How to Talk to Children and Adolescents With Cancer About Spirituality? Establishing a Conversation Model

Abstract

Talking to children and adolescents with cancer about spirituality is a challenge. This study aimed to develop and evaluate a conversation model for a spiritual approach with children and adolescents with cancer. It was a methodological study with a systematic approach in three stages: (a) review of the literature for the selection of photographs and guiding questions, (b) using an expert committee to evaluate photographs and preselected questions, and (c) cognitive interview with children and adolescents to test the methodology. The expert committee evaluated and selected 20 photos and their respective guiding questions. Fifteen children and adolescents hospitalized with cancer tested the spirituality conversation model and expressed feelings, values, beliefs, fears, and the meaning they give to life and illness. The implementation of the conversation model can contribute both to the clinical practice, facilitating care for the spiritual dimension of pediatric patients, and to qualitative research on spirituality involving children.

Spirituality in Adolescents and Young Adults With Cancer: An Evolutionary Concept Analysis

“…Articles included in this analysis defined spirituality in different ways; however, common features included spirituality as a universal experience (Alvarenga et al, 2021; Robb et al, 2014; Sira et al, 2020; Torabi et al, 2018), a search for meaning (Alvarenga et al, 2021; Barton et al, 2018; Caldeira et al, 2017; Hendricks-Ferguson, 2006, 2008; Park & Cho, 2017; Petersen, 2014; Robb et al, 2014; Sira et al, 2020; Taylor et al, 2015; Vazifeh Doust et al, 2020), and a means for connectedness to others and the divine (Alvarenga et al, 2021; Caldeira et al, 2017; King et al, 2021; Robb et al, 2014; Sira et al, 2020; Taylor et al, 2015; Vazifeh Doust et al, 2020; Table 1).…”

“…King et al (2021) described the Divine as God or Higher power (King et al, 2021). This was described by adolescents in the study by Alvarenga et al (2021) and in another study as faith or belief in God (Alvarenga et al, 2021;Torabi et al, 2018). The following participant statements illustrate the relationship of the belief or wonder about the divine or higher power as an antecedent to spirituality and how this occurs regardless of an individual's beliefs.…”

“…Connectedness. The second attribute of spirituality identified was connectedness (Alvarenga et al, 2021;Sira et al, 2020;Torabi et al, 2018;Vazifeh Doust et al, 2020).…”

“…In the RIM model, spiritual perspective is a factor that drives resilience outcomes of enhanced well-being and illness acceptance. Other articles also described improved mental health, quality of life (Zebrack & Chesler, 2002), and illness acceptance (Alvarenga et al, 2021) as outcomes of spirituality.…”

Spiritual Needs of Brazilian Children and Adolescents with Chronic Illnesses: A Thematic Analysis

“…Individual audio-recorded interviews were carried out with the support of six photographs (Table 2). This technique is known as photo-elicitation interviewing and the set of photographs and guiding questions used were adapted from a model for addressing spirituality developed from a literature review, then evaluated by a committee of experts and tested with children and adolescents with cancer (Alvarenga et al, 2020). We adapted the conversation model of 20 photographs to six photographs which responded to the aims of the study.…”