Spiritual beliefs, practices, and needs at the end of life: Results from a New Zealand national hospice study

Abstract

As a result of our study, which was the first nationwide study in NZ to examine spirituality in hospice care, Hospice New Zealand has developed a spirituality professional development program. Given that spirituality was found to be important to the majority of our participants, it is hoped that the adoption of such an approach will impact on spiritual care for patients and families in NZ hospices.

Patients' spirituality perspectives at the end of life: a qualitative evidence synthesis

“…The majority of studies were conducted in North America (n=26),19–44 with 11 from Europe,45–55 7 from Oceania4 56–61 and 6 from Asia 62–67. Participants were sampled from hospice settings (inpatient and hospice at home) in 27 studies,4 19 25 26 28–35 38–40 45–47 53 54 56–58 60–62 66 acute and long-term care settings in 9,22 27 44 55 59 63–65 67 general practices settings in 3,42 48 52 cancer centres in 4,23 24 36 37 a mix of settings in 3 studies21 49 50 and palliative care centres in 2 studies 43 51. One study provided no details on where participants were recruited from 41.…”

“…For 10 datasets, studies were included where they reported that the majority of patients (ie, ≥50%) had died within a year or before study completion 23 24 26 27 31 34 36 39 46 59 61. Twenty-one datasets included participants with a mix of chronic conditions,19 21 25 28–33 39–45 47–50 53 54 56–58 61 18 datasets included only participants with cancer,4 20 23 24 26 27 34–37 46 51 52 59 60 62–67 and 1 dataset included participants with only neurodegenerative diseases 55. Two datasets did not specify participants’ conditions 22 38…”

“…Twenty-two studies focused on issues of spirituality at the end of life,4 19 20 22 25 28 32 33 38 39 44 47–49 53 54 56–58 60 62 63 while the remaining studies provided insights into spirituality within the broader context of patient needs and experiences at the end of life 21 23 24 26 27 29–31 34–37 40–43 45 46 50–52 55 59 61 64–67. In the studies that reported religious affiliation, patients included Christians (predominantly Catholics, Protestants, Baptists and Methodists), Muslims, Jews, Sikhs, Buddhists, Confucian or Taoists, charismatic denominations, and those with no specific religious affiliation.…”

“…Spirituality at the end of life is important to patients,4 5 and family carers,6 and has a positive association with patients’ quality of life, physical health and social well-being 2 7. Patients report being comfortable with healthcare providers inquiring about spiritual needs8; however, spiritual and social issues are discussed less often by healthcare providers than other end-of-life issues such as physical symptoms 9.…”

“…However, where national end-of-life quality indicators exist, only a small number of indicators measure spiritual care 11. Spiritual care is often neglected by healthcare providers,4 5 and barriers to the provision of spiritual care reported by healthcare providers include lack of time, personal, cultural or institutional factors, and professional educational needs 8 12…”