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.
Despite increased focus on the role of spiritual care in palliative care, there is limited knowledge about spirituality/religiosity among dying patients in secularized cultures such as Denmark. This study aims through semi-structured interviews with Danish hospice patients and participant observation to elucidate how hospice patients reflect and act upon their potential faith. The results demonstrate three dimensions of faith: (1) "Knowing" (cognition), (2) "doing" (praxis) and (3) "being" (meaning). The article concludes that most patients had a hesitant, but according to their situation, important faith although it was not something they knew much about, let alone discussed or practiced much.
Background Research suggests that addressing dying patients' existential concerns can help improve their quality of life. Common existential conditions, such as a search for meaning and considerations about faith, are probably intensified in a palliative setting and existential concerns about death are likewise intensified when patients face their impending death. Knowledge of modern, secular existential concerns about death is under-researched, and therefore, it is difficult to develop and implement specifically targeted support to dying patients. Aim The aim of this paper is to present the results from a qualitative field study illuminating the variety of dying patientś existential concerns about their impending death. Method Data was generated through ethnographic fieldwork comprising 17 semi-structured interviews with dying patients and 38 days of participant observation at three Danish hospices. Results The analyses of interview data revealed two categories of existential concerns. The first category "Thoughts and feelings about death" demonstrated how the patients: 1) realized the forthcoming death; 2) felt sorrow about leaving life; 3) were not anxious about death as a final state. The second category "Managing death" demonstrated how the patients: 1) avoided thinking about death; 2) reconstructed individual ideas about afterlife on the basis of faith and previous cultural meaningmaking; 3) were planning practical aspects about death; 4) wished to focus on living. The patients' existential concerns of death in a modern, secular setting is not adequately described by neither Irvin Yalom's existential psychology nor Kübler-Ross' theory about death stages. The complex concerns might be explained in the light of research in everyday life based on Martin Heidegger's phenomenological thinking. Conclusion The analyses indicated that the patients' concerns were complex, contradictory and not suited to be understood within a single theory. An ongoing reflection including different theoretical perspectives seems important when providing existential care and support to dying patients.
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