The Role of Religion and Spirituality in Parent Decision-Making for Critically Ill Young Children

Saturday, 29 July 2017

Melissa J. Kurtz, MSN, MA, RN1
Marie T. Nolan, PhD1
Jill Hamilton, PhD2
(1)School of Nursing, Johns Hopkins University, Baltimore, MD, USA
(2)Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA

Purpose: Approximately 85% of African Americans and 58% of Caucasians say religion is very important in their lives (Grossoehme et al., 2012). More specifically, significant literature cites parents’ use of religious coping in pediatric decision making. However, what is still unknown is how parents of young children utilize religion and spirituality during the decision making process. A more in-depth exploration of the exisiting research that has explored religion and spirituality and parent decision making will inform the development of decision support interventions that promote parent engagement in complex pediatric decision making. Therefore, the purpose of this presentation is to systematically review the literature describing the role of religion and/or spirituality in critical care decision making for parents of children under 2 years of age.

Methods: Keyword searches of peer-reviewed literature investigating the relationship between spirituality or religion and parents’ medical decision making for a critically ill child under 2 years of age were conducted using relevant databases, including PubMed, CINAHL plus, PsychInfo, and Embase. The review was limited to studies published between January 2004 and September 2016. Titles and abstracts for 141 nonduplicate records were screened. Thirty three of these full-text articles were reviewed and 20 published studies were included. Resulting quantitative and qualitative studies were summarized using thematic analysis.

Results: Twenty articles met final inclusion criteria examining the relationships among religion/spirituality and shared decision making. Resulting thematic categories included: 1) Finding meaning in the experience of caring for a critically ill young child; 2) Using spirituality and religion for guidance in medical decision making for a critically ill young child; 3) Using spirituality and religion as a coping strategy during the illness or after the death of a critically ill young child.

Conclusion: The review revealed that religion/spirituality is an important and primarily positive influence on shared medical decision making among parents of a critically ill child. Future research should explore how to facilitate health care providers’ understanding of these religious/spiritual beliefs and to incorporate these beliefs into medical decision making for their critically ill child..