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J Pain Symptom Manage · Dec 2019
Patients' and caregivers' contested perspectives on spiritual care for those affected by advanced illnesses: a qualitative descriptive study.
- Clare O'Callaghan, Joanne Brooker, William de Silva, David Glenister, Melia Cert Adelaide A 4th Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia., Xavier Symons, David Kissane, and Natasha Michael.
- Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia; Institute for Ethics & Society, The University of Notre Dame Australia, New South Wales, Australia; Departments of Psychosocial Cancer Care and Medicine, St. Vincent's Hospital Fitzroy, The University of Melbourne, Victoria, Australia. Electronic address: COCallaghan@cabrini.com.au.
- J Pain Symptom Manage. 2019 Dec 1; 58 (6): 977-988.
ContextSpiritual care refers to practices and rituals addressing spiritual/religious concerns. It supports coping with loss and finding hope, meaning, and peace. Although integral to palliative care, its implementation is challenging.ObjectiveTo understand an Australian cohort of patients' and caregivers' perspectives about experiencing and optimizing spiritual care in the context of advanced illness.MethodsPatients and caregivers of patients with ≤12 month prognosis were recruited from a broader spiritual study via criterion sampling and agreed to opt-in interviews. Participants from an Australian, metropolitan health service received a spiritual care definition and were interviewed. Transcripts were analyzed using qualitative description.Results30 patients (17 male; mean age 70 years) and 10 caregivers (six male; mean age 58.9 years) participated. 27 identified as Christian, and 10 had no religion. Participants described multifaceted and contested beliefs about spirituality. Many queried the tangibility of spirituality, but all valued respectful staff who affirmed personhood, that is, each individual's worth, especially when care exceeded expectations. They also resonated with positive organizational and environmental tones that improved holistic well-being. Participants stressed the importance of the hospital's welcoming context and skilled care, which comforted and reassured.ConclusionAlthough many patients and caregivers did not resonate with the term "spiritual care," all described how the hospital's hospitality could affirm their values and strengthen coping. The phrase "spiritual care and hospitality" may optimally articulate and guide care in similar, pluralist inpatient palliative care contexts, recognizing that such care encompasses an interplay of generalist and specialist pastoral care staff and organizational and environmental qualities.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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