Table 3.

Main results found.

Authors, Year, Country	Design and Sample	Aim	Scale /Instrument	Main Findings
Al-Yousefi, 2012, Saudi Arabia [29]	Cross-sectional descriptive multicentre study n = 225 (physicians)	To assess the beliefs and behaviours of Muslim physicians regarding religious discussions in clinical practice and to understand the factors that facilitate or impede the discussion of religion in clinical settings.	Ad hoc survey	First study of this type carried out in a Muslim population. Most think that religion (not spirituality) has a positive influence on health, and more than half donot ask about this aspect in clinical practice. Doctors with a more careful religiosity approached it more easily; this coincided with those of greater age and experience.Spiritual care is mainly not approached due to lack of training and ethical dilemmas. Other barriers highlighted include: insufficient time and unsuitable environment.
Cocksedgeand May, 2009, UK [30]	Qualitative study n = 23 (physicians)	To explore the limitations of spiritual care in primary care physicians through two concepts: touch and spiritual care.	Semi-structured interviews	They identified barriers such as a lack of awareness of spiritual care, a lack of training, and thinking that other interests are more important to the person they serve.
Gijsberts et al., 2020, Netherlands [24]	Descriptive cross-sectional study n = 284 (physicians)	To examine the perceptions and experiences related to the provision of spiritual care at the end of life of elderly care physicians in nursing homes in the Netherlands, as well as factors associated with the provision of spiritual care at the end of life.	Ad hoc survey and Religious and Spirit Beliefs and Practices Scale (RSBPS)	Most perceived spirituality as a broad concept. Religious physicians and those trained in palliative care experience fewer barriers to providing spiritual care. Additional training in reflections on one’s own perception of spirituality and multidisciplinary training in spiritual care may contribute to the quality of care.
Hamouda et al., 2019, USA [27]	Multicentre cross-sectional descriptive study n = 255 (physicians)	To describe the perspectives and practices of American Muslim physicians with respect to R/S discussions, as well as how physician characteristics correlate with them.	Duke University Religiousness Index (DUREL) and Multidimensional Empathy Scale (MES)	More empathetic physicians were reported to be more likely to ask about patients’ R/S, share their own religious ideas and experiences, and encourage patients in their own beliefs and practices. They were also more likely to encourage the discontinuation of unhelpful life-sustaining interventions. They also encouraged their patients to reconcile their own lives. This shows that improving physician empathy may be key to addressing patients’ health-related R/S needs.
Kichenadasse et al., 2017, Australia [25]	Multicentre cross-sectional descriptive study n = 69 (physicians)	To explore the current practice, preparedness, and education of Australian oncologists and oncology residents on the provision of spiritual care to their cancer patients.	Spirituality and SpiritualCare Rating Scale (SSCRS)	Most had encountered patients with spiritual care needs during consultations, and less than half perceived that they could meet their spiritual needs. The barriers they identified were a lack of time, a lack of education, and a lack of understanding of spirituality and spiritual care in the health context. A small minority stated that they had received some education on spiritual care, and a few of them stated that the education was adequate. They indicated that they learned how to provide spiritual care on the job or through their own interest and not through specific training.
Koenig et al., 2017, USA [31]	Multicentre cross-sectional descriptive study n = 737 (513 physicians and 224 nurses)	To report on the attitudes and practices of health professionals in the largest Protestant health system in the USA (Adventist Health System).	Ad hoc survey	Many stated that a spiritual history should be taken to identify spiritual values, beliefs, and preferences in patients, they were are willing to do so and review the results, although few currently do so. Education, training, and support can help healthcare professionals identify and address patients’ spiritual preferences.
Penderell and Brazil, 2010, Canada [21]	Qualitative study n = 6 (physicians)	To seek greater physician understanding of spiritual care in palliative care.	Semi-structured interviews	This study advocated the training and education of palliative physicians in both the spiritual care of patients and the care of their own spirituality.
Seccareccia and Brown, 2009, Canada [32]	Qualitative study n = 10 (physicians)	To explore palliative care physicians’ perspectives and experiences of spiritual care and to identify the role of this practice both personally and professionally.	Semi-structured interviews	This study considered the importance of the spiritual dimension in the holistic care of terminally ill persons by physicians and the importance of the spiritual self-care of practitioners.
Smyre et al., 2018, USA [22]	Multicentre cross-sectional descriptive study n = 1156 (physicians)	To explore physicians’ beliefs about the relative importance and appropriateness of engaging with patients’ spiritual concerns and physicians’ options for intervention.	Ad hoc survey	Most believe it is essential that patients’ spiritual concerns are addressed at the end of life. The more religious were more likely to believe this and that it is appropriate to always encourage patients to talk to a chaplain. Most stated that, if asked, they would join the family and patient in prayer. Most support a limited role in the provision of spiritual care, although opinions varied according to the religious characteristics of the physicians.