ObjectivesThe overall study aim was to synthesise understandings and experiences regarding the concept of spiritual care (SC). More specifically, to identify, organise and prioritise experiences with the way SC is conceived and practised by professionals in research and the clinic.DesignGroup concept mapping (GCM).SettingThe study was conducted within a university setting in Denmark.ParticipantsResearchers, students and clinicians working with SC on a daily basis in the clinic and/or through research participated in brainstorming (n=15), sorting (n=15), rating and validation (n=13).ResultsApplying GCM, ideas were identified, organised and prioritised online. A total of 192 unique ideas of SC were identified and organised into six clusters. The results were discussed and interpreted at a validation meeting. Based on input from the validation meeting a conceptual model was developed. The model highlights three overall themes: (1) ‘SC as an integral but overlooked aspect of healthcare’ containing the two clusters SC as a part of healthcare and perceived significance; (2) ‘delivering SC’ containing the three clusters quality in attitude and action, relationship and help and support, and finally (3) ‘the role of spirituality’ containing a single cluster.ConclusionBecause spirituality is predominantly seen as a fundamental aspect of each individual human being, particularly important during suffering, SC should be an integral aspect of healthcare, although it is challenging to handle. SC involves paying attention to patients’ values and beliefs, requires adequate skills and is realised in a relationship between healthcare professional and patient founded on trust and confidence.

The aim of this article is to illustrate and outline an understanding of spiritual care as a process involving a number of organically linked phases: (1) the identification of spiritual needs and resources, (2) understanding the patient’s specific needs, (3) developing the individual spiritual care treatment plan, hereunder involving the relevant healthcare/spiritual care professionals, (4) the provision of spiritual care, and (5) evaluating the spiritual care provided. The focus on spiritual care in healthcare research has increased throughout the past decades, showing that existential, spiritual, and/or religious considerations and needs increase with life-threatening illness, that these needs intensify with the severity of disease and with the prospect of death. Furthermore, research has shown that spiritual care increases quality of life, but also that failing to provide spiritual care leads to increased chance of depression and lowered health conditions. The World Health Organization accordingly emphasizes that providing spiritual care is vital for enhancing quality-of-life. Looking at spiritual care as a process suggests that working within a defined conceptual framework for providing spiritual care, is a recommendable default position for any institution where spiritual care is part of the daily work and routines. This so, especially because looking at spiritual care as a process highlights that moving from identifying spiritual needs in a patient to the actual provision of spiritual care, involves deliberate and considered actions and interventions that take into account the specific cultural and ontological grounding of the patient as well as the appropriate persons to provide the spiritual care. By presenting spiritual care as a process, we hope to inspire and to contribute to the international development of spiritual care, by enabling sharing experiences and best-practices internationally and cross-culturally. This so to better approach the practical and daily dimensions of spiritual care, to better address and consider the individual patient’s specific spiritual needs, be they secular, spiritual and/or religious. In the final instance, spiritual care has only one ambition; to help the individual human being through crisis.

Background Safeguarding the dignity of patients at the end of life is a key objective in palliative care practice in Denmark. The concept of dignity and how it influences a dying persons’ quality of life is thus influential in end‐of‐life care at hospices. However, what is meant by dignity, how dignity is understood and practiced by healthcare professionals in Danish hospices, and whether this relates to the patients’ understandings and needs concerning dignity remains unanswered. Aim The aim of this study was to explore and improve dignity in care through an action research study with patients and hospice staff at two different hospices in Denmark. This was done by exploring how patients and healthcare professionals expressed their understandings and needs concerning dignity and involving participants in the research process with the goal of improving dignity in care. Methods An action research method with reflection‐of‐praxis and action‐in‐praxis was applied. It was combined with methods of semi‐structured individual interviews with twelve patients, five staff and nine focus‐group interviews with staff. Results Three themes emerged from the analysis of data. The themes were as follows: (1) being understood, (2) contributing and (3) holistic care. Deeper analysis indicated that staff understandings of dignity mostly focused on preserving patients’ autonomy, whereas patients expressed needs for relational and spiritual aspects of dignity. Staff were mostly concerned about preserving patients’ autonomy when providing dignity in care, however, through the action‐in‐praxis they increased their awareness on their own praxis and patients’ needs and understanding concerning dignity. The theoretical model on dignity presented in the study also worked as a map to guide staffs’ reflections on dignity in praxis and facilitated a broader focus on supporting and caring for patients’ dignity in care. We believe this study has improved dignity in care at the two hospices involved in the study.

Objective: Patients treated for multiple myeloma often suffer from anxiety and depression related to concerns about the future. This indicates a need for improvement of communication between patients and healthcare professionals within haematology. The aim of this study was to explore how patients with multiple myeloma and their caregivers experience serious illness conversation focusing on illness understanding, concerns, values, and wishes for the future.Methods: Phenomenological, semi-structured dyad interviews were carried out in patients with multiple myeloma (n = 12) and their caregivers (n = 11) 2-20 days after participation in one serious illness conversation. interpretive phenomenological analysis was used for analysing data.Results: Three themes emerged (1) transforming patient-caregiver communication,(2) redeeming communication, and (3) equality in communication in an unequal relation. Furthermore, time allocated for the conversation and preparatory materials for the conversations highly influenced outcome. Conclusion:The findings suggest that serious illness conversation can help patients and family caregivers managing living life with multiple myeloma by increasing dyadic communication and strengthen their use of existential language together with healthcare professionals. This study highlights the benefits of preparing patients and caregivers prior to the conversation and cancer care systems should strive to allocate ample time for serious illness conversations.

We systematically reviewed the research literature on spiritually and religiously integrated group psychotherapy to answer the following three questions: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group psychotherapy; and, third, what is the outcome of the group psychotherapies? We searched in two databases: PsycINFO and PubMed. Inclusion and exclusion criteria and checklists from standardized assessment tools were applied to the research literature. Qualitative and quantitative papers were included. In total, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from other types of group psychotherapies, was not fully conceptualized or understood either. However, clear and delimited conceptualization of spiritual and religious factors is crucial in order to be able to conclude the direct influences of spiritual or religious factors on outcomes. Implications for spiritually or religiously integrated group psychotherapy and conducting research in this field are propounded.

Spiritual care has been a growing focus in international healthcare research over the last decades. The approaches to spiritual care are many and derive from many different medical fields and different cultural contexts and often remain unknown across healthcare areas. This points to a potential knowledge gap between existing instruments and the knowledge and use of them cross-disciplinarily and cross-culturally, and thus best practice insights are not sufficiently shared. This article contributes to the growing field of spiritual care by providing an overview of the various approaches (henceforth instruments) to assess patients’ spiritual needs in view of improving spiritual care. This was done through a scoping review method. The results of the review were collected and catalogued and presented here as ‘The Catalogue of Spiritual Care Instruments’. The included instruments derive from a wide range of geographical contexts and healthcare areas and are aimed at patients and healthcare professionals alike, clearly showing that spiritual care is a focus in healthcare internationally. However, it also shows the difficulties of defining spiritual care, the importance of local contexts, and the difficulties of cross-cultural validity. The catalogue contains 182 entries and is available as an interactive platform for the further development of spiritual care internationally.

Denmark is considered one of the World’s most secular societies, and spiritual matters are rarely verbalized in public. Patients report that their spiritual needs are not cared for sufficiently. For studying spiritual care and communication, twelve patients admitted to two Danish hospices were interviewed. Verbal and non-verbal communication between patients and healthcare professionals were identified and analysed. Methodically, the Interpretative Phenomenological Analysis was used, and the findings were discussed through the lenses of existential psychology as well as philosophy and theory of caring sciences. Three themes were identified: 1. When death becomes present, 2. Direction of the initiative, and 3. Bodily presence and non-verbal communication. The encounter between patient and healthcare professional is greatly influenced by sensing, decoding, and interpretation. A perceived connection between the patient and the healthcare professional is of great importance as to how the patient experiences the relationship with the healthcare professional.The patient’s perception and the patient’s bodily experience of the healthcare professional are crucial to whether the patient opens up to the healthcare professional about thoughts and needs of a spiritual nature and initiates a conversation hereabout. In this way we found three dynamically connected movements toward spiritual care: 1. From secular to spiritual aspects of care 2. From bodily, sensory to verbal aspects of spiritual care and 3. From biomedical to spiritual communication and care. Thus, the non-verbal dimension becomes a prerequisite for the verbal dimension of spiritual communication to develop and unfold. The behaviour of the healthcare professionals, characterised by the way they move physically and the way they touch the patient, was found to be just as important as verbal conversation when it comes to spiritual care. The healthcare professional can create a connection to the patient through bodily and relational presence. Furthermore, the healthcare professionals should let their sensing and impressions guide them when meeting the patient in dialog about matters of a spiritual nature. Their perception of the patient and non-verbal communication are a prerequisite for being able to meet patient’s spiritual needs with care and verbal communication.

The aim was to explore transformations of religiosity experienced by Danish Pentecostals following a crisis and religiously integrated group psychotherapy. The study included semistructured interviews with 18 participants. The qualitative method of interpretative phenomenological analysis was applied for generating and analyzing the datamaterial. The findings suggested that all participants encountered a secondary religious transformation following the personal crisis or religiously integrated group psychotherapy. From a religious development perspective, however, the transformations following the crisis could not all be considered mentally healthy although the religious transformations facilitated by the group therapy were mentally healthy from both developmental and meaning system perspectives.