Search Results (600)

Background: Understanding the psychological and spiritual needs of family caregivers, including their experiences of death anxiety and levels of death literacy, is essential for delivering holistic palliative care. This study aimed to examine the relationships between death anxiety, spiritual well-being, and death literacy among relatives of patients receiving palliative care in Türkiye. Methods: A cross-sectional correlational study was conducted with 160 relatives of patients receiving treatment in a palliative care unit in Türkiye. The participants had a mean age of 47.56 ± 12.33 years, and 62.5% were male. Data were obtained using the Abdel-Khalek Death Anxiety Scale (ASDA), the Three-Factor Spiritual Well-Being Scale (SWBS), and the Death Literacy Index (DLI). Results: The mean scores were 61.34 ± 17.45 for ASDA, 122.94 ± 15.84 for SWBS, and 96.13 ± 16.36 for DLI. Participants exhibited relatively elevated death anxiety scores, comparatively higher spiritual well-being scores, and moderate death literacy scores within the study sample. Correlation analyses showed that death anxiety was positively associated with spiritual well-being and negatively associated with death literacy, whereas death literacy was positively associated with spiritual well-being. Regression analyses further indicated that spiritual well-being was independently and positively associated with both death anxiety and death literacy, whereas death literacy was independently and negatively associated with death anxiety. Conclusions: The findings suggest that psychosocial, spiritual, and informational dimensions should be considered together in holistic palliative care. Supporting death literacy and spiritual well-being may contribute to better coping with death-related concerns among relatives of patients receiving palliative care. Full article

Religious psychopathology as a field lies at the intersection of psychiatry, theology, and culture. It addresses scientific discoveries and questions relating to the manifestation of mental health disorders that are expressed through religious content, ideation, and/or behavior. Religious psychopathology, being a multifaceted phenomenon, challenges clinicians, researchers, and religious leaders because it is non-trivial to distinguish between culturally normative religious experiences and pathological symptoms. The present integrative narrative review examines historical perspectives, diagnostic challenges, clinical manifestations, cultural considerations, therapeutic interventions, neurobiological models, ethical issues, and future directions in the field of religious psychopathology. It focuses primarily on literature from 2013 to 2025, while also incorporating selected foundational historical, theoretical, and clinical sources necessary for conceptual clarification. A special emphasis is placed on culturally informed and interdisciplinary approaches. Particular focus is given to approaches that respect spiritual frameworks while concurrently promoting evidence-based mental health care. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article

The study of sobriety in fashion can be understood as a form of spiritual exercise within a Christian ecological framework. This article argues that sobriety, understood as a virtue that shapes desire and moderates consumption, offers a theological response to the environmental and social consequences of contemporary fashion. Drawing on biblical sources, patristic and medieval theology, and early modern reflections, it traces the evolution of sobriety from a principle of bodily moderation to a broader philosophy of life. Through a theological analysis of fashion consumption, the article shows how sobriety can function as an ethical and spiritual practice capable of resisting hyperconsumerism and fostering ecological responsibility. The shift from modesty to sobriety thus provides a renewed framework for linking Christian virtue ethics, fashion consumption, and care for the planet. Full article

Nuclear contamination challenges assumptions that harm can be contained through technological control, political borders, or bodily separation. Across the Asia-Pacific, radioactive exposure moves unevenly through racialised, gendered, and colonial histories, rendering some bodies more vulnerable to ecological violence than others. Nuclear regimes continue to depend upon theological logics of purity, sacrificial exclusion, and protected innocence. This article develops a spirituality of fermentation through Asian eco-feminist theology and the Korean practice of sakhim. Fermentation becomes a practice of sustaining wounded life through endurance, permeability, and communal care. From this spirituality of fermentation, I develop the concept of Vital Fluidity as an ethical and theological framework for understanding how life continues through shared vulnerability, where bodies, nourishment, and histories remain deeply entangled. The article contributes to intersectional debates in theology, religion, gender, and ecology by approaching contamination through relation rather than separation. Under nuclear conditions, ethical responsibility emerges through practices that hold grief, contamination, memory, and nourishment together within shared existence. Fermentation therefore becomes a practical theological model for living with nuclear bodies. Full article

Background/Objectives: This systematic review aims to synthesize existing evidence on the impact of nursing interventions based on Watson’s Theory of Human Caring (THC) on women’s mental health and to provide an evidence-based framework for clinical practice. Methods: The review followed the PRISMA guidelines and was registered in the PROSPERO database (Registration No: CRD420251111577). A comprehensive literature search was conducted across databases, including PubMed, CINAHL, and Google Scholar. Ten studies (nine randomized controlled trials and one quasi-experimental study), involving 869 participants, met the eligibility criteria. Data were analyzed using a narrative synthesis approach due to methodological and clinical heterogeneity. Results: A total of 10 studies involving 894 women met the inclusion criteria. Geographically, nine studies were conducted in Türkiye and one in Iran. The included studies spanned various clinical contexts directly associated with significant mental health challenges for women, including medical abortion, infertility, gynecological oncology, and the postpartum period. The synthesized findings demonstrated that nursing interventions based on Watson’s Human Caring Theory led to statistically significant reductions in anxiety, depression, stress, postpartum depression risk, and infertility-related distress. Furthermore, these caritas-based frameworks significantly enhanced positive psychological assets, including self-efficacy, hope, meaning in life, prenatal attachment, and social support perception. Conclusions: Watson’s Theory of Human Caring provides a transformative framework for women’s health nursing that extends beyond symptom management to strengthen the individual’s internal resources and spiritual integrity. Integrating this theory into clinical protocols and nursing curricula is essential for humanizing care and protecting women’s mental health during challenging life transitions, particularly within the examined sociocultural contexts. Full article

Background/Objectives: Spiritual care is core to holistic patient care, yet a persistent implementation gap exists in Chinese hospitals. This study examines the association between spiritual leadership and nurses’ spiritual care behavior, with career calling as mediator and empathy as moderator. Methods: A cross-sectional design was adopted. Data were collected from 323 frontline nurses in 10 public hospitals across five provinces in China from June to September 2025 using validated Likert scales. Analyses included confirmatory factor analysis, hierarchical regression, and a second-stage moderated mediation model with 5000 bootstrap resamples using SPSS 26.0 and Mplus 8.3. Results: Spiritual leadership was positively associated with both nurses’ spiritual care behavior and career calling. Career calling partially mediated the relationship between spiritual leadership and nurses’ spiritual care behavior. Furthermore, empathy significantly strengthened the positive association between career calling and spiritual care behavior, and amplified the indirect effect of spiritual leadership on nurses’ spiritual care behavior via career calling. Conclusions: Spiritual leadership, career calling, and empathy are key factors associated with nurses’ spiritual care delivery. Targeted interventions for these factors can bridge the spiritual care implementation gap and enhance holistic patient care. Full article

Background/Objectives: To identify and evaluate contemporary clinical practice guidelines for the care of adult patients in their last days of life, their families and caregivers. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement (PROSPERO: CRD42021258311). PubMed, TRIP Database, Cochrane Library, ProQuest, and CINAHL were searched for CPGs published between January 2016 and December 2025 in English or Spanish, supplemented by searches of seven palliative care organisation websites. Two independent reviewers screened records; the AGREE II instrument was applied by four evaluators to assess methodological quality. Recommendations from included guidelines were categorised into 12 inductively derived decision areas encompassing recognition of the dying phase, communication and decision-making, multidisciplinary care, symptom management, and grief and bereavement. A narrative synthesis was adopted due to heterogeneity in guideline structure and recommendation grading systems. Results: Of 1118 records identified, 20 were retrieved for full-text assessment. Sixteen met CPG criteria and were appraised with AGREE II, of which eight were finally included. Included guidelines originated from five countries (UK, Spain, USA, Canada, and Europe) and were published between 2018 and 2021. Overall AGREE II scores ranged from 71% to 100%, with the lowest domain scores consistently found in Applicability. Strong recommendations were identified across most guidelines for recognition of the LDS, communication, and interdisciplinary coordination; recommendations on symptom management were mixed. Conclusions: Findings may inform professionals and health system managers in identifying key LDS care recommendations. Gaps in social, cultural, and spiritual dimensions should guide future guideline development. Key limitations include heterogeneity in guideline methods and restriction to English and Spanish publications. No external funding was received. Full article

Investigating the predictors of moral distress is particularly important for protecting nurses’ mental health and professional satisfaction, thereby preventing burnout and attrition from the profession. The primary aim of this study was to evaluate the predictors of moral distress among nurses. A cross-sectional study design was used. The sample consisted of 412 nurses from 11 hospitals across Slovakia. The mean age of the respondents was 40.48 years (SD = 10.92). Moral distress was assessed using the Modified Moral Distress Scale. Linear regression analysis was used to evaluate predictors of moral distress. Personal accomplishment, the maladaptive coping strategy of self-distraction, continuous shift operation, and emotional burnout emerged as significant predictors of the frequency of moral distress among nurses (AdjR² = 15.5%; R² = 0.155). Regarding the intensity of moral distress, significant predictors included personal accomplishment, the maladaptive strategy of self-distraction and the adaptive strategy of religiosity and spirituality (AdjR² = 14.0%; R² = 0.140), which appear to function as adaptive coping mechanisms for dealing with the intensity of moral distress. Systematic investigation of predictors of moral distress among nurses may contribute to the development of interventions and programs that support nurses, thereby improving not only their job satisfaction but also the quality of patient care. Full article

Background/Objectives: Spirituality is increasingly recognised as a core dimension of holistic and palliative care. Neurodegenerative diseases such as dementia, amyotrophic lateral sclerosis and Parkinson’s disease involve prolonged trajectories of loss, uncertainty and relational change, which may heighten spiritual and existential needs for patients, particularly among those involved in caregiving, such as family caregivers and, to a lesser extent, healthcare professionals. However, evidence on how spirituality is understood, experienced and addressed within neurodegenerative palliative care remains fragmented and conceptually heterogeneous. This scoping review aimed to map the literature on caregivers’ spiritual needs and challenges. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for Scoping Reviews (PRISMA ScR). Searches were conducted across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycINFO, and Scopus, with no date or geographical restrictions. Grey literature was searched through Google Scholar and relevant organisational and policy sources in the field of palliative care and spirituality. Reference list screening of included studies and relevant reviews was also conducted. Quantitative, qualitative, and mixed methods studies published in English or Italian were included. Results: Twenty-four studies published between 2007 and 2025 were included. Findings were organised into three interconnected domains: spiritual needs, spiritual processes and spiritual care. Spirituality emerged as a dynamic, relational and context-dependent dimension of caregiving, encompassing meaning, identity, connection and coping with vulnerability and loss. Spiritual needs and processes were widely described, while spiritual care was inconsistently recognised within healthcare systems. Conceptual ambiguity, under-representation of end-of-life dementia and cultural imbalances were evident. The evidence predominantly focused on family caregivers, with limited representation of healthcare professionals. Conclusions: This scoping review highlights a persistent gap between caregivers’ lived spiritual experiences and system-level responses in neurodegenerative palliative care in caregiving contexts globally. The findings support integrated, caregiver-inclusive and culturally responsive approaches to spiritual care. Full article

Background: Cultural, religious, and spiritual (CRS) needs are central to holistic palliative and end-of-life care (PEoLC), yet the confidence and perceived preparedness of community and voluntary sector staff in addressing them remain underexplored. As PEoLC increasingly occurs in community settings, understanding staff preparedness for culturally and spiritually sensitive care is vital. Objective: This service evaluation examined CRS perceived preparedness and confidence among staff across Leicester, Leicestershire, and Rutland (LLR), exploring perceived challenges and available resources. Methods: A modified Confidence and Perceived preparedness in the CRS Care Survey was distributed to healthcare, hospice, charity, and community staff (May–August 2025). Likert scale data (n = 39) were analysed descriptively; qualitative responses underwent thematic analysis using Braun and Clarke’s framework, which was co-produced with stakeholders. Results: Staff placed high importance on CRS needs (cultural M = 4.48, SD = 0.61; religious/spiritual M = 4.66, SD = 0.53) but reported lower confidence in the organisational capacity to meet them (M = 3.15 and M = 3.05). Qualitative survey findings showed that staff recognised CRS needs as central to holistic, individualised care, emphasising proactive assessment and avoiding assumptions. Barriers included fear of causing offence, organisational constraints, and challenges in supporting families, alongside concerns about unmet needs. Participants highlighted reliance on informal resources and a clear need for accessible, lived-experience-based training and practical guidance. A prototype CRS resource toolkit, including lived-experience videos and guidance for supporting Muslim patients, was co-developed and reviewed by healthcare, community, and public contributors. Conclusions: Staff commitment to CRS-sensitive PEoLC is strong, but practical tools and training are lacking. A virtual CRS toolkit could enhance confidence, communication, and culturally responsive care across multidisciplinary settings. Full article

Background/Objectives: Patients in palliative care frequently experience multidimensional suffering that extends beyond physical symptoms to include existential distress, demoralization, and loss of meaning. Psychedelic-assisted therapies (PAT), including ketamine-assisted psychotherapy (KAP), have re-emerged as promising interventions for these domains. This study aimed to provide a narrative overview and critical evaluation of the existing secondary literature on PAT in palliative care and serious illness and to examine the extent to which emerging best-practice recommendations are reflected in this literature. Methods: An overview of reviews with framework-based narrative synthesis was conducted, including narrative reviews, systematic reviews, scoping reviews, and meta-analyses addressing psychedelic-assisted interventions in patients with life-limiting illness. A comprehensive search of major databases was performed from inception to February 2026. Data extraction and narrative synthesis focused on clinical outcomes, safety, and the incorporation of key domains derived from recent interdisciplinary best-practice recommendations for PAT in palliative care. Results: Twenty-two reviews were included, synthesizing evidence primarily from early-phase clinical trials and observational studies, predominantly in oncology populations. Across reviews, PAT was consistently associated with reductions in depression, anxiety, and existential distress, along with improvements in quality of life and spiritual well-being. Safety profiles were generally favorable under controlled conditions. However, the incorporation of key therapeutic domains—such as preparation and integration, therapeutic setting, clinician training, and relational and biographical factors—was heterogeneous and often incomplete. Most reviews emphasized outcomes over process and context. Conclusions: The current body of secondary literature suggests potential application of PAT to address psychological and existential suffering in palliative care. However, the available evidence remains preliminary and is predominantly derived from small early-phase studies characterized by methodological heterogeneity, limited blinding, and highly selected populations. At the same time, the partial incorporation of emerging best-practice recommendations highlights a gap between evidence synthesis and normative clinical guidance. Full article

Background/Objectives: Adolescents living with HIV (ALHIV) face compounded health and psychosocial challenges while managing lifelong antiretroviral therapy (ART). Mental health difficulties among ALHIV are strongly associated with suboptimal adherence and disengagement from care. While mental illness is well documented, limited empirical evidence exists on the influence of positive mental wellness on adherence self-efficacy among ALHIV. This study assessed mental wellness among ALHIV and identified key psychosocial predictors of adherence self-efficacy in public healthcare facilities in Cape Town, South Africa. Methods: A cross-sectional survey was conducted among ALHIV (N = 251) aged 10–19 years who were receiving ART at public healthcare facilities across the Cape Town metropole. Participants completed an electronic questionnaire that assessed ten mental wellness domains and adherence self-efficacy. Descriptive statistics were calculated to summarise participant characteristics and mental wellness scores, while Pearson correlations and multiple linear regression were done to identify associations and independent predictors of adherence self-efficacy using SPSS v29. Results: Most participants were aged 15–19 years (76.9%) and diagnosed with HIV at birth (68.9%). Mental wellness scores were high across all domains (M = 3.14–3.71). Hope (M = 3.71), spirituality (M = 3.58), and purpose in life (M = 3.52) were the highest-rated domains. All mental wellness domains were positively correlated with adherence self-efficacy (p < 0.001), with the strongest associations being purpose in life (r = 0.66), self-acceptance (r = 0.66) and resilience (r = 0.66). Hope (p < 0.001), resilience (p = 0.001), purpose in life (p = 0.03) and self-acceptance (p = 0.012) emerged as significant independent predictors. Conclusions: Positive mental wellness and adolescent-centred psychosocial support in routine HIV care may strengthen adherence self-efficacy and support adolescents’ confidence in managing treatment. Full article

Background: Specialized palliative care requires nursing professionals to address the complex physical, psychological, social and spiritual needs of patients with advanced incurable illness. This study aimed to assess the perceived adequacy of formal educational preparation among nurses working in specialized palliative care services in the Republic of Croatia and examine its association with self-assessed knowledge and the perceived need for additional education. Methods: A nationwide cross-sectional survey was conducted among nursing professionals employed in specialized palliative care services across Croatia. Data were collected using a structured questionnaire assessing sociodemographic characteristics, perceived adequacy of formal education, self-assessed knowledge, as well as the need for additional education in physical, psychological, social and spiritual care domains. An Educational Sufficiency Discrepancy Index (ESDI) was calculated to quantify the difference between perceived educational sufficiency and continuing education needs. For inferential statistics significance was set at p < 0.05 (two-tailed). Results: Among the 194 nursing professionals who participated in the study, perceived educational sufficiency was highest in the physical domain (87.5%), where it exceeded the reported need for additional education (31.6%). Negative discrepancies were observed in social (−12.9) and spiritual care (−17.6), indicating perceived educational deficits. Representation of physical care content in formal education was significantly associated with higher self-assessed knowledge across several domains (physical p < 0.001; psychological p = 0.008; social p < 0.001; spiritual p = 0.008). No significant associations were found between self-assessed knowledge and age, work experience or level of education. Conclusions: Formal nursing education alone may not fully meet the multidimensional competency requirements of specialized palliative care practice. Strengthening structured continuing professional development, particularly in psychosocial and spiritual care, may support holistic palliative care delivery and sustained professional competence. Full article

Currently, there is a lack of sufficient research regarding spirituality in the lives of young people in youth care contexts. In this study, youth care refers to various forms of either voluntary or mandatory support and care for young people (children and teenagers) and their educators for growing-up problems, parenting problems, and psychological, psychosocial, and behavioral problems or intellectual disabilities. The available research is not systematically gathered in an overview. Against this background, this article presents a systematic literature review based on the following main research question: What insights can be distilled from scholarly peer-reviewed journal articles published from January 2000–July 2025 regarding spiritual formation in youth care? The results of the review study were based on 41 journal articles. Half of these articles thematize the foster care context. The other articles are spread over other youth care contexts, including psychiatric care, child and youth welfare, residential care, social work, and services for unaccompanied minors. Most of the articles presented empirical research. Three major themes can be defined that connect most articles: (a) the discussion of religion and spirituality as naturally present in the lives of children and the need or right to recognize that dimension and to facilitate continuity in it; (b) the question or the hypothesis that religion and spirituality can promote well-being, including the finding that this does not always appear unambiguous, up to and including attention to the harmful effects of religion and spirituality; and (c) the question of whether and how religion and spirituality can be used more instrumentally in youth care services to provide the best possible care to young people. The article discusses these findings, and recommendations for youth care professionals and follow-up research are presented. Full article