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McDarby M, Miller M, Rosa WE, Buller H, Ferrell BR. Multidisciplinary oncology clinicians' experiences delivering spiritual care to patients with cancer and their care partners. Support Care Cancer 2024; 32:586. [PMID: 39136780 PMCID: PMC11382597 DOI: 10.1007/s00520-024-08773-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: 05/01/2024] [Accepted: 07/29/2024] [Indexed: 09/08/2024]
Abstract
PURPOSE To understand multidisciplinary healthcare clinicians' meaningful and challenging experiences providing spiritual care to patients with cancer and their care partners. METHODS Multidisciplinary clinicians who participated in a communication training program supported by the National Cancer Institute or a palliative care training for nurses (N = 257) responded to two, open-ended questions about meaningful and challenging experiences of providing spiritual care. A thematic analysis of responses using an iterative, inductive approach was conducted until saturation was reached. RESULTS Participants from nursing (68%), social work (22%), and chaplaincy (10%) responded to open-ended survey questions. Three themes related to meaningful experiences of providing spiritual care emerged: building authentic interpersonal connection with patients and care partners; creating intentional space for patients and care partners to inform spiritual care; and actively supporting patients and care partners in their processes with spirituality. Three themes related to challenging experiences of providing spiritual care emerged: contextual factors and clinical circumstances complicate provision of spiritual care; facing barriers to providing high-quality, patient-centered care; and navigating ethical and logistical issues that affect spiritual and other care. CONCLUSION Clinicians derive meaning from a range of experiences throughout their provision of spiritual care to patients with cancer. However, they also face many challenges in delivering person-centered spiritual care in cancer settings, with some challenges reflecting significant gaps in spiritual care knowledge and training. Findings can guide future training and educational endeavors for multidisciplinary clinicians in the domain of spiritual care.
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Affiliation(s)
- Meghan McDarby
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Avenue, 4th floor, New York, NY, 10017, USA.
| | - Megan Miller
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - William E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Avenue, 4th floor, New York, NY, 10017, USA
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Wang EY, Pan A, Srinivas T, Loftus J, Geller G, Carrese JA, Antoine D, Fingerhood M. Patient and Physician Perspectives on Discussing Addiction Recovery and Spirituality in the Primary Care Setting. J Gen Intern Med 2024:10.1007/s11606-024-08939-9. [PMID: 39028404 DOI: 10.1007/s11606-024-08939-9] [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: 11/19/2023] [Accepted: 07/05/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Spirituality is an important component of recovery for many individuals with substance use disorder (SUD). However, few studies have compared patient and physician attitudes on spirituality in SUD recovery. OBJECTIVE This study investigates patient and physician beliefs about the role of spirituality in SUD recovery and about discussing spirituality in relationship to recovery in primary care settings. DESIGN Semi-structured interviews were conducted with primary care physicians recruited at two academic hospitals, and patients recruited from a faith-based residential therapeutic community. Interview transcripts were independently coded by two researchers and a grounded theory approach was used to generate themes that reflected participants' experiences. KEY RESULTS Interviews were conducted with 15 patients and 10 physicians. Patients had diverse views about the impact of spirituality on their SUD recovery, including positive, negative, and neutral. Patient and physician opinions on discussing spirituality in a primary care setting differed: most physicians felt positively towards this, believing that understanding their patients' spirituality helped them care for their patients as whole people. Many patients felt neutral, stating that they did not feel like these conversations were necessary for their care, and that they believed physicians preferred not to discuss spirituality in medical settings. Tolerance from both the patient and physician, open-ended questioning, and an individualized approach were identified as facilitators to effective discussions about spirituality and recovery. CONCLUSIONS Spirituality can have diverse effects on an individual's SUD recovery. Physicians endorsed the benefits of discussing spirituality in the context of their patients' recovery, while patients expressed reservations about engaging in these conversations with their physicians. This variation in perspectives highlights the need for additional research to understand the individual and structural factors that contribute to it, as well as best practices for engaging in effective, non-judgmental conversations about spirituality in recovery.
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Affiliation(s)
- Erin Y Wang
- Division of Addiction Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
| | - Annabelle Pan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tara Srinivas
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John Loftus
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gail Geller
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joseph A Carrese
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Denis Antoine
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Fingerhood
- Division of Addiction Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Tanzi S, Artioli G, Bertocchi E, Balestra GL, Ghirotto L, Cagna M, Laurenti F, Sacchi S. Experiential training course on spirituality for multidisciplinary palliative care teams in a hospital setting: a feasibility study. BMC Palliat Care 2024; 23:38. [PMID: 38336683 PMCID: PMC10858494 DOI: 10.1186/s12904-024-01341-6] [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] [Received: 02/24/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND There is widespread agreement about the importance of spiritual training programs (STPs) for healthcare professionals caring for cancer patients, and that reflecting on one's spirituality is the first step. Health professionals (HPs) working in hospitals must develop this dimension to guarantee the quality of life as well as spiritual and emotional support. In this paper, we propose a possible training format for hospital professionals and assess its implementation. METHODS This is a phase 0-I study that follows the Medical Research Council (MRC) framework. The program was implemented for hospital palliative care specialists. The program included one theory lesson, three spiritual interactions, four pieces of reflective writing, and two individual follow-up sessions for each participant. The evaluation was performed quantitatively according to the MRC framework and qualitatively according to Moore's framework with data triangulation from interviews, reflective writings, and indicators. RESULTS The program was implemented for palliative care physicians, nurses, psychologists, and bioethicists according to the plan, and the program components were highly appreciated by the participants. The results suggest the feasibility of a training course with some corrections, regarding both the components of the training and organizational issues. The qualitative analysis confirmed a shift in the meaning of the themes we identified. The trainees went from intrapersonal spirituality to interpersonal spirituality (engagement with the other person's spirituality, acknowledging their unique spiritual and cultural worldviews, beliefs, and practices), with colleagues, patients, and people close to them. The training had an impact on Moore's Level 3b. CONCLUSIONS Spiritual training for hospital professionals working in palliative care is feasible. Having time dedicated to spirituality and the ongoing mentorship of spiritual care professionals were suggested as key elements. The next step is increasing awareness of spirituality from our hospital reality and creating a stable competent group (with nurses, chaplains, nuns, counselors, etc.) with the support of the management.
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Affiliation(s)
- Silvia Tanzi
- Palliative Care Unit, Azienda USL-IRCCS, Reggio Emilia, Italy.
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | | | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | | | | | - Simona Sacchi
- Palliative Care Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
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Best MC, Jones K, Merritt F, Casey M, Lynch S, Eisman JA, Cohen J, Mackie D, Beilharz K, Kearney M. Australian Patient Preferences for Discussing Spiritual Issues in the Hospital Setting: An Exploratory Mixed Methods Study. JOURNAL OF RELIGION AND HEALTH 2024; 63:238-256. [PMID: 36807254 PMCID: PMC10861658 DOI: 10.1007/s10943-023-01767-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
While there is high patient acceptance for clinical staff discussing issues regarding spirituality with hospital inpatients, it is not clear which staff member patients prefer for these discussions. This unique exploratory study investigated inpatient preferences regarding which staff member should raise the topic of spirituality. A cross-sectional survey was conducted with inpatients at six hospitals in Sydney, Australia (n = 897), with a subset invited to participate in qualitative interviews (n = 41). Pastoral care staff (32.9%) were the preferred staff members with whom to discuss spiritual issues, followed by doctors (22.4%). Qualitative findings indicated that individual characteristics of the staff member are more important than their role.
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Affiliation(s)
- Megan C Best
- Institute for Ethics and Society, University of Notre Dame Australia, Broadway, PO Box 944, Sydney, NSW, 2007, Australia.
| | - Kate Jones
- Institute for Ethics and Society, University of Notre Dame Australia, Broadway, PO Box 944, Sydney, NSW, 2007, Australia
| | - Frankie Merritt
- The School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
| | - Michael Casey
- The School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
| | - Sandra Lynch
- Institute for Ethics and Society, University of Notre Dame Australia, Broadway, PO Box 944, Sydney, NSW, 2007, Australia
| | - John A Eisman
- The School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
- St Vincent's Private Hospital, Sydney, Australia
- St Vincent's Hospital, Sydney, Australia
- Faculty of Medicine, University of NSW, Kensington, NSW, Australia
| | - Jeffrey Cohen
- The School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
- St Vincent's Private Hospital, Sydney, Australia
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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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No One Dies Alone: A Unique Volunteer Program. J Christ Nurs 2023; 40:59-61. [PMID: 36469879 DOI: 10.1097/cnj.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT No One Dies Alone is a hospital-based volunteer program that provides a caring human presence at the end of life for patients when nurses cannot remain at the bedside. No One Dies Alone volunteers offer peace of mind for families who can know their loved ones will not die alone. Volunteers live out the second greatest commandment of loving your neighbor as yourself by providing a calming presence, voice, touch, support, and validation of feelings. A case study illustrates the value of a volunteer's presence.
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Rykkje L, Søvik MB, Ross L, McSherry W, Cone P, Giske T. Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review. J Clin Nurs 2022; 31:1440-1464. [PMID: 34611922 DOI: 10.1111/jocn.16067] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To map existing evidence about educational interventions or strategies in nursing and allied healthcare concerning students' and staffs' spiritual care provision. BACKGROUND Spiritual care is an important part of whole person care, but healthcare staff lack competence and awareness of spiritual issues in practice. To rectify this, it is important to identify what educational approaches are most helpful in supporting them to provide spiritual care. DESIGN A scoping review using the PRISMA-ScR checklist. METHOD Searches in the databases CINAHL, MEDLINE, ATLA and ERIC were conducted for papers spanning January 2009-May 2020. Search terms were related to spirituality, spiritual care, education and clinical teaching. Appraisal tools were used. RESULTS From the 2128 potentially relevant papers, 36 were included. The studies were from 15 different countries and involved nurses, physicians and other health-related professions, and both quantitative, qualitative and mixed methods were used. The results are presented in three themes: Understanding of spirituality, Strategies in educational settings, and Strategies in practice settings. The review points to great diversity in the content, lengths and setting of the educational interventions or strategies. CONCLUSIONS Courses in spiritual care should be implemented in curricula in both undergraduate and postgraduate education, and several studies suggest it should be mandatory. Courses should also be available for healthcare staff to raise awareness and to encourage the integration of spiritual care into their everyday practice. There is a need for greater consensus about how spirituality and spiritual care are described in healthcare settings. RELEVANCE TO CLINICAL PRACTICE Spiritual care must be included both in monodisciplinary and multidisciplinary educational settings. The main result of spiritual care courses is in building awareness of spiritual issues and self-awareness. To ensure the provision of spiritual care for patients in healthcare practices, continuing and multidisciplinary education is recommended.
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Affiliation(s)
- Linda Rykkje
- Faculty of Health Studies, VID Specialized University, Bergen, Norway
| | | | - Linda Ross
- School of Care Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Wilfred McSherry
- Faculty of Health Studies, VID Specialized University, Bergen, Norway.,Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK
| | - Pamela Cone
- School of Nursing, Azusa Pacific University, Azusa, California, USA
| | - Tove Giske
- Faculty of Health Studies, VID Specialized University, Bergen, Norway
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Ibrahim H, Harhara T. Palliative care training: a national study of internal medicine residency program directors in the United Arab Emirates. BMC Palliat Care 2022; 21:44. [PMID: 35365150 PMCID: PMC8973813 DOI: 10.1186/s12904-022-00935-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 03/24/2022] [Indexed: 11/04/2022] Open
Abstract
Background Internal medicine residents are responsible for providing much of the direct care for palliative and terminally ill patients in teaching hospitals in the United Arab Emirates (UAE). To date, little systematic information is available on the prevalence of palliative care (PC) programs or faculty in UAE academic hospitals, or on the nature of PC education in internal medicine residency programs in the country. Methods Semi-structured interviews were conducted with program directors of all 7 internal medicine residency programs in the UAE. Qualitative content analysis was conducted to identify recurring themes. Results All program directors agreed that PC knowledge and skills are an essential component of training for internal medicine residents, but have had variable success in implementing the components. Three themes emerged, namely lack of structured PC training, perceptions of resident preparedness, and barriers to implementing a PC curriculum. Conclusion Internal medicine residency programs in the UAE currently lack structured, mandatory PC curricula and have limited opportunities for formal teaching and assessment of PC knowledge and skills. The planned development of comprehensive oncology and palliative care centers and ongoing curricular reform in teaching hospitals in the country will provide important opportunities to train a cadre of competent health professionals to provide high quality palliative and end-of-life care to UAE patients and their families. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00935-2.
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Fang HF, Susanti HD, Dlamini LP, Miao NF, Chung MH. Validity and reliability of the spiritual care competency scale for oncology nurses in Taiwan. BMC Palliat Care 2022; 21:16. [PMID: 35114991 PMCID: PMC8815162 DOI: 10.1186/s12904-022-00903-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 01/06/2022] [Indexed: 02/07/2023] Open
Abstract
Background Nurses must have spiritual competence to provide holistic patient care. Therefore, the designed instrument to assess nurses’ competence could be a practical guide for health care professionals. This study aimed to evaluate the validity and reliability of the spiritual care competency scale (SCCS) for oncology nurses in Taiwan. Methods This study used a convenience sample from a regional teaching hospital in Taiwan from November 2017 to February 2019, who were asked to complete the SCCS. We employed scale-content validity index (S-CVI). Exploratory Factor Analysis (EFA) was also used to evaluate the structural factor of SCCS. Confirmatory Factor Analysis (CFA) verified the construct validity of SCCS scale for oncology nurses in Taiwan. Test–retest reliability were also measured in this study at 2-week interval. Results The average S-CVI of SCCS was 0.96. The EFA produced four factors of 27 items, such as professionalization, improving the quality of spiritual care, personal support, patient counseling and referral, attitude towards patient spirituality and communication, assessment, implementation providing and evaluation of spiritual care. Fitting the 27 items yielded an acceptable model fit; X2/df = 2.41, RMSEA = 0.08, GFI = 0.80, AGFI = 0.80, CFI = 0.92, IFI = 0.92, NFI = 0.90, RFI = 0.90, TLI = 0.91, SRMR = 0.06. Cronbach’s alpha values were between 0.93 and 0.95, and the total Cronbach’s alpha was 0.96. The intraclass correlation coefficient (ICC) scores were between 0.43 and 0.88. Conclusions The result of this study demonstrated satisfactory validity and reliability for the SCCS in the nursing field in Taiwan. Implications for practice in this study serves as a reference for effectively evaluating nursing competency in spiritual care.
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Affiliation(s)
- Hui-Fen Fang
- Director of Administration Department, Taipei Cancer Center, Taipei Medical University, No. 250, Wu-Xing Street, 110, Taipei, Taiwan.,Deputy Director of Cancer Center, Taipei Medical UniversityTaipei Medical University Hospital, No. 252, Wu-Xing Street, 110, Taipei, Taiwan
| | - Henny Dwi Susanti
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, 110, Taipei, Taiwan.,Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, East Java, Indonesia
| | - Lindelwa Portia Dlamini
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, 110, Taipei, Taiwan
| | - Nae-Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, 110, Taipei, Taiwan.
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, 110, Taipei, Taiwan. .,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, No. 291, Zhongzheng Rd., Zhonghe District, 23561, New Taipei City, Taiwan.
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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: 2] [Impact Index Per Article: 1.0] [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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Jones KF, Paal P, Symons X, Best MC. The Content, Teaching Methods and Effectiveness of Spiritual Care Training for Healthcare Professionals: A Mixed-Methods Systematic Review. J Pain Symptom Manage 2021; 62:e261-e278. [PMID: 33757893 DOI: 10.1016/j.jpainsymman.2021.03.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need. OBJECTIVE The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators. METHODS A mixed-methods systematic review was conducted. The search terms ('religio*' OR 'spiritual*' OR 'existenti*') were combined with ('educat*' OR 'train*' OR 'curricul*' OR 'program*'), AND ('care' OR 'therap*' OR 'treatment' OR 'competenc*'). Search terms were entered into the following data bases: PsycINFO, Medline, Cinahl and Web of Science. Findings were restricted to peer-reviewed studies published in English between January 2010 and February 2020. RESULTS Fifty-five studies were identified. The quality of studies was mixed. Programs encompassed a range of content and teaching methods. Reported outcomes included increased levels of competency across intrapersonal spirituality, interpersonal spirituality, and spiritual assessment and interventions. Identified barriers included competing healthcare priorities, negative perceptions of spirituality and spiritual care, resistance towards focusing on one's own spirituality, staff feeling inadequate, and the need for ongoing training. Facilitators included opportunities for reflection, involvement of chaplains, application of practical tools, opportunities for practice, online training, and managerial support. CONCLUSIONS Positive outcomes following spiritual care training were identified. Further research is needed to identify patient-related outcomes of staff training, and to examine how the benefits of such training can be maintained over time.
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Affiliation(s)
- Kate Fiona Jones
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia.
| | - Piret Paal
- Institute for Nursing Science and Practice, Paracelsus Medical University, Austria
| | - Xavier Symons
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia; Plunkett Centre for Ethics, Australian Catholic University, Australia
| | - Megan C Best
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia
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Mahilall R, Swartz L. Spiritual Care: Motivations and Experiences through the Lenses and Voices of a Cohort of Spiritual Care Workers at an Established Hospice in Cape Town, South Africa. JOURNAL OF RELIGION AND HEALTH 2021; 60:2906-2924. [PMID: 33755819 PMCID: PMC7985573 DOI: 10.1007/s10943-021-01232-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
While palliative care is beginning to gain prominence in South Africa, spiritual care remains less understood. Spiritual care is less prioritised and, consequently, this service, if offered, is mostly entrusted to volunteers. It therefore becomes prudent to understand who these volunteers are, what motivates them to volunteer, and how they see spiritual care being sustainable in the future. A cohort of spiritual care workers from a prominent hospice in Cape Town, South Africa, participated in this qualitative study. The participants made suggestions about formalising spiritual care as well as making a call for a basic entry requirement into spiritual care work.
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Affiliation(s)
- Ronita Mahilall
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7700, South Africa.
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7700, South Africa
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13
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Mahilall R, Swartz L. Challenges and opportunities for spiritual care practice in hospices in a middle-income country. BMC Palliat Care 2021; 20:62. [PMID: 33888120 PMCID: PMC8062111 DOI: 10.1186/s12904-021-00756-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet. METHODS We explored spiritual care practices, and training needs, through a national quantitative online study of palliative care organisations in South Africa registered with the Hospice Palliative Care Association of South Africa. A survey was sent to representatives of all member organisations listed on the national database of Hospice Palliative Care Association of South Africa. Viable data from 41% (n = 40) member organisations were analysed through the use of simple statistics. RESULTS An expressed need (75%; n = 30) was recorded for the development of a national spiritual care curriculum. Although 48% (n = 20) of the member organisations were willing to participate in the development of a spiritual care curriculum, 37% (n = 14) could not participate, citing financial (n = 27), time (n = 31) and expertise constraints (n = 22). A set of hard and soft skills were suggested to suit the diverse South African context. CONCLUSIONS Spiritual care was seen by participants as a key component of palliative care. International curricula in spiritual care, while useful, do not offer easy adaptation to the diversities of South Africa. A bespoke spiritual care curriculum was called for, for diverse South Africa.
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Affiliation(s)
- Ronita Mahilall
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychology, Stellenbosch University, Private Bag X4, Cape Town, 7745 South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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de Vries S, Lormans T, de Graaf E, Leget C, Teunissen S. The Content Validity of the Items Related to the Social and Spiritual Dimensions of the Utrecht Symptom Diary-4 Dimensional From a Patient's Perspective: A Qualitative Study. J Pain Symptom Manage 2021; 61:287-294.e2. [PMID: 32777457 DOI: 10.1016/j.jpainsymman.2020.07.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/26/2020] [Accepted: 07/29/2020] [Indexed: 02/02/2023]
Abstract
CONTEXT In palliative care, caregivers often lack words and competences to discuss patients' needs in social and spiritual dimensions. The Utrecht Symptom Diary-4 Dimensional (USD-4D) is an instrument that can be used to monitor symptoms and needs in the physical, psychological, social, and spiritual dimensions and to optimize communication between patients and caregivers. OBJECTIVE To assess the content validity of the USD-4D items related to the social and spiritual dimensions from a patient's perspective, measured in terms of comprehensibility, relevance, and comprehensiveness. METHODS An explorative qualitative study was conducted using in-depth semistructured interviews and thematic analysis. Twelve participants (male N = 7, 53-87 years old) with an estimated life expectancy of less than one year were recruited in two home care services: a general hospital and a hospice. RESULTS The instructions, items, and response options were comprehensible for almost all participants. The meaning that was provided to the items was expressed in themes: maintaining personal identity and autonomy, resilience, letting go, perceived balance in one's life, and death and afterlife. This corresponds with the intended meaning. The items were relevant at some points in time. Not all participants had needs for personal care during the interviews. Participants found the USD-4D comprehensive, no key concepts related to the social or spiritual dimensions appeared to be missing. CONCLUSIONS The USD-4D constitutes a content valid PROM from the patient's perspective. The items support patients in identifying needs in the social and spiritual dimensions and in the conversation to further explore these needs.
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Affiliation(s)
- Sita de Vries
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tom Lormans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Everlien de Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carlo Leget
- Chair of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Saskia Teunissen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Duque PA, Betancur Manrique Y, Franco Galvis A, Hoyos Castañeda M, Valencia Hernández EE. Afrontamiento de docentes de enfermería ante la muerte del paciente en unidades de cuidado crítico. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2021. [DOI: 10.11144/javeriana.ie22.adem] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introducción. La muerte es un fenómeno que preocupa a la humanidad, por tanto, es objeto de cuidado por enfermería como parte de las competencias inherentes a la disciplina. Objetivo. Describir el nivel de afrontamiento de las enfermeras frente a la muerte de pacientes en unidades de cuidado crítico. Método. Estudio piloto observacional, de tipo descriptivo transversal, con método de muestreo probabilístico, teniendo en cuenta el número de enfermeras que se desempañaban como docentes de enfermería en el área de cuidado crítico de cuatro universidades de Pereira y Manizales (n = 30). Se aplicó encuesta autoadministrada, elaborada por las investigadoras, con datos sociodemográficos, curriculares y del perfil docente. Para evaluar el nivel de afrontamiento, se utilizó la escala de Bugen de afrontamiento de la muerte, validada al castellano. Resultados. El 100% de docentes de enfermería tuvo una experiencia cercana a la muerte con algún ser querido, y el 73.3% no había tenido ninguna preparación como enfermera acerca de la muerte, lo que se puso de manifiesto según la escala de Bugen, donde el 36.8% (n = 11) de la población puntuó por debajo del percentil 33, el 33.4% (n = 10) de la población por encima del percentil 66, y el 29.9% (n = 9) puntuó en la zona intermedia. Conclusión. Las enfermeras necesitan mejorar su nivel de afrontamiento ante la muerte, mediante una formación sólida en cuidados integrales al final de la vida y el buen morir, para lograr competencias específicas que puedan ser enseñadas en los actos docentes de manera consciente.
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Spiritual Needs of Older Adults during Hospitalization: An Integrative Review. RELIGIONS 2020. [DOI: 10.3390/rel11100529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A hospital admission presents various challenges for a patient which often result in high or intense spiritual needs. To provide the best possible care for older adults during hospitalization, it is essential to assess patients’ spiritual needs. However, little research has been done into the spiritual needs of geriatric patients. This article seeks insight into what is known in the literature on the spiritual needs of geriatric patients. This integrative review presents a summary of the articles on this topic. To select eligible studies, the PRISMA Flow Diagram was used. This resulted in ten articles that have been reviewed. Results show (1) a wide interest in researching spiritual needs, using different research designs. In addition, (2) four subcategories of spiritual needs can be distinguished: (a) the need to be connected with others or with God/the transcendent/the divine, (b) religious needs, (c) the need to find meaning in life, and (d) the need to maintain one’s identity. Moreover, results show that (3) assessing spiritual needs is required to provide the best possible spiritual care, and that (4) there are four reasons for unmet spiritual needs. Further research is needed on the definition of spiritual needs and to investigate older patients’ spiritual needs and the relation with their well-being, mental health and religious coping mechanisms, in order to provide the best spiritual care.
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Best M, Leget C, Goodhead A, Paal P. An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliat Care 2020; 19:9. [PMID: 31941486 PMCID: PMC6964109 DOI: 10.1186/s12904-019-0508-4] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The EAPC White Paper addresses the issue of spiritual care education for all palliative care professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and education; as well as national and local curricula development groups. METHODS Early in 2018, preliminary draft paper was written by members of the European Association for Palliative Care (EAPC) spiritual care reference group inviting comment on the four core elements of spiritual care education as outlined by Gamondi et al. (2013) in their paper on palliative care core competencies. The preliminary draft paper was circulated to experts from the EAPC spiritual care reference group for feedback. At the second stage feedback was incorporated into a second draft paper and experts and representatives of national palliative care organizations were invited to provide feedback and suggest revisions. The final version incorporated the subsequent criticism and as a result, the Gamondi framework was explored and critically revised leading to updated suggestions for spiritual care education in palliative care. RESULTS The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different development stages of the palliative care services across the European region. CONCLUSIONS Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all palliative care staff.
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Affiliation(s)
- Megan Best
- Senior Lecturer, Institute for Ethics and Society, University of Notre Dame, Fremantle, Australia
- Post-doctoral research fellow, PoCoG and Sydney Health Ethics, University of Sydney, PO Box, 944, Broadway NSW 2007, Sydney, Australia
| | - Carlo Leget
- Professor in Care Ethics at the University of Humanistic Studies, Kromme Nieuwegracht 29, Utrecht, 3512 HD The Netherlands
| | - Andrew Goodhead
- Spiritual Care Lead, St Christopher’s Hospice, 51/59 Lawrie Park Road, London, Sydenham SE26 6DZ UK
| | - Piret Paal
- Researcher at the Palliative Care Research Hub, Institute of Nursing Science and Practice, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg, Austria
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Hu Y, Leeuwen RV, Li F. Psychometric properties of the Chinese version of the spiritual care competency scale in nursing practice: a methodological study. BMJ Open 2019; 9:e030497. [PMID: 31601590 PMCID: PMC6797272 DOI: 10.1136/bmjopen-2019-030497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To determine the validity and reliability of the Spiritual Care Competency Scale (SCCS) among nurses in China. DESIGN Methodological research. METHODS After the SCCS was translated into Chinese, the validity and reliability of the Chinese version of the SCCS (C-SCCS) were evaluated using a convenience sample of 800 nurses recruited from different healthcare centres. The construct validity of the C-SCCS was determined by an exploratory factor analysis (EFA) with promax rotation. Pearson's correlation coefficients of the C-SCCS and the Palliative Care Spiritual Care Competency Scale (PCSCCS-M) were computed to assess the concurrent validity and construct validity of the C-SCCS. To verify the quality of the component structure, we conducted a confirmatory factor analysis (CFA). We tested the internal consistency and stability of the measure using Cronbach's alpha coefficient and the Guttman split-half coefficient, respectively, and a factorial analysis was performed. RESULTS A total of 709 participants completed the questionnaire (response rate: 88.63%), and all completed questionnaires were suitable for analysis. Three factors were abstracted from the EFA and explained 58.19% of the total variance. The Cronbach's alpha coefficients of the three subscales were .93, .92, and .89, and the Guttman split-half coefficient for the C-SCCS was .84. The CFA indicated a well-fitting model, and the significant correlations between the C-SCCS and the PCSCCS-M (r=0.67, p<0.01) showed adequate concurrent validity. Nurses' education and income level showed a significant association with the C-SCCS score. CONCLUSION The C-SCCS was shown to be a psychometrically sound instrument for evaluating Chinese nurses' spiritual care competencies.
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Affiliation(s)
- Yanli Hu
- School of Nursing, Jilin University, Changchun, China
| | - René Van Leeuwen
- Health Care, Viaa Christian University of Applied Sciences, Zwolle, The Netherlands
| | - Fan Li
- School of Nursing, Jilin University, Changchun, China
- Health Care, Viaa Christian University of Applied Sciences, Zwolle, The Netherlands
- The Key Laboratory for Bionics Engineering, Ministry of Education, Jilin University, Changchun, China
- Engineering Research Center for Medical Biomaterials of Jilin Province, Jilin University, Changchun, China
- Key Laboratory for Biomedical Materials of Jilin Province, Jilin University, Changchun, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang University, Xinjiang, China
- Department of Pathogenobiology, The Key Laboratory of Zoonosis Research, Chinese Ministry of Education, College of Basic Medicine, Jilin University, Changchun, China
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