Spirituality in Renal Supportive Care: A Thematic Review

Abstract

Chronic kidney disease is marked by a reduced life expectancy and a high symptom burden. For those who reach end-stage renal disease, the prognosis is poor, and this combined with the growing prevalence of the disease necessitates supportive and palliative care programmes that will address people’s psychosocial, cultural and spiritual needs. While there is variation between countries, research reveals that many renal specialist nurses and doctors are reluctant to address spirituality, initiate end-of-life conversations or implement conservative treatment plans early. Yet, other studies indicate that the provision of palliative care services, which includes the spiritual dimension, can reduce symptom burden, assist patients in making advanced directives/plans and improve health-related quality of life. This review brings together the current literature related to renal supportive care and spirituality under the following sections and themes. The introduction and background sections situate spirituality in both healthcare generally and chronic kidney disease. Gaps in the provision of chronic kidney disease spiritual care are then considered, followed by a discussion of the palliative care model related to chronic kidney disease and spirituality. Chronic kidney disease spiritual needs and care approaches are discussed with reference to advanced care planning, hope, grief and relationships. A particular focus on quality of life is developed, with spirituality named as a key dimension. Finally, further challenges, such as culture, training and limitations, are explicated.

Relação da espiritualidade no tratamento de pacientes com doença renal crônica / Relation of spirituality in the treatment of patients with chronic kidney disease

“…A gente vai preparando o ambiente, a família (Sujeito 7). Egan et al (2015), referem que pacientes com doenças crônicas e debilitantes, por vezes, são levados a examinar questões existenciais e espirituais como um meio de se ajustar à sua doença e lidar com a onipresença da morte.…”

Illness perceptions of Turkish Cypriot patients receiving haemodialysis: A qualitative study

“…Religious faith has been indicated as a coping mechanism, letting some patients adopt positive views about their condition (Wu et al 2015) including Muslim patients who recognise health and illness as a natural part of the life which comes from God (Yodchai et al 2017). Psycho-spiritual interventions may be particularly relevant to aid adjustment to HD amongst Turkish-Cypriots and indeed for patients from other cultural backgrounds where religion and or spirituality offers meaning and facilitates coping (Egan et al 2015).…”

Illness perceptions of Turkish Cypriot patients receiving haemodialysis: A qualitative study

“…Religious faith has been indicated as a coping mechanism, letting some patients adopt positive views about their condition (Wu et al, 2015) including patients who are Muslim who recognise health and illness as a natural part of the life which comes from God (Yodchai et al, 2017). Psycho‐spiritual interventions may be particularly relevant to aid adjustment to HD amongst Turkish Cypriots and indeed for patients from other cultural backgrounds where religion and or spirituality offers meaning and facilitates coping (Egan et al, 2015).…”