'Maybe we are losing sight of the human dimension' - physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study

Abstract

Objective: Research suggests that existential, spiritual, and religious issues are important for patient's psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients' needs.

Design: Physicians' experiences with and approaches to existential, spiritual, and religious needs when treating chronic pain or multiple sclerosis were studied in eight semi-structured interviews and analysed using interpretative phenomenological analysis (IPA).

Results: Physicians found that only few patients had spiritual and religious needs; however, they experienced that every patient were struggling with existential challenges related to the illness and rooted in a changed identity and approaching death. How the physicians approached these needs appeared to be influenced by six conditions: Their medical culture, training, role, experiences of time pressure, their personal interests, and interpersonal approach.

Conclusion: Physicians' training seems better suited to meet biomedical objectives and their patients' concrete needs than patients' wish for a relational meeting focused on their subjective lifeworld. This challenge is discussed in relation to modern patient-centeredness, doctor-patient relationship, culturally constructed experiences of privacy, and future clinical practice and research needs.

Keywords: Doctor–patient communication; chronic pain; existential needs; interpretative phenomenological analysis; multiple sclerosis; qualitative methods; religious needs; spiritual needs.