1. Introduction
Currently, reports from the World Health Organization (WHO) highlight a global increase in oncological diseases. This development has transformed cancer into an unprecedented public health challenge, given its alarming mortality and morbidity statistics. Within this context, the disease demands significant attention in terms of healthcare services, the need for well-trained professionals, and the provision of highly specialized care [
1].
In the context of specialized nursing care, it is imperative to offer cancer patients palliative care that incorporates spirituality. Spirituality represents a facet of inner life, often underexplored and underserved by healthcare professionals. Nevertheless, it is a dimension that individuals relentlessly seek to attain a sense of balance in their health. When this equilibrium is disrupted, it triggers the body’s defense mechanisms, all aimed at safeguarding and preserving inner peace [
2].
In this regard, the nursing professional takes on the role of accompanying individuals who are suffering, assuming the responsibility of satisfying their basic needs, providing comfort, and alleviating their suffering throughout the course of their illness. Moreover, it is undeniable that spiritual care has a profound impact on the quality of life and the patient’s perspective on illness and mortality [
3,
4]. Intellectual humility strengthens critical thinking, aiding patients in reflection, evaluation, and decision-making [
5].
On the other hand, the expressions and spiritual practices adopted by patients are events that foster inner strength and imbue human existence with meaning [
6]. Hence, individuals who fall ill or experience the loss of a family member require this inner energy to safeguard their personal well-being. Moreover, the healthcare professionals responsible for the patient’s care must also address their spiritual needs [
7]. To enhance the quality of life and emotional well-being, there is a need for an emphasis on interrelation and humanized care, which aims to fulfill spiritual and emotional needs 7. These essential emotional supports serve to bolster patient and family care [
8,
9].
Humanization involves commitment, dedication, and a shift away from a traditional paradigm toward a more humane approach [
10,
11,
12,
13]. Attributes that foster sensitivity [
14], creativity, the cultivation of values, and spirituality collectively highlight the qualifications, identity, and vocation of nursing professionals. Hence, it is imperative to incorporate into the curriculum the education and training of expert professionals in spiritual care [
15,
16]. These professionals will manifest, in their practice, qualities such as humane treatment, religious understanding, empathy, compassion, and consolation, especially during the most crucial moments in life, marked by illness or the loss of a loved one. Such an approach views these experiences as opportunities for effective and efficient personal growth [
17,
18]. Furthermore, active listening and the expression of comfort through a compassionate embrace provide solace in times of human loss. Even going as far as bending the rules to allow loved ones to approach restricted areas to bid farewell to their dear ones is a fundamental aspect of a dignified end-of-life experience [
6,
14,
19,
20].
Similarly, within the realm of nursing care practice, there is often a lack of understanding regarding experiences such as meditation, reflection, and prayer. These practices hold significance in elevating spirituality and constitute forms of religious therapy. They contribute to the appreciation and intervention in the emotional dimension of individuals, recognizing them as holistic beings where there exists a harmonious unity of mind, body, and spirit [
21,
22,
23,
24].
On the other hand, spirituality, as an essential element of the human being, “is akin to a musical symphony of love” that accompanies the individual who is unwell [
25,
26,
27]. This person feels, thinks, suffers, and questions the multitude of diagnoses that can overshadow the essence of their own life [
28]. Particularly, concerning the enhanced management of stress and the religious/spiritual support offered by professionals, it is crucial that such support is provided promptly and with a positive attitude. This approach serves to bolster spiritual competencies through the respectful, responsible, compassionate, and affectionate interactions of nurses with their patients [
29].
Spiritual care encompasses addressing the essential triad of body, mind, and spirit, which stands as a pivotal element in fortifying self-esteem and navigating the challenges of diagnosis, treatment, recovery, and even death [
30,
31,
32]. Patients often engage in religious practices like prayer, reading the Bible, or singing praises as part of their routine. Additionally, various forms of spiritual support, such as meditation, contemplation of life’s purpose, connecting with nature, and listening to music, are regarded as sources of spiritual strength. These practices extend beyond emotional well-being and can alleviate the physical symptoms of the illness [
33].
In other words, the profound connection to faith serves as a foundational support principle for the vulnerable population affected by cancer. It equips them to navigate the challenging aspects of the disease with greater resilience. Those who exhibit a stronger religious-spiritual coping mechanism tend to do so with a sense of hope. This hope acts as a strategy for confronting fear, uncertainty, and the stigma associated with suffering. These factors often bring about feelings of anxiety, depression, and, in some cases, even suicidal thoughts [
34].
The theorist Pamela Reed highlights that spirituality includes the pursuit of meaning and existential purpose, establishing connections beyond the individual, cultivating ethical principles, practicing meditation and mindfulness, exploring nature’s interconnectedness, expressing oneself through art, surrendering to others, and seeking inner harmony [
35,
36]. These aspects are vital to consider, given that spirituality is a broad and subjective concept with significant variations among individuals.
Furthermore, spirituality is characterized as an inherent aspect of the human condition, enabling individuals to find meaning through a sense of connection with a supreme being or a higher purpose entity that transcends the individual self. This is fundamentally a human experience that empowers individuals to discover the significance and purpose of their lives, particularly when facing illness. These practices, experiences, and beliefs are rooted in the connection with a transcendent being, especially during stages and moments when the fragile awareness of mortality becomes apparent [
37].
From the perspective of Pamela Reed’s humanistic care, two dimensions are established: spiritual practices, where each person holds unique beliefs and engages in specific spiritual activities, which have the capacity to evolve and change over time [
35,
37], and spiritual beliefs, which provide a sense of connection with a supreme entity or a being beyond the scope of human experience [
35,
37]. Likewise, prayer provides an atmosphere of peace, inner strength, and elevates the sense of hope [
38,
39].
Within spirituality, practices and beliefs are open to transformation and the integration of elements from various religions, mystical traditions, or esoteric currents, all of which aim to establish a connection with a higher being beyond oneself. Individuals develop unique life trajectories centered around their personal spiritual reality, where the extraordinary and the attainable merge to construct a narrative that serves as a guiding path towards the process of recovery and emotional well-being in everyday life [
40].
Considering the aforementioned, it is emphasized that Spiritual Perspective is an integral dimension that should be approached from the standpoint of spirituality and religiosity. These aspects are inherent attributes of the human essence and encompass the entirety of the individual [
41]. This approach is regarded as a positive way to cope with illness. Therefore, humanized care enhances both transpersonal and interpersonal treatment, enriching the nurse-patient relationship, especially in critical situations [
42,
43]. The bonds of trust and security enable the discussion of topics related to spirituality and religiosity, facilitating the anticipation of the patient’s desired rituals in end-of-life situations [
44], because they favor the fullness of care and improve spiritual well-being [
45,
46]. Therefore, the overarching problem emerges: What is the overall level of Spiritual Perspective perceived by hospitalized oncology patients, according to Reed’s theoretical framework? What is the frequency of spiritual practices and the strength of spiritual beliefs among hospitalized oncology patients? Are there patterns or differences in perceived Spiritual Perspective based on the sociodemographic characteristics of hospitalized oncology patients?
While spiritual care is a broad and multidimensional concept that includes emotional presence, compassionate communication, and therapeutic relationships, this study focuses specifically on spiritual beliefs and practices as measurable components. These elements, drawn from Pamela Reed’s Spiritual Perspective Theory, represent core expressions of spirituality that are accessible to quantitative assessment and reflect key aspects of patients’ inner lives. Future studies could expand on this approach by integrating interpersonal or relational aspects of spiritual care more deeply.
Theoretical Foundation and Research Objective
Pamela Reed’s theoretical perspective on Spiritual Perspective provides a robust framework for understanding the spiritual dimension of human existence [
47]. According to Reed, Spiritual Perspective encompasses the pursuit of meaning, connection with entities beyond the self, and cultivation of ethical and moral principles. By grounding this research in Reed’s theory, we align with a comprehensive understanding of spirituality that extends beyond religious affiliations and encompasses a broad spectrum of human experiences.
In practical terms, addressing the spiritual needs of hospitalized cancer patients is essential for providing holistic care. Cancer diagnosis and treatment can evoke profound existential questions and spiritual distress in patients. By measuring the level of Spiritual Perspective perceived by patients in a hospital setting, we can tailor nursing interventions to meet their spiritual needs effectively. This research informs healthcare practices by highlighting the importance of integrating spiritual care into patient-centered approaches, ultimately improving patient outcomes and enhancing their overall well-being during the cancer care journey.
Despite increasing global attention to spiritual care in oncology, limited empirical evidence exists on how Spiritual Perspective is experienced by cancer patients in Latin America, particularly in Peru. Additionally, few studies have applied Pamela Reed’s theory quantitatively in hospital settings. This study addresses these gaps by evaluating Spiritual Perspective among Peruvian oncology patients, offering culturally grounded insights that can inform nursing practice and healthcare management.
Based on this rationale, the objectives of this study were as follows:
To measure the overall level of Spiritual Perspective among hospitalized oncology patients using the Spiritual Perspective Scale (SPS) developed by Pamela Reed in 1987, which reflects early aspects of spirituality later integrated into her broader Spiritual Perspective theory.
To assess the frequency of spiritual practices and the strength of spiritual beliefs.
To empirically validate the hypothesized two-factor structure of the scale, through confirmatory factor analysis.
To identify patterns in Spiritual Perspective based on sociodemographic characteristics.
While Reed’s theory emerged from a Western context emphasizing individual growth and personal spirituality, its dimensions also resonate with collectivist cultures like those in Latin America. In this context, Spiritual Perspective is often experienced through interpersonal relationships, family cohesion, and shared faith practices. Therefore, the application of Reed’s framework in this study was culturally adapted to highlight collective spiritual expressions, such as community prayer, family support, and religious traditions grounded in Peruvian society.
In the Peruvian context, evidence has been reported regarding the use of the Self-Transcendence Scale in oncology and chronic care settings. In one study, the relationship between self-transcendence, anxiety, and depression in cancer patients undergoing treatment was examined using Reed’s theoretical approach [
48]. Additionally, the model has been applied in research on older adults with chronic non-communicable diseases in the southern region of the country, showing its relevance in geriatric nursing and long-term care [
49]. These applications support the cultural adaptability of Reed’s theory and its utility in holistic nursing interventions within Peru.
Therefore, the application of Reed’s framework in this study was culturally adapted to highlight collective spiritual expressions, such as community prayer, family support, and religious traditions grounded in Peruvian society [
50].
4. Discussion
4.1. Overview of Key Findings
This study represents one of the first quantitative assessments of Spiritual Perspective using Pamela Reed’s theoretical framework in a Peruvian oncology context. By applying a culturally adapted version of the Spiritual Perspective Scale, this research provides original data that can guide spiritual care practices in Latin American hospitals and contributes to the global understanding of how spiritual beliefs and practices manifest in diverse cultural settings. The findings revealed that 88.32% of hospitalized oncology patients experienced a moderate level of Spiritual Perspective, while 11.68% reached high levels and none fell into the low category. These results suggest that while most patients maintain spiritual awareness and connection, they may not fully achieve the deeper forms of meaning-making, interpersonal connection, and personal growth that define a high Spiritual Perspective. The absence of low-level scores reinforces the relevance of spirituality during illness, as noted by Silva et al. [
52], highlighting its importance as a coping resource for individuals facing life-threatening conditions.
4.2. Interpreting Spiritual Perspective Through Reed’s Theory
According to Pamela Reed [
35,
37], Spiritual Perspective represents the expansion of personal boundaries in four key directions: inward (toward self-awareness), outward (toward others), temporally (connecting past, present, and future), and transpersonally (toward a higher purpose or spiritual being). In this study, moderate levels may indicate that patients are engaging in some of these dimensions but are not fully supported in others. For example, transpersonal and inward reflections might be present, while outward connections or spiritual expression could be limited by institutional or emotional constraints.
Illness often provokes existential reflection and intensifies spiritual needs [
2,
52]. However, when these needs are not sufficiently addressed in clinical settings, patients may experience spiritual discomfort, which can limit their ability to access the deeper healing potential of Spiritual Perspectives. This underscores the importance of creating environments where spiritual connection is acknowledged, respected, and encouraged, particularly in oncology units where vulnerability is heightened.
These results are comparable to findings in European and North American settings where moderate levels of Spiritual Perspective are commonly observed in hospitalized populations [
38,
53]. However, unlike some Western cohorts, the Peruvian sample reported more pronounced alignment with traditional religious practices, reflecting cultural differences in the expression of spirituality during illness.
4.3. Discrepancy Between Spiritual Beliefs and Practices
A significant finding was the contrast between the high level of spiritual beliefs (59.12%) and the lower level of spiritual practices (45.26%). Most patients agreed that forgiveness, inner peace, and closeness to a higher power were essential, but fewer reported engaging in daily or weekly practices such as prayer, meditation, or reading spiritual literature. This discrepancy aligns with prior studies that emphasize how institutional barriers, fatigue, lack of privacy, and unfamiliarity with available spiritual resources can inhibit spiritual practice [
2,
54].
This difference may also indicate spiritual unmet needs. While beliefs are sustained internally, active practice often requires space, energy, or encouragement—elements that may be lacking during hospitalization. As Reed’s theory suggests, the potential for Spiritual Perspective exists inherently but is shaped and strengthened through relational, reflective, and environmental factors [
35,
37]. This highlights the need to integrate simple yet meaningful spiritual practices into daily care routines.
4.4. Sociodemographic Patterns and Spiritual Coping
The predominance of older adults, single individuals, and homemakers with high school education suggests a specific sociocultural profile in which spirituality may serve as an emotional anchor. Individuals in these groups may rely more heavily on internal belief systems and religious values when formal social roles or economic resources are limited. These results are consistent with prior research in Peru and Latin America that identifies spirituality as a protective factor in cancer patients’ coping processes [
50,
55].
Moreover, aging populations tend to seek greater existential meaning and demonstrate increased spiritual awareness, particularly in contexts of suffering and illness [
56,
57]. These findings suggest that the moderate-to-high spiritual beliefs observed in this population reflect both cultural traditions and age-related transformations in meaning-making processes.
4.5. Confirmatory Factor Analysis Supports Two-Factor Structure with Strong Reliability and Validity
The confirmatory factor analysis provided strong evidence for the hypothesized two-factor structure, with all items loading significantly on their intended factors and demonstrating good reliability. The model fit indices (CFI = 0.96, RMSEA = 0.06) supported the proposed structure. These results validate the use of this measurement model for assessing these latent variables in subsequent analyses.
The findings suggest that Items 1–4 and Items 5–10 form coherent and psychometrically sound scales, though the somewhat lower AVE for Factor 2 (0.50) may warrant attention in future refinements. While the sample size (N = 137) was adequate for the analysis, replication in larger and more diverse samples would strengthen confidence in the factor structure. Overall, these results support the theoretical distinction between the two constructs while providing a robust foundation for their operationalization in future research.
4.6. Role of Support Networks in Promoting Spiritual Perspective
Support networks emerged in the study as crucial facilitators of spiritual well-being. Patients who experience emotional connection with family, friends, or healthcare professionals may find it easier to engage in spiritual reflection and practice. Previous studies show that emotional and social support improve quality of life in cancer patients and buffer the emotional burden of illness [
58,
59].
Healthcare teams should therefore view support networks not only as social resources but also as spiritual mediators. Encouraging patient–family dialogue, peer support groups, or interaction with chaplains and religious volunteers can enhance patients’ sense of connection and promote higher levels of Spiritual Perspective.
4.7. Implications for Nursing Practice and Holistic Care
The findings point to the urgent need for training nurses and care providers to recognize and support patients’ spiritual needs. Spiritual assessments should be integrated into nursing protocols alongside physical and psychological evaluations. Tools like spiritual history forms, reflection journals, or guided meditation programs can help bridge the gap between belief and practice.
Pamela Reed’s theory highlights the dynamic and ongoing nature of the Spiritual Perspective [
35,
37]. Healthcare professionals should approach spirituality not as a static belief but as a lived, evolving experience that can be nurtured through compassionate presence, meaningful rituals, and authentic communication. These strategies align with global recommendations for delivering holistic, person-centered cancer care [
30,
45,
46].
4.8. Limitations and Future Research
This study has several limitations. Its cross-sectional design prevents the analysis of changes in spirituality over time or during different stages of illness. The use of self-report questionnaires introduces subjectivity and social desirability bias, which may affect how participants respond to spiritual items. Moreover, spirituality is influenced by culture, gender, religious tradition, and personal history (factors that should be explored further using mixed methods).
Another limitation of this study is the absence of clinical data such as cancer stage, diagnosis type, or religiosity level, which may influence patients’ spiritual engagement. Future research should incorporate these variables to allow for a more nuanced understanding of the factors associated with the Spiritual Perspective.
This study primarily used descriptive statistics and confirmatory factor analysis. While informative, more advanced statistical modeling (such as regression analysis) could offer deeper insight into the variables influencing spiritual beliefs and practices. Future studies should explore these relationships using inferential models.
Additionally, potential biases such as social desirability may have influenced participants to overreport spiritual engagement. The absence of a control for confounding variables—such as religious affiliation, disease severity, or psychosocial support—may also limit the interpretation of results. Future studies should control these variables using multivariate models to refine the findings.
Future research could also incorporate longitudinal designs to examine how spiritual practices evolve throughout treatment and recovery. Qualitative interviews could also provide richer insights into how patients interpret and experience the Spiritual Perspective, especially in diverse religious and cultural groups. In addition, it would be valuable to compare oncology patients with other chronic disease populations to explore the broader applicability of Reed’s model.
5. Conclusions
Measuring the variable of Spiritual Perspective perception from Pamela Reed’s perspective in hospitalized oncology patients holds significant promise for both patients and nursing professionals alike. By deepening nursing professionals’ understanding, this measurement can lead to enhanced experiences for hospitalized oncology patients, addressing not only the physical aspects of the disease but also the emotional and spiritual dimensions associated with Spiritual Perspectives. This holistic approach can result in more patient-centered care.
Pamela Reed’s Spiritual Perspective theory emphasizes patient-centered care, urging nursing professionals to focus on individual patient needs and deliver care that is personalized and meaningful. By identifying specific strategies to support patients’ Spiritual Perspective, nursing professionals can positively impact their overall well-being and foster a sense of hope, thereby promoting a higher quality of life despite the challenges posed by illness.
Nevertheless, it is essential to approach such studies with ethical sensitivity, recognizing the delicate nature of addressing spirituality and Spiritual Perspective in a healthcare setting. Methodological limitations and the diversity of beliefs and experiences among oncology patients must also be carefully considered. Ultimately, research of this nature enriches nursing practice and improves care by honoring the individual needs and desires of these patients.
Therefore, it is recommended that hospitals implement training programs in spiritual care, provide dedicated spaces for prayer or meditation, and encourage the integration of spiritual assessments into routine oncology care. By operationalizing these findings, nursing professionals can better support patients’ inner strengths and coping mechanisms, ultimately contributing to more humanized and effective healthcare services.
6. Implications for Healthcare Management
Given that many patients engage in spiritual practices such as prayer, meditation, and discussions on faith, integrating holistic patient care into hospital policies becomes essential. Hospitals could enhance patient satisfaction by providing interfaith chaplaincy services, dedicated prayer and meditation spaces, and staff training on recognizing and addressing patients’ spiritual needs. Acknowledging spirituality in healthcare may foster a sense of comfort and hope, ultimately contributing to better emotional and physical recovery outcomes.
Beyond patient care, these insights have important implications for healthcare workers’ well-being and decision-making. While many professionals value spirituality, they may not always have time to engage in it actively. The stressful nature of hospital work often leads to burnout, making it crucial for management to implement mindfulness programs, peer support groups, and ethical decision-making training rooted in spiritual perspectives. Encouraging hospital staff to reflect on their own values and spiritual well-being could help them handle emotional distress, particularly in high-pressure scenarios such as palliative care and end-of-life decisions.
Additionally, effective communication between healthcare providers and patients is essential, especially when addressing sensitive topics such as illness, suffering, and recovery. Hospitals could provide counseling services that integrate both psychological and spiritual support. Furthermore, mental health professionals and social workers could work alongside spiritual leaders to develop programs that help both patients and caregivers cope with stress, grief, and uncertainty. By fostering a hospital culture that recognizes the role of spirituality in healing, healthcare management can contribute to a more empathetic and humanized healthcare system, ultimately improving both patient and staff experiences.