Spiritual care at the end of life: whose job is it?

To provide an updated overview about the role of spirituality and religiosity in the way patients with lifethreatening illnesses cope, and the importance of providing a comprehensive spiritual assessment and spiritual care in an interdisciplinary team work setting, such as supportive and palliative care.

Hospice and Palliative Medicine International Journal, 2017

Background: Palliative care and spirituality are still very little discussed, but when studied and applied they become capable of alleviating some of the dimensions of suffering of man. Objective: To evaluate the understanding of health professionals about the concept of assistance to patients under palliative care and spirituality, as well as the application of techniques to alleviate the spiritual suffering for these patients. Method: This study used questionnaires in 91 professionals that work in the palliative care area (doctors, nurses and psychologists, chaplains), with at least three years of experience, regardless of gender. Results: The study shows a divergence in the work of professionals of the multidisciplinary staff, as well as the difficulty in addressing issues of spirituality. Conclusion: The palliative care and spirituality provide relief to many suffering patients, it is important to have health professionals aligned in concepts and prepared to use it in clinical practice.

To provide an updated overview about the role of spirituality and religiosity in the way patients with lifethreatening illnesses cope, and the importance of providing a comprehensive spiritual assessment and spiritual care in an interdisciplinary team work setting, such as supportive and palliative care.

Religions

From its inception palliative care has been understood as addressing four dimensions: physical, social, emotional/psychological, and spiritual/religious. However, the spiritual and/or religious element is poorly understood and under-researched, and little is known about palliative care professionals’ understandings of spiritual care, or how they seek to implement spiritual care in practice. Members of the European Association of Palliative Care (EAPC) Spiritual Care Taskforce (SCTF) designed and conducted a 28-item survey, supported by the EAPC Board, investigating palliative care professionals’ understandings and attempts to implement spiritual care. Following pilot-testing with 30 participants, the survey ran for a month. It was engaged with by 527 people from 67 countries and most regions of the world, with 502 answering at least two questions, 465 people answering at least one substantive questions, 228 providing examples of spiritual care at Q24, and 115 providing further comme...

Journal of Clinical Nursing, 2013

Aims and objectives. To explore Singapore hospice nurses' perspectives of spirituality and spiritual care. Design. A descriptive, cross-sectional design was used. Background. Spiritual care is integral to providing quality end-of-life care. However, patients often report that this aspect of care is lacking. Previous studies suggest that nurses' neglect of this aspect of care could be attributed to poor understanding of what spirituality is and what such care entails. This study aimed to explore Singapore hospice nurses' perspectives about spirituality and spiritual care. Methods. A convenience sample of hospice nurses was recruited from the eight hospices in Singapore. The survey comprised two parts: the participant demographic details and the Spirituality Care-Giving Scale. This 35-item validated instrument measures participants' perspectives about spirituality and spiritual care. Results. Sixty-six nurses participated (response rate of 65%). Overall, participants agreed with items in the Spiritual Care-Giving Scale related to Attributes of Spiritual Care; Spiritual Perspectives; Spiritual Care Attitudes; and Spiritual Care Values. Results from general linear model analysis showed statistically significant main effects between race, spiritual affiliation and type of hospice setting, with the total Spiritual Care-Giving Scale score and four-factor scores. Conclusions. Spirituality was perceived to be universal, holistic and existential in nature. Spiritual care was perceived to be relational and centred on respecting patients' differing faiths and beliefs. Participants highly regarded the importance of spiritual care in the care of patients at end-of-life. Factors that significantly affected participants' perspectives of spirituality and spiritual care included race, spiritual affiliation and hospice type. Relevance to clinical practice. Study can clarify values and importance of spirituality and care concepts in end-of-life care. Accordingly, spirituality and care issues can be incorporated in multi-disciplinary team discussions. Explicit guidelines regarding spiritual care and resources can be developed.

Religions, 2023

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Annals of Psychophysiology, 2018

Background: Palliative care is the provision of end of life care to the patient with a terminal disease; its primary focus is on improving the quality of life rather than quantity of life. While palliative care emphasizes over physical body pain reduction, it also suggests psychological comfort and spiritual wellbeing. Several research studies corroborate that interventions are done to keep the patient mentally relaxed greatly affects the patient's bodily functions and reduces the sensation of pain. Case Presentation: In this case, the physical attributes were excellently managed but neglect was done in terms of mental and spiritual need that was evident through her verbalization of hopelessness and fear, that the disease condition is a severe punishment by God. In addition, the patient was less likely to socialize with people including friends and family. Therefore, this case has been investigated in light of multiple recent articles (2010-2015) and pointed out the evidenced-ba...

The Gerontologist, 2002

This article presents a model for research and practice that expands on the biopsychosocial model to include the spiritual concerns of patients. Design and Methods: Literature review and philosophical inquiry were used. Results: The healing professions should serve the needs of patients as whole persons. Persons can be considered beings-in-relationship, and illness can be considered a disruption in biological relationships that in turn affects all the other relational aspects of a person. Spirituality concerns a person's relationship with transcendence. 'therefore, genuinely holistic health care must address the totality of the patient's relational existence-physical, psychological, social, and spiritual. The literature suggests that many patients would like health professionals to attend to their spiritual needs, but health professionals must be morally cautious and eschew proselytizing in any form. Four general domains for measuring various aspects of spirituality are distinguished: religiosity, religious coping and support, spiritual well-being, and spiritual need. A framework for understanding the interactions between these domains i s presented. Available instruments are reviewed and critiqued. An agenda for research in the spiritual aspects of illness and care at the end of life i s proposed. Implications: Spiritual concerns are important to many patients, particularly at the end of life. Much work remains to be done in understanding the spiritual aspects of patient care and how to address spirituality in research and practice.

Journal of Pain and Symptom Management, 2012

Context. Spirituality is a distinctive subject within palliative care practice and literature, but research to date is relatively undeveloped in this field and studies often throw more light on conceptual and methodological issues than producing reliable data for clinical practice. Objectives. To determine what is known about the spiritual needs of palliative care patients from the evidence presented in published research. Methods. Specialist online databases were interrogated for primary empirical studies of patients with a chronic disease unresponsive to curative treatment. Studies that only used a proxy for the patient or reported expert opinion were excluded. Each study was critically appraised for quality and the strength of its evidence to determine if any data could be pooled. Results. Thirty-five studies were identified, equating to a total of 1374 patients. Study populations were typically people with advanced-stage cancer, older than 60 years, who were English speaking, and with a Christian or Jewish religious affiliation, reflecting the predominance of Anglo-American studies. Studies fell into two groups: those that investigated the nature of spiritual experience and those that examined the relationship of spirituality with other phenomena. The evidence was insufficiently homogeneous to pool. Conclusion. Relevant accounts of what spirituality means for palliative care patients and evidence of how it operates in the lives of people with life-limiting disease can be derived from research. Studies to date are limited by reductive representations of spirituality and the conduct of research by health professionals within health care communities demarcated from disciplines and interpretive traditions of spirituality.

BMJ Open, 2024

Objectives This study aims to provide an in-depth exploration of everyday spiritual concerns of patients with advanced cancer seeking palliative care in Bangladesh, and assess their spiritual well-being (SWB). Methods This study was conducted among 163 patients with advanced cancer from three tertiary care hospitals in Bangladesh. It was divided into two parts: a quantitative segment that assessed the SWB of the participants using the EORTC QLQ SWB32, and a qualitative segment that explored their spiritual history. Result Spirituality was commonly interpreted and understood synonymously with religion by all participants, and their sense of life’s meaning centred on their families and friends. The lack of support from religious organisations led to feelings of isolation and disconnection from spiritual communities. Highest scores in SWB were observed in Relationships with God and Someone/Something Greater Scales. The lowest score was observed for Existential fulfilment. Patients expressed a desire for their palliative care team to address their spiritual concerns, regardless of their training in this area. Conclusion Spirituality is a deeply personal aspect of the human experience. Understanding and respecting these beliefs can empower palliative care professionals to deliver culturally sensitive care to their patients, irrespective of their level of training.