Spiritual care practices in hospices in the Western cape, South Africa: the challenge of diversity

Abstract

Background South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust. Discussion Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.

Exploring the challenges and roles of nurses in delivering palliative care for cancer patients and co-morbidities in Ghana

“…This finding aligns with the results of previous studies that emphasized the significance of spiritual care as an essential aspect of palliative care. It was found that spiritual care can provide a sense of serenity, being present, enabling and alleviating patients' suffering [ 38 , 39 ]. The World Health Organization (WHO) recommends that spiritual care be incorporated as a vital aspect of palliative care for patients, as it can aid in reducing their anxieties and provide comfort [ 29 , 40 ].…”

Healthcare practitioners’ perspectives of providing palliative care to patients from culturally diverse backgrounds: a qualitative systematic review

“…• Interviews, face-to-face -Bellamy and Gott [32], Debesay et al [33], de Graaff et al [34,35], Eckemoff et al [37], Henry and Timmins [39], Johnstone et al [40][41][42][43], Khosla et al [44][45][46], Neiman [49], Nielsen et al [50,51], Roider-Schur et al [52], Schrank et al [53], Shahid et al [54], Vincent et al [56], Washington et al [57] • Telephone interviews -Shahid et al [54], Vincent et al [56] • Focus groups -Bellamy and Gott [30], de Voogd et al [36], Khosla et al [44][45][46], Green et al [38], Mahilall et al [47], Milberg et al [48], Neiman [49], Torres et al [55] and Washington et al [57] • Observation -Nielsen et al [50,51] Themes • Communication and connection [33-48, 48, 49, 49, 50, 50, 51, 51-54, 54, 55, 55, 56, 56, 57, 57] • The role of the family in death and dying [33] • The role of education in addressing uncertainty [33, 34, 34, 35, 35, 36, 36, 37, 37, 38, 38, 39, 39, 40, 40, 41, 45, 46, 46, 47, 47, 48, 48, 49, 49-52, 52, 53, 53, 54, 54, 55, 55, 56, 56, 57, 57] • Institutional and societal factors [33-43, 43, 44, 44-46, 46, 47, 47, 48, 48, 49, 49, 50, 50, 51, 51, 52, 52, 53, 53, 54, 54, 55, 55,...…”

“…One study across 4 papers • Johnstone et al [40,41,41,42,42,43,43,44] • Washington et al [33,57] and Khosla et al [44,45,45,46,46,47] One study across 2 papers • de Graaff et al [34,35,35,36] • Roider-Schur et al [52,53] Country of origin • Austria [52,53] • Australia [38,[40][41][42][43] • Canada [50,51,56] • Ireland [39] • Netherlands [34][35][36] • New Zealand [30] • Norway [33] • Sweden [48,55] • United States [37, 44-46, 49, 57] • South Africa [47].…”

‘I am Dying a Slow Death of White Guilt’: Spiritual Carers in a South African Hospice Navigate Issues of Race and Cultural Diversity

“…At SLCH, the spiritual care services are offered predominantly by volunteers, with three being paid staff, of whom two are part-time employees. Spiritual care services are offered by very few organisations in SA, with SLCH having one of the largest cohorts of spiritual care workers in SA (Mahilall and Swartz, 2021b ).…”