Search Results (99)

Pediatric palliative care (PPC) aims to enhance the quality of life of children with life-limiting conditions and their families through individualized, interdisciplinary support. Among this population, children with neurological diseases represent a substantial and growing group, often facing prolonged disease courses, cognitive impairment, and high prognostic uncertainty. Effective communication is central to PPC; however, it remains deeply influenced by cultural, religious, and spiritual frameworks that shape family perceptions of illness, suffering, and decision-making. This narrative review explores communication strategies in PPC, with a specific focus on children with neurological conditions, highlighting conceptual foundations, cross-cultural variations, and emerging best practices. Key findings highlight the importance of culturally humble approaches, family-centered communication models, and structured tools, such as co-designed advance care planning and dignity therapy, to enhance communication. Additionally, the review highlights the presence of ethical and interdisciplinary challenges, particularly in neonatal and neurology settings, where misaligned team messaging and institutional hesitancy may compromise trust and timely referral to palliative care. Future research, policy, and clinical education priorities should advocate for models that are inclusive, ethically grounded, and tailored to the unique trajectories of neurologically ill children. Integrating cultural competence, team alignment, and family voices is essential for delivering equitable and compassionate PPC across diverse care settings. Full article

Background: Spirituality is increasingly seen as a key component of patient-centered care, especially in serious illness or surgery. However, its role among surgical patients in Eastern Europe remains underexplored. Objective: To assess daily spiritual experiences among surgical patients compared to healthy individuals in the Bucovina region (northeastern Romania). Methods: This observational case-control study included 102 participants (51 surgical patients and 51 healthy controls), recruited between March 2023 and April 2024. Participants completed the validated Romanian version of the Daily Spiritual Experiences Scale (DSES). Results: Surgical patients reported significantly higher mean DSES scores (M = 66.27, SD = 16.40) than healthy individuals (M = 55.06, SD = 12.81; p < 0.001). Higher scores were also associated with female gender (p = 0.002), older age, and oncological conditions. Widowed and highly educated participants showed a trend toward higher spirituality, though it was not statistically significant. Conclusions: Surgery may intensify spiritual experiences, possibly as a coping response to perceived risk. Addressing spiritual needs in perioperative care—particularly among women, older adults, and oncology patients—could enhance holistic care and improve patient well-being. Full article

This study explores how Black student leaders (BSLs) at public historically white institutions (HWIs) in Florida and Georgia navigate racial battle fatigue (RBF) in the context of anti-DEI legislation. Amid rising political hostility toward diversity, equity, and inclusion (DEI) efforts, this research examines the lived experiences of 11 BSLs as they respond to racialized campus climates that are increasingly ambiguous and unsupportive. Using a critical qualitative approach, data were collected through two in-depth interviews per participant and analyzed using inductive and deductive coding. Four major findings emerged: (1) BSLs experience heightened psychological, physiological, and emotional forms if stress linked to their identity and leadership roles; (2) anti-DEI policies contribute to institutional erasure and confusion; (3) students express emotional withdrawal, hypervigilance, and disillusionment with performative leadership; (4) students employ culturally grounded coping strategies centered on self-care, spirituality, and community. This study underscores that BSLs are both empowered and burdened by their leadership, especially under politically restrictive conditions. The findings call for student affairs educators to prioritize engagement and belonging and offer identity-affirming support. Further, scholars with academic freedom are urged to continue documenting racialized student experiences. These insights are critical to protecting Black student leadership and equity-centered educational transformation. Full article

This article describes the design and implementation of a Specialized Mental Health Clinical Pastoral Education (CPE) program for clergy and theological students of all spiritual, religious, and cultural backgrounds. Addressing the need for mental health competencies in religious leaders and chaplains, this training equips participants with specialized skills in individual and group mental health spiritual assessment and spiritual care. Program participants become effective members of a multiprofessional team, gain knowledge of mental health philosophies of concordant and discordant spiritual orienting systems, and gain greater relational capacity. The Mental Health CPE Program includes traditional and novel CPE elements: (1) clinical practice, (2) group and individual supervision, (3) didactic presentations and journal clubs, (4) verbatim (Protocols of patient encounters) and case presentations, (5) group leadership training and practica, and (6) experience of faith reflections. This article provides insights into the origins of CPE, a description of the implementation in a free-standing psychiatric hospital, and observed developmental changes of program participants. We include graduates’ anecdotal feedback about their learning experience and its impact on their leadership in chaplaincy and in religious communities. Additionally, we report on areas for future development and further study of the effectiveness of Mental Health CPE. Full article

Background: Spiritual care is vital for the holistic well-being of hospitalized cancer patients, addressing their emotional, psychological, and spiritual needs. This study addresses gaps in the relevant literature by evaluating spiritual perspectives among Peruvian oncology patients, offering culturally grounded insights that can inform nursing practice and healthcare management. The main objective of this research was 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. Materials and methods: This study aimed to evaluate the perceived levels of Spiritual Perspective among oncology patients in a hospital setting. Adopting a quantitative, descriptive, cross-sectional design, data were gathered from 137 patients at a national hospital in Lima, Peru. Results: The majority of participants were older adults, with a high school education, and predominantly single. Findings revealed that most patients experienced moderate levels of Spiritual Perspective, spiritual practices, and beliefs. Patients commonly practiced prayer, meditation, and spiritual reading. Beliefs centered on a higher power and forgiveness. Essential support networks also provided emotional aid, complementing spiritual care. Conclusions: This study highlights the importance of spiritual care in nursing for oncology patients. Findings advance understanding of spirituality in illness and support interventions to improve patient outcomes. Full article

There are many different perspectives on what the spiritual aspect of education entails, as well as how it should be addressed in a professional context. Spirituality has been defined as a central aspect of children’s overall development in Denmark since the Primary School Act of 1993, but at the same time public schools in Denmark are secular institutions not affiliated with any particular faith and a non-confessional spiritual education. This article addresses the concept of spiritual education of children in a Danish post-secular context by presenting and discussing different studies, knowledge, and definitions on children’s spirituality, as well as spiritual education of children and spiritual care for children. We point to the importance of the concept of “dannelse” or “bildung”, Hans-Georg Gadamer’s concept of “the basic movement of spirit”, and Hannah Arendt’s concepts related to “the life of the mind”, and thus what is meant by spiritual education. We conclude how educators, parents, and healthcare professionals should facilitate spiritual education through the perspective of “dannelse”, and we present a model for doing so through spiritual dialogue and relationships. Full article

Parents provide most of the support needed for children with cerebral palsy (CP) to increase the child’s participation and independence. Understanding the experiences of parents caring for children with CP is essential for developing effective family programs and services. The current knowledge about parents’ experiences in CP is based on studies in Western countries, with little known about this phenomenon in Arab countries like Saudi Arabia. This study aimed to understand the unique experiences and support needs of Saudi parents caring for children with CP from a social-ecological perspective. We conducted a qualitative, exploratory, descriptive study involving 12 semi-structured interviews with mothers and fathers of children with different types of CP. We analyzed the data using a reflexive thematic approach, following six distinct phases. Participants’ narratives revealed a complex caregiving journey marked by both challenges and rewards. Support from Saudi nuclear and extended family members was considered important; however, many parents expressed a need for additional physical and financial assistance from their families. Parents reported feeling stressed and experiencing challenges in accessing and navigating educational and healthcare services. Our findings highlight that Islamic values play a crucial role in the experiences of Saudi parents. These values foster a sense of collectivism, highlighting the importance of family support and community involvement, which can affect the Saudi caregiving environment. Parents remain an essential yet often invisible part of the Saudi caregiving system. Without adequate support, parents are at risk of experiencing social, financial, academic, physical, and mental health challenges, which may affect their overall family well-being. Future work may need to consider spiritual and gender roles when developing programs or services to support Saudi parents of children with CP. Full article

Self-care is a complex concept that incorporates various strategies designed to promote personal wellbeing and prevent illness, which is a critical need in nursing given the profession’s inherent stressors. The physical, emotional, spiritual, and psychological demands placed on nurses can significantly influence their wellbeing and the quality of care they provide. Yet, professional accountability and responsibility for self-care remains contested within the profession. To support a healthier and more sustainable healthcare workforce, Approved Education Institutions (AEIs) delivering pre-registration nursing programmes can play a pivotal role in embedding self-care ethos and practices into the nursing curricula. Grounded in educational psychology and drawing on insights from related theories, this paper explores barriers to self-care, proposes actionable interventions, and advocates for its integration as a cornerstone of nursing education. Full article

Background/Objectives: Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide, with transarterial chemoembolization (TACE) commonly used as a palliative approach for patients who are not candidates for surgical resection. Understanding the factors that influence health-related quality of life (HRQoL) after TACE is essential for improving patient-centered care. This systematic review seeks to consolidate current evidence on the variables that impact HRQoL in HCC patients post-TACE. Methods: In adherence to PRISMA guidelines, a comprehensive search was conducted across five English and Chinese databases—PubMed, Scopus, Web of Science, CNKI, and Wanfang—covering studies from database inception to May 2025. Eligible studies were observational and examined factors affecting HRQoL in post-TACE HCC patients. Two independent reviewers performed screening, data extraction, and quality assessment using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Results: Nine studies met the inclusion criteria, including six cohort studies and three cross-sectional studies. The quality assessment rated seven studies as high quality and two as moderate. A range of validated HRQoL assessment tools was used, with the EORTC QLQ-C30 and FACT-G being the most commonly employed. The factors influencing HRQoL were grouped into five categories: (1) demographic factors (e.g., age, gender, education level); (2) clinical indicators (e.g., liver function, tumor burden); (3) psychological factors (e.g., depression, anxiety, spiritual well-being); (4) social support (e.g., financial status, coping mechanisms); and (5) physical symptoms (e.g., fatigue, pain, appetite loss). Across studies, both symptom severity and psychological distress were consistently associated with lower HRQoL. Conclusions: The HRQoL of HCC patients following TACE is influenced by a complex interplay of demographic, clinical, psychological, social, and symptomatic factors. Tailored, multidimensional interventions addressing these diverse aspects are crucial to optimizing recovery and improving overall well-being. Full article

The article seeks to read the contribution of religious practices in prison education within the broader framework of spirituality as a search for meaning in life. It argues that religious engagement can foster cognitive and emotional development, providing inmates with a sense of purpose, community, and resilience that supports their reintegration into society. In light of an exceptional and extremely significant experience with APAC in Brazil’s police-free prison model, the authors aim to highlight the nexus between spirituality and re-education in contexts of deprivation and restriction of personal liberty. Indeed, the APAC (Association for the Protection and Assistance of the Convicted) model, central to this study, emphasizes nonviolent coexistence, responsibility, and spiritual care as part of its rehabilitative framework, with a significant reduction in recidivism rates and costs compared to traditional prisons. The model’s approach, grounded in a collective sense of responsibility and spirituality, aligns with Viktor Frankl’s and Paulo Freire’s theories on meaning and liberation, illustrating how spirituality can transform prison environments and promote social justice. The study concludes that spirituality in prisons not only aids individual redemption but also calls for structural changes to support reintegration, marking a shift towards a more human-centered penitentiary system. Full article

Background/Objectives: Population aging has become a common concern worldwide. At present, the aging rate of China far exceeds the international standard, and the rural population in China faces a more obvious aging problem. With the increasing number of the older population, the demand for elderly care services is constantly diversified, and the homogenized service supply in rural areas fails to effectively meet the service needs of older adults. Methods: This study employs a multi-stage stratified sampling method to survey rural older adults in Shaanxi, Hebei and Jiangsu provinces (n = 803, effective response rate > 95%). The dependent variable is categorized into four levels: no, mild, moderate and severe demands. Independent variables include demographic characteristics (age and gender), predisposing factors (education and marital status), enabling resources (income and family support) and need factors (health status). In the survey, the questionnaire survey method is adopted, and a multinomial logistic regression model is used to analyze the factors influencing the demand degree for elderly care services in rural areas. Results: Regression analysis indicates that pension level exerts a significant influence on the demand intensity for medical care, entertainment and spiritual comfort services. Family support is significantly associated with the demand intensity for medical care and spiritual comfort services. This study reveals that the pension level of elderly adults in rural areas is a key factor affecting the demand degree for elderly care services. The influence of family support on the demand for elderly care services should not be underestimated. Older adults in rural areas have a high demand for medical care services. Conclusions: A gap remains between elderly care service resources and the needs of older adults in rural areas of China. The government should pay attention to allocating and optimizing elderly care service resources to meet the needs of older adults. Full article

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2025 Annual Conference, titled “Responding to the Human Experience of Cancer and Caring for the Soul: Building on 40 years of global leadership in psychosocial oncology”. The 40th Annual CAPO Conference was held in Toronto from 23 April 2025 to 25 April 2025. In an era marked by the rapid advancement of biologically focused precision medicine, it is imperative to redirect our attention towards the human experience of illness and the soul of medicine. Biomedicine has conceptualized illness in ways that have proved profoundly productive from a curative and biological point of view. But it cannot—and it does not pretend to—illuminate the experience of living with it. (Hurwitz 2009). This conference aims to delve into the intricate interplay between cutting-edge biomedical technologies inclusive of artificial intelligence and big data and the deeply personal narratives of individuals navigating illness. By shifting the focus from mere disease pathology to encompassing the holistic human experience, we aspire to foster a more compassionate and patient-centered approach to healthcare with psychosocial support at the core of humanistic care that can improve survival and well-being in all aspects of a whole-person approach to illness. Through interdisciplinary dialogue and introspection, we endeavor to illuminate the profound connection between mind, body, and spirit in the practice of medicine, reaffirming the timeless significance of empathy, understanding, and human connection in healing and psychosocial aspects of care as fundamental to living well with cancer. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over two hundred (200) abstracts were submitted for presentation as symposia, 20-minute oral presentations, 10-minute oral presentations, 90-minute workshops and poster presentations. We congratulate all the presenters on their research work and contribution. Full article

Improving public awareness of palliative care is crucial for improving access to, and uptake of, palliative care, which has demonstrated benefits for patients and health systems. However, there is a lack of engaging, accessible educational palliative care resources designed for public audiences. As part of a larger quality improvement initiative to strengthen awareness of palliative care, we developed “Understanding Palliative Care”—an innovative, online educational module incorporating best practices for defining and promoting palliative care to a public audience. An expert working group with representation from nursing, medicine, social work, instructional design, and care navigation advised on the development of the module. Incorporating the perspectives of Albertans with lived palliative care experience was deemed essential by the working group. We identified three Albertans (one patient and two family caregivers) of diverse ages and cultural backgrounds who had personally benefitted from palliative care and consented to record virtual interviews. We incorporated multiple interview segments into the module that highlight the physical, emotional, social, and spiritual support provided by palliative care. Finally, a panel of thirteen public volunteers provided feedback on the content, design, and navigation of the draft module. The Understanding Palliative Care module fills an important gap in Alberta, providing a free, online, evidence-based, and engaging educational tool to improve public awareness and understanding of palliative care. Full article

Background/Objective: Although the context, personal conditions, and caregivers’ abilities influence the nutrition of older people with dementia, adequate parameters are not always applied to identify these conditions. The aim of this study was to characterize the nutritional care needs of older people with dementia and their caregivers. Method: This descriptive exploratory study was conducted in Colombia. An intentional sample included 73 elderly individuals with dementia and 73 caregivers. This study described the participants’ characteristics with the GCPC-UN-D survey. Their nutritional conditions include medical history, objective tests, and interviews. We used the Edinburgh Scale to evaluate elderly feeding behavior and the QUALID tool to evaluate their quality of life. This study measured caregiver competence using the CUIDAR tool. Results: Adults of 78.8 years on average, with low to middle socio-economic status, low education levels, and multiple comorbidities, have adverse well-being and support conditions, except for the spiritual component. These adults have visible nutritional issues including low muscle mass indices (47.9%), muscle mass levels (arm 61.6%; calf 58.9%), and vitamin D levels (50.7%), with high cholesterol levels (57.9%) and altered hematocrit and red blood cell counts (46.4%). These adults required supervision (41%) or help (23%) for their nutrition. Caregivers were predominantly women with an average age of 32.4 years, with moderate caregiving competences (70.43%), experienced high caregiver burden (83.6%), and had low orientation in nutritional management (30.1%). Conclusions: Elderly individuals with dementia had significant nutritional and feeding problems. Their caregivers lacked adequate conditions to ensure quality care. These dyads need a strategy to improve their healthcare experience. Full article

Background/Objectives: This study aimed to adapt evidence-based diabetes self-management education and support (DSMES) into a faith-based (FB) context for Hispanic communities and compare its effectiveness to a faith-placed (FP) approach using the church as a venue for DSMES delivery. Methods: A cluster-randomized trial was conducted among adults with type 2 diabetes from predominantly Hispanic churches. The churches were assigned to either the FB Group (nine churches, n = 146) or the FP Group (seven churches, n = 125). The FB Group, led by trained lay health leaders, received a health sermon, a six-session DSMES program, and a seven-session Healthy Bible Study. The FP Group, led by outside health professionals, received the same six-session DSMES and a seven-session partial attention control curriculum. Key outcomes, including hemoglobin A1c (HbA1c), waist circumference (WC), diabetes distress, self-care activities, and self-efficacy, were assessed at baseline, 6, 9, and 12 months. Results: The FB Group had lower HbA1c levels than the FP Group at 6 months (−0.3%, p < 0.01), with no within-group differences post-intervention. No significant between-group differences were found for other outcomes. Within-group comparisons from baseline showed that both groups reduced WC at 9 and 12 months. Both groups showed reductions in diabetes distress and increased self-efficacy at all time points post-intervention (p < 0.05). The FB Group increased self-care scores at all time points post-intervention, while the FP Group increased at 9 and 12 months. Conclusions: DSMES can be effectively delivered in church settings by trained lay leaders or health professionals in Hispanic communities. Adding a spiritual dimension to DSMES may enhance outcomes. Full article