Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams

Abstract

Background: Patients receiving palliative care value attention given to their spiritual needs. However, these needs often remain unexplored as healthcare professionals lack the skills to identify and explore them and to integrate this information into care plans. Aim: To evaluate the effects of an interactive communication training intervention for palliative care teams in order to identify and explore the spiritual dimension and integrate it in patients’ care plans. Design: A mixed methods pre-post study, including self-assessment questionnaires, evaluation of videos with simulated consultations (applied competence) and medical record review (implementation). Setting/participants: Three palliative care teams including nurses ( N = 21), physicians ( N = 14) and spiritual caregivers ( N = 3). Results: The questionnaires showed an improvement on ‘Patient and family-centred communication’ of the End-of-life professional caregiver survey (+0.37, p < 0.01; the 8-item S-EOLC (+0.54, p < 0.01) and regarding the Spiritual Care Competence Scale, on the three subscales used (+0.27, p < 0.01, +0.29, p < 0.01 and +0.32, p < 0.01). Video evaluations showed increased attention being paid to patient’s aims and needs. The medical record review showed an increase in anticipation on the non-somatic dimension (OR: 2.2, 95% CI: 1.2–4.3, p < 0.05) and, using the Mount Vernon Cancer Network assessment tool, addressing spiritual issues (OR: 10.9, 95% CI: 3.7–39.5, p < 0.001). Conclusions: Our training intervention resulted in increased palliative care professionals’ competence in identifying and exploring patients’ spiritual issues, and their integration in multidimensional proactive palliative care plans. The intervention directly addresses patients’ spiritual concerns and adds value to their palliative care plans.

Spiritual Care[Givers] Competence in Palliative Care: A Scoping Review

“…Compassion and empathy are core values in delivering high-quality, person-centered care. These essential values can be fostered through various reflective practices, including individual and group reflection, case discussions, written exercises, debriefing sessions, simulation activities, role-playing, and shadowing other experienced professionals in the multidisciplinary team, thereby enhancing professionals’ proficiency in compassionate engagement and spiritual level [ 54 , 62 , 64 ]. It is recognized that professionals must proactively pursue personal and experiential learning opportunities to update and expand their spiritual knowledge base [ 60 ].…”

“…Cognitive (knowledge)-Assessing and planning spiritual care [5,47] Intrapersonal Resources [48] Interpersonal Resources [48] Transpersonal Resources [48] Understanding the concept of spiritual care [5,27,36,47,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] Awareness of different approaches to spiritual assessment [21,27,36,47,[50][51][52][53][54][55]59,61,62,[65][66][67][68] Integration of being human into the evolutionary axis of its existence [5,21,46,47,50,53,…”

“…Affective (attitudes)-Self-assessment, personal support and patient counseling-, attitude towards patient spirituality [5,47] Intrapersonal Resources [48] Interpersonal Resources [48] Transpersonal Resources [48] Willing to explore personal, religious, and spiritual beliefs [21,26,47,50,52,57,64,68,70] Being trustworthy and respectful of people's expressions of spirituality and different world/religious views [5,47,[49][50][51]53,59,[61][62][63][64][65]71,72] Developing and sustaining loving, trusting, and caring relationships [5,63] Respecting and being open to people's diverse expressions of spirituality [47,49- Recognizing personal limitations in spiritual caregiving and resorting to others when appropriate [21,46,50,62,67,68,72,73] Using evidence-informed practices to help patients and families address fears and spiritual and other distress related to life-limiting and end-of-life care [5,[46][47][48]…”

Exploring spirituality, religion and life philosophy among parents of children receiving palliative care: a qualitative study

“…Such an assessment tool would require a much larger number of participants than the number of participants in the present study [45]. Our findings can also be applied to increase healthcare professionals' awareness and skills in identifying spiritual needs in training interventions [31,46,47]. On the other hand, evaluations based on categorical (yes/no) questions frequently prevent parents' expression of their spiritual needs and concerns [7].…”

Expressão da espiritualidade nos cuidados paliativos: revisão narrativa

“…A pesquisa de Van Meurs e colaboradores 15 proporcionou um treinamento de comunicação para médicos e enfermeiros de uma equipe de cuidados paliativos a fim de explorar a dimensão espiritual no cuidado oferecido. Com o uso de pacientes atores, essa abordagem obteve bons resultados por se aproximar da prática clínica.…”