The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: a meta-study of qualitative research
From Palliative Medicine
Patients confronted with death often engage in spiritual reflection with an increased questioning and searching for meaning. This study looks at the role of spirituality in end-of-life care, how these needs are defined and healthcare professionals response. Spiritual care is regarded as very important for many terminally ill patients. There has been a growing separation of the concepts of spirituality and religion. Spiritual needs may have fewer associations with a god and more with relationships. The study recognises that professionals have difficulty defining what such care could include but do recognise that relationships are an integral part of spiritual needs. This includes family, friends and care givers. Examining data from both patients and healthcare providers this research considers the physical, personal and social needs of the patient. Findings indicate that It is important to clarify the meaning of spirituality in relation to healthcare in order to enhance communication, practice, education and research, and to reduce the gap between policy and patient expectations.
Spirituality and spiritual care are gaining increasing attention but their potential contribution to palliative care remains unclear. The aim of this study was to synthesize qualitative literature on spirituality and spiritual care at the end of life using a systematic (‘meta-study’) review.
Eleven patient articles and eight with healthcare providers were included, incorporating data from 178 patients and 116 healthcare providers, mainly from elderly White and Judaeo-Christian origin patients with cancer. Spirituality principally focused on relationships, rather than just meaning making, and was given as a relationship. Spirituality was a broader term that may or may not encompass religion. A ‘spirit to spirit’ framework for spiritual care-giving respects individual personhood. This was achieved in the way physical care was given, by focusing on presence, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing. Affirmative relationships supported patients, enabling them to respond to their spiritual needs. The engagement of family caregivers in spiritual care appears underutilized. Relationships formed an integral part of spirituality as they were a spiritual need, caused spiritual distress when broken and were the way spiritual care was given. Barriers to spiritual care include lack of time, personal, cultural or institutional factors, and professional educational needs. By addressing these, we may make an important contribution to the improvement of patient care towards the end of life.
Edwards, A., Pang, N., Shiu, V., & Chan, C. (2010). Review: The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: a meta-study of qualitative research Palliative Medicine, 24 (8), 753-770 DOI: 10.1177/0269216310375860