Challenges and opportunities for spiritual care practice in hospices in a middle-income country

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.

Spiritual care needs and their attributes among Chinese inpatients with advanced breast cancer based on the Kano model: a descriptive cross-sectional study

“…Nonetheless, research has demonstrated that religious belief is a vital component of spiritual care needs and a means of expressing spirituality in and of itself. Patients who practice religion have better inner serenity [ 43 , 49 ]. Thus, the factors listed above contribute to indifference mainly focused on the “help thinking” and “help religious practice” dimensions.…”

‘I am Dying a Slow Death of White Guilt’: Spiritual Carers in a South African Hospice Navigate Issues of Race and Cultural Diversity

“…The issue of the need for sensitivity regarding culture, religion and ethnicity in palliative care interventions are currently gaining impetus in the global North as a specialised area (Cain, et al 2018 ; Curtis, 2019; Elk, et al 2020 ). Given SA’s history and divided society, however, issues of cultural and spiritual diversity, and race and racism, have long been core concerns in the development of health care interventions, including palliative care interventions (Baldwin-Ragaven, London, and De Gruchy 1999 ; De Beer and Chipps 2014 ; Drenth et al 2018 ; Swartz 1985 , 1998 ; Mahilall and Swartz 2021a ).…”