The unique challenges that the COVID-19 pandemic has put upon us are more pronounced when dealing with cancer patients. Healthcare teams are adjusting to an ever-changing environment with an elusive disease that requires adaptation to new practices. Since much of the effort is directed toward Corona-dedicated departments, other teams are depleted, while required to maintain the same level of service. When dealing with cancer patients, things are even more complex: among those who do come to get treated, many are immunecompromised and are at a higher risk of complications upon contracting the virus. Others are reluctant to seek medical care in hospitals since they are perceived as "risky" places to contract the disease. We are starting to see patients that postponed seeking medical care in previous months and currently presenting with malignancies at later stages of their disease [1]. All this puts a huge burden on healthcare providers in general and those who treat cancer patients in particular. Positive professional quality of life leads to compassion satisfaction and better patient care. However, with the increased burden the tables turn.
Background Little is known about the impact of spiritual caregivers, psychologists, and social workers on desired end-of-life (EoL) medical outcomes, such as reduced use of aggressive care in the final 2 weeks of life, having more time between the last active oncological treatment and death, and increased hospice use. Patients and Methods We conducted a prospective study of 180 patients with cancer and their families, their interactions with social work, psychology, and spiritual care, and the above three treatment outcomes. Results We found that having one or more spiritual care visits (adjusted odds ratio (AOR) = 2.02; P = .04), having more quality visits with the psychologist (P = .01), and speaking with someone about one’s inner resources (AOR = 2.25; P = .03) all correlated with reduced EoL aggressive care. The key interventions correlating with increased time after final treatment were more visits with the spiritual caregiver or the social worker (AOR = 1.30; P < .001), and speaking about the medical treatment (AOR = 1.54; P < .001) and about interpersonal relationships (AOR = 2.28; P < .001). A subjectively good-quality connection with the spiritual caregiver correlated with increased hospice use (AOR = 10.00; P = .01). Conclusions Patients with cancer who availed themselves of the spiritual care, psychology, and social work services, each profession in distinct ways, had significantly different outcomes in their EoL medical treatment, including undergoing fewer futile aggressive measures, having more time after their last active treatment, and using hospice services more. These outcomes directly bear on improved quality of life and reduced costs.
Unlike Western countries with a majority of Protestant citizens, initiatives in the field of spiritual care provision in Israel have involved mostly lay leadership and secular individuals from their very inception, rather than clergy and religious adherents. This religiously neutral position made it easier for spiritual care to be accepted across the varied sub-populations that compose the unique mosaic of Israeli culture. Adhering to a religiously neutral approach led to the use of a broader set of tools in order to reach people in their time of distress. Currently, there are about 130 certified spiritual caregivers in Israel who graduated from four accredited training programs. This article describes three short case studies, in which we can see the benefits of three such neutral approaches – connecting with nature, gentle touch, and non-theistic personal prayer.
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