Spiritual Care in Palliative Care

Abstract

Palliative care has always included spiritual care, but the provision and inclusion of spiritual care within and across palliative care services internationally is sub-optimal. In this summary overview, we address understandings and meanings of spirituality and related terms, both generally and in the context of healthcare, and outline the importance of spiritual well-being and spiritual care at the end of life. We summarise what spiritual care involves, its benefits for palliative care patients and their families, and consider how its provision might be helped or hindered. There is currently a limited evidence base for the efficacy of interventions including spiritual and/or religious care, and large-scale studies in particular are lacking. However, those mostly small-scale and/or qualitative studies which have been conducted to date show that addressing the spiritual needs of patients in palliative care is associated with many positive outcomes for both patients and their relatives. More research in this area is necessary to develop and enhance the evidence base, and optimal provision of spiritual care requires that providers explicitly recognise the need for such care, including through providing training and support for staff.

Perceived Barriers to Providing Spiritual Care in Palliative Care among Professionals: A Portuguese Cross-Sectional Study

“…One of PC’s fundamental aims is meeting the spiritual needs of patients [ 5 ]. Spirituality is a means to connect to oneself, others, nature, meaning, and/or the sacred during a particular moment [ 7 , 8 ]. Spirituality also encompasses the transcendent dimension of believing in a higher entity and is associated with more humanistic and person-centered care [ 9 ].…”

“…The provision of spiritual care as part of healthcare services is gaining popularity but is sub-optimal within and across palliative care services internationally [ 8 ]. Spiritual care guidelines for PC patients have been developed and frequently recommend evaluation of spiritual issues using validated instruments (allowing identification of a patient’s hopes, dreams, fears, and beliefs), incorporation of their spiritual concerns into their everyday care, and performance of life completion activities (such as a life review).…”

“…Although one of PC’s basic competencies is to satisfy the spiritual needs of patients with life-threatening illnesses, research has shown that professionals frequently neglect to include spiritual care in care plans [ 18 , 20 ]. This could be attributed to a perception that professionals lack the necessary abilities to provide spiritual assistance to patients on an individual basis, a dearth of spiritual education in training programs, and a shortage of time that gives the impression that spiritual care is being neglected [ 8 , 15 , 20 ]. Relevant organizational hurdles to delivering spiritual care include noncompliance with workforce standards and managers’ disregard for the significance of providing holistic care [ 20 ].…”

Effect of a Spiritual Care Training Program to Build Knowledge, Competence, Confidence and Self-awareness Among Australian Health and Aged Care Staff: An Exploratory Study

“…Studies of spiritual care with Australian healthcare professionals have revealed that perspectives on spirituality and spiritual care may differ substantially from countries where Christianity plays a culturally more significant role, such as the USA (Best et al, 2022a ; Jones et al, 2021b ). The latest census data reveal that more Australians are reporting “no religion” (38.9% in 2021, compared with 30.1% in 2016) and that those who identify as Christian are declining (43.9% in 2021 compared to 52.1% in 2016) (Australian Bureau of Statistics, 2022 ). Other faith groups are increasing in their proportion of the Australian population (since 2016, Hinduism has grown from 1.9 to 2.7%, and Islam has grown from 2.6 to 3.2%) (Australian Bureau of Statistics, 2017 , Australian Bureau of Statistics, 2022 ).…”

“…The latest census data reveal that more Australians are reporting “no religion” (38.9% in 2021, compared with 30.1% in 2016) and that those who identify as Christian are declining (43.9% in 2021 compared to 52.1% in 2016) (Australian Bureau of Statistics, 2022 ). Other faith groups are increasing in their proportion of the Australian population (since 2016, Hinduism has grown from 1.9 to 2.7%, and Islam has grown from 2.6 to 3.2%) (Australian Bureau of Statistics, 2017 , Australian Bureau of Statistics, 2022 ). Furthermore, the spirituality of Aboriginal Australians is gaining greater visibility and acknowledgement, and the inclusion of the perspective of Aboriginal Australians in all healthcare training has been strongly recommended at government level (NSW Ministry of Health, 2020 ).…”