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Spirituality in Palliative Care

Textbook of Palliative Care

Abstract

Patients who are confronted with a life-threatening disease may experience the limits of their existence. In many patients, this confrontation results in struggles and questions on an existential level, which can be discerned, but hardly separated, from questions that are primarily related to the psychosocial or physical dimension of human existence. In this contribution an overview will be given on the state of the art of spiritual care in palliative care. After having given a definition of spirituality, we will focus on how to identify the aspect of spirituality, what a spiritual process and a spiritual crisis look like, what is needed for a conversation on spirituality, how spirituality can be measured and how effective spiritual interventions are, how one can deal with the hope of patients and families, how one can deal with intercultural issues, what conditions are needed for providing good spiritual care, and how to report and refer this dimension in palliative care.

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References

  • Agrimson LB, Taft LB. Spiritual crisis: a concept analysis. J Adv Nurs. 2009;65(2):454–61. Available from: https://doi.org/10.1111/j.1365-2648.2008.04869.x.

  • Balboni TA, Fitchett G, Handzo GF, Johnson KS, Koenig HG, Pargament KI, Puchalski CM, Sinclair S, Taylor EJ, Steinhauser KE. State of the science of spirituality and palliative care research part II: screening, assessment, and interventions. J Pain Symptom Manag. 2017;54(3):441–53.

    Article  Google Scholar 

  • Bayes R, Limonero J, Barreto P, et al. A way to screen for suffering in palliative care. J Palliat Care. 1997;13(2):22–6.

    CAS  PubMed  Google Scholar 

  • Best M, Aldridge L, Butow P, Olver I, Price M, Webster F. Assessment of spiritual suffering in the cancer context: a systematic literature review. Pall Supp Care. 2015;13:1335–61.

    Article  Google Scholar 

  • Blaber M, Jones J, Willis D. Spiritual care: which is the best assessment tool for palliative settings? Int J Palliat Nurs. 2015;21(9):430–8.

    Article  PubMed  Google Scholar 

  • Candy B, Jones L, Varagunam M, Speck P, Tookman A, King M. Spiritual and religious interventions for well-being of adults in the terminal phase of disease. Cochrane Database Syst Rev. 2012;(5):CD007544. Available from: https://doi.org/10.1002/14651858.CD007544.pub2.

  • Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, Harlos M. Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol. 2011;12(8):753–62. Available from: https://doi.org/10.1016/S1470-2045(11)70153-X.

  • Cobb M, Dowrick C, Lloyd-Williams M. What can we learn about the spiritual needs of palliative care patients from the research literature? J Pain Symptom Manag. 2012;43(6):1105–19. Available from: https://doi.org/10.1016/j.jpainsymman.2011.06.017.

  • Gamondi C, Larkin P, Payne S. Core competencies in palliative care: an EAPC white paper on palliative care education – part 2. Eur J Palliat Care. 2013;20:140–5.

    Google Scholar 

  • Griffith JL, Norris L. Distinguishing spiritual, psychological, and psychiatric issues in palliative care: their overlap and differences. Prog Palliat Care. 2012;20(2):79–85. Available from: https://doi.org/10.1179/1743291X12Y.0000000007

    Article  Google Scholar 

  • Johnston B, Gaffney M, Pringle J, Buchanan D. The person behind the patient: a feasibility study using the patient dignity question for patients with palliative care needs in hospital. Int J Palliat Nurs. 2015;21(2):71–7.

    Article  PubMed  Google Scholar 

  • Keall R, Clayton JM, Butow P. How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. J Clin Nurs. 2014;23(21–22):3197–205.

    Article  PubMed  Google Scholar 

  • Kellehear A. Spirituality and palliative care: a model of needs. Palliat Med. 2000;14(2):149–55. Available from: https://doi.org/10.1191/026921600674786394.

  • Kruizinga R, Hartog ID, Jacobs M, Daams JG, Scherer-Rath M, Schilderman JB, Sprangers MAG, Van Laarhoven HW. The effect of spiritual interventions addressing existential themes using a narrative approach on quality of life of cancer patients: a systematic review and meta-analysis. Psycho-Oncology 2016;25(3):253–65. Available from: https://doi.org/10.1002/pon.3910.

  • Leget C. Art of living, art of dying. Spiritual care for a good death. London/Philadelphia: Jessica Kingsley Publishers; 2017.

    Google Scholar 

  • Lucchetti G, Bassi RM, Lucchetti ALG. Taking spiritual history in clinical practice: a systematic review of instruments. Explore: J Sci Healing. 2013;9(3):159–70.

    Article  Google Scholar 

  • Martínez M, Arantzamendi M, Belar A, Carrasco JM, Carvajal A, Rullán M, Centeno C. ‘Dignity therapy’, a promising intervention in palliative care: a comprehensive systematic literature review. Palliat Med. 2017;31(6):492–509. Available from: https://doi.org/10.1177/0269216316665562.

  • Mount Vernon Cancer Network. Spiritual support steering group. Final report on spiritual support. Stevenage: Mount Vernon Cancer Network; 2007.

    Google Scholar 

  • Nolan S. Spiritual care at the end of life: the chaplain as a 'Hopeful Presence'. London/Philadelphia: Jessica Kingsley Publishers; 2011.

    Google Scholar 

  • Nolan S, Saltmarsh P, Leget C. Spiritual care in palliative care: working towards an EAPC task force. Eur J Palliat Care. 2011;18(2):86–9.

    Google Scholar 

  • Olsman E, Leget C, Onwuteaka-Philipsen B, Willems D. Should palliative care patients’ hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals’ perspectives on hope of palliative care patients. Palliat Med. 2014a;28(1):59–70. Available from: https://doi.org/10.1177/0269216313482172.

  • Olsman E, Duggleby W, Nekolaichuk C, Willems D, Gagnon J, Kruizinga R, Leget C. Improving communication on hope in palliative care. A qualitative study of palliative care professionals’ metaphors of hope: grip, source, tune, and vision. J Pain Symptom Manag. 2014b;48(5):831–8. Available from: https://doi.org/10.1016/j.jpainsymman.2014.02.008.

  • Olsman E, Leget C, Willems D. Palliative care professionals’ evaluations of the feasibility of a hope communication tool: a pilot study. Prog Palliat Care. 2015a;23(6):321–5. Available from: https://doi.org/10.1179/1743291X15Y.0000000003.

  • Olsman E, Leget C, Duggleby W, Willems D. A singing choir: understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study. Palliat Support Care. 2015b;13(6):1643–50. Available from: https://doi.org/10.1017/S147895151500019X.

  • Park CL. Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychol Bull. 2010;136(2):257–301. Available from: https://doi.org/10.1037/a0018301.

  • Puchalski C, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, et al. Improving the quality of spiritual care as a dimension of palliative care: the report of the consensus conference. J Palliat Med. 2009;12(10):885–904.

    Article  PubMed  Google Scholar 

  • Puchalski C, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. 2014;17(6):642–656. Available from: https://doi.org/10.1089/jpm.2014.9427.

  • Sansó N, Galiana L, Oliver A, Pascual A, Sinclair S, Benito E. Palliative care professionals’ inner life: exploring the relationships among awareness, self-care, and compassion satisfaction and fatigue, burnout, and coping with death. J Pain Symptom Manag. 2015;50(2):200–7.

    Google Scholar 

  • Schrank B, Rumpold T, Amering M, Masel EK, Watzke H, Schur S. Pushing boundaries – culture-sensitive care in oncology and palliative care: a qualitative study. Psycho-Oncology. 2017;26(6):763–9.

    Article  PubMed  Google Scholar 

  • Selman L, Speck P, Gysels M, Agupio G, Dinat N, Downing J, et al. ‘Peace’ and ‘life worthwhile’ as measures of spiritual well-being in African palliative care: a mixed-methods study. Health Qual Life Outcomes. 2013;11(1):94.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sinclair S, Raffin S, Pereira J, Guebert N. Collective soul: the spirituality of an interdisciplinary palliative care team. Palliat Support Care. 2006;4(1):13–24.

    Article  PubMed  Google Scholar 

  • Sinclair S, Bouchal SR, Chochinov H, Hagen N, McClement S. Spiritual care: how to do it. BMJ Support Palliat Care. 2012;2:319–27. https://doi.org/10.1136/bmjspcare-2011-000191.

    Article  PubMed  Google Scholar 

  • Steinhauser KE, Voils CI, Clipp EC, Bosworth HB, Christakis NA, Tulsky JA. “Are you at peace?” One item to probe spiritual concerns at the end of life. Arch Int Med. 2006;166(1):101–5. Available from: https://doi.org/10.1001/archinte.166.1.101.

  • Steinhauser KE, Fitchett G, Handzo GF, Johnson KS, Koenig HG, Pargament KI, Puchalski CM, Sinclair S, Taylor EJ, Balboni TA. State of the science of spirituality and palliative care research part II: screening, assessment, and interventions. J Pain Symptom Manag. 2017;54(3):428–40.

    Article  Google Scholar 

  • van de Geer J, Groot M, Andela R, Leget C, Prins J, Vissers K, Zock H. Training hospital staff on spiritual care in palliative care influences patient-reported outcomes: results of a quasi-experimental study. Palliat Med. 2017;31(8):743–53.

    Article  PubMed  Google Scholar 

  • Vermandere M, Warmenhoven F, Van Severen E, De Lepeleire J, Aertgeerts B. The ars moriendi model for spiritual assessment: a mixed-methods evaluation. Oncol Nurs Forum. 2015;42(4):E294–E301. Available from: https://doi.org/10.1188/15.ONF.294-301.

  • Weiher E. Das Geheimnis des Lebens berühren. Spiritualität bei Krankheit, Sterben, Tod: eine Grammatik für Helfende. [touching upon the mystery of life. Spirituality in disease, dying, death: a grammar for those who are helping]. Stuttgart: Kohlhammer Verlag; 2014.

    Google Scholar 

  • Williams A-L, Selwyn PA, Liberti L, Molde S, Njike VY, McCorkle R, Zelterman D, Katz Dl. A randomized controlled trial of meditation and massage effects on quality of life in people with late-stage disease: a pilot study. J Palliat Med. 2005;8(5):939–52. Available from: https://doi.org/10.1089/jpm.2005.8.939.

  • Xiao H, Kwong E, Pang S, Mok E. Effect of a life review program for Chinese patients with advanced cancer: a randomized controlled trial. Cancer Nurs. 2013;36(4):274–83. Available from: https://doi.org/10.1097/NCC.0b013e318268f7ba.

  • Yang W, Staps T, Hijmans E. Existential crisis and the awareness of dying: the role of meaning and spirituality. Omega (Westport). 2010;61(1):53–69. Available from: https://doi.org/10.2190/OM.61.1.c.

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Correspondence to Carlo Leget .

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Leget, C. (2018). Spirituality in Palliative Care. In: MacLeod, R., van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-31738-0_28-1

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  • DOI: https://doi.org/10.1007/978-3-319-31738-0_28-1

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  • Print ISBN: 978-3-319-31738-0

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Chapter history

  1. Latest

    Spirituality in Palliative Care
    Published:
    29 December 2023

    DOI: https://doi.org/10.1007/978-3-319-31738-0_28-2

  2. Original

    Spirituality in Palliative Care
    Published:
    05 January 2018

    DOI: https://doi.org/10.1007/978-3-319-31738-0_28-1