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Religions
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Religious and Spiritual Needs in Palliative Care
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Religious and Spiritual Needs in Palliative Care

A special issue of Religions (ISSN 2077-1444).

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 35611

Special Issue Editor

Prof. Megan Best

E-Mail Website
Guest Editor
Institute for Ethics and Society, the University of Notre Dame Australia, Sydney NSW 2007, Australia
Interests: spirituality in healthcare; existential suffering; euthanasia; psycho-oncology; whole-person care; end of life; genomics in palliative care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is with pleasure that I announce the launch of a new Special Issue in Religions, which will aim to examine religious and spiritual needs in palliative care. Spirituality is defined as the dynamic dimension of human life that relates to the way persons (individual and community) experience, express, and seek meaning, purpose, and transcendence, as well as the way they connect to the moment, to self, to others, to nature, to the significant, and to the sacred. Spiritual needs are commonly encountered by patients with sudden ill-health or loss and chronic and life-limiting conditions, as they seek to integrate their illness experience into their life trajectory.

The spiritual domain is, and has always been, integral to palliative care, and is embedded within palliative care definitions. The experience of spirituality is individual and multidimensional, consisting of:

(1) Existential challenges (e.g., questions concerning identity, meaning, suffering and death, guilt and shame, reconciliation and forgiveness, freedom and responsibility, hope and despair, love and joy);

(2) Value-based considerations and attitudes (questioning what is most important for each person, such as relations to oneself, family, friends, work, things, nature, art and culture, ethics and morals, and life itself);

(3) Religious considerations and foundations (faith, beliefs and practices, the relationship with God or the ultimate).

If spiritual challenges are not successfully encountered, they can result in existential distress.

This Special Issue calls for contributions from those who wish to examine the nature of religious and spiritual needs in palliative care patients, carers, and families, and how they should be addressed. Currently, much work is being done on the need for spiritual care training in palliative care staff and how it should be best delivered. However, more information is needed on the nature and trajectory of spiritual and religious needs in palliative care patients, their family members, and carers, and how these factors are most successfully addressed. The interface between spiritual and physical needs would be part of this exploration. Working in palliative care is known to precipitate death anxiety in staff members, and this aspect of spiritual need is also of interest, as is the role of institutional support. The challenges of providing spiritual care in the context of secularization and pluralism within society also require more investigation.

This issue seeks essays and empirical research examining these issues, from the perspectives of both those experiencing spiritual needs and those attempting to meet them, whether coming from a generalist or specialist spiritual care perspective. The contents of this Special Issue will provide a useful supplementation to the existing literature on spiritual care in palliative care, which is growing in this important area.

References:

Balboni TA, Balboni MJ. The Spiritual Event of Serious Illness. J Pain Symptom Manage. 2018; 30; 56(5):816–22.

Best M, Leget C, Goodhead A, Paal P. An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliative Care. 2020;19(1):9.

Best M, Aldridge L, Butow P, Olver I, Webster F. Conceptual Analysis of Suffering in Cancer: a systematic review. Psycho-Oncology. 2015; 24(9):977–86.

Kellehear A. Spirituality and palliative care: a model of needs. Palliative Medicine. 2000;14(2):149–155.

Mesquita AC, Chaves ÉD, Barros GA. Spiritual needs of patients with cancer in palliative care: an integrative review. Current opinion in supportive and palliative care. 2017; 11(4):334–40.

World Health Organization. WHO Definition of Palliative Care. https://www.who.int/cancer/palliative/definition/en/

Prof. Megan Best
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 double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Religions 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 1800 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

  • spirituality
  • religion
  • spiritual needs
  • spiritual care
  • palliative care
  • hospice
  • end of life

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Published Papers (7 papers)

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Research

11 pages, 220 KiB  
Article
Spiritual Meaning of Cadaveric Organ Donation among Protestant Korean Immigrants in the United States
by Hajung Lee
Religions 2023, 14(3), 352; https://doi.org/10.3390/rel14030352 - 7 Mar 2023
Viewed by 1484
Abstract
This qualitative study investigated Protestant Korean immigrants’ views on cadaveric organ donation through the analysis of in-depth interviews with thirty-two Protestant Korean immigrants in the United States. The interviews show a meaning-making process of cadaveric organ donation among study participants. They describe participants’ [...] Read more.
This qualitative study investigated Protestant Korean immigrants’ views on cadaveric organ donation through the analysis of in-depth interviews with thirty-two Protestant Korean immigrants in the United States. The interviews show a meaning-making process of cadaveric organ donation among study participants. They describe participants’ complex sentiments on cadaveric organ donation, based on a blend of Protestant, Confucian, Shamanistic, and Daoist views. This study shows how Protestant Korean immigrants can overcome potential fears of organ procurement, stemming from indigenous Korean contexts, and describes their religious views on the afterlife. The findings indicated that most participants held positive views of cadaveric organ donation because they considered organ donation to be an altruistic, life-giving, Christian spiritual practice for the benefit of others. I argue that Protestant Korean immigrants’ lived religion can lead them to overcome fear of indigenous Korean beliefs and to choose organ donation as a spiritual practice. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
11 pages, 329 KiB  
Article
Spiritual Care in Palliative Care
by Megan C. Best, Bella Vivat and Marie-Jose Gijsberts
Religions 2023, 14(3), 320; https://doi.org/10.3390/rel14030320 - 28 Feb 2023
Cited by 16 | Viewed by 8855
Abstract
Palliative care has always included spiritual care, but the provision and inclusion of spiritual care within and across palliative care services internationally is sub-optimal. In this summary overview, we address understandings and meanings of spirituality and related terms, both generally and in the [...] Read more.
Palliative care has always included spiritual care, but the provision and inclusion of spiritual care within and across palliative care services internationally is sub-optimal. In this summary overview, we address understandings and meanings of spirituality and related terms, both generally and in the context of healthcare, and outline the importance of spiritual well-being and spiritual care at the end of life. We summarise what spiritual care involves, its benefits for palliative care patients and their families, and consider how its provision might be helped or hindered. There is currently a limited evidence base for the efficacy of interventions including spiritual and/or religious care, and large-scale studies in particular are lacking. However, those mostly small-scale and/or qualitative studies which have been conducted to date show that addressing the spiritual needs of patients in palliative care is associated with many positive outcomes for both patients and their relatives. More research in this area is necessary to develop and enhance the evidence base, and optimal provision of spiritual care requires that providers explicitly recognise the need for such care, including through providing training and support for staff. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
23 pages, 1155 KiB  
Article
What Do Palliative Care Professionals Understand as Spiritual Care? Findings from an EAPC Survey
by Bella Vivat, Rebecca Lodwick, Maria Teresa Garcia-Baquero Merino and Teresa Young
Religions 2023, 14(3), 298; https://doi.org/10.3390/rel14030298 - 22 Feb 2023
Cited by 3 | Viewed by 3718
Abstract
From its inception palliative care has been understood as addressing four dimensions: physical, social, emotional/psychological, and spiritual/religious. However, the spiritual and/or religious element is poorly understood and under-researched, and little is known about palliative care professionals’ understandings of spiritual care, or how they [...] Read more.
From its inception palliative care has been understood as addressing four dimensions: physical, social, emotional/psychological, and spiritual/religious. However, the spiritual and/or religious element is poorly understood and under-researched, and little is known about palliative care professionals’ understandings of spiritual care, or how they seek to implement spiritual care in practice. Members of the European Association of Palliative Care (EAPC) Spiritual Care Taskforce (SCTF) designed and conducted a 28-item survey, supported by the EAPC Board, investigating palliative care professionals’ understandings and attempts to implement spiritual care. Following pilot-testing with 30 participants, the survey ran for a month. It was engaged with by 527 people from 67 countries and most regions of the world, with 502 answering at least two questions, 465 people answering at least one substantive questions, 228 providing examples of spiritual care at Q24, and 115 providing further comments at Q28. We analysed the sociodemographic data descriptively, thematically analysed the diverse, detailed spiritual care examples provided at Q24, and conducted a content analysis of Q28 responses. We identified nine themes from Q24 responses. Of these nine themes, five encompassed interactions between staff and patients, one of these five addressing the character, nature, or quality of care provided by staff; the other four specific content of that care: supporting patients’ wellbeing, supporting patients’ religious faiths, enabling reflection, and facilitating focused discussions. A sixth theme covered staff roles and responsibilities, including specific input from specialist providers. Three smaller themes addressed supporting others than patients: families before patients’ deaths, families during bereavement, and staff. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
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22 pages, 730 KiB  
Article
The Nature of Religious and Spiritual Needs in Palliative Care Patients, Carers, and Families and How They Can Be Addressed from a Specialist Spiritual Care Perspective
by Kate L. Bradford
Religions 2023, 14(1), 125; https://doi.org/10.3390/rel14010125 - 16 Jan 2023
Cited by 2 | Viewed by 8692
Abstract
This paper is written from the perspective of a specialist religious and spiritual care practitioner who practises in major referral hospitals in Sydney, Australia. In these hospitals, religious care and ward-based spiritual care chaplaincy services are offered in tandem. The perspective offered is [...] Read more.
This paper is written from the perspective of a specialist religious and spiritual care practitioner who practises in major referral hospitals in Sydney, Australia. In these hospitals, religious care and ward-based spiritual care chaplaincy services are offered in tandem. The perspective offered is based on the author’s knowledge, research, and experience in how people make the necessary religious or spiritual adjustments to their deep view of reality when faced with severe or chronic pain or terminal illness. Religious and/or Spiritual Care (R/SC) are interventions that scaffold people through a process of sense-making which helps them find meaning in their new reality. These R/SC adjustments concern conscious and unconscious beliefs about ultimate meaning, morality, justice, transcendence, and relationships within themselves, and with others and the supernatural. Palliative care practitioners described the importance of spiritual care and integrated spiritual care principles into their biopsychosocial-spiritual model of care in the 1960s. As palliative care practitioners have increasingly clarified their discipline as a distinct discipline in medicine, religious and spiritual care practitioners have struggled to define their place. These concerns merit a fresh evaluation of the religious and spiritual needs of patients, carers, and families of those suffering chronic pain and terminal illness and further clarification of the specialist discipline of religious and spiritual care. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
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16 pages, 304 KiB  
Article
Beyond Compassion Fatigue: Motive-Based Approaches to Sustaining Compassion in Palliative Care
by Annette Pierdziwol
Religions 2023, 14(1), 50; https://doi.org/10.3390/rel14010050 - 28 Dec 2022
Viewed by 2386
Abstract
Compassionate care is vital to quality palliative care and integral to the provision of spiritual care at the end of life. But is sustaining compassion costly for healthcare providers (HCP), impacting their emotional and spiritual wellbeing, professional purpose, and moral self-image? Concerns about [...] Read more.
Compassionate care is vital to quality palliative care and integral to the provision of spiritual care at the end of life. But is sustaining compassion costly for healthcare providers (HCP), impacting their emotional and spiritual wellbeing, professional purpose, and moral self-image? Concerns about the costs of compassion for carers have gathered pace in a growing healthcare literature on compassion fatigue. Critics, however, argue that compassion fatigue lacks adequate conceptualisation, querying whether it fits with HCP’s own perceptions and suggesting it lacks utility for identifying interventions. This article contributes to this debate about moving beyond compassion fatigue, by bringing new psychological research on compassion as a motivated choice to bear on these questions and demonstrating its potential for illuminating interventions to support compassion in palliative care contexts. It proposes a focus on motive-based interventions which serve to tip the cost–benefit analysis in relation to compassion and thus support HCP motivation to feel and act compassionately. A key implication of this approach is that sustaining compassion is not up to individuals alone, as can often seem to be the case with ‘self-care’ paradigms. Rather, there are multiple ways institutions and society can play a role in motive-based interventions to sustain HCP compassion and wellbeing. The final section explores one example in the form of institutional support for spiritual care education. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
16 pages, 616 KiB  
Article
How Buddhist Religious Care Is Incorporated for End-of-Life Stroke Patients Receiving Palliative Care at Home during the COVID-19 Pandemic: Revisiting Constructivist Grounded Theory
by Jinpitcha Mamom and Hanvedes Daovisan
Religions 2022, 13(10), 1000; https://doi.org/10.3390/rel13101000 - 20 Oct 2022
Cited by 3 | Viewed by 3071
Abstract
Coping with the COVID-19 pandemic has involved unprecedented health challenges, impacting not only the receipt of palliative care, but also that of religious care. The present article aimed to explore how Buddhist religious care is incorporated for end-of-life stroke patients receiving palliative care [...] Read more.
Coping with the COVID-19 pandemic has involved unprecedented health challenges, impacting not only the receipt of palliative care, but also that of religious care. The present article aimed to explore how Buddhist religious care is incorporated for end-of-life stroke patients receiving palliative care at home during the COVID-19 pandemic in Thailand. A constructivist grounded theory (CGT) was utilised with theoretical sampling of 30 respondents in the Angthong, Ayutthaya, and Pratumthani provinces, central Thailand, from June 2020 to March 2022. Online in-depth interviews were video-recorded and transcribed, using written memos and constant comparative methods. Data transcripts were analysed using open, axial, selective coding, categorising, and themes. Our CGT study identified five themes of Buddhist religious care incorporated for end-of-life stroke patients receiving palliative care at home, namely Buddhist therapies, religious beliefs, religious life satisfaction, religious mental care, and religious needs. The implications of Buddhist religious care being incorporated for end-of-life stroke patients receiving home palliative care during the COVID-19 pandemic are discussed. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
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6 pages, 400 KiB  
Communication
Spiritual Care in Palliative Care: A Physician’s Perspective
by Marie-José H.E. Gijsberts
Religions 2022, 13(4), 323; https://doi.org/10.3390/rel13040323 - 4 Apr 2022
Cited by 3 | Viewed by 4011
Abstract
Palliative care is defined as ‘an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through identification, assessment and treatment of pain and other problems, whether physical, [...] Read more.
Palliative care is defined as ‘an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through identification, assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual’. As a palliative care physician, I aim to explore and meet the needs of my patients and their loved ones. As I am specifically trained as a specialist in assessing and treating ‘pain and other physical symptoms’, in psychological, social and spiritual issues, I am a generalist. Two approaches are described to assess spiritual needs in palliative care: The first is adjoining the analytic concept of the four dimensions of palliative care: using an instrument, measuring spiritual well-being or spiritual needs, and measuring the quality of life, with specific attention to spiritual issues. Second, a holistic approach is promoted, with openness to the patients’ narrative of their life, disease and suffering. In the integrity of the clinical encounter, medical, ethical and spiritual issues may be discussed. Broadening our clinical language with ethical, psychosocial, and spiritual vocabulary is mandatory, and self-reflection, interdisciplinary collaboration and specific interdisciplinary training may be supportive to develop such a clinical language. Full article
(This article belongs to the Special Issue Religious and Spiritual Needs in Palliative Care)
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