more religious patients often prefer aggressive end-of-life (EOL) treatment. The new study uu to be published in the March 18 issue of the Journal of the American Medical Association uu examined whether these patients actually receive such care. The study's findings suggest that physicians tend to comply with religious patients' wishes for more aggressive care.

"Recent research has shown that religion and spirituality are major sources of comfort and support for patients confronting advanced disease," says the study's senior author, Holly Prigerson, PhD, of Dana-Farber and Brigham and Women's Hospital (BWH). "We focused specifically on positive religious coping, on people who rely on their faith to handle the stresses of serious illness and approaching death. Our findings indicate that patients who turn to religion to cope in times of crisis, such as when facing death, are more likely to receive aggressive care when they die."

The study involved 345 advanced cancer patients at seven hospital and cancer centers around the country. Participants were interviewed about their means of coping with the illness, their use of advance care planning tools such as living wills and durable power of attorney, and their preferences regarding end-of-life treatment. Investigators then tracked each patient's course of care during the remainder of his or her life.

An analysis of the data showed that patients identified as positive religious copers had nearly three times the odds of receiving life-prolonging care, in the form of being on a ventilator or receiving cardiopulmonary resuscitation, in the final week of life. Even after researchers accounted for the influence of important factors such as age, ethnicity, or other coping techniques, the connection between religious coping and aggressive EOL care held up.

The researchers also found that religious copers in the study were less likely to ...