Spiritual care at the end of life in the primary care setting: experiences from spiritual caregivers - a mixed methods study

Abstract

BackgroundSpiritual care is an important aspect of palliative care. In the Netherlands, general practitioners and district nurses play a leading role in palliative care in the primary care setting. When they are unable to provide adequate spiritual care to their patient, they can refer to spiritual caregivers. This study aimed to provide an overview of the practice of spiritual caregivers in the primary care setting, and to investigate, from their own perspective, the reasons why spiritual caregivers are infrequently involved in palliative care and what is needed to improve this.MethodSequential mixed methods consisting of an online questionnaire with structured and open questions completed by 31 spiritual caregivers, followed by an online focus group with 9 spiritual caregivers, analysed through open coding.ResultsSpiritual caregivers provide care for existential, relational and religious issues, and the emotions related to these issues. Aspects of spiritual care in practice include helping patients find meaning, acceptance or reconciliation, paying attention to the spiritual issues of relatives of the patient, and helping them all to say farewell. Besides spiritual issues, spiritual caregivers also discuss topics related to medical care with patients and relatives, such as treatment wishes and options. Spiritual caregivers also mentioned barriers and facilitators for the provision of spiritual care, such as communication with other healthcare providers, having a relationship of trust and structural funding.. In the online focus group, local multidisciplinary meetings were suggested as ideal opportunities to familiarize other healthcare providers with spirituality and promote spiritual caregivers’ services. Also, structural funding for spiritual caregivers in the primary care setting should be organized.ConclusionSpiritual caregivers provide broad spiritual care at the end of life, and discuss many different topics beside spiritual issues with patients in the palliative phase, supporting them when making medical end-of-life decisions. Spiritual care in the primary care setting may be improved by better cooperation between spiritual caregiver and other healthcare providers, through improved education in spiritual care and better promotion of spiritual caregivers’ services.

Sikap Perawat dalam Memberikan Asuhan Keperawatan pada Pasien Paliatif

“…Namun demikian petawat tetap harus menyesuaikan kondisi lingkungan dan keluarga pasien agar asuhan keperawatan berjalan lancar (Alvariza et al, 2020). Berdoa, bercerita dan membeikan semangat melalui spiritual adalah bagian dari asuhan dan tugas keperawatan (Koper et al, 2019), (Riahi & Khajehei, 2019).…”

Spiritual Care: Motivations and Experiences through the Lenses and Voices of a Cohort of Spiritual Care Workers at an Established Hospice in Cape Town, South Africa

“…Palliative care in South Africa (SA) has, in relative terms, only recently been formalised as a discipline (Republic of South Africa, 2017). Both locally (Bhagwan, 2017;Chandramohan & Bhagwan, 2015;Ratshikana-Moloko et al, 2020) and internationally (Abel et al, 2013;Koper et al, 2019;Paal et al, 2015;Puchalski et al, 2019) there is consensus that spiritual care should play a pivotal role in palliative care.…”

Strengthening the spiritual domain in palliative care through a listening consultation service by spiritual caregivers in Dutch PaTz-groups: an evaluation study

“…Although spiritual issues are considered relevant by Dutch GPs [18], they often struggle to provide adequate spiritual care, due to lack of time or attention for spiritual issues, or insufficient expertise and training [19]. When a GP finds him-or herself unable to provide adequate spiritual care, for example in a case with complex spiritual needs or when crisis intervention is needed, they can theoretically refer their patient to a professional spiritual caregiver, a healthcare provider with specific expertise in the assessment of spiritual needs and the delivery of spiritual care [2,20].…”