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Nassehi A, Saake I, Breitsameter C, Bauer A, Barth N, Berger K, Gigou S. "Do you Really Believe that There is Something More?" - The Offer of Transcendental Communication by Pastoral Care Workers in German Hospices and Palliative Care Units: A Qualitative Study. Am J Hosp Palliat Care 2024; 41:730-738. [PMID: 37485839 PMCID: PMC11070121 DOI: 10.1177/10499091231191220] [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: 07/25/2023] Open
Abstract
BACKGROUND Palliative Care also encompasses the dimension of spiritual pain. Pastoral care workers and chaplains are specialists in the provision of spiritual care. Decreasing religious affiliation and increasing spiritual diversification in modern societies raise the question of the function of pastoral care. AIM The goal of this study is to answer the question of what pastoral care workers can offer to dying residents in hospices and palliative care units. DESIGN A qualitative interview study was designed to explore the specific perspective of pastoral care workers in a multidisciplinary environment. The study is based on differentiation theory which is particularly well adjusted to reveal differences in perspectives in so called 'holistic' care settings. The reporting follows the COREQ guidelines. SETTING Problem centered interviews were conducted at five hospices and two palliative care units. RESULTS Eight pastoral care workers were interviewed (5 Catholic, 3 Protestant, mean age of 58 years). The analysis of the interviews revealed three major themes: (A) Self-positioning in relation to the organization, (B) Offering conversations to patients and relatives, (C) Performing religious rituals. Minor themes were: mediating conflicts between patients, relatives and staff, sensing moods in silence with patients and organizing workshops for staff. CONCLUSION In modern hospice care, pastoral care workers routinely address the problem of making death more tangible and of answering the unanswerable question of what comes afterwards. Through this, they support dying residents in hospices and palliative care units in dealing with the inexplicability of death.
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Affiliation(s)
- Armin Nassehi
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
| | - Irmhild Saake
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
| | | | - Anna Bauer
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
| | - Niklas Barth
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
| | - Katharina Berger
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
| | - Sophie Gigou
- Department of Sociology, Ludwig-Maximilians-University, Muenchen, Germany
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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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Phiri GG, Muge-Sugutt J, Porock D. Palliative and End-of-Life Care Access for Immigrants Living in High-income Countries: A Scoping Review. Gerontol Geriatr Med 2023; 9:23337214231213172. [PMID: 38026093 PMCID: PMC10666706 DOI: 10.1177/23337214231213172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
This scoping review aimed to explore what is known about palliative and End-of-Life (EOL) care access by immigrants with culturally and linguistically diverse (CALD) background living in high-income Organization for Economic Co-operation and Development (OECD) countries. CaLD immigrants have low utilization of palliative care services with patients' family members taking up the role of caring, leading to immigrants not fully benefiting from the specialized services that are offered to alleviate suffering and promote quality of life. While there is some research in this area mainly in Europe, it cannot be said about all high-income OECD countries. Achieving person-centered care in high-income countries, requires identifying and addressing barriers to care access, especially by immigrants with CaLD background. Five-stage methodological framework by Arksey and O'Malley was used to undertake the review. Immigrants in OECD countries experience challenges in accessing palliative and EOL care services. The review also identified limited literature on the subject and establishes need for more research on the subject.
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Scherer JS, Milazzo KC, Hebert PL, Engelberg RA, Lavallee DC, Vig EK, Kurella Tamura M, Roberts G, Curtis JR, O'Hare AM. Association Between Self-reported Importance of Religious or Spiritual Beliefs and End-of-Life Care Preferences Among People Receiving Dialysis. JAMA Netw Open 2021; 4:e2119355. [PMID: 34347059 PMCID: PMC8339933 DOI: 10.1001/jamanetworkopen.2021.19355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Although people receiving maintenance dialysis have limited life expectancy and a high burden of comorbidity, relatively few studies have examined spirituality and religious beliefs among members of this population. OBJECTIVE To examine whether there is an association between the importance of religious or spiritual beliefs and care preferences and palliative care needs in people who receive dialysis. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional survey study was conducted among adults who were undergoing maintenance dialysis at 31 facilities in Seattle, Washington, and Nashville, Tennessee, between April 22, 2015, and October 2, 2018. The survey included a series of questions assessing patients' knowledge, preferences, values, and expectations related to end-of-life care. Data were analyzed from February 12, 2020, to April 21, 2021. EXPOSURES The importance of religious or spiritual beliefs was ascertained by asking participants to respond to this statement: "My religious or spiritual beliefs are what really lie behind my whole approach to life." Response options were definitely true, tends to be true, tends not to be true, or definitely not true. MAIN OUTCOMES AND MEASUREMENTS Outcome measures were based on self-reported engagement in advance care planning, resuscitation preferences, values regarding life prolongation, preferred place of death, decision-making preference, thoughts or discussion about hospice or stopping dialysis, prognostic expectations, and palliative care needs. RESULTS A total of 937 participants were included in the cohort, of whom the mean (SD) age was 62.8 (13.8) years and 524 (55.9%) were men. Overall, 435 (46.4%) participants rated the statement about religious or spiritual beliefs as definitely true, 230 (24.6%) rated it as tends to be true, 137 (14.6%) rated it as tends not to be true, and 135 (14.4%) rated it as definitely not true. Participants for whom these beliefs were more important were more likely to prefer cardiopulmonary resuscitation (estimated probability for definitely true: 69.8% [95% CI, 66.5%-73.2%]; tends to be true: 60.8% [95% CI, 53.4%-68.3%]; tends not to be true: 61.6% [95% CI, 53.6%-69.6%]; and definitely not true: 60.6% [95% CI, 52.5%-68.6%]; P for trend = .003) and mechanical ventilation (estimated probability for definitely true: 42.6% [95% CI, 38.1%-47.0%]; tends to be true: 33.5% [95% CI, 25.9%-41.2%]; tends not to be true: 35.1% [95% CI, 27.2%-42.9%]; and definitely not true: 27.9% [95% CI, 19.6%-36.1%]; P for trend = .002) and to prefer a shared role in decision-making (estimated probability for definitely true: 41.6% [95% CI, 37.7%-45.5%]; tends to be true: 35.4% [95% CI, 29.0%-41.8%]; tends not to be true: 36.0% [95% CI, 26.7%-45.2%]; and definitely not true: 23.8% [95% CI, 17.3%-30.3%]; P for trend = .001) and were less likely to have thought or spoken about stopping dialysis. These participants were no less likely to have engaged in advance care planning, to value relief of pain and discomfort, to prefer to die at home, to have ever thought or spoken about hospice, and to have unmet palliative care needs and had similar prognostic expectations. CONCLUSIONS AND RELEVANCE The finding that religious or spiritual beliefs were important to most study participants suggests the value of an integrative approach that addresses these beliefs in caring for people who receive dialysis.
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Affiliation(s)
- Jennifer S Scherer
- Division of Geriatrics and Palliative Care, Department of Internal Medicine, NYU Grossman School of Medicine, New York
- Division of Nephrology, Department of Internal Medicine, NYU Grossman School of Medicine, New York
| | - Kaylin C Milazzo
- Division of Geriatrics and Palliative Care, Department of Internal Medicine, NYU Grossman School of Medicine, New York
- Department of Spiritual Care, NYU Langone Health, New York
| | - Paul L Hebert
- Department of Health Services, University of Washington, Seattle
- US Department of Veterans Affairs (VA) Health Services Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, Washington
| | - Ruth A Engelberg
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Danielle C Lavallee
- Department of Health Services, University of Washington, Seattle
- Department of Surgery, University of Washington, Seattle
- British Columbia Academic Health Science Network, Vancouver, British Columbia, Canada
| | - Elizabeth K Vig
- Division of Geriatrics, Department of Medicine, University of Washington, Seattle
- Geriatrics and Extended Care, VA Puget Sound Health Care System, Seattle, Washington
| | - Manjula Kurella Tamura
- Division of Nephrology, Stanford University Medical Center, Palo Alto, California
- Geriatric Research and Education Clinical Center and Division of Nephrology, VA Palo Alto Health Care System, Palo Alto, California
| | - Glenda Roberts
- Kidney Research Institute, University of Washington, Seattle
| | - J Randall Curtis
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Ann M O'Hare
- US Department of Veterans Affairs (VA) Health Services Research and Development Center of Innovation, VA Puget Sound Health Care System, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle
- Division of Nephrology, Department of Medicine, University of Washington, Seattle
- Hospital Specialty and Medicine Service, VA Puget Sound Health Care System, Seattle, Washington
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Louise Cooper K, Luck L, Chang E, Dixon K. What is the practice of spiritual care? A critical discourse analysis of registered nurses' understanding of spirituality. Nurs Inq 2020; 28:e12385. [PMID: 33017505 DOI: 10.1111/nin.12385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022]
Abstract
Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non-denominational public hospital and a faith-based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study. Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers.
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Affiliation(s)
| | - Lauretta Luck
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Esther Chang
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Kathleen Dixon
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
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Toward a clinical model for patient spiritual journeys in supportive and palliative care: Testing a concept of human spirituality and associated recursive states. Palliat Support Care 2020; 19:28-33. [PMID: 32729457 DOI: 10.1017/s1478951520000607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In 2015, a Chaplaincy Research Consortium generated a model of human spirituality in the palliative care context to further chaplaincy research. This article investigates the clinical fit of (a) the model's fundamental premise of universal human spirituality and (b) its 4 proposed stage descriptors (Discovery, Dialogue, Struggle, and Arrival). METHOD First, we collected qualitative data from an interdisciplinary palliative care focus group. Participants (n = 5) shared responses to the statement "the human spirit has essential commonalities across [ … ] groups and [ … ] attributes." Participants also shared vignettes of spiritual care, and 48 vignettes illustrating patients' spiritual journeys were subsequently taken from the transcript of that group. Second, we invited different mixed discipline palliative care professionals (n = 9) to individually card sort these vignettes to the model's 4 stage descriptors; we conducted pattern analysis on the results. We then administered a third step, convening six physicians to complete the card sort again, this time allowing designation of cards to one or two of the 4 stage descriptors. RESULTS Focus group participants were supportive of the model's all-encompassing definition of spirituality. The concept of "connectedness" was a shared focus for all participants, connectedness and spirituality appearing almost synonymous. Pattern analysis of assigned 48 vignettes to the 4 stages showed stronger consensus around Discovery and Arrival than Struggle and Dialogue. Results of the additional card sort suggested Struggle and Dialogue involve oscillation and are harder to think of as a steady state as distinct from processes associated with Discovery or Arrival. SIGNIFICANCE OF RESULTS "Connectedness" is a productive concept for modeling human spiritual experience near the end of life. As one healthcare professional said: "this connectedness piece is [ … ] what I always look for … " Although further work is needed to understand struggle and dialogue elements in peoples' spiritual journeys, discovery and arrival shared consensus among participants.
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Affiliation(s)
- Yi-Hui Lee
- College of Nursing and Health, Wright State University-Miami Valley, Dayton, Ohio, USA
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Kincheloe DD, Stallings Welden LM, White A. A Spiritual Care Toolkit: An evidence-based solution to meet spiritual needs. J Clin Nurs 2018; 27:1612-1620. [PMID: 29315996 DOI: 10.1111/jocn.14265] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To determine differences between baseline spiritual perspectives of nurses, patients and their families and examine the effectiveness of a spiritual care (SC) toolkit as an intervention to facilitate meeting spiritual needs of hospitalised patients and families. BACKGROUND Provision of SC by nurses in the acute care environment is an issue of high priority for patients. Nurses report lack of time, comfort, training, cultural knowledge and mobilisation of resources as obstacles to SC delivery. Evidence points to positive patient outcomes and patient satisfaction, yet few studies include interventions to help nurses meet spiritual needs of patients and families. DESIGN Descriptive and quasi-experimental design. METHODS Patients, family members (n = 132) and nurses (n = 54) were administered SC surveys while hospitalised on two acute care units of a Midwest hospital system in the United States. Population represented patients suffering acute, chronic and terminal illness. Data collected over a 13-week period examined relationships between the groups spiritual perspectives and the effectiveness of a SC toolkit intervention. RESULTS Significant differences between nurse-patient and nurse-family groups were found, whereas no significant differences existed between patient-family groups. A pretest-posttest revealed the SC toolkit aided in overcoming obstacles to nurses' SC delivery. Patients and their family members found the SC toolkit helpful. CONCLUSIONS Findings suggest an evidence-based SC toolkit has the propensity to help nurses meet spiritual needs of hospitalised patients and families. However, successful implementation and sustainability require organisational support, funding for resources and SC training for staff. RELEVANCE TO CLINICAL PRACTICE A SC toolkit supplied with culturally sensitive faith resources supporting what patients and families value, believe and practice can be easily customised and implemented by any healthcare organisation in the world. Further investigation of SC toolkit effectiveness using multiple sites is recommended.
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Affiliation(s)
- Donna D Kincheloe
- Medical-Telemetry-Renal Unit, Deaconess Gateway Hospital, Deaconess Gateway Campus, Newburgh, IN, USA
| | | | - Ann White
- The University Southern Indiana College of Nursing and Health Professions, Evansville, IN, USA
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Lai C, Luciani M, Di Mario C, Galli F, Morelli E, Ginobbi P, Aceto P, Lombardo L. Psychological impairments burden and spirituality in caregivers of terminally ill cancer patients. Eur J Cancer Care (Engl) 2018; 27:e12674. [DOI: 10.1111/ecc.12674] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- C. Lai
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - M. Luciani
- Psychiatry and Psychology Institute; Catholic University of Sacred Heart; Rome Italy
| | - C. Di Mario
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - F. Galli
- Dynamic and Clinical Psychology; Sapienza University of Rome; Rome Italy
| | - E. Morelli
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
| | - P. Ginobbi
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
| | - P. Aceto
- Department of Anaesthesiology and Intensive Care; Catholic University of Sacred Heart; Rome Italy
| | - L. Lombardo
- U.O. di Cure Palliative, Fondazione Sanità e Ricerca; Rome Italy
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Caldeira S, Aparício M, Pinto S, Silva RS. Bringing ‘forgiveness’ into the International Classification for Nursing Practice. Int J Palliat Nurs 2016; 22:421-422. [DOI: 10.12968/ijpn.2016.22.9.421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sílvia Caldeira
- PhD in Nursing, MSc Bioethics, Post Graduate Diploma in Paediatric Nursing, Assistant Professor at School of Nursing, Lisbon and researcher at the Centre for Interdisciplinary Research in Health, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Portugal
| | - Maria Aparício
- PhD Student in Universidad de Navarra, Pamplona, Spain. MSc Palliative Care, Nursing Diploma. Staff nurse at St John's Hospice, London, UK
| | - Sara Pinto
- PhD Student in Nursing Sciences, Instituto de Ciências Biomédicas Abel Salazar, University of Porto. MSc Palliative Care, Nursing Diploma. Staff nurse at Centro Hospitalar de São João, Portugal
| | - Rita Santos Silva
- MSc student in palliative care, Universidade Católica Portuguesa. Staff nurse at Palliative Care Unit, Hospital da Luz, Lisbon, Portugal
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Evangelista CB, Lopes MEL, Costa SFGD, Batista PSDS, Batista JBV, Oliveira AMDM. Cuidados paliativos e espiritualidade: revisao integrativa da literatura. Rev Bras Enferm 2016; 69:591-601. [DOI: 10.1590/0034-7167.2016690324i] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 12/01/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar artigos científicos disseminados em periódicos online no cenário internacional acerca da temática cuidados paliativos e espiritualidade. Métodos: revisão integrativa da literatura, com coleta de dados no mês de setembro de 2014, nas bases de dados LILACS, SCIELO, MEDLINE/PubMed, IBECS. Resultados: foram identificadas 39 publicações, cujas analises textuais permitiram a construção de quatro abordagens temáticas: significado da espiritualidade no contexto dos cuidados paliativos; cuidados paliativos e assistência espiritual; espiritualidade e alivio da dor e de outros sintomas que acometem pacientes sob cuidados paliativos; e instrumentos de avaliação da dimensão espiritual no âmbito dos cuidados paliativos. Conclusão: estudo verificou a relevância da dimensão espiritual durante a assistência de pacientes assistidos por meio de cuidados paliativos e a necessidade do desenvolvimento de novos estudos para disseminar conhecimento sobre o tema.
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14
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Lai C, Luciani M, Galli F, Morelli E, Del Prete F, Ginobbi P, Penco I, Aceto P, Lombardo L. Spirituality and Awareness of Diagnoses in Terminally Ill Patients With Cancer. Am J Hosp Palliat Care 2016; 34:505-509. [DOI: 10.1177/1049909116630985] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Aims of the present study were to investigate the association between awareness of own illness condition and psychological outcome in end-of-life phase and to test the association between the spirituality and the awareness of own illness condition. Methods: Three hundred and ninety-nine terminally ill patients with cancer were enrolled in a hospice in central Italy. One hundred patients satisfied the inclusion criteria. The Systems of Belief Inventory, the Hospital Anxiety and Depression Scale, and a psychological interview to determine the level of awareness of the illness diagnosis (aware; partially aware; and not aware) were administered to terminally ill patients. Results: The main finding was that the awareness of one’s own illness condition was positively associated with the extrinsic spirituality and negatively associated with intrinsic spirituality (regression model R = .26; R2 = .07; adjusted R2 = .05; F2, 97 = 3.45; P = .036). The aware group showed lower anxiety and depression ( F2, 97 = 1.9; P = . 075; F2, 97 = 2.6; P = .04) scores than partially aware and not aware groups. The psychological outcome was not associated with the spirituality level. Conclusion: In terminally ill patients with cancer, the levels of depression and anxiety were lower in patients aware of their own illness state. Moreover, higher levels of extrinsic and lower levels of intrinsic spirituality predicted the awareness of one’s own illness state.
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Affiliation(s)
- Carlo Lai
- Dynamic and Clinical Psychology, Sapienza University of Rome, Italy
| | - Massimiliano Luciani
- Psychiatry and Psychology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Federico Galli
- Dynamic and Clinical Psychology, Sapienza University of Rome, Italy
| | | | | | | | - Italo Penco
- Palliative Care Unit, Fondazione Roma Sanità, Italy
| | - Paola Aceto
- Department of Anaesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy
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Spirituality and/or religious faith: A means for coping with the effects of amyotrophic lateral sclerosis/motor neuron disease? Palliat Support Care 2015; 13:1603-14. [PMID: 25851240 DOI: 10.1017/s1478951515000097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The notion of spirituality/religious belief is recognized internationally as a domain within end-of-life care and is important in patients' and carers' quality-of-life. When faced with incurable illness, patients often become more philosophical about their life; many seek comfort in spiritual or religious philosophies. Our intention was to understand how personal spirituality and religious faith might help those living with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) cope with their impending death. METHOD Unsolicited narratives (internet and print-published) written by individuals diagnosed with the terminal condition of ALS/MND were analyzed thematically. Narratives from 161 individuals diagnosed with ALS/MND written over a period of 37 years (from 1968 to 2005) were included. RESULTS Our findings reveal that religious faith sustains and helps people to avoid despair, and personal spirituality helps them make sense of what is happening to them. SIGNIFICANCE OF RESULTS The use of personal narratives by people with ALS/MND has provided a vehicle for sharing their deepest spiritual and religious thoughts with others. The place of spirituality and religious faith within ALS/MND care should not be underestimated. Assessment of religious or spiritual needs should become a routine part of practice and is the responsibility of all members of the multidisciplinary team.
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Hirsh CD, Friebert S. Primary pediatric palliative care: psychological and social support for children and families. Pediatr Rev 2014; 35:390-5. [PMID: 25183774 DOI: 10.1542/pir.35-9-390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Cassandra D Hirsh
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH
| | - Sarah Friebert
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH
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Saffari M, Koenig HG, Ghanizadeh G, Pakpour AH, Baldacchino DR. Psychometric properties of the Persian spiritual coping strategies scale in hemodialysis patients. JOURNAL OF RELIGION AND HEALTH 2014; 53:1025-1035. [PMID: 23504574 DOI: 10.1007/s10943-013-9700-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Spiritual strategies may provide an effective way of coping with disease. This study sought to investigate the validity and reliability of the Persian version of the spiritual coping strategies (SCS) scale among Iranian hemodialysis patients. A convenience sample of 204 hemodialysis patients was recruited to participate in the study. A forward-backward translation method was used to produce the Persian version of the scale. Internal consistency was assessed by Cronbach's alpha and item-total score correlation. Two-week test-retest reliability was also assessed. The convergent and divergent validity of the scale was evaluated using the Duke University Religion Index and a visual analogue scale for health status. Exploratory and confirmatory factor analyses were used to assess the factor structure. Participants consisted of 113 males and 91 females (mean age 57.2 [SD = 9.7]). Cronbach's alpha was acceptable (0.87). We found two underlying factors similar to the original scale. The correlations between the study scales confirmed the convergent and divergent validity of the SCS. Confirmatory factor analysis showed a good fit to the data (GFI = 0.923, CFI = 0.948 and RMSEA = 0.068). The Persian version of the SCS has sound psychometric properties in Iranian hemodialysis patients. Future research should consider applying the scale to populations with other religious/cultural backgrounds.
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Affiliation(s)
- Mohsen Saffari
- Religion and Medicine Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,
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Abstract
There is a compelling need to integrate spirituality into the provision of quality palliative care by oncology professionals. Patients and families report the importance of spiritual, existential, and religious concerns throughout the cancer trajectory. Leading palliative care organizations have developed guidelines that define spiritual care and offer recommendations to guide the delivery of spiritual services. There is growing recognition that all team members require the skills to provide generalist spiritual support. Attention to person-centered, family-focused oncology care requires the development of a health care environment that is prepared to support the religious, spiritual, and cultural practices preferred by patients and their families. These existential concerns become especially critical at end of life and following the death for family survivors. Oncology professionals require education to prepare them to appropriately screen, assess, refer, and/or intervene for spiritual distress.
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Chang BH, Stein NR, Trevino K, Stewart M, Hendricks A, Skarf LM. Spiritual needs and spiritual care for veterans at end of life and their families. Am J Hosp Palliat Care 2012; 29:610-7. [PMID: 22363038 DOI: 10.1177/1049909111434139] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Spiritual care is an important domain of palliative care programs across the country and in the Veterans Affairs (VA) Healthcare System specifically. This qualitative study assessed the spiritual needs, spiritual care received, and satisfaction with spiritual care of both Veterans at the end of life and their families. Seventeen Veterans and 9 family members participated. They expressed a wide range of spiritual needs, including a wish of Veterans to have a better understanding of traumatic events that occurred during their combat experience. Some Veterans reported military experience enhanced their spirituality. Generally, respondents reported satisfaction with VA spiritual care, but indicated that Veterans may benefit from greater access to VA chaplains and explicit discussion of the impact of their military experience on their spirituality.
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Abstract
Spirituality is a fundamental element to the human experience of health and healing, illness and dying. Spiritual care is an essential component of palliative and end-of-life care provision and is the responsibility of all staff and carers involved in the care of patients and families. As end-of-life care is a significant element of community nursing, this article explores the relevancy of spirituality to end-of-life practice, the challenge of defining spirituality and the attributes and skills required for the practice of spiritual care. The aim of is to encourage self reflection and open dialogue about the subject, thus enhancing community nurses' understanding of spiritual care practice. By reflecting and generating talk about the practice of spiritual care, it may become more normalized, recognized, and practically meaningful, thereby retaining its significance in holistic nursing.
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Affiliation(s)
- Deborah Hayden
- Our lady's Hospice & Care Services, School of Nursing Midwifery and Health Systems, University College Dublin, Ireland.
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