GPs’ views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study

Vermandere, Mieke; Choi, Yoona; Brabandere, Heleen De; Decouttere, Ruth; Meyere, Evelien De; Gheysens, Elien; Nickmans, Brecht; Schoutteten, Melanie; Seghers, Lynn; Truijens, Joachim; Vandenberghe, Stien; Wiele, Sofie Van de; Oevelen, Laure-Anne Van; Aertgeerts, Bert

doi:10.3399/bjgp12x656865

Cited by 28 publications

(56 citation statements)

References 13 publications

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“…Given that an increasing number of publications within research and clinical guidance in general practice have focused on the concept of “spirituality” and on how GPs provide “spiritual care”,[5,16–18] one of the interesting questions raised in this study was whether Danish GPs understand the existential dimension as involving relationships to the concepts of spirituality or religion/religiosity. Findings showed that, for the majority of GPs, the reflections about the existential dimension concerned secular-existential issues such as assessments of one’s life, relationships, and future being.…”

Section: Discussionmentioning

confidence: 99%

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

Hvidt

Søndergaard

Ammentorp

et al. 2016

Scandinavian Journal of Primary Health Care

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ObjectiveThe objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP–patient encounter.DesignA qualitative methodology with semi-structured focus group interviews was employed.SettingGeneral practice setting in Denmark.SubjectsThirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews.ResultsAlthough understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains.ConclusionGPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients’ multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. Key pointsAlthough integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP–patient encounter.The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects.The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient symptoms occur. Integration of the existential dimension happens in unsystematic and intuitive ways.Cultural barriers such as shyness and lack of existential self-awareness seem to hinder GPs in communicating about issues related to the existential dimension. Educational initiatives might be needed in order to lessen barriers and enhance a more natural integration of communication about existential issues.

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Section: Discussionmentioning

confidence: 99%

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

Hvidt

Søndergaard

Ammentorp

et al. 2016

Scandinavian Journal of Primary Health Care

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“…Lack of time is often cited as a major reason for not addressing spiritual issues and concerns. [ 7 8 9 10 ] It cannot be denied that clinicians are sometimes overburdened with work, and they may indeed have no time to address nonphysical symptoms of disease. Yet, lack of time may also serve as a convenient excuse for not having to tread an area in which some clinicians do not feel entirely conversant.…”

Section: Introductionmentioning

confidence: 99%

“…Because of their own insecurity about the subject, they may prefer not to talk about it. [ 7 10 ] Physicians and nurses may then feel tempted to think that the provision of spirituality is the sole responsibility of other professionals, in particular chaplains. [ 7 12 ] Concrete talking about spirituality is sometimes further complicated by the power imbalance that exists between clinicians and patients, due to which the former may consider inquiring about spirituality as an inappropriate intrusion into the patient's private life.…”

Section: Introductionmentioning

confidence: 99%

Signs of spiritual distress and its implications for practice in Indian Palliative Care

Bhatnagar

Gielen

Satija

et al. 2017

Indian J Palliat Care

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Introduction:Given the particularity of spirituality in the Indian context, models and tools for spiritual care that have been developed in Western countries may not be applicable to Indian palliative care patients. Therefore, we intended to describe the most common signs of spiritual distress in Indian palliative care patients, assess differences between male and female participants, and formulate contextually appropriate recommendations for spiritual care based on this data.Methods:Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. We calculated frequencies and percentages, and we compared responses of male and female participants using Chi-squared tests.Results:Most participants believed in God or a higher power who somehow supports them. Signs of potential spiritual distress were evident in the participants’ strong agreement with existential explanations of suffering that directly or indirectly put the blame for the illness on the patient, the persistence of the “Why me?” question, and feelings of unfairness and anger. Women were more likely to consider illness their fate, be worried about the future of their children or spouse and be angry about what was happening to them. They were less likely than men to blame themselves for their illness. The observations on spirituality enabled us to formulate recommendations for spiritual history taking in Indian palliative care.Conclusion:Our recommendations may help clinicians to provide appropriate spiritual care based on the latest evidence on spirituality in Indian palliative care. Unfortunately, this evidence is limited and more research is required.

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“…When selecting a proper instrument to measure spiritual dimensions, researchers should consider the clinical and cultural traits of the population wherein the instrument was validated and the psychometric properties of the instrument, but this is not a frequent practice (40) . In this sense, further research should investigate the most feasible instrument for spiritual evaluation in situations of specific care, like patients under palliative care (43) .…”

Section: Discussionmentioning

confidence: 99%

Cuidados paliativos e espiritualidade: revisao integrativa da literatura

et al. 2016

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GPs’ views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study

Cited by 28 publications

References 13 publications

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

Signs of spiritual distress and its implications for practice in Indian Palliative Care

Cuidados paliativos e espiritualidade: revisao integrativa da literatura

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