Describing Spirituality at the End of Life

Abstract

Spirituality is salient to persons nearing the end of life (EOL). Unfortunately, researchers have not been able to agree on a universal definition of spirituality reducing the effectiveness of spiritual research. To advance spiritual knowledge and build an evidence base, researchers must develop creative ways to describe spirituality as it cannot be explicitly defined. A literature review was conducted to determine the common attributes that comprise the essence of spirituality, thereby creating a common ground on which to base spiritual research. Forty original research articles (2002 to 2012) focusing on EOL and including spiritual definitions/descriptions were reviewed. Analysis identified five attributes that most commonly described the essence of spirituality, including meaning, beliefs, connecting, self-transcendence, and value.

State of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes

“…Within palliative care, several literature reviews, both theoretical 27 but most often relying on inductive approaches, have sought to identify primary dimensions of spirituality specific to the context of serious illness (Table 1). 11,28,29 For example, Stephenson and Berry 11 identified five commonly defined attributes of spirituality noted in studies of spirituality and palliative care: meaning, beliefs, connecting, self-transcendence, and value. These findings overlap with other reviews that include interpersonal, transpersonal, and transcendent aspects of spirituality.…”

“…7,9 Foundational observational work on spirituality in palliative care is limited and offers a significant opportunity for advancement of the field. 11,28,31 Based on these current limitations in measurement, the following principles should be applied when choosing a measure from another setting to be applied to palliative care: (1) establish the instrument's reliability and validity in a palliative care population, (2) test the tool in diverse cultural contexts, (3) determine its applicability across specific care settings, (4) establish its responsiveness to change over time, (5) ascertain whether the tool captures clinically meaningful data (this is most relevant in QI and audit contexts), and (6) ensure it is easy to administer to the particular patient population. 7,9,32 These principles also should be applied to new tool development and should be augmented by the charge to create tools in collaboration with patients, families, and interdisciplinary and spiritual care provider colleagues.…”

The Provision of Spiritual Care in Hospices: A Study in Four Hospices in North Rhine-Westphalia

“…The open “definition” of spirituality has both advantages and disadvantages. Its breadth renders the concept virtually meaningless in itself, since everything that has some kind of meaning for human beings can be subsumed under it (Walter 1994 ; Paley 2008 ; Stephenson and Berry 2015 ). Nevertheless, the advantages of a broader—vague—definition lie in “spiritual care” no longer being bound to one single profession, namely that of the chaplain.…”

Spiritual Care in Hospice and Palliative Care

“…The literature emphasizes spiritual care throughout serious illness with special attention at the end of life (17). The above definition, which originated from a United States Consensus meeting, has since been disseminated internationally (20,21).…”