End of life in acute hospital setting—A systematic review of families' experience of spiritual care

Abstract

Aims and objectives To systematically review qualitative studies exploring families' experiences of spiritual care at the end of life in acute hospital settings. Background Although there is a widespread belief that the consideration of spiritual and religious needs is outdated in the context of secularism, from a practical perspective patients and families appear to benefit from spiritual support at the end of life. Methods Six key databases, CINAHL, MEDLINE, EMBASE, Global Health Library, Web of Science and Applied Social Sciences Index and Abstracts (ASSIA), were searched, and three reviewers independently extracted the data and coded them into themes and subthemes. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) was used as a reporting framework. Results Five main themes emerged: anticipating needs; honouring the family by honouring the patient; personal connection; lack of sensitivity; and making space for religious and spiritual practices. Conclusions Families experiencing end‐of‐life care in acute hospital settings may benefit from spiritual care. While this can also be considered as fundamental care, understanding this through the lenses of spiritual care allows for incorporation of religious and spiritual practices that many seek at this time, irrespective of their faith perspectives. Relevance to clinical practice Although hospice care is well established internationally, many families experience end‐of‐life care in acute hospital settings. Nurses usually get to know families well during this time; however, the demands of the clinical environment place restrictions on family care and perceptions of lack of communication, limited support and/or limited sensitivity can compound families' suffering. Consideration of families' spiritual needs can help to support families during this time. Nurses are ideally placed for this and can anticipate and plan for patient and family needs in this regard, or refer to a specialist, such as the Healthcare Chaplain.

Healthcare professionals’ perceptions of palliative care quality in a combined acute oncology-palliative care unit: A cross-sectional study

“…17,39,41 In addition, our findings are in line with studies evaluating quality of palliative care from the families' perspective. 24,41,53 Therefore, we stress the need for developing palliative care quality in settings outside hospices and specialist palliative care units. Consequently, intervention studies are needed.…”

Muslim nurse’s spiritual sensitivity as a higher perception and reflection toward spiritual care: a qualitative study in southeast Iran

“…Nurses must first identify these needs to provide spiritual care. A study showed that families of dying patients required spiritual support and peace of mind, which were ignored by some nurses [ 32 ]. Although nurses in the present study emphasized the importance of the spiritual needs of patients and their family members, studies revealed that healthcare professionals and nurses still paid little attention to patients’ religious and spiritual needs compared to their needs for acute medicine [ 33 , 34 ].…”

Families may benefit from spiritual care in acute settings when loved ones are coming to the end of their lives

“…However, compared to palliative care in hospices and palliative care settings, the evidence for end of life care in the acute hospital setting is less consistent and developed (2), with the majority of this research focusing on the experiences of patients and healthcare providers (3) rather than from a families' perspective. Therefore, this review seeks to examine families' experiences of spiritual care at the end of life in the acute hospital setting (3).…”