Spirituality, Quality of Life, and End of Life Among Indigenous Peoples: A Scoping Review

Abstract

Introduction: While spirituality and quality of life (QOL) are essential components of end-of-life (EOL) care, limited studies have examined these constructs for indigenous peoples. Therefore, the purpose of this article was to examine the state of the science regarding spirituality and QOL at EOL for indigenous people, particularly Native Americans. Method: The Arksey and O’Malley (2005) framework guided this scoping review, which examined 30 articles that included qualitative and quantitative studies, commentary papers, and reviews. Results: The findings identified five spiritual dimensions: the life and death journey, a belief in spirits, tribally grounded traditions, dominant cultural religion influences, and a family focus. QOL indicators included survivorship, optimization of holistic health, communication, and access to appropriate resources. Death rituals were important EOL elements. Discussion: Given the importance of spirituality to QOL for indigenous people, clinicians must be knowledgeable and responsive to indigenous spiritual needs to promote QOL at EOL.

Integrative review of the needs and challenges of indigenous palliative care in rural and remote settings

“…This theme includes empirical results related to Indigenous Elders, patients' and families' perspectives on death and dying, and the characteristics needed for good palliative care. While acknowledging the diversity of Indigenous worldviews, a majority of studies showed that death and dying translate into a non‐linear holistic and natural life process that begins at birth (Colclough & Brown, 2019; Dennis & Washington, 2018; Duggleby et al, 2015; Gebauer et al, 2016; Gott et al, 2017, 2019; Isaacson & Lynch, 2018; Moeke‐Maxwell et al, 2018, 2020; Terpstra et al, 2021). Moeke‐Maxwell et al (2018) describe death and dying as “the idea of the spirit transitioning between the metaphysical and physical realms” (p. 32).…”

“…Family involvement in decision‐making constitutes a central value underpinning culturally responsive palliative care among Indigenous peoples (Colclough & Brown, 2019; Dennis & Washington, 2018; Duggleby et al, 2015; Galloway et al, 2020; Gebauer et al, 2016; Gott et al, 2019; Isaacson & Lynch, 2018; Moeke‐Maxwell et al, 2020; Terpstra et al, 2021).…”

“…Recall biases and a 3-week data collection period. Results can be transferrable life process that begins at birth (Colclough & Brown, 2019;Dennis & Washington, 2018;Duggleby et al, 2015;Gebauer et al, 2016;Gott et al, 2017Gott et al, , 2019Isaacson & Lynch, 2018;Moeke-Maxwell et al, 2018Terpstra et al, 2021). Moeke-Maxwell et al ( 2018) describe death and dying as "the idea of the spirit transitioning between the metaphysical and physical realms" (p. 32).…”

“…Western institutions have historically undermined Indigenous worldviews involving traditional medicinal and spiritual practices (Schill & Caxaj, 2019). To address institutional and systematic barriers, health organizations must provide care providers with opportunities for training as a means to enhance cultural competency and safety (Bernardes et al, 2021;Caxaj et al, 2018;Colclough & Brown, 2019;Simpson et al, 2016;Terpstra et al, 2021). Health care professionals should avoid racist stereotypes that limit Indigenous access and utilization of palliative care (Bernardes et al, 2021;Caxaj et al, 2018;Shahid et al, 2018) indicating that cultural safety is the necessary prerequisite both at the individual and system level to ensure the delivery of culturally responsive care.…”

A scoping review of spirituality and religiosity in people who have had a kidney transplant

“…Sivertsen et al ( 2020 ) explored the relationship between spirituality and coping in Aboriginal people, and identified that an individual's spiritual well‐being includes the connection between the person, family and community. According to Terpstra et al ( 2021 ), spirituality is perceived uniquely within Indigenous populations and is closely linked with their overall quality of life. Given that spirituality is considered a powerful determinant of health for Indigenous populations, more depth in understanding is required to meaningfully integrate spirituality in health‐care programs for Indigenous people (Harrington, 2016 ; Sivertsen et al, 2020 ).…”