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Spiritual Wellbeing in Palliative Care and Health and Social Care

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 13603

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Dr. Bella Vivat

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Guest Editor

Department of Marie Curie Palliative Care Research, Division of Psychiatry, University College London, London WC1E 6BT, UK
Interests: spiritual wellbeing; spirituality; life-limiting conditions; chronic long-term health conditions; palliative care; end of life care; supportive care; qualitative research; ethnography; mixed methods
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Special Issue Information

Dear Colleagues,

I am delighted to be guest-editing a Special Issue on Spiritual Wellbeing in Palliative Care and Health and Social Care.

Palliative care has been identified as a matter for public health (Conway, 2008; Kellehear, 2013) and for health promotion (Richardson, 2002), and has been concerned with spiritual wellbeing from its inception; Cicely Saunders’ “total pain” had a spiritual dimension, which she said should be addressed by “total care” (physical, emotional, social, and spiritual) (Saunders, 1981).

In 1960s UK, when Saunders established St Christopher’s Hospice in South London, the spiritual aspect of “total care” was understood as synonymous with religion. This meaning has since expanded, such that religious care is now considered to be an element of spiritual care, but not exclusively, and not its entirety, while of course varying with sociocultural context.

Spiritual wellbeing is also of interest in health and social care beyond palliative care. It has been a longstanding focus of nursing (Taylor, 2002), and more recently psychiatry too (Poole, Cook & Higgo, 2019). However, there is currently a lack of consensus on how to improve and promote spiritual wellbeing, and how to provide spiritual care in an effective and meaningful way.

This Special Issue will explore perspectives on spiritual wellbeing from all areas of health and social care, and for all care recipients, including, but not exclusively, people receiving supportive, palliative, and end-of-life care, and people living with life-limiting and/or chronic long-term conditions.

I would be pleased to receive submissions across the breadth of health and social care, including articles from a health promotion and public health perspective, and those discussing compassionate communities. I am keen to include papers which reflect theoretically as well as presenting empirical data, and look forward to receiving articles covering a wide variety of fields and approaches, and recognising the socio-cultural specificity and variety shaping spiritual wellbeing.

Dr. Bella Vivat
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

spiritual wellbeing
supportive
palliative
end-of-life
EOLC
life-limiting
long-term conditions
chronic
compassion
compassionate

Published Papers (6 papers)

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Research

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13 pages, 383 KiB

Open AccessArticle

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

by Carlos Laranjeira, Maria Anjos Dixe and Ana Querido

Int. J. Environ. Res. Public Health 2023, 20(12), 6121; https://doi.org/10.3390/ijerph20126121 - 14 Jun 2023

Cited by 4 | Viewed by 1804

Abstract

Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants’ perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

14 pages, 339 KiB

Open AccessArticle

Role-Perceptions of Dutch Spiritual Caregivers in Implementing Multidisciplinary Spiritual Care: A National Survey

by Jacqueline van Meurs, Roos Breedveld, Joep van de Geer, Carlo Leget, Wim Smeets, Robert Koorneef, Kris Vissers, Yvonne Engels and Anne Wichmann

Int. J. Environ. Res. Public Health 2023, 20(3), 2154; https://doi.org/10.3390/ijerph20032154 - 25 Jan 2023

Cited by 3 | Viewed by 1433

Abstract

Background: During the course of their disease, patients often not only suffer physical discomfort, but also face psychological, social, and spiritual challenges. However, healthcare professionals often lack the knowledge and skills to address the spiritual dimension and are in need of support for taking this responsibility. Spiritual caregivers are experts in spiritual care, but their contribution to the integration of this care by other healthcare professionals is largely unknown. Objective: The aim of this study was to investigate how Dutch spiritual caregivers view their role in increasing the integration of spiritual care in daily healthcare practice as provided by other healthcare professionals in the Netherlands, and how they address this role. Methods: An online survey was conducted from May until June 2021 among spiritual caregivers working in Dutch healthcare. Data were analysed using descriptive statistics. Results: The majority of the 174 respondents answered that they already fulfil a role in the integration of spiritual care by, for example, providing education, coaching on the job, or participating in multidisciplinary consultation. However, the majority of respondents experienced barriers to their contribution, such as confusion of terminology and use of language while collaborating with other healthcare professionals and reluctance to share information. Conclusions: While spiritual caregivers realise having a role in increasing the integration of spiritual care into daily practice of other healthcare professionals, some practices and perceptions, especially from within their own discipline, may hamper this. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

15 pages, 341 KiB

Open AccessArticle

The Meaning of Healing to Adult Patients with Advanced Cancer

by Eve Namisango, Emmanuel B. K. Luyirika, Lawrence Matovu and Ann Berger

Int. J. Environ. Res. Public Health 2023, 20(2), 1474; https://doi.org/10.3390/ijerph20021474 - 13 Jan 2023

Cited by 5 | Viewed by 1901

Abstract

Background: This study aimed to explore the meaning of healing from the perspective of adult patients with advanced cancer. Methods: We conducted a secondary analysis of data from a primary study which used a cognitive interview approach to assess the face and content validity of a spiritual and psychological healing measure (NIH-HEALS). This analysis focused on responses to the question, “What does the term ‘healing’ mean to you?” Data were de-identified, transcribed verbatim, and imported in NVivo for thematic analysis in line with interpretive phenomenological methods. Results: Thirty-five adults with advanced cancer participated in the study. We identified nine major themes: acceptance, surrender, faith, hope, peace, freedom from suffering (e.g., pain, problems, or other bothersome factors), overcoming/transcending disease, positive emotions (e.g., happiness), recovery from illness or disease. One participant discussed healing as synonymous with death, and two associated it with social relations and social support. Conclusion: Themes from patients’ responses suggest subjective and varied definitions of healing which encompass physical, social, spiritual, and psychological domains of well-being, distinct from the physical cure of disease. Clinicians should adopt a holistic, person-centered approach to care, attending to bodily, psychosocial, spiritual, and emotional needs to help patients find meaning in their experiences, nourish resilience, and experience a sense of healing—as they define it. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

9 pages, 334 KiB

Open AccessArticle

Spiritual Distress and Spiritual Needs of Chronically Ill Patients in Poland: A Cross-Sectional Study

by Maciej Klimasiński, Ewa Baum, Joanna Praczyk, Monika Ziemkiewicz, Daria Springer, Szczepan Cofta and Katarzyna Wieczorowska-Tobis

Int. J. Environ. Res. Public Health 2022, 19(9), 5512; https://doi.org/10.3390/ijerph19095512 - 1 May 2022

Cited by 10 | Viewed by 2990

Abstract

Introduction: Spiritual care is needed in a clinical setting to improve the patients’ quality of life. Deep connection with another person and delight with the beauty of nature or art and (in some cases) with God are all transcendental experiences. They may enable patients to ascribe meaning to their life with a chronic illness, find hope and well-being despite burdening symptoms. The opposite situation: lack of inner peace, inability to accept what is happening, feeling disconnected from others is called spiritual distress. Objectives: The aim of this research is to assess spiritual distress and spiritual needs of a group of Polish chronically ill patients and find associations with independent variables in order to provide data for recommendations on spiritual care in Poland. Patients and methods: 204 patients treated at the University Hospital and the Cystic Fibrosis Clinic in Poznan were surveyed in 2017 and 2018 with an original questionnaire. Results: Over half of the patients felt that their illness was life-threatening. A little more than half reported that faith was a resource to cope with suffering. Almost all patients showed signs of spiritual distress, and more than half expressed spiritual needs. The intensity of distress correlated only with the severity of the disease. The most important predictor of having spiritual needs was recognizing faith as a resource. Conclusions: Spiritual needs are associated with personal beliefs; however, spirituality spans beyond the religious context since spiritual distress is unrelated to the level of religious devotion. Therefore, any patient with a severe chronic disease needs basic spiritual care, which includes being treated with compassion. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

15 pages, 360 KiB

Open AccessArticle

Spiritual Well-Being for Croatian Cancer Patients: Validation and Applicability of the Croatian Version of the EORTC QLQ-SWB32

by Ivana Dabo, Iva Skočilić, Bella Vivat, Ingrid Belac-Lovasić and Iva Sorta-Bilajac Turina

Int. J. Environ. Res. Public Health 2021, 18(22), 11920; https://doi.org/10.3390/ijerph182211920 - 13 Nov 2021

Cited by 3 | Viewed by 2397

Abstract

Spiritual well-being is a recognized predictor of health-related quality of life in palliative patients. No research in Croatia has yet addressed this field. This study, the first of its kind in Croatia, validated a Croatian translation of the EORTC QLQ-SWB32 measure of spiritual well-being with curative Croatian oncology patients and assessed its use and value. The study was conducted between July 2019 and January 2020 at the Department of Radiotherapy and Oncology, University Hospital Rijeka, with 143 cancer patients, using the linguistically validated Croatian version of the measure. All patients found the measure acceptable. Confirmatory factor analysis aligned with the structure found in previous studies. Cronbach’s alpha confirmed internal consistency. Female participants scored higher on the RSG (Relationship with Someone or Something Greater), RG (Relationship with God), and EX (Existential) scales, and on Global-SWB. Patients with breast and gynecological tumors scored higher on RG. Older patients scored lower on RSG, RG and EX. Retirees and those with below-average incomes scored lower on EX. Participants who identified as having no religion scored lower on RSG. Stage I cancer patients scored higher on RG. The Croatian version of the EORTC QLQ-SWB32 is an acceptable, valid, and reliable measure of SWB for Croatian cancer patients. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

Other

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11 pages, 768 KiB

Open AccessStudy Protocol

SPACEE Protocol: “Spiritual Care Competence” in PAlliative Care Education and PracticE: Mixed-Methods Research in the Development of Iberian Guidelines

by Carlos Laranjeira, Enric Benito, Maria Anjos Dixe, Monica Dones, Marcela Specos and Ana Querido

Int. J. Environ. Res. Public Health 2023, 20(4), 3505; https://doi.org/10.3390/ijerph20043505 - 16 Feb 2023

Cited by 4 | Viewed by 1742

Abstract

Spiritual care requires understanding the spiritual experiences of patients and recognizing their resources and needs. Therefore, educators and practitioners should develop their knowledge and understanding in this regard. Spiritual care helps people overcome their anxieties, worries, and suffering; reduces stress; promotes healing; and encourages patients to find inner peace. To provide comprehensive and appropriate care while upholding human/ethical virtues, the spiritual dimension must be a priority. We aim to develop spiritual care competence guidelines for Palliative Care (PC) education and practice in Portugal and Spain. The study detailed in this protocol paper will include three phases. In phase I, the phenomenon will be characterized and divided into two tasks: (1) a concept analysis of “spiritual care competence”; and (2) a systematic review of interventions or strategies used to integrate spiritual care in PC education and practice. Phase II will entail a sequential explanatory approach (online survey and qualitative interviews) to deepen understanding of the perceptions and experiences of educators, practitioners, and patients/family carers regarding spiritual care in PC education and practice and generate ideas for the next steps. Phase III will comprise a multi-phased, consensus-based approach to identify priority areas of need as decided by a group of experts. Results will be used to produce guidelines for integrating spirituality and spiritual care competence within PC education and practice and synthesized in a white book for PC professionals. The value of this improved examination of spiritual care competence will ultimately depend on whether it can inform the development and implementation of tailored educational and PC services. The project will promote the ‘spiritual care’ imperative, helping practitioners and patients/family carers in their preparedness for End-of-Life care, as well as improving curricular practices in this domain. Full article

(This article belongs to the Special Issue Spiritual Wellbeing in Palliative Care and Health and Social Care)

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