Background: Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients’ expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions. Aim: To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature. Design: A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571). Data sources: The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients’ perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools. Results: Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death. Conclusion: What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients’ linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients’ needs and enables interdisciplinary teamwork to allocate patient-tailored care.

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 ¼ 7, 53e87 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. J Pain Symptom Manage 2021;61:287e294.

No abstract

Prof.dr. Fred Wester is emeritus hoogleraar Communicatiewetenschap aan de Radboud Universiteit Nijmegen. Hij doet onderzoek naar de rol van media en mediaboodschappen: televisieprogramma’s, krantenberichten, websites, tijdschriftartikelen en reclameborden, en in het bijzonder naar de kenmerken en tendenties in de uitingen en de sociaal-culturele boodschappen die zij bevatten. Publicaties van zijn hand als Strategieën voor kwalitatief onderzoek (1996) en Inhoudsanalyse: theorie en praktijk (2013) helpen (toekomstige) onderzoekers nog altijd bij het opzetten, verhelderen en beschrijven van hun onderzoek. Ook is hij voorzitter van KWALON, een onafhankelijke organisatie van onderzoekers en docenten aan universiteiten, hogescholen, onderzoeksbureaus en andere organisaties die zich bezighouden met reflectie op de methodologie van kwalitatief sociaalwetenschappelijk onderzoek. Zijn kennis van en ervaring met het verrichten van kwalitatief onderzoek maken hem een expert van wie veel geleerd kan worden op het gebied van case studies.