• Fu-Jin Shih, Hung-Ru Lin, Meei-Ling Gau, Ching-Huey Chen, Szu-Mei Hsiao, Shaw-Nin Shih, and Shuh-Jen Sheu.
• Institute of Clinical and Community Health Nursing, Department and Institute of Nursing, National Yang-Ming University, Taipei, Taiwan.
• Oncol Nurs Forum. 2009 Jan 1;36(1):E31-8.

Purpose/ObjectivesTo explore the core constitutive patterns from the perspective of the older patient with terminal cancer, the major foci of spiritual needs, and professional actions that manifest tangibly as spiritual care.DesignHermeneutic inquiry.SettingTwo leading teaching hospitals in Taiwan.Sample35 older patients with terminal cancer with a life expectancy of three months.MethodsParticipatory observation and in-depth interviews were the major data collection strategies. Hermeneutic inquiry was used to disclose, document, and interpret participants' lived experiences.Main Research VariablesThe perceptions of older Taiwanese patients with terminal cancer and their particular healthcare needs across various transition stages.FindingsTwo constitutive patterns, "caring for the mortal body" and "transcending the worldly being," each with three themes and a related transformational process emerged from the data analysis. Two foci of spiritual needs were discovering patients' concerns about their dying bodies and their worldly being and facilitating the transcendence of the spiritual being from the physical realm.ConclusionsCaring for older Taiwanese patients with terminal cancer and helping them transcend the fear of the unknown when they give up worldly being can produce insights into patients' primary concerns, perceptions, and spiritual needs to help them achieve a "good" death.Implications For NursingThe knowledge gained in this study and the six major spiritual care actions identified may empower oncology nurse educators to develop culturally valid spiritual care courses. Research-based guidance for nurse clinicians who are taking care of older Taiwanese patients with terminal cancer will be provided.

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