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D'Andria Ursoleo J, Calì C, Losiggio R, Limone V, Mucci E, Monaco F. Spiritual Care in Palliative Medicine and End of Life: A Bibliometric Network Analysis. J Palliat Med 2024. [PMID: 39093919 DOI: 10.1089/jpm.2024.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Background and Objectives: Spiritual care is an essential component of care for the terminally ill, because of its potential to positively impact patient perception of quality of life and dignity. However, it continues to be the least cultivated or even most overlooked aspect of palliative care and end of life. We performed a methodological review using bibliometric analysis to provide a holistic view of the scientific output published on this topic in the literature at the same time outlining present perspectives and research trends. Methods: In accordance with the BIBLIO checklist for reporting the bibliometric reviews of the biomedical literature, pertinent articles were retrieved from the Web of Science (WOS) database. The search string included "spiritual care," "end of life," and their synonyms. The VOSviewer (version 1.6.17) software was used to conduct comprehensive analyses. Semantic and research networks, bibliographic coupling, and journal analysis were examined. Results: A total of 924 articles were identified in WOS, and 842 were retrieved. An increasing trend in the number of publications is observed from 1981 to date, with a peak in the 2019-2021 timeframe. Most articles focused on palliative care, spirituality, spiritual care, religion, end of life, and cancer. The Journal of Pain and Symptom Management contributed the highest number of published documents, while the Journal of Palliative Medicine was the top-cited journal. The highest number of publications originated from collaborations of authors from the United Kingdom, the United States, and Australia. Conclusion: The remarkable increase in the number of publications on spiritual care observed in the years of the COVID-19 pandemic likely reflected global concerns, reasserting the importance of prioritizing spiritual care for whole-person palliation. Spiritual care is integrated with palliative care, in line with the latter's holistic nature and the recognition of spirituality as a fundamental aspect of end-of-life care. Nurses and chaplains exhibited more involvement in palliative-spiritual care than physicians reflecting the belief that chaplains are perceived as specialized providers, and nurses, owing to their direct exposure to spiritual suffering and ethos, are deemed suitable for providing spiritual care.
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Affiliation(s)
- Jacopo D'Andria Ursoleo
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristiano Calì
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy
| | - Rosario Losiggio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vito Limone
- Faculty of Philosophy, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Mucci
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Fabrizio Monaco
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Steinhauser KE, Jeffreys AS, Perry K, Parker RP, Nieuwsma J, Olsen MK, Johnson KS, Kirshner MA, Majette N, King HA. Validating a tool to measure spiritual beliefs, needs and resources in serious illness: The I-SPIRIT. J Am Geriatr Soc 2024; 72:2148-2156. [PMID: 38666330 DOI: 10.1111/jgs.18887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Seriously ill patients rely on spiritual and existential beliefs to support coping and approach crucial treatment and healthcare decisions. Yet, we lack gold standard, validated approaches to gathering information on those spiritual beliefs. Therefore, we developed I-SPIRIT, a spiritual needs and beliefs inventory for those with serious illness (IIR-10-050). METHODS In prior work to develop measure content, we interviewed a total of 74 participants: 20 patients (veterans with Stage IV cancer, CHF, COPD, ESRD), 19 caregivers, 14 chaplains, 10 social workers, 12 nurses, and 5 physicians. Using directed content analyses, we identified over 50 attributes of spiritual experience comprising five domains: overall importance of spirituality; affiliations and practices; impact on decisions; spiritual needs; and spiritual resources. We then translated these attributes into individual items with Likert response scales. In the quantitative validation of I-SPIRIT, we administered the instrument and a battery of comparison measures to 249 seriously ill veterans. The comparison measures captured general spiritual well-being, religious coping, and emotional functioning. Convergent and discriminant validity was examined with the FACIT-sp (faith, meaning, and purpose), BMMRS (religious/spirituality), POMS and PHQ-8 (emotional function), and FACT-G (quality of life). We administered the I-SPIRIT a week later, for test-retest reliability. RESULTS Psychometric analyses yielded a final I-SPIRIT Tool including 30 items. Results demonstrated reliability and validity and yielded a tool with three main components: Spiritual Beliefs (seven items); Spiritual Needs (nine items); and Spiritual Resources (14 items). The Spiritual Beliefs items include key practices and affiliations, and impact of beliefs on healthcare. Higher levels of Spiritual Needs were associated with higher anxiety and depression. CONCLUSION The I-Spirit measures relevance of spirituality, spiritual needs and spiritual resources and demonstrates validity, reliability, and acceptability for patients with serious illness.
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Affiliation(s)
- Karen E Steinhauser
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Amy S Jeffreys
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Kathleen Perry
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Ryan P Parker
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Jason Nieuwsma
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina, USA
| | - Maren K Olsen
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Division of Biostatistics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kimberly S Johnson
- Geriatrics Research, Education, and Clinical Center (GRECC), Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Medicine, Division of Geriatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Miriam A Kirshner
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Nadya Majette
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Heather A King
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410), Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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Galchutt PK. Spiritual assessment models for palliative care chaplains: a narrative review. J Health Care Chaplain 2024:1-17. [PMID: 38900925 DOI: 10.1080/08854726.2024.2368999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Palliative care chaplains conduct spiritual assessments for those within their care. This narrative review examined the literature concerning existing spiritual assessment models developed or designated for palliative care chaplain use. The literature review was performed using four databases, including a hand search of references due to the variability of keywords used within the spiritual care literature. Five spiritual assessment models were identified. The analysis of the models focused on three areas: (1) Foundational basis, (2) Spiritual needs, and (3) Structural frameworks. Published spiritual assessment models for palliative care chaplain use are variable in how each one was formed, how each tool describes and structures spiritual care needs, and how the models are implemented within their respective contexts. The PC-7 advances the field, especially through its mixed methods approach. Future validation and reliability research is needed as well as investigations concerning which models are taught by chaplain educators and used by palliative care chaplains.
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Affiliation(s)
- Paul K Galchutt
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
- Department of Pharmacy Practice and Science, University of Maryland, Baltimore, MD, USA
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Spirituality moderates the relationship between cancer caregiver burden and depression. Palliat Support Care 2024; 22:470-481. [PMID: 38131143 DOI: 10.1017/s1478951523001785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. METHODS This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. RESULTS Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = -1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. SIGNIFICANCE OF RESULTS Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- Wisdom of the Whole Coaching Academy, Asheville, NC, USA
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Olga R, Lina S, Jolita R, Laima K. Spiritual Needs and Life Satisfaction of Lithuanian Palliative Care Patients. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02049-w. [PMID: 38662023 DOI: 10.1007/s10943-024-02049-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 04/26/2024]
Abstract
Life satisfaction remains a value-based orientation and an important positive dimension of human well-being. Little is known about the relationship of this construct with palliative care patients' spiritual needs. This study assesses spiritual needs of palliative care patients and their association with life satisfaction. An exploratory cross-sectional study design was employed. During structured face-to-face interviews, 110 hospitalized palliative care patients responded to the Spiritual Needs Questionnaire (SpNQ) regarding their spiritual needs and the Brief Multidimensional Life Satisfaction Scale (BMLSS) regarding life satisfaction. The patients, generally satisfied with their health and future prospects, showed variations in life satisfaction based on education and family status. Stronger Existential and Inner Peace needs were expressed. Factors such as age, gender, education, family status, and religiosity make a difference in the expression of spiritual needs. Religiosity emerged as the key predictor for Religious, Inner Peace, and Existential needs. Life satisfaction had a very weak negative correlation (-0.207, p < 0.05) with Inner Peace needs. Recommendations include understanding and addressing the spiritual needs of palliative patients and preparing healthcare professionals to address them.
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Affiliation(s)
- Riklikienė Olga
- Department of Nursing, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Eiveniu str. 4, Kaunas, LT-50161, Lithuania.
| | - Spirgienė Lina
- Department of Nursing, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Eiveniu str. 4, Kaunas, LT-50161, Lithuania
| | - Rapolienė Jolita
- Department of Rehabilitation, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Eiveniu str. 4, Kaunas, LT-50161, Lithuania
| | - Karosas Laima
- Department of Nursing, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Eiveniu str. 4, Kaunas, LT-50161, Lithuania
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Beaussant Y, Tarbi E, Nigam K, Miner S, Sager Z, Sanders JJ, Ljuslin M, Guérin B, Thambi P, Tulsky JA, Agrawal M. Acceptability of psilocybin-assisted group therapy in patients with cancer and major depressive disorder: Qualitative analysis. Cancer 2024; 130:1147-1157. [PMID: 38105653 DOI: 10.1002/cncr.35024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The present study explored the acceptability of psilocybin-assisted group therapy from the perspective of patients with cancer and depression who participated in a clinical trial assessing the safety and efficacy of this novel intervention. METHODS Guided by the conceptual framework of acceptability, the authors conducted semi-structured interviews with participants of the psilocybin trial. Data were analyzed using template and thematic analyses. RESULTS Participants' (n = 28) perspectives on the acceptability of the group and simultaneous sessions was generally positive, both in terms of safety and efficacy: first, the groups contributed to increase participants' sense of safety and preparedness as they were engaging in the therapy; and second, the groups fostered a sense of connection and of belonging, which served to enrich and deepen the meaning of participants' experience, ultimately opening a dimension of self-transcendence and compassion. Other subthemes related to factors influencing the acceptability of the group approach included: 1) the importance of the therapeutic framework, 2) the complementary value of individual sessions, 3) disruptive factors related to the group and/or simultaneous setting, and 4) opportunities and challenges related to group size and how to structure interactions. CONCLUSIONS This study enhances understanding of what promotes acceptability of the psilocybin-assisted therapy group model for the treatment of MDD in cancer patients. PLAIN LANGUAGE SUMMARY We conducted exit interviews with participants of a phase 2 trial of psilocybin-assisted therapy (PAT) conducted in a community cancer center, to assess the acceptability of a novel psilocybin delivery model combining simultaneous individual therapy and group sessions. Our findings support the acceptability of this intervention and suggest that in addition to being feasible, it might also enhance participants' perceived safety and efficacy compared to uniquely individual or group delivery models of PAT. Our analysis highlights critical factors conditioning acceptability and suggests new ways PAT may be scaled and integrated into cancer care.
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Affiliation(s)
- Yvan Beaussant
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Elise Tarbi
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Nursing, University of Vermont, Burlington, Vermont, USA
| | - Kabir Nigam
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Skye Miner
- Department of Medical Humanities and Bioethics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Zachary Sager
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Justin J Sanders
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael Ljuslin
- Harvard Medical School, Boston, Massachusetts, USA
- University of Geneva, Geneva, Switzerland
- Palliative Medicine Division, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Benjamin Guérin
- Department of Philosophy, University of Franche Comté, Besançon, France
| | - Paul Thambi
- Sunstone Therapies, Rockville, Maryland, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Matos J, Querido A, Laranjeira C. Spiritual Care through the Lens of Portuguese Palliative Care Professionals: A Qualitative Thematic Analysis. Behav Sci (Basel) 2024; 14:134. [PMID: 38392487 PMCID: PMC10886057 DOI: 10.3390/bs14020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Providing spiritual care is paramount to patient-centered care. Despite the growing body of data and its recognized importance in palliative care, spiritual care continues to be the least advanced and most overlooked aspect. This study aims to explore the perceptions and experiences of spiritual care from the perspective of PC professionals and identify their strategies to address spiritual care issues. Data were collected through semi-structured personal interviews and managed using WebQDA software (Universidade de Aveiro, Aveiro, Portugal). All data were analyzed using thematic content analysis, as recommended by Clark and Braun. The study included 15 palliative care professionals with a mean age of 38.51 [SD = 5.71] years. Most participants identified as lacking specific training in spiritual care. Thematic analysis spawned three main themes: (1) spiritual care as key to palliative care, (2) floating between "shadows" and "light" in providing spiritual care, and (3) strategies for competent and spiritual-centered care. Spiritual care was considered challenging by its very nature and given the individual, relational, and organizational constraints lived by professionals working in palliative care. With support from healthcare institutions, spiritual care can and should become a defining feature of the type, nature, and quality of palliative care provision. Care providers should be sensitive to spiritual needs and highly skilled and capable of an in-the-moment approach to respond to these needs. Further research on educating and training in spiritual care competence is a priority.
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Affiliation(s)
- Juliana Matos
- Hospital Palliative Care Team, Local Health Unit of the Leiria Region, Hospital of Santo André, Rua das Olhalvas, 2410-197 Leiria, Portugal
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Abusafia AH, Khraisat AMS, Tableb OK, Al-Mugheed K, Alabdullah AA, Abdelaliem SMF. The impact of a nursing spiritual care module on nursing competence: an experimental design. BMC Palliat Care 2024; 23:21. [PMID: 38246991 PMCID: PMC10802070 DOI: 10.1186/s12904-024-01356-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE This study aimed to assess the impact of the Nursing Spiritual Care Module on the competence of nurses in providing spiritual care in the context of Malaysia. METHOD This study employed an experimental design and involved a total of 122 nurses, with 59 in the experimental group and 63 in the control group. Participants were selected from palliative care wards associated with Hospital Universiti Sains Malaysia. Nurses in the experimental group underwent a two-week educational module on nursing spiritual care, while nurses in the control group attended a single lecture on spiritual care provided by the hospital. RESULTS The results indicated no significant differences in sociodemographic characteristics between the two groups. A significant difference in spiritual care competence within the intervention group and the control group over time (p-value = 0.001), between the two groups (p-value = 0.038), and in the interaction between time and group (p-value = 0.001). CONCLUSION The Nursing Spiritual Care Module is crucial in aiding nurses and healthcare professionals in cultivating the appropriate and wholesome attitudes and practices necessary to address the spiritual needs of patients.
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Haufe M, Leget C, Potma M. Better spiritual support for people living with early stage dementia: Developing the diamond conversation model. DEMENTIA 2024; 23:91-108. [PMID: 37934923 PMCID: PMC10797830 DOI: 10.1177/14713012231213907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND People with early-stage dementia could benefit greatly from on-going spiritual support. However, health care professionals working in dementia care often do not have a clear idea of what such support might entail. There is a lack of tools that can help professionals provide such support. The Diamond conversation model used in palliative care could provide such a support. Aims: To develop the Diamond model for early-stage dementia so that professionals can provide better spiritual support. METHODS Participatory research was conducted. Reflective interviews with chaplains, case managers and health psychologists identified frequently occurring existential and spiritual issues of clients and family members. A core participatory group consisting of chaplains, a psychologist and a researcher further analysed these issues thematically and co-developed the Diamond model for early stage dementia over three co-creation sessions. Researchers with Diamond model expertise provided feedback to the core participatory group in between these sessions based on the session output. FINDINGS Central existential and spiritual issues were found to be: self-confidence and -worth, adaptability and capacity, security and loss, burden and enrichment of memory and faith and meaning. The five polarities of the Diamond model were found helpful to understand tensions surrounding these issues. Specific tensions were identified between maintaining a self and being valued, finding direction in what to do and a way to bear changes in ability, a strong need for attachment and letting go of past ways to relate to one another, the renewed intensity of long term memories and decline of the short term ones and surrendering to one's life situation and wanting certainty and meaning. CONCLUSIONS The newly developed Diamond model for people with early-stage dementia offers a valuable framework to help professionals provide conversational support. More research needs to be done to further test and develop the model in practice.
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Affiliation(s)
- Marc Haufe
- University for Humanistic Studies, The Netherlands
| | - Carlo Leget
- University for Humanistic Studies, The Netherlands
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10
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Baker KM, Ulrich CM, Meghani SH. An Integrative Review of Measures of Spirituality in Experimental Studies of Psilocybin in Serious Illness Populations. Am J Hosp Palliat Care 2023; 40:1261-1270. [PMID: 36604312 DOI: 10.1177/10499091221147700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Psilocybin-assisted therapies (PAT) are reemerging as a treatment for complex distress often prompting mystical experiences, enhanced meaning, and spiritual wellbeing. We sought to investigate how measures of spirituality are employed in experimental studies of PAT conducted with seriously ill adults. Methods: We included experimental studies of psilocybin conducted with seriously ill adults, which employed measures that contained spirituality and mysticism concepts within their domains or subdomains. Included studies were peer-reviewed and published in English language (up to December 2021). Results: Seven articles met our inclusion criteria. A total of 12 unique instruments were identified. The most frequently used instruments were the Mystical Experience Questionnaire (MEQ30), the Functional Assessment of Chronic Illness Therapy-Spirituality (FACIT-Sp-12), and the Demoralization Scale (DS-I/II) (used in four studies each), followed by the Persisting Effects Questionnaire (PEQ) (used in three studies). Overall, studies did not consistently define and contextualize spirituality domains and subdomains studied. Conclusions: Despite well-recognized significance of spirituality in PAT, there was considerable heterogeneity in number and types of spirituality measures employed across studies. There also seemed a lack of attention to defining and operationalizing spirituality and its domains and subdomains. This is notable as spirituality and overlapping concepts (eg mystical experiences) contributes substantially to this body of research and patients' therapeutic outcomes. Towards developing more rigorous science of spirituality in PAT research, there is a critical need to evaluate and refine measures of spirituality to enhance their utility and replicability, limit participant burden, and better contextualize spirituality-related findings and outcomes.
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Affiliation(s)
- Kayla M Baker
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics; University of Pennsylvania; Philadelphia, PA; United States
| | - Connie M Ulrich
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences; University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics; University of Pennsylvania; Philadelphia, PA; United States
| | - Salimah H Meghani
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences; University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics; University of Pennsylvania; Philadelphia, PA; United States
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Stephenson P, Hansen D, Lalani N, Biggs J. Nursing and Medical Students' Responses About End-of-Life Communication Reveal Educational Opportunities for Spiritual Care. J Nurs Educ 2023; 62:601-605. [PMID: 37934687 DOI: 10.3928/01484834-20230906-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND The need for improved spiritual care education is a national directive, prompting many nursing and medical education programs to respond with spiritual curriculum. This article reports on research that tested an educational intervention to enhance nursing and medical students' understanding of end-of-life communication with families. METHOD This mixed-methods study included three reflection questions to ascertain students' attitudes about their own death and dying. RESULTS Many of the students' responses were spiritual in nature. Findings revealed two important misconceptions about death and one educational strategy that can be used to help students identify potential sources of spiritual discomfort in clinical situations. CONCLUSION The findings offer a glimpse into the attitudes and beliefs of nursing and medical students that could influence how they view and deliver spiritual care, contributing to the evidence base for spiritual care education and curriculum. [J Nurs Educ. 2023;62(11):601-605.].
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Guldin MB, Leget C. The integrated process model of loss and grief - An interprofessional understanding. DEATH STUDIES 2023; 48:738-752. [PMID: 37883693 DOI: 10.1080/07481187.2023.2272960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Despite the vast developments in research on loss and grief, dominant grief models fall short in reflecting the comprehensive issues grieving persons are facing. Three causes seem to be at play: grief is usually understood to be connected to death and other types of loss are under-researched; the majority of research is done from the field of psychology and on pathological forms of grief, hardly integrating research from other disciplines; and the existential suffering related to grief is not recognized or insufficiently integrated in the dominant models. In this paper, we propose an integrated process model (IPM) of loss and grief, distinguishing five dimensions of grief: physical, emotional, cognitive, social, and spiritual. The integrated process model integrates therapies, tools, and models within different scientific theories and paradigms to connect disciplines and professions. The comprehensive and existential understanding of loss and grief has relevance for research, clinical settings and community support.
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Affiliation(s)
- Mai-Britt Guldin
- Research Unit for General Practice, Institute for Public Health, Aarhus University, Denmark. Center for Grief and Existential Values, Aarhus, Denmark
| | - Carlo Leget
- University of Humanistic Studies, Utrecht, The Netherlands
- Center for Grief and Existential Values, Aarhus, Denmark
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Miller M, Speicher S, Hardie K, Brown R, Rosa WE. The Role of Spirituality in Pain Experiences among Adults with Cancer: An Explanatory Sequential Mixed Methods Study. RESEARCH SQUARE 2023:rs.3.rs-3425339. [PMID: 37886465 PMCID: PMC10602141 DOI: 10.21203/rs.3.rs-3425339/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Purpose Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing. Methods This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences. Results Results indicate that spirituality was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan. Conclusions This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.
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Heikkinen PJ, Roberts B. I see you: a Chaplain case study on existential distress and transdisciplinary support. J Health Care Chaplain 2023; 29:381-398. [PMID: 35895688 DOI: 10.1080/08854726.2022.2097780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In the setting of major disease progression coupled with active pain, hospitalized patients may become disconnected from their metanarratives and personal grounding. Transdisciplinary palliative care teams are poised to foster patients' connection with their metanarratives by collaborating across areas of expertise to establish goals of care and manage total pain. This case study demonstrates: (1) the unique value of the palliative Chaplain in journeying with the patient through existential distress towards self-discovery, and (2) the role of the palliative chaplain in encouraging a transdisciplinary approach to total pain within a palliative care team.
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Affiliation(s)
- Peter J Heikkinen
- Department of Spiritual Care, Chaplaincy Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
- Palliative Care Program, Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Benjamin Roberts
- Palliative Care Program, Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
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15
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Kang KA, Kim SJ, Kim DB, Koh SJ, Park MH, Yoon SJ. Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea: A Nonrandomized Controlled Trial. Cancer Nurs 2023; 46:405-412. [PMID: 37607376 DOI: 10.1097/ncc.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. OBJECTIVE The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). METHODS This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions' preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ 2 test, 1-way analysis of variance, and repeated-measures analysis of variance. RESULTS There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency ( P = .002) and spiritual care therapeutics ( P = .038), whereas no significant difference was found for compassion fatigue ( P = .716). CONCLUSION The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. IMPLICATIONS FOR PRACTICE The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.
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Affiliation(s)
- Kyung-Ah Kang
- Author Affiliations: College of Nursing, Sahmyook University (Dr Kang), Seoul; School of Nursing, Hallym University (Dr SJ Kim), Chuncheon; Holistic Healing Institute of Sam Medical Center (Dr DB Kim), Gunpo; Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine (Dr Koh); Hospice & Palliative Center, Seoul St. Mary's Hospital (Dr Park), Seoul; and Dongbaek St. Luke's Hospital, Gyeonggi-do (Dr Yoon), Republic of Korea
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Britt KC, Boateng ACO, Zhao H, Ezeokonkwo FC, Federwitz C, Epps F. Spiritual Needs of Older Adults Living with Dementia: An Integrative Review. Healthcare (Basel) 2023; 11:1319. [PMID: 37174861 PMCID: PMC10178032 DOI: 10.3390/healthcare11091319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore and Knafl method, this integrative review examined the literature from 2000 to 2022 on the spiritual care needs of PLwDs. We sought to identify characteristics of the spiritual needs of PLwDs and ways to address them. The ATLA Religion, CINAHL, PsycINFO, PubMed, and Socindex databases were used to search the literature, and 12 peer-reviewed articles met the inclusion criteria. Spiritual care needs varied across studies. Overall, findings support the importance of identifying PLwDs' religious and spiritual backgrounds to inform person-centered care. Spiritual needs were identified as verbal and non-verbal expressions related to past meaning and religious and spiritual background and were not consistently addressed in care. Providers reported observing spiritual distress in the mild stage prompting the need for spiritual care. There is a great need for dementia-specific spiritual assessment tools and spiritual care interventions to support spiritual well-being in dementia care. Spiritual care involves facilitating religious rituals and providing spiritual group therapy and religious and spiritual activities.
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Affiliation(s)
- Katherine Carroll Britt
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Augustine C. O. Boateng
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hui Zhao
- School of Nursing, James Madison University, Harrisonburg, VA 22807, USA
| | | | - Chad Federwitz
- Gerontology, Western Colorado Community College, Grand Junction, CO 81505, USA
| | - Fayron Epps
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA
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17
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Goyarrola R, Lipsanen J, Saarelainen SM, Suviranta R, Rahko E, Lamminmäki A, Klaavuniemi T, Ahtiluoto S, Ohvanainen A, Metso P, Pöyhiä R. Spiritual well-being correlates with quality of life of both cancer and non-cancer patients in palliative care - further validation of EORTC QLQ-SWB32 in Finnish. BMC Palliat Care 2023; 22:33. [PMID: 36991431 PMCID: PMC10061907 DOI: 10.1186/s12904-023-01153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The European Organisation for Research and Treatment of Cancer (EORTC) has developed the Spiritual Well-being Questionnaire (EORTC QLQ-SWB32), a measure of spiritual well-being validated with people receiving palliative care for cancer, although its usefulness is not restricted to that population. We aimed to translate and validate this tool in Finnish and to study the relationship between spiritual well-being (SWB) and quality of life (QOL). METHODS A Finnish translation was produced according to the guidelines of EORTC and included forward- and back-translations. Face, content, construct and convergence/divergence validity and reliability were studied in a prospective manner. QOL was assessed with EORTC QLQ-C30 and 15D questionnaires. Sixteen individuals participated in the pilot testing. 101 cancer patients drawn from oncology units, and 89 patients with other chronic diseases drawn from religious communities in different parts of the country participated in the validation stage. Retest was obtained from 16 individuals (8 cancer and 8 non-cancer patients). Inclusion criteria included patients with either a well-defined palliative care plan, or who would benefit from palliative care, as well as the capacity to understand and communicate in Finnish. RESULTS The translation appeared understandable and acceptable. Factorial analysis identified four scoring scales with high Cronbach alfa values: Relationship with Self (0.73), Relationship with Others (0.84), Relationship with Something Greater (0.82), Existential (0.81), and, additionally, a scale on Relationship with God (0.85). There was a significant correlation between SWB and QOL in all participants. CONCLUSIONS The Finnish translation of EORTC QLQ-SWB32 is a valid and reliable measure both for research and clinical practice. SWB is correlated with QOL in cancer and non-cancer patients undergoing palliative care or who are eligible for it.
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Affiliation(s)
- Raimo Goyarrola
- School of Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Jari Lipsanen
- Department of Statistics, University of Helsinki, Helsinki, Finland
| | - Suvi-Maria Saarelainen
- School of Theology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Raili Suviranta
- Diaconia Journal, Evangelical Lutheran Church of Finland, Helsinki, Finland
| | - Eeva Rahko
- Department of Oncology, University Hospital, Oulu, Finland
| | | | | | | | - Antti Ohvanainen
- Palliative care unit and hospital at home, Siun sote, Joensuu, Finland
| | - Pekka Metso
- School of Theology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Reino Pöyhiä
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Palliative Center, Essote, Mikkeli, Finland
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Taylor EJ, Pariñas S, Mamier I, Atarhim MA, Angeles L, Aslan H, Aktürk Ü, Ercİ B, Soriano G, Sinaga J, Chen YH, Merati-Fashi F, Odonel G, Neathery M, Permatasari W, Ricci-Allegra P, Foith J, Caldeira S, Dehom S. Frequency of nurse-provided spiritual care: An international comparison. J Clin Nurs 2023; 32:597-609. [PMID: 36039033 PMCID: PMC10087347 DOI: 10.1111/jocn.16497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To compare the frequency of nurse-provided spiritual care across diverse cultures. BACKGROUND Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. DESIGN This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. METHODS Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed. RESULTS Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. CONCLUSIONS In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. RELEVANCE TO CLINICAL PRACTICE Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.
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Affiliation(s)
| | - Sabina Pariñas
- Nursing Department, Mariano Marcos State University, Batac, Philippines
| | - Iris Mamier
- School of Nursing, Loma Linda University, Loma Linda, California, USA
| | - Mohd Arif Atarhim
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Leonardo Angeles
- Department of Nursing, School of Nursing and Allied Medical Sciences, Holy Angel University, Angeles City, Philippines
| | - Hakime Aslan
- Faculty of Nursing, İnönü University, Malatya, Turkey
| | | | - Behice Ercİ
- Faculty of Nursing, İnönü University, Malatya, Turkey
| | - Gil Soriano
- Department of Nursing, College of Allied Health, National University, Manila, Philippines
| | | | - Yi-Heng Chen
- College of Nursing, Department of Nursing, Mackay Medical College, New Taipei, Taiwan
| | - Fatemeh Merati-Fashi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Girlie Odonel
- College of Nursing, Pharmacy and Allied Health Sciences, Negros Oriental State University, Dumaguete, Philippines
| | - Melissa Neathery
- Louise Herrington School of Nursing, Baylor University Eta Gamma Chapter, Waco, Texas, USA
| | - Winda Permatasari
- Faculty of Medicine, Lambung Mangkurat University, Banjarbaru, Indonesia
| | | | - Joanne Foith
- Aultman Hospital Internal Medicine Group, Malone University School of Nursing & Health Sciences, Canton, Ohio, USA
| | - Silvia Caldeira
- Institute of Health Sciences, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Salem Dehom
- School of Nursing, Loma Linda University, Loma Linda, California, USA
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19
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Abasseri M, Hoque S, Slavica Kochovska BA, Caldwell K, Sheahan L, Zekry A. Barriers to palliative care in hepatocellular carcinoma: A review of the literature. J Gastroenterol Hepatol 2023. [PMID: 36634200 DOI: 10.1111/jgh.16107] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023]
Abstract
Hepatocellular carcinoma (HCC) is a deadly and burdensome form of liver cancer with an increasing global prevalence. Its course is unpredictable as it frequently occurs in the context of underlying end-stage liver disease, and the associated symptoms and adverse effects of treatment cause severe suffering for patients. Palliative care (PC) is a medical specialty that addresses the physical, emotional, and spiritual needs of patients and their carers in the context of life-limiting illness. In other cancers, a growing body of evidence has demonstrated that the early introduction of PC at diagnosis improves patient and carer outcomes. Despite this, the integration of palliative care at the diagnosis of HCC remains suboptimal, as patients usually receive PC only at the very terminal phase of their disease, even when diagnosed early. Significant barriers to the uptake of palliative care in the treatment algorithm of hepatocellular carcinoma fall under four main themes: data limitations, disease, clinician, and patient factors. Barriers relating to data limitations mainly encapsulated the risk of bias inherent in published work in the field of PC. Clinician-reported barriers related to negative attitudes towards PC and a lack of time for PC discussions. Barriers related to the disease align with prognostic uncertainty due to the unpredictable course of HCC. Significantly, there exists a paucity of evidence exploring patient-perceived barriers to timely PC implementation in HCC. Given that patients are often the underrepresented stakeholder in the delivery of PC, future research should explore the patient perspective in adequately designed qualitative studies as the first step.
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Affiliation(s)
- Mostafa Abasseri
- School of Medicine and Health, UNSW, Sydney, New South Wales, Australia
| | - Shakira Hoque
- Gastroenterology and Hepatology Department, St George Hospital, Sydney, New South Wales, Australia
| | - B A Slavica Kochovska
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,IMPACCT, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Kim Caldwell
- Palliative Medicine, Calvary Hospital Kogarah, Kogarah, New South Wales, Australia
| | - Linda Sheahan
- Clinical Ethics Service, South Eastern Sydney Local Health District, Randwick, New South Wales, Australia.,Sydney Health Ethics, The University of Sydney, Camperdown, New South Wales, Australia.,UNSW Medicine & Health, St George and Sutherland Clinical Campus.,Palliative Medicine Department, St George Hospital, Sydney, New South Wales, Australia
| | - Amany Zekry
- School of Medicine and Health, UNSW, Sydney, New South Wales, Australia.,Gastroenterology and Hepatology Department, St George Hospital, Sydney, New South Wales, Australia.,UNSW Medicine & Health, St George and Sutherland Clinical Campus
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20
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Leidl BF, Fox-Davis D, Walker FO, Gabbard J, Marterre B. Layers of Loss: A Scoping Review and Taxonomy of HD Caregivers' Spiritual Suffering, Grief/Loss and Coping Strategies. J Pain Symptom Manage 2023; 65:e29-e50. [PMID: 36198334 PMCID: PMC9790041 DOI: 10.1016/j.jpainsymman.2022.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 02/03/2023]
Abstract
CONTEXT Huntington's disease (HD), an incurable, multi-generational, autosomal dominant disorder, creating unique challenges and a myriad of spiritually-related stressors in those affected and their familial caregivers. Spiritual suffering, experiences of grief/loss, and coping strategies have not been systematically studied in HD caregivers. OBJECTIVES To comprehensively define spiritual suffering, grief/loss, and coping strategies used by HD caregivers. METHODS A PRISMA-ScR scoping literature review was conducted. Data from included research articles were organized thematically using induction and open coding. A grounded, deductive approach was used to delineate a demarcated taxonomy of themes, which encompasses all three over-arching domains. Four reviewers, employing a modified Delphi approach, ascertained which themes were demonstrated by research participants in each study. RESULTS 36 of 583 articles met the review criteria; none were published in the palliative care literature. Investigations primarily focused on intrapersonal (self-image) distress and existential angst; only rarely looking deeper into divine/transpersonal suffering, disrupted religious relationships, or meaning distress. HD caregivers experience profound grief/loss, expressed as disenfranchised grief that is associated with the ambiguous loss of their loved one, loss of family structure, social connectedness, and personal losses. Half of the studies reported maladaptive HD caregiver coping strategies-characterized by dysfunctional escape schemes; in contrast, transcendent/creative strategies were often unexplored. CONCLUSION HD caregivers experience prolonged grief and other forms of spiritual suffering as they progressively lose their loved ones and disruption to their own lives. With an improved assessment tool, teams with spiritual and palliative care experts will better be able to support HD family caregivers.
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Affiliation(s)
- Bethany Faith Leidl
- Wake Forest University School of Medicine, (B.F.L., B.M.) Winston-Salem, North Carolina
| | | | - Francis O Walker
- Department of Neurology, Emeritus, Winston-Salem, (F.O.W.) North Carolina, USA
| | - Jennifer Gabbard
- Department of Internal Medicine, Section on Gerontology and Geriatrics (Palliative Care), (J.G., B.M.) Winston-Salem, North Carolina
| | - Buddy Marterre
- Wake Forest University School of Medicine, (B.F.L., B.M.) Winston-Salem, North Carolina; Department of Internal Medicine, Section on Gerontology and Geriatrics (Palliative Care), (J.G., B.M.) Winston-Salem, North Carolina; Department of General Surgery, (B.M.) Winston-Salem, North Carolina.
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21
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van Meurs J, Wichmann AB, van Mierlo P, van Dongen R, van de Geer J, Vissers K, Leget C, Engels Y. Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams. Palliat Med 2022; 36:1493-1503. [PMID: 36305616 PMCID: PMC9749014 DOI: 10.1177/02692163221122367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Patients receiving palliative care value attention given to their spiritual needs. However, these needs often remain unexplored as healthcare professionals lack the skills to identify and explore them and to integrate this information into care plans. AIM To evaluate the effects of an interactive communication training intervention for palliative care teams in order to identify and explore the spiritual dimension and integrate it in patients' care plans. DESIGN A mixed methods pre-post study, including self-assessment questionnaires, evaluation of videos with simulated consultations (applied competence) and medical record review (implementation). SETTING/PARTICIPANTS Three palliative care teams including nurses (N = 21), physicians (N = 14) and spiritual caregivers (N = 3). RESULTS The questionnaires showed an improvement on 'Patient and family-centred communication' of the End-of-life professional caregiver survey (+0.37, p < 0.01; the 8-item S-EOLC (+0.54, p < 0.01) and regarding the Spiritual Care Competence Scale, on the three subscales used (+0.27, p < 0.01, +0.29, p < 0.01 and +0.32, p < 0.01). Video evaluations showed increased attention being paid to patient's aims and needs. The medical record review showed an increase in anticipation on the non-somatic dimension (OR: 2.2, 95% CI: 1.2-4.3, p < 0.05) and, using the Mount Vernon Cancer Network assessment tool, addressing spiritual issues (OR: 10.9, 95% CI: 3.7-39.5, p < 0.001). CONCLUSIONS Our training intervention resulted in increased palliative care professionals' competence in identifying and exploring patients' spiritual issues, and their integration in multidimensional proactive palliative care plans. The intervention directly addresses patients' spiritual concerns and adds value to their palliative care plans.
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Affiliation(s)
- Jacqueline van Meurs
- Department of Spiritual and Pastoral Care & Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anne B Wichmann
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Patricia van Mierlo
- Department of Geriatrics & Centre of Supportive and Palliative Care, Rijnstate Arnhem, The Netherlands
| | - Robert van Dongen
- Department of Pain Management and Palliative Care, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands and Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joep van de Geer
- Chaplain at Academic Hospice Demeter, Bilthoven and Policy Advisor Spiritual Care in Palliative Care at Agora, The Netherlands
| | - Kris Vissers
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carlo Leget
- Department of Care and Welfare, University of Humanistic Studies, Utrecht, The Netherlands
| | - Yvonne Engels
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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Oliveira GMMD, Almeida MCCD, Marques-Santos C, Costa MENC, Carvalho RCMD, Freire CMV, Magalhães LBNC, Hajjar LA, Rivera MAM, Castro MLD, Avila WS, Lucena AJGD, Brandão AA, Macedo AVS, Lantieri CJB, Polanczyk CA, Albuquerque CJDM, Born D, Falcheto EB, Bragança ÉOV, Braga FGM, Colombo FMC, Jatene IB, Costa IBSDS, Rivera IR, Scholz JR, Melo Filho JXD, Santos MAD, Izar MCDO, Azevedo MF, Moura MS, Campos MDSB, Souza OFD, Medeiros OOD, Silva SCTFD, Rizk SI, Rodrigues TDCV, Salim TR, Lemke VDMG. Position Statement on Women's Cardiovascular Health - 2022. Arq Bras Cardiol 2022; 119:815-882. [PMID: 36453774 PMCID: PMC10473826 DOI: 10.36660/abc.20220734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Daniel Born
- Escola Paulista de Medicina , São Paulo SP - Brasil
| | | | | | | | | | | | | | - Ivan Romero Rivera
- Hospital Universitário Professor Alberto Antunes / Universidade Federal de Alagoas , Maceió AL - Brasil
| | | | | | | | | | | | | | | | | | | | | | - Stéphanie Itala Rizk
- Instituto do Coração (Incor) do Hospital das Clínicas FMUSP , São Paulo SP - Brasil
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23
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Gargiulo MT, Hernán Vázquez S. Incommensurability: an obstacle to the integration of psychotherapy and spirituality. the desert fathers as an overcoming epistemological paradigm. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:341-350. [PMID: 36404247 DOI: 10.1016/j.rcpeng.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 12/28/2020] [Indexed: 06/16/2023]
Abstract
In recent years, the body of literature that deals with trying different ways of integrating spirituality into psychotherapeutic practice has grown exponentially. Probably the interest in this topic has arisen with regard to the inclusion in the DSM-IV of the new category "Religious or Spiritual Problem" (Code V62.89). Until then, religious or spiritual issues had been viewed in the clinical practice as symptoms of some mental illnesses like, for example, the delusions with religious content typical of schizophrenics. But with the fourth edition of the aforementioned manual, there began to be an interest in the study of spirituality as it expresses a fundamental aspect of personality. In this vein, various models of integration of spirituality and psychotherapy have been formulated. Our intention is to study the problem of incommensurability as one of the epistemological and methodological problems that supposes a project of this type. We present the writings of the Desert Fathers as an explanatory model that guarantees an epistemologically legitimate integration of spiritual traditions with psychotherapeutic practice. And for that reason, we argue that their writings could constitute a way to overcome the relationship of mutual incommensurability that apparently exists between scientific rationality and spirituality.
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Stang V, Barnes P, Enfield C, Koots H. Competencies for Spiritual Care Professionals Specializing in Palliative and Bereavement Care in Canada: A Mixed-Methods Study Using Qualitative Interviews and Modified Delphi Survey. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2022; 76:171-180. [PMID: 35593093 DOI: 10.1177/15423050221101818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of this project was to update competencies for spiritual care professionals specializing in palliative and bereavement care in Canada. Phase one feedback was obtained from 11 clients: six inpatients with greater than two weeks of life expectancy using interviews and five bereaved family members in a focus group. Results were analyzed for congruence or discordance with draft competencies. In phase two, 22 spiritual care experts reached a consensus on nine competencies using a modified Delphi survey. Two limitations were the small sample size and cultural and religious homogeneity of participants.
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Laranjeira C, Baptista Peixoto Befecadu F, Da Rocha Rodrigues MG, Larkin P, Pautex S, Dixe MA, Querido A. Exercising Hope in Palliative Care Is Celebrating Spirituality: Lessons and Challenges in Times of Pandemic. Front Psychol 2022; 13:933767. [PMID: 35846675 PMCID: PMC9278349 DOI: 10.3389/fpsyg.2022.933767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,Research in Education and Community Intervention (RECI I&D), Piaget Institute, Viseu, Portugal
| | - Filipa Baptista Peixoto Befecadu
- Palliative and Supportive Care Service and Institute of Higher Education and Research in Healthcare, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Maria Goreti Da Rocha Rodrigues
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western, Lausanne, Switzerland.,High School of Health (HEdS), Geneva, Switzerland
| | - Philip Larkin
- Palliative and Supportive Care Service and Institute of Higher Education and Research in Healthcare, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sophie Pautex
- Department of Readaptation and Geriatrics, Palliative Medicine Division, University Hospital Geneva and University of Geneva, Geneva, Switzerland
| | - Maria Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, Porto, Portugal
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26
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Gao J, Wang Q, Wu Q, Weng Y, Lu H, Xu J. Spiritual care for the management of Parkinson's disease: Where we are and how far can we go. Psychogeriatrics 2022; 22:521-529. [PMID: 35644375 DOI: 10.1111/psyg.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 11/27/2022]
Abstract
An increasing number of studies have investigated the neural networks and brain regions activated by different aspects of religious faith or spiritual practice. The extent to which religiousness and spirituality are dependent on the integrity of neural circuits is a question unique to neurological illnesses. Several studies have reported that neural networks and brain areas represent the various components of religious faith or spiritual activity in recent decades. In addition to research in healthy people, another strategy is to observe if neurological abnormalities caused by stroke, tumour, brain damage, or degenerative sickness are accompanied by an alteration in religiosity or spirituality. Similarly, Parkinson's disease (PD), an ailment characterized by dopaminergic neuron malfunction, has been utilized to explore the role of dopaminergic networks in the practice, experience, and maintenance of religious or spiritual beliefs. Case-control and priming studies have demonstrated a decline in spirituality and religion in people with PD due to dopaminergic degeneration. These studies could not adequately control for confounding variables and lacked methodological rigour. Using qualitative and quantitative assessments, a mixed-method approach might shed additional light on putative religious beliefs alterations in PD. In the current review paper, we discussed the recent research on the impact of PD on spiritual beliefs and spirituality.
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Affiliation(s)
- Jia Gao
- Science and Research Office, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Qunjuan Wang
- Neurology Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Qin Wu
- Neurology Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Yu Weng
- Neurology Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Huamei Lu
- Nursing Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Jingzhi Xu
- Neurology Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
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Türkben Polat H, Özdemir AA. Relationship between Compassion and Spiritual Care among Nurses in Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:1894-1905. [PMID: 34032974 PMCID: PMC8144689 DOI: 10.1007/s10943-021-01287-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to determine the effect of the compassion level of nurses on the frequency of their provision of spiritual care therapeutics to patients. The research was conducted as a correlational descriptive study and included 253 nurses working in a university hospital in Turkey between October and December 2020. The data were collected via an online survey using psychometrically valid scales to assess the nurses' compassion and provision of spiritual care therapeutics. The nurses had a high compassion level and a medium level of spiritual care therapeutics. Compassion level explained 31% of the frequency of spiritual care therapeutics. As nurses' compassion levels increased, the frequency of their provision of spiritual care therapeutics to patients also increased.
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Smith C, Lakin T. Effects of an Interprofessional Spiritual Care Education Project. J Hosp Palliat Nurs 2022; 24:78-83. [PMID: 34840281 DOI: 10.1097/njh.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Spiritual care is a critical aspect of end-of-life care that is often undervalued and underaddressed by hospice health care teams. The purpose of this quality improvement project was to determine if the implementation of an evidence-based spiritual care protocol changed practices regarding the initial assessment of spiritual needs, frequency of reassessment of needs, the inclusion of spiritual interventions, and staff perspectives on spiritual care. The preimplementation and postimplementation data evaluation displayed increased compliance with spiritual needs assessment within 5 days of admission, increased reassessment intervals, an increase in the percentage of interactions that included spiritual interventions, and improved staff perspectives on spiritual care. The findings of the study support implementation of a spiritual care protocol in hospice patients.
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Antunes ML, Reis-Pina P. The Physician and End-of-Life Spiritual Care: The PALliatiVE Approach. Am J Hosp Palliat Care 2022; 39:1215-1226. [PMID: 35044883 DOI: 10.1177/10499091211068819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Spiritual care is universally acknowledged as a cornerstone of palliative care, yet most healthcare professionals find it difficult to address. The present work aims to provide a simple educational tool that may help physicians address spirituality in their clinical practice. We found articles written in both Portuguese and English through PubMed, using the combination of MeSH terms: "Spirituality" and "Palliative Care." The research was complemented by relevant monographs previously known to the authors, consultation of selected references of the main bibliography, and interviews to an experienced spiritual care provider. In order to help physicians to incorporate spiritual care in their clinical practice, a flexible yet standardized approach is long overdue. This is the aim of the PALliatiVE approach, which compiles the literature in a set of 5 attitudes that may aid the clinician in the delivery of spiritual care: Prepare (P), Ask (A), Listen (L), Validate (V), and consult an Expert (E). This approach is based on a synthesis of a broad literature review, which motivated the five-layered approach. There is a significant literature coverage supporting each attitude of this five-layered approach, including at least one randomized control trial or systematic review per attitude. Though still requiring external validation, the PALliatiVE approach can be a guide to the physician on how to provide spiritual care, a practice rooted in compassion and in simply being-with the one who suffers.
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Affiliation(s)
| | - Paulo Reis-Pina
- Palliative Care Unit, Casa de Saúde da Idanha, Sintra, Portugal.,Faculty of Medicine, Ringgold:37809University of Lisbon, Lisboa, Portugal
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30
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Ünal Aslan KS, Çetinkaya F. The effects of therapeutic touch on spiritual care and sleep quality in patients receiving palliative care. Perspect Psychiatr Care 2022; 58:374-382. [PMID: 33861467 DOI: 10.1111/ppc.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/04/2021] [Accepted: 03/21/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was conducted to investigate the effect of therapeutic touch (TT) on spiritual care and sleep quality in patients receiving palliative care. DESIGN AND METHODS The research was conducted on 73 inpatients receiving palliative care in a training and research hospital. Data were collected with Socio-Demographic Status Questionnaire, Spirituality and Spiritual Care Rating Scale (SSCRS), Pittsburgh Sleep Quality Index (PSQI). FINDINGS As a result of this study, a statistically significant difference was found between the intervention and control group SSCRS (Z = -7.356 p = 0.000) and PSQI (Z = -7.292 p = 0.000) in post-test data after 4 weeks of TT application. PRACTICE IMPLICATIONS The results revealed that TT application has a positive impact on spiritual care and sleep quality of the patients.
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Affiliation(s)
- Kevser S Ünal Aslan
- Fundamentals of Nursing Department, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Funda Çetinkaya
- Department of Surgical Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
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31
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Anandarajah G, Roseman J, Mennillo LG, Kelley B. Spirituality in Primary Palliative Care and Beyond: A 20-Year Longitudinal Qualitative Study of Interacting Factors Impacting Physicians' Spiritual Care Provision Over Time. J Pain Symptom Manage 2021; 62:1216-1228. [PMID: 34051292 DOI: 10.1016/j.jpainsymman.2021.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 12/25/2022]
Abstract
CONTEXT Spiritual care (SC) is central to palliative care. However, a mismatch between patients' desire for SC and physicians' SC provision remains. The shortage of specialty-trained palliative physicians, necessitates that all physicians provide primary palliative care, including SC. Although several quantitative studies explore physicians' barriers to SC, few qualitative studies and no longitudinal studies exist. OBJECTIVE To gain in-depth understanding of factors influencing physicians' ability to provide SC over time. METHODS A 20-year longitudinal, individual interview study. In study year-1, we interviewed all residents in a USA primary care residency (full study-group) regarding SC beliefs, experiences and skills. The longitudinal study-group (PGY1 subgroup) was interviewed again in study-years 3, 11, and 20. Interviews were audio-recorded and transcribed. Four researchers analyzed transcripts using a grounded theory approach. IRB approval was obtained. RESULTS We analyzed 66 interviews from 34 physicians. Physicians had diverse personal spiritual beliefs. Seven themes emerged from both groups (response rate 89%): patients' needs; practice setting; beliefs regarding physician's role; personal spiritual beliefs; SC training; life experiences (professional, personal); self-care and reflection. Longitudinal interviews revealed thematic evolution and interactions over 20-years: patients' needs and physicians' belief in whole-person care remained primary motivators; cross-cultural SC communication training diminished impact of personal spiritual beliefs and worries; life experiences enhanced SC skills; work environment helped or hindered SC provision; and spiritual self-care/reflection fostered patient-centered, compassionate SC. CONCLUSION Facilitating SC provision by nonpalliative care specialists is complex and may require both individual and systems level interventions fostering motivation, SC skill development, and supportive work environments.
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Affiliation(s)
- Gowri Anandarajah
- Warren Alpert Medical School, Brown University (G.A.,B.K.), Providence, Rhode Island; Hope Hospice and Palliative Care Rhode Island (G.A.), Providence, Rhode Island.
| | - Janet Roseman
- Nova Southeastern College of Osteopathic Medicine (J.R.), Florida
| | | | - Brendan Kelley
- Warren Alpert Medical School, Brown University (G.A.,B.K.), Providence, Rhode Island
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Peng-Keller S, Moergeli H, Hasenfratz K, Naef R, Rettke H, Hefti R, Ljutow A, Rittmeyer I, Sprott H, Rufer M. Including the Spiritual Dimension in Multimodal Pain Therapy. Development and Validation of the Spiritual Distress and Resources Questionnaire (SDRQ). J Pain Symptom Manage 2021; 62:747-756. [PMID: 33631326 DOI: 10.1016/j.jpainsymman.2021.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 01/19/2023]
Abstract
CONTEXT Valid instruments for assessing spiritual resources and distress in pain therapy are scarce. The Spiritual Distress and Resources Questionnaire (SDRQ) was developed to fill this gap. GOALS The objective of this study was to investigate the SDRQ's psychometric properties. METHODS We presented the SDRQ to 219 patients with chronic pain conditions and examined its measurement properties, namely reliability and structural, convergent and discriminant validity. To investigate test-retest reliability, the SDRQ was presented a second time to a subsample of 58 randomly selected participants. RESULTS Factor analysis required a grouping of the 22 SDRQ items into four subscales: spiritual distress, spiritual coping, immanence and transcendence, the latter two representing spiritual resources. Cronbach's alpha was high for spiritual distress (0.93), transcendence (0.85), and immanence (0.81) while it was somewhat lower but still satisfactory for spiritual coping (0.70). The construct validity of the SDRQ was shown by correlations with established measures in the field. Higher levels of spiritual distress were associated with signs of more severe illness, such as emotional distress and pain intensity. CONCLUSION The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.
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Affiliation(s)
| | - Hanspeter Moergeli
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | | | - Rahel Naef
- University Hospital Zurich, Centre of Clinical Nursing Science, Zurich, Switzerland; University of Zurich, Institute for Implementation Science in Health Care, Zurich, Switzerland
| | - Horst Rettke
- University Hospital Zurich, Centre of Clinical Nursing Science, Zurich, Switzerland; University of Zurich, Institute for Implementation Science in Health Care, Zurich, Switzerland
| | - René Hefti
- Clinic SGM Langenthal und Research Institute for Spirituality and Health, Langenthal, Switzerland
| | - André Ljutow
- Centre for Pain Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
| | | | - Haiko Sprott
- University of Zurich and Arztpraxis Hottingen, Zurich, Switzerland
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
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33
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Nobre F, Esporcatte R, Brandão AA, Avezum Á, Feitosa ADM, Amodeo C, Barbosa ECD, Moriguchi EH, Lucchese FA, Griz HB, Nicolau JC, Magalhães LBNC, Mota-Gomes MA, Borba MHED, Pontes MRN, Jardim PCBV, Spineti PPDM, Mourilhe-Rocha R, Miranda RD, Couceiro SLM, Barroso WKS. Position Statement on Hypertension and Spirituality - 2021. Arq Bras Cardiol 2021; 117:599-613. [PMID: 34550245 PMCID: PMC8462965 DOI: 10.36660/abc.20210723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fernando Nobre
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP - Brasil.,Hospital São Francisco, Ribeirão Preto, SP - Brasil
| | - Roberto Esporcatte
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ - Brasil.,Hospital Pró-Cradíaco, Rio de Janeiro, RJ - Brasil
| | | | - Álvaro Avezum
- Hospital Alemão Oswaldo Cruz, São Paulo, SP - Brasil
| | - Audes Diógenes Magalhães Feitosa
- Universidade Federal de Pernambuco, Recife, PE - Brasil.,Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
| | - Celso Amodeo
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | | | | | | | - José Carlos Nicolau
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | | | | | | | - Weimar Kunz Sebba Barroso
- Liga de Hipertensão Arterial, Goiânia, GO - Brasil.,Universidade Federal de Goiás, Goiânia, GO - Brasil
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Liu VLX, Lin SC, Harding R. Conceptual Models and Mechanisms of Action that Underpin End-of-Life Care Interventions to Improve Spiritual Well-Being. J Palliat Med 2021; 25:106-118. [PMID: 34435877 DOI: 10.1089/jpm.2021.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Understanding the conceptual models that underpin interventions, and the linkage between mechanisms of action and their intended outcomes, makes replication possible. Aim: To identify and appraise conceptual models and mechanisms of action underpinning end-of-life care interventions to improve spiritual well-being. Design: A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis was conducted. Data sources: A comprehensive search was performed in eight databases from inception to January 12, 2021. Results: A logic model was developed and potential mechanisms of action were identified from the seven included studies. Conclusion: First, conceptual models that have relevance and appropriateness to cultural setting are required to underpin future intervention development and implementation. Second, careful intervention development should articulate the link between concept, mechanisms, and outcomes. Third, selection of valid outcome measured must have a strong justification of how the construct being measured relates to the intervention goals.
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Affiliation(s)
- Victoria Liang-Xin Liu
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
| | - Shih-Chun Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
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35
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Wysocka M, Wawrzyniak M, Jarosz J, Hordowicz M, Klimkiewicz A. Is There a Connection Between Spiritual Transcendence and Quality of Life? A Cross-Sectional Survey Study in Patients Under the End-of-Life Care. J Palliat Care 2021; 38:10-16. [PMID: 34397294 DOI: 10.1177/08258597211034642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: There is limited data available on the spiritual dimension of palliative care in Eastern Europe. In countries such as Poland, investigating spirituality and its essential aspects is further complicated because in a predominantly Catholic country, spirituality is mistakenly thought to be identical to religiousness. Aim: This study investigated the connection between spiritual transcendence, meaning in life, altruism, and the quality of life of cancer patients in end-of-life care in an Eastern Europe Country (Poland). Design: This cross-sectional study was based on 4 surveys. The Quality of Life Questionnaire MQOL-R, the Scale of Spiritual Transcendence, the Purpose in Life Questionnaire PIL-6, and the Altruism Scale were used. Setting/Participants: Data from 41 oncology patients receiving end-of-life care at home and in a stationary hospice was obtained. Results: Results indicate that there is a significant positive correlation between transcendence, spiritual growth, and global quality of life. There is also a positive correlation between altruism and the meaning of life, as well as between the meaning of life, spirituality and quality of life, while altruism is positively associated exclusively with spirituality. Conclusion: This study revealed that spiritual transcendence can be understood, according to Piedmont's theory, as a personality trait that allows the patients to cross the boundaries of their existence and identify subjectively important values in their life. It can be examined and developed not only in the context of the need but also as a predisposition and a resource of personhood.
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Affiliation(s)
- Maria Wysocka
- Department of Social Psychology and Personality, SWPS University, Poland.,St. Christopher Oncology Hospice Foundation, Poland.,Department of Medical Ethics and Palliative Medicine, Medical University of Warsaw, Poland
| | | | - Jerzy Jarosz
- St. Christopher Oncology Hospice Foundation, Poland
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Comparison of Perceptions of Spiritual Care Among Patients With Life-Threatening Cancer, Primary Family Caregivers, and Hospice/Palliative Care Nurses in South Korea. J Hosp Palliat Nurs 2021; 22:532-551. [PMID: 33044420 DOI: 10.1097/njh.0000000000000697] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to compare perceptions of spiritual care among patients with life-threatening cancer, their primary family caregivers, and hospice/palliative care nurses.Data were collected using both structured and unstructured approaches. Structured questionnaire data were examined using statistical analysis methods, and unstructured data were examined using content analysis to compare the 3 participant groups. The questionnaire revealed that among all 3 groups, spiritual care was commonly perceived to relate to "having the opportunity for internal reflection," "finding meaning," "encouraging hope," and "listening to and being with patients." Content analysis of the unstructured data revealed 5 themes: "Caring with sincerity," "Strengthening spiritual resources," "Alleviating physical pain and discomfort" (among patients and primary family caregivers only), "Improving spiritual care service," and "Multifaceted cooperation" (among hospice/palliative care nurses only). Our findings suggest that for patients with life-threatening illnesses such as terminal cancer, spiritual care should not be limited to religious practice but should also satisfy inner existential needs, for example, by encouraging hope, providing empathy, and helping patients find meaning in their circumstances.
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37
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Britt KC, Acton G. Exploring the Meaning of Spirituality and Spiritual Care with Help From Viktor Frankl. J Holist Nurs 2021; 40:46-55. [PMID: 34166126 DOI: 10.1177/08980101211026776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Problem: A difficult concept to understand, spirituality is not often addressed in healthcare. Purpose: This paper will explore the concept of spirituality and spiritual care using the theory of meaning by Viktor Frankl. Implications: Authors will provide ways for nurses to think about spiritual needs and spiritual care for patients and identify barriers to spiritual care implementation. Suggestions are made for spiritual inquiry, resources are provided for spiritual care education and training, and recommendations are made for nursing education curricula and health care policy change. Conclusions: With a greater understanding of spirituality, nurses practicing holistic care can increase their spiritual care competence and implement spiritual care into practice.
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Cipta A, Turner B, Haupt EC, Werch H, Reinke L, Mularski RA, Nguyen HQ. Spiritual distress: symptoms, quality of life and hospital utilisation in home-based palliative care. BMJ Support Palliat Care 2021; 11:322-328. [PMID: 34088743 DOI: 10.1136/bmjspcare-2021-003090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/21/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The purpose of this study was to use a spiritual screening question to quantify the prevalence of spiritual distress (SD) in a large cohort of seriously ill patients at admission to home-based palliative care (HBPC) and to examine the associations between SD with symptom burden, quality of life and hospital-based utilisation up to 6 months after admission to HBPC. METHODS Data for this cohort study (n=658) were drawn from a pragmatic comparative-effectiveness trial testing two models of HBPC. At admission to HBPC, SD was measured using a global question (0-10-point scale: none=0; mild=1-4; moderate-to-severe=5+); symptoms and quality of life were measured with the Edmonton Symptom Assessment Scale (ESAS) and PROMIS-10. Hospital utilisation was captured using electronic records and claims. Median regression and proportional hazard competing risk models assessed the association between SD with symptoms and quality of life, and hospital utilisation, respectively. RESULTS Nearly half of the patients/proxies reported some level of SD. Increasing SD was significantly associated with higher symptom burden (increase of 7-14 points on ESAS) and worse mental well-being (decrease of 2.7 to 4.6 points on PROMIS-10-mental) in adjusted models. Compared with patients/proxies who reported no SD, those with at least some level of SD were not at increased risk for hospital-based utilisation over a median follow-up period of 2 months. CONCLUSION While SD is cross-sectionally associated with worse symptoms and mental well-being, it did not predict downstream hospital-based utilisation. Our results highlight the importance of assessing for and managing SD in patients with serious illness.
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Affiliation(s)
- Andre Cipta
- West Los Angeles Medical Center, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Bethany Turner
- San Diego Medical Center, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Eric C Haupt
- Department of Research and Evaluation, Kaiser Permanente Southern California Research and Evaluation, Pasadena, California, USA
| | | | - Lynn Reinke
- VA Puget Sound Health Care System Seattle Division, Seattle, Washington, USA
| | - Richard A Mularski
- Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, USA
| | - Huong Q Nguyen
- Department of Research and Evaluation, Kaiser Permanente Southern California Research and Evaluation, Pasadena, California, USA
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39
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Esperandio MRG, de Souza YQ, Nadalin O, Hefti R. Spirituality in Clinical Practice: The Perspective of Brazilian Medical Students. JOURNAL OF RELIGION AND HEALTH 2021; 60:2154-2169. [PMID: 33420650 DOI: 10.1007/s10943-020-01141-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to evaluate the beliefs, opinions, and experiences of medical students from a Catholic confessional university concerning spirituality in medical practice. This is a descriptive and cross-sectional study with a sample of 323 undergraduate students, of which 162 were in their first two years of their studies and 161 in the final two years. A validated questionnaire consisting of 58 questions was applied. Although the spiritual dimension was recognized as important for patient care, 95% of students were not familiar with spiritual and religious issues. Advanced students reported that they had not received adequate training in this area. Therefore, this topic should be included in the medical curriculum, preferably in the first years.
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Affiliation(s)
- Mary Rute Gomes Esperandio
- Post-Graduate Program in Bioethics, Pontifical Catholic University of Paraná (PUCPR), Rua Imaculada Conceição, 1155 - Prado Velho, Curitiba, PR, 80215-901, Brazil.
| | - Yasmin Quiroga de Souza
- Pontifical Catholic University of Paraná (PUCPR), Rua Imaculada Conceição, 1155 - Prado Velho, Curitiba, PR, 80215-901, Brazil
| | - Odenir Nadalin
- Pontifical Catholic University of Paraná (PUCPR), Rua Imaculada Conceição, 1155 - Prado Velho, Curitiba, PR, 80215-901, Brazil
| | - René Hefti
- Lecturer for Spiritual Care, University of Basel, Head of the Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
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Farfán-Zúñiga X, Jaman-Mewes P. Understanding the experience of nursing students' internship at a palliative care unit: A phenomenological research study. NURSE EDUCATION TODAY 2021; 100:104848. [PMID: 33743515 DOI: 10.1016/j.nedt.2021.104848] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 02/02/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Palliative care is characterised as a holistic, interdisciplinary and humanised approach to care. It transcends the traditional bio-medical perspective in health through a bio-psycho-social and spiritual approach. Holistic point of view in palliative care is essential, and needs to be consistently hi-lighted to nursing students to improve end of life care. OBJECTIVE To describe nursing students' experience in a palliative care unit in Santiago, Chile. DESIGN A qualitative phenomenological study utilising purposive sampling of 10 nursing students from a Chilean university was undertaken, who completed their final year in a palliative care unit between 2017 and 2019. METHODS Data were collected using in-depth interviews, which were conducted, recorded, transcribed and analysed according to Streubert-Carpenter method. This study was approved by the Ethics Committee of Universidad de los Andes, Chile. RESULTS Three main themes were identified in the data with their consequent units of meaning; these were experiences from all participants. The first theme identified was the diverse learning experiences students had. Topics included were: spirituality, dignity, teamworking and communication with the patient and family. They also identified personal growth. The second theme was living through the experience of difficult times; this included how they dealt facing death and how they found meaning on this. Also, patient loneliness, abandonment and the impact of shortage of human and material resources. The final theme was recognising that touching patients is often the essence of nursing and is paramount in palliative care. CONCLUSIONS Completing a placement in a palliative care unit contributes to student nurses' personal and professional development. It provides multiple tools related to the care of terminally-ill patients and their families. It is recommended to undergraduate nurses have the opportunity to experience palliative care throughout curriculum and that they learn to embed theory to practice.
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Affiliation(s)
| | - Paula Jaman-Mewes
- Universidad de los Andes, Chile, Facultad de Enfermería y Obstetricia, Chile.
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Beaussant Y, Tulsky J, Guérin B, Schwarz-Plaschg C, Sanders JJ. Mapping an Agenda for Psychedelic-Assisted Therapy Research in Patients with Serious Illness. J Palliat Med 2021; 24:1657-1666. [PMID: 33848208 DOI: 10.1089/jpm.2020.0764] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: With support from the Radcliffe Institute for Advanced Study at Harvard University, we convened researchers representing palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies. We aimed to define priorities and envision an agenda for future research on psychedelic-assisted therapies in patients with serious illness. Over two days in January 2020, participants engaged in an iterative series of reflective exercises that elicited their attitude and perspectives on scientific opportunities for this research. Objectives: The aim of the study is to identify themes that shape priorities and an agenda for research on psychedelic-assisted therapy for those affected by serious illness. Methods: We collected data through preconference interviews, audio recordings, flip charts, and sticky notes. We applied thematic qualitative analysis to elucidate key themes. Results: We identified seven key opportunities to advance the field of psychedelic-assisted therapies in serious illness care. Four opportunities were related to the science and design of psychedelic-assisted therapies: clarifying indications; developing and refining therapeutic protocols; investigating the impact of set and setting on therapeutic outcomes; and understanding the mechanisms of action. The other three pertained to institutional and societal drivers to support optimal and responsible research: education and certification for therapists; regulations and funding; and diversity and inclusion. Additionally, participants suggested epistemological limitations of the medical model to understand the potential value and therapeutic use of psychedelics. Conclusions: Medicine and society are witnessing a resurgence of interest in the effects and applications of psychedelic-assisted therapies in a wide range of settings. This article suggests key opportunities for research in psychedelic-assisted therapies for those affected by serious illness.
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Affiliation(s)
- Yvan Beaussant
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - James Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Benjamin Guérin
- Laboratoire Logiques de l'Agir EA 2274 and Université de Franche-Comté, Besançon, France.,Laboratoire de Neurosciences Intégratives et Cliniques, Université de Franche-Comté, Besançon, France
| | | | - Justin J Sanders
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Hamill Howard E, Schwartz R, Feldstein B, Grudzen M, Klein L, Piderman KM, Wang D. Harnessing the Chaplain's Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department. J Palliat Care 2021; 37:480-485. [PMID: 33818162 DOI: 10.1177/08258597211003359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To explore chaplains' ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. METHODS A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age ≥80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. RESULTS Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. CONCLUSION Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.
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Affiliation(s)
| | - Rachel Schwartz
- WellMD Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Bruce Feldstein
- Spiritual Care Service, Stanford Health Care, Stanford, CA, USA.,Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.,Jewish Chaplaincy Services serving Stanford Medicine, a program of Jewish Family & Children's Services of San Francisco, the Peninsula, Marin and Sonoma Counties, CA, USA
| | - Marita Grudzen
- Stanford Geriatric Education Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Lori Klein
- Spiritual Care Service, Stanford Health Care, Stanford, CA, USA
| | - Katherine M Piderman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.,Transforming Chaplaincy, Chicago, IL, USA
| | - David Wang
- Palliative Medicine, Scripps Health, San Diego, CA, USA
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Rahman S, Elbi H, Cakmakci Cetinkaya A, Altan S, Ozan E, Pirincci E. Factors that predict the perception of spirituality and spiritual care of nurses working in high-risk units and the effect of death anxiety. Perspect Psychiatr Care 2021; 57:473-480. [PMID: 33196114 DOI: 10.1111/ppc.12651] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/04/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Spirituality contributes to the health and well-being of individuals. This study investigates the factors that predict the spirituality perceptions and the effect of death anxiety of nurses. DESIGN AND METHODS This was a cross-sectional study, 382 nurses working in four public hospitals intensive care and emergency departments setting in two different cities in Turkey. FINDINGS Variables predicting the total and subscale scores of the Spirituality and Spiritual Care Rating Scale of nurses were determined by linear multiple regression analysis. Except for the religiousness subscale, the satisfaction level of nurses was found to be a significant predictor in total of Spirituality and Spiritual Care Scale. PRACTICE IMPLICATIONS Nurses working in high-risk units are unclear about their perception of spirituality and spiritual care.
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Affiliation(s)
- Suheyla Rahman
- Department of Medical Education, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Huseyin Elbi
- Department of Family Medicine, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Aynur Cakmakci Cetinkaya
- Department of Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Selim Altan
- Department of Medical History and Ethics, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Erol Ozan
- Department of Psychiatry, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Edibe Pirincci
- Department of Public Health, Faculty of Medicine, Fırat University, Elazığ, Turkey
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Gargiulo MT, Vázquez SH. Incommensurability: An Obstacle to the Integration of Psychotherapy and Spirituality. The Desert Fathers as an Overcoming Epistemological Paradigm. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(21)00027-5. [PMID: 33771362 DOI: 10.1016/j.rcp.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/27/2019] [Accepted: 12/28/2020] [Indexed: 10/21/2022]
Abstract
In recent years, the body of literature that deals with trying different ways of integrating spirituality into psychotherapeutic practice has grown exponentially. Probably the interest in this topic has arisen with regard to the inclusion in the DSM-IV of the new category "Religious or Spiritual Problem" (Code V62.89). Until then, religious or spiritual issues had been viewed in the clinical practice as symptoms of some mental illnesses like, for example, the delusions with religious content typical of schizophrenics. But with the fourth edition of the aforementioned manual, there began to be an interest in the study of spirituality as it expresses a fundamental aspect of personality. In this vein, various models of integration of spirituality and psychotherapy have been formulated. Our intention is to study the problem of incommensurability as one of the epistemological and methodological problems that supposes a project of this type. We present the writings of the Desert Fathers as an explanatory model that guarantees an epistemologically legitimate integration of spiritual traditions with psychotherapeutic practice. And for that reason, we argue that their writings could constitute a way to overcome the relationship of mutual incommensurability that apparently exists between scientific rationality and spirituality.
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Handzo RG, Hughes RB. Commentary on Chaplain-Physician Interactions From the Chaplain's Perspective: A Mixed Method Analysis. Am J Hosp Palliat Care 2021; 39:144-146. [PMID: 33739151 DOI: 10.1177/10499091211003080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Gomez and her colleagues have presented a helpful study of the relationship of the chaplains in her health system to physicians which highlights several barriers to a well-integrated relationship and thus to more optimal patient care. We have seen these same barriers as we have consulted with health systems nationally and have also identified many best practices that mediate or even eliminate many of these barriers. This commentary describes some of what we have seen as chaplain-generated causes of those barriers and effective strategies that have been employed to overcome them. We also provide some resources for chaplains who wish to institute some of these best practices themselves.
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Affiliation(s)
- Rev George Handzo
- Health Services Research & Quality, 101595HealthCare Chaplaincy Network, New York, NY, USA
| | - Rev Brian Hughes
- Programs and Services, 101595HealthCare Chaplaincy Network, New York, NY, USA
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Kang KA, Kim SJ, Kim DB, Park MH, Yoon SJ, Choi SE, Choi YS, Koh SJ. A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation. BMC Palliat Care 2021; 20:30. [PMID: 33563253 PMCID: PMC7871309 DOI: 10.1186/s12904-021-00718-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). METHODS The modules' content was informed by Viktor Frankl's meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants' demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). RESULTS We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs' SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). CONCLUSIONS The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.
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Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Shin-Jeong Kim
- School of Nursing, Hallym University, 39 Hallymdaehak-gil, Chuncheon, Gangwon-do 24252 Republic of Korea
| | - Do-Bong Kim
- Holistic Healing Institute of Sam Medical Center, Gunpo, Republic of Korea
| | - Myung-Hee Park
- Hospice & Palliative Center, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Soo-Jin Yoon
- Dongbaek St. Luke Hospice, Gyeonggi-do, Republic of Korea
| | - Sung-Eun Choi
- Hospice Care Center of the Regional Cancer Center, Chungnam University Hospital, Daejeon, Republic of Korea
| | - Young-Sim Choi
- Department of Nursing, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Kwak J, Cho S, Handzo G, Hughes BP, Hasan SS, Luu A. The Role and Activities of Board-Certified Chaplains in Advance Care Planning. Am J Hosp Palliat Care 2021; 38:1495-1502. [PMID: 33504174 DOI: 10.1177/1049909121989996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Healthcare chaplains have key roles in providing palliative support to patients and families, and they are well-suited to facilitate advance care planning (ACP). However, empirical data on the roles and responsibilities of chaplains in facilitating ACP are limited. OBJECTIVES To examine the roles of board-certified healthcare chaplains in ACP in various healthcare settings. METHODS A cross-sectional, web-based self-report survey was conducted with 585 board-certified chaplains recruited from 3 major professional chaplains' organizations in the U.S. The survey data included chaplains' demographic and professional characteristics, their roles and responsibilities, and responses regarding communication and participation with other healthcare team members in facilitating ACP, including experienced barriers. RESULTS More participants worked in community hospital settings (42%) and academic medical centers (19.6%) than in any other setting. Over 90% viewed ACP as an important part of their work, 70% helped patients complete advance directives, and 90% helped patients discuss their preferences about end-of-life treatments. Many chaplains were not consistently included in team discussions regarding decision-making, although most chaplains reported that they could always find ways to communicate with their teams. CONCLUSION Professional board-certified chaplains regularly engage in facilitating ACP discussions with patients and families in various healthcare settings. There is a need to recognize and provide systematic support for the role of chaplains in facilitating ACP conversations and to integrate chaplains into routine interdisciplinary team and family meetings.
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Affiliation(s)
- Jung Kwak
- School of Nursing, 12330The University of Texas at Austin, TX, USA
| | - Soyeon Cho
- Human Services Department, The City University of New York, City Tech, Brooklyn, New York, NY, USA
| | - George Handzo
- 101595HealthCare Chaplaincy Network, New York, NY, USA
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Kang KA, Chun J, Kim HY, Kim HY. Hospice palliative care nurses' perceptions of spiritual care and their spiritual care competence: A mixed-methods study. J Clin Nurs 2021; 30:961-974. [PMID: 33434358 DOI: 10.1111/jocn.15638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/10/2020] [Accepted: 12/31/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To understand hospice palliative care nurses' (HPCNs) perceptions towards spiritual care and their competence to provide spiritual care. BACKGROUND Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients' spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited. DESIGN A mixed-methods research design was used. METHODS Quantitative data were collected from 282 nurses in forty hospice palliative care (HPC) institutions in South Korea and analysed using descriptive statistics, independent t-test, one-way ANOVA with Bonferroni test and multiple regression. Qualitative data collection involved two stages: first, an open-ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative data sets were analysed separately using content analysis. This study followed the GRAMMS guidelines. RESULTS Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in 'attitude towards the patient's spirituality' and 'communication', whereas the 'assessment and implementation of spiritual care' and 'professionalisation and improving the quality of spiritual care' had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardised terminology, and the opportunity to reflect on nurses' own spirituality. CONCLUSIONS Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance. RELEVANCE TO CLINICAL PRACTICE The results of this study provide a useful resource to develop educational programmes for strengthening the SCC of nurses and the entire HPC team.
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Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Korea
| | - Jiyoung Chun
- College of Nursing, Sahmyook University, Seoul, Korea
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Bond R, Brown NS. Testing of a (Spiritual) Self-Assessment Tool ((S)SAT) in a Community Hospital Setting. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2020; 74:229-233. [PMID: 33228494 DOI: 10.1177/1542305020949443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The (Spiritual) Self-Assessment Tool Study was designed to test the novel engagement tool's effectiveness. Providing the (Spiritual) Self-Assessment Tool Study to newly admitted medical patients led to few instances where the tool was completed. Nevertheless, the (Spiritual) Self-Assessment Tool Study patient questionnaire generated significant secondary findings: a third of responding patients consider their hospital care incomplete without their care team having access to (Spiritual) Self-Assessment Tool data. Nursing staff also desire this data, but are unable to access it without the (Spiritual) Self-Assessment Tool or an equivalent source.
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Affiliation(s)
- Robert Bond
- Niagara Health, Canada; McMaster University, Canada
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McNamara LC, Okoniewski W, Maurer SH, Moehling K, Hall DE, Schenker Y. "Give them the door but don't push them through it": Family Attitudes Toward Physician-Led Spiritual Care in Pediatric Palliative Medicine. JOURNAL OF RELIGION AND HEALTH 2020; 59:2899-2917. [PMID: 32052280 DOI: 10.1007/s10943-020-00991-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Little is known about pediatric caregivers' perceptions of religious or spiritual (R/S) care provided by physicians. We conducted a qualitative, semistructured interview study to understand perceptions of pediatric caregivers toward physician-led R/S care. Participants were 20 primary caregivers whose children were hospitalized and receiving palliative care services. Interviews were audio recorded, transcribed verbatim, and analyzed using constant comparative methods. Three recurrent themes emerged regarding physician-led R/S care: (1) Most caregivers view providing R/S care as a positive sign of physician empathy, while a minority (3/20) prefer to keep R/S and medical care separate, (2) many caregivers prefer R/S care from a physician with whom they have a close relationship and/or share a faith background, and (3) physicians should open the door, but allow families to lead conversations about R/S care. Caregivers have mixed perceptions on physicians engaging in R/S care; most prefer that families set the direction of R/S care for themselves and their loved ones. Physicians should be trained to evaluate families' spiritual backgrounds and needs in ways that respectfully open the door to these conversations.
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Affiliation(s)
- Laura C McNamara
- Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | | | - Scott H Maurer
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Krissy Moehling
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel E Hall
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Bioethics and Health Law, University of Pittsburgh, Pittsburgh, PA, USA
- Wolff Center at UPMC, UPMC, Pittsburgh, PA, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Yael Schenker
- Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA
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