CAPTURING WHOLE PERSON CARE

Spiritual Care within Dietetic Practice: A Systematic Literature Review

Registered dietitians assess, diagnose and treat nutritional problems. Although integral to healthcare, their role in spiritual care is unknown. We conducted a systematic review of spiritual needs and spiritual care in nutrition and dietetic practice. Subject Headings and keywords were used to search Medline, CINAHL, PsycINFO and AMED for studies exploring spiritual care and nutrition or dietetic practice. From 1433 records, 13 studies were included. Medium quality evidence showed unmet spiritual needs among dietetic patients suffering from cancer, COPD, heart failure and diabetes. Unmet needs occurred in patients from a variety of ethnicities, religions and none. However, dietitians were only involved in spiritual care regarding nutrition and hydration at the end of life. Integrating spiritual screening and sign-posting within dietetic practice is prudent, but clinical trials are needed to evaluate its effectiveness.

Understanding the impact of haemodialysis on UK National Health Service patients' well-being: A qualitative investigation

Aims and objectives

While haemodialysis is an effective treatment for end‐stage renal disease, the requirements and restrictions it imposes on patients can be onerous. The aim of this study was to obtain UK National Health Service patients’ perspectives on the challenges arising from haemodialysis with the intention of identifying potential improvements.

Background

Depression rates are particularly high in those with end‐stage renal disease; however, there is limited insight into the range of stressors associated with haemodialysis treatment within the National Health Service contributing to such high rates, particularly those of a cognitive or psychological nature.

Design

A qualitative approach was used to obtain rich, patient‐focused data; one‐to‐one semi‐structured interviews were conducted with twenty end‐stage renal disease at a UK National Health Service centre.

Methods

Patients were interviewed during a typical haemodialysis session. Thematic analysis was used to systematically interpret the data. Codes were created in an inductive and cyclical process using a constant comparative approach.

Results

Three themes emerged from the data: (i) fluctuations in cognitive/physical well‐being across the haemodialysis cycle, (ii) restrictions arising from the haemodialysis treatment schedule, (iii) emotional impact of haemodialysis on the self and others. The findings are limited to predominantly white, older patients (median = 74 years) within a National Health Service setting.

Conclusions

Several of the experiences reported by patients as challenging and distressing have so far been overlooked in the literature. A holistic‐based approach to treatment, acknowledging all aspects of a patient's well‐being, is essential if optimal quality of life is to be achieved by healthcare providers.

Relevance to clinical practice

The findings can be used to inform future interventions and guidelines aimed at improving patients’ treatment adherence and outcomes, for example, improved reliable access to mental health specialists.