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. 2025 Apr 1;131(7):e35797.
doi: 10.1002/cncr.35797.

Utilization and perceptions of chaplaincy among hospitalized adults of Dharmic religions with cancer

Rushil V Patel  1   2   3 , Jill M Bowden  1   4 , Danielle Boselli  5 , Ashley E Strahley  6 , Sydney-Evelyn L Gibbs  7 , Komal P Murali  8 , Viraj R Patel  9 , Ritesh R Kotecha  1   10 , Judith E Nelson  1   10
Affiliations

Utilization and perceptions of chaplaincy among hospitalized adults of Dharmic religions with cancer

Rushil V Patel et al. Cancer. .

Abstract

Background: Spiritual care provided by chaplains plays a key role in cancer care in the United States, yet little is known about chaplaincy utilization among people of Dharmic religions (Hinduism, Buddhism, Sikhism, Jainism) with cancer.

Methods: This multi-methods study reviewed the records of patients (aged 18 years and older) who were hospitalized at a dedicated cancer hospital (2015-2019) and conducted interviews with chaplains and adults of Dharmic religions (2020). Primary outcomes included measuring chaplaincy utilization (at least one chaplain visit) across different religions and identifying perceptions of chaplaincy. Secondary outcomes involved measuring unmet spiritual needs on admission, types of spiritual care needs, and variables associated with chaplaincy utilization.

Results: Of 54,828 patients, 2% were of Dharmic religions (n = 1163; 58.4% Hindu, 33.2% Buddhist, 4.8% Sikh, 3.4% multiple, <1% Jain). Compared with others, those of Dharmic religions were younger (median age, 59 vs. 63 years; p < .001), predominantly East or South Asian (78.7% vs. 5.6%; p < .001), and had higher rates of advanced illness (22.6% vs. 15.2%; p < .001) but lower chaplaincy utilization (31.6% vs. 36.7%; p < .001). There were no significant differences in unmet spiritual needs on admission (Dharmic religions vs. others, 8.7% vs. 9.4%; p = .41). Ritual care was the most frequently documented spiritual care need (72%). Multivariable analysis indicated that longer length of stay, non-Dharmic religion, and advanced illness were associated with higher chaplaincy utilization. Themes identified from the interviews included unfamiliarity with chaplaincy, concerns about faith-discordant care, addressing spiritual care needs independently, and solutions for concordant care.

Conclusions: People of Dharmic religions with cancer were less likely to use chaplaincy services. Barriers included unfamiliarity and faith discordance. Spiritual care incorporating faith-specific resources is urgently needed.

Keywords: chaplaincy; health equity; psycho‐oncology; spiritual care.

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Conflict of interest statement

Rushil V. Patel reports personal/consulting fees from for the Hospice & Palliative Nurses Association and has served on advisory committees for the Yeshiva University School of Social Work Gerontology and Palliative Care Program for Interfaith Clergy, Pallium India, and the Coalition to Transform Advanced Care outside the submitted work. Ritesh R. Kotecha reports grants/contracts from Allogene Therapeutics, Arsenal Bio, Exelixis, Novartis, Pfizer, Takeda Oncology, the US Department of Defense, and Xencor; and personal/consulting fees from Eisai outside the submitted work. The remaining authors disclosed no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Chaplaincy utilization by year.
FIGURE 2
FIGURE 2
Spiritual care needs.
See this image and copyright information in PMC

References

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