Research documents that many chronic non-malignant pain patients experience existential, spiritual and religious needs; however, research knowledge is missing on if and how physicians approach these needs. We conducted a systematic review to explore the extent to which physicians address these needs in their communication with chronic non-malignant pain patients and to explore the facilitators and challenges of this communication. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching Embase, Medline, Scopus and PsycINFO. The quality of the included articles was assessed based on design-specific screening tools. We included four of 2337 screened articles and found the quality to be good. Physicians’ communication about existential, spiritual and religious needs was given low priority and depended on the patients’ own initiative, except when clinicians were interested in holistic care. Patient dissatisfaction with the physician’s attention to these needs was related to higher pain and depression. Physicians’ challenges for addressing these needs were their tendency to prioritize physiological aspects and close further elaboration of existential needs when addressed by the patients. The main facilitator was the individual physician’s willingness to listen with openness and empathy to the patients’ existential concerns. A tentative conclusion is that physicians rarely meet the existential, spiritual and religious needs of their chronic non-malignant pain patients. This might be due to higher priority of physical aspects, lack of time and a lack of knowledge about the importance of and training in the ability to address these needs. Further research is needed on physicians’ communication about existential, spiritual and religious needs and on their training in here.

To explore patients’ existential challenges when living with chronic pain or multiple sclerosis, 23 semistructured patient interviews were conducted together with an interpretative, phenomenological analysis inspired by Søren Kierkegaard. Patients experienced their illness as a “stroke of fate” resulting in despair and a profound struggle to find out, who they were, and how they could relate to themselves in their new life-situation. Becoming oneself was experienced as a long-term existential process realized by synthesizing the existential poles of necessities and possibilities through “the other,” such as relationships, nature, spirituality, or God. The different ways to respond to the existential challenges were identified as subjective choices of aesthetic, ethic, and religious life-spheres. The Kierkegaardian relational self and the life-spheres as diverse possibilities are valuable for understanding patients’ existential challenges and the complicated process of finding a new way to relate to oneself when life is fundamentally transformed by illness. To resolve the existential struggles, it seems essential to take a subjective stand in life and have a relationship to something bigger than oneself. The findings can inform clinical practice and inspire health care professionals to identify patients who would welcome a dialogue about illness-related existential struggles for the benefit of their health.

(2020) 'Maybe we are losing sight of the human dimension'-physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis.

This article aims to understand why religion has proven difficult to address in secular healthcare, although existential communication is important for patients’ health and wellbeing. Two qualitative data samples exploring existential communication in secular healthcare were analyzed following Interpretative Phenomenological Analysis, leading to the development of the analytical constructs of ‘the secular’ and ‘the non-secular’. The differentiation of the secular and the non-secular as different spheres for the individual to be situated in offers a nuanced understanding of the physician–patient meeting, with implications for existential communication. We conceptualize the post-secular negotiation as the attempt to address the non-secular through secular activities in healthcare. Employment of the post-secular negotiation enables an approach to existential communication where the non-secular, including religion, can be addressed as part of the patients’ life without compromising the professional grounding in secular healthcare. The post-secular negotiation presents potential for further research, clinical practice, and for the benefit of patients.

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The lockdown of society arising out of COVID-19 can be viewed as a microscope exposing the existential conditions and challenges of young people’s lives and their manner of dealing with crises. This study employs a qualitative research methodology using semi-structured interviews of 19 young people, aged 16–17 years, after the second COVID-19 lockdown in Denmark, March 2021. An analytical strategy was applied using reflexive methodology taking concepts from Søren Kierkegaard, Martin Buber, and Martin Heidegger to interpret the participants’ experiences of existential themes important to them, such as identity. Drawing on Kierkegaard’s idea of different “interpretive spheres” of life, we suggest that crisis revealed a disruption of the young peoples’ performance-oriented approach to life that made it possible to reflect and relate to themselves through aesthetic, ethical and self-transcending spheres. We suggest that the relationship to the other—as an ethical obligation, as an affective Being-with, and as something bigger than themselves—is crucial to the ways in which young people handle and relate to existential challenges and the experience of being and becoming themselves. The findings contribute to education and well-being, pointing out mental challenges among young people and stressing an existential focus as a priority in educational practice.

ObjectiveBreast cancer is the most common cancer diagnosis among women. The acute crisis and uncertainty that often follow diagnosis put the family at risk of exhaustion and dysfunction. Adolescents have been identified as a particularly vulnerable group of relatives. To investigate how to prevent distress in this group, we systematically reviewed research on adolescents' (11–21 years) needs for information and psycho‐social support during their mothers' breast cancer trajectory.MethodSystematic searches were conducted in five bibliometric databases. Peer‐reviewed, original research of adolescents aged 11–21 with a mother diagnosed with breast cancer was included. Two researchers conducted screening, quality assessment, and data extraction independently. Thematic synthesis was applied to the included studies.ResultsA total of 8066 studies were screened, and five quantitative and six qualitative studies were included. The results indicated that adolescents' information and psycho‐social support needs were poorly met. Many were reluctant to share feelings with family and peers and experienced abandonment during the crisis. Adolescents who were not well informed experienced distress. Poor family functioning increased the level of adolescents' distress.ConclusionsDespite limitations regarding heterogeneity among the studies, eligibility criteria, and quality assessment, this review provides clear clinical implications. Encounter groups may support adolescents during their mother's breast cancer trajectory. Furthermore, healthcare professionals could provide more indirect support to adolescents by providing support and clearer guidelines to parents. Finally, adolescents from poor‐functioning families need extra attention.

Faith experiences constitute important sources of meaning but also a risk of religious struggles. However, studies exploring the faith experiences of clients in relation to psychological functioning in psychotherapy are needed, especially in secularized countries. This study investigated how clients described faith experiences when addressed in psychotherapy, how they experienced faith in relation to coping, and how the experiences were integrated into the psychotherapy. Written records of 33 clients from a psychological clinic with outpatient care in Denmark were analyzed using interpretative phenomenological analysis. The most prevalent diagnoses among the clients were stress, depression, anxiety, and life crises. The clients reported that spiritual and religious beliefs functioned as sources of meaning and constituted either a strength, a challenge, or a combination of both. The psychosocial life and coping strategies of the clients were interwoven with faith experiences. A psychological, resource-focused approach in relation to the clients’ religious challenges seemed to help them toward a more flexible and resource-oriented faith. Assessing faith experiences as sources of meaning in a therapeutic approach focusing on the client’s resources may increase both the psychological functioning of clients and the therapists’ understanding of clients’ lifeworlds.