Spiritual care provision to end‐of‐life patients: A systematic literature review

Abstract

Aim To develop an understanding of how nurses provide spiritual care to terminally ill patients in order to develop best practice. Background Patients approaching the end of life (EoL) can experience suffering physically, emotionally, socially and spiritually. Nurses are responsible for assessing these needs and providing holistic care, yet are given little implementable, evidence‐based guidance regarding spiritual care. Nurses internationally continue to express inadequacy in assessing and addressing the spiritual domain, resulting in spiritual care being neglected or relegated to the pastoral team. Design Systematic literature review, following PRISMA guidelines. Methods Nineteen electronic databases were systematically searched and papers screened. Quality was appraised using the Critical Appraisal Skills Programme qualitative checklist, and deductive thematic analysis, with a priori themes, was conducted. Results Eleven studies provided a tripartite understanding of spiritual caregiving within the a priori themes: Nursing Spirit (a spiritual holistic ethos); the Soul of Care (the nurse–patient relationship); and the Body of Care (nurse care delivery). Ten of the studies involved palliative care nurses. Conclusion Nurses who provide spiritual care operate from an integrated holistic worldview, which develops from personal spirituality, life experience and professional practice of working with the dying. This worldview, when combined with advanced communication skills, shapes a relational way of spiritual caregiving that extends warmth, love and acceptance, thus enabling a patient's spiritual needs to surface and be resolved. Relevance to clinical practice Quality spiritual caregiving requires time for nurses to develop: the personal, spiritual and professional skills that enable spiritual needs to be identified and redressed; nurse–patient relationships that allow patients to disclose and co‐process these needs. Supportive work environments underpin such care. Further research is required to define spiritual care across all settings, outside of hospice, and to develop guidance for those involved in EoL care delivery.

Understanding Spiritual Care—Perspectives from Healthcare Professionals in a Norwegian Nursing Home

“…The International Council of Nurses stated in their Code of Ethics, that nurses are responsible for promoting an environment for the patient where human rights, values, customs, and spiritual beliefs are respected and acknowledged (ICN 2021). In nursing homes for older people, family members, nurses, and allied healthcare professionals are central in facilitating and caring for the spiritual needs and resources of the patients (Batstone et al 2020). According to the population projection for Norway , as in other western countries, there will be a demographic shift to more older persons above 70 years than children and teenagers (Statistics Norway (SSB) (2021)).…”

“…According to several studies (Ødbehr et al 2014;Veloza-Gómez et al 2017;Kleiven et al 2021), spiritual care and caring for patient's spiritual needs are concepts associated with various definitions (Giske and Cone 2019). This means that, healthcare professionals often have inadequate skills and knowledge about addressing spiritual aspects of care (Batstone et al 2020;Ødbehr et al 2014). In addition, patients often report that spiritual care is missing in clinical practice due to a lack of time and de-prioritization (Selman et al 2018).…”

“…Moreover, patients describe spiritual care as necessary for finding meaning in life and coping with existential issues, and they value healthcare professionals supporting them to meet their spiritual needs (Gautam et al 2019). Furthermore, healthcare professionals who provide spiritual care to patients operate from a holistic worldview arising from their own spirituality, life experiences, maturity, education, and the professional practice of working with dying patients (Batstone et al 2020;Giske and Cone 2015). Much research has addressed healthcare professional practice within hospice care (O'Brien et al 2019;Batstone et al 2020), but research conducted within nursing homes addressing spiritual care and caring for the patient's spiritual needs is however, sparse, especially in Norway (Ødbehr et al 2014).…”

Effectiveness of an Educational Intervention to Teach Spiritual Care to Spanish Nursing Students

“…Some of the most frequent barriers giving rise to this lack of communication have been identified as: insufficient time, personal unease, lack of knowledge or preparation, little or no training, lack of clarity about whether this is part of the health professional's role and concern that the patient may be upset or take it badly (Oxhandler et al 2019;Zumstein-Shaha et al 2020). Thus, despite awareness that spiritual needs arise in the health context, they are currently not being met, recognised or addressed by doctors or nurses (Batstone et al 2020). Although this requires verification, it is highly likely that the teaching subject of Health counselling taught as part of the nursing curriculum at our University has the knowledge, skills and attitudes necessary to endow nursing students with initial therapeutic resources for cultivating and maintaining good patient communication.…”

Brazilian nurses' concept of religion, religiosity, and spirituality: A qualitative descriptive study

“…In nursing, research around religion and spirituality has grown sharply in recent years (Cullen, 2016). Batstone, Bailey, and Hallett (2020) argue that nurses who provide spiritual care act from a holistic standpoint, which develops from personal perspectives gained through spirituality, life experience, and working in a clinical setting with palliative patients. This integrated holistic stance, when combined with advanced communication skills, shapes a relational way of caregiving that extends warmth, love, and acceptance, thereby enabling the patient's spiritual needs to surface and potentially be resolved.…”