Spirituality, Religiosity, and Spiritual Pain in Advanced Cancer Patients

Delgado-Guay, Marvin Omar; Hui, David; Parsons, Henrique A.; Govan, Kathy; Cruz, Maxine de la; Thorney, Steven; Bruera, Éduardo

doi:10.1016/j.jpainsymman.2010.09.017

Cited by 221 publications

(161 citation statements)

References 36 publications

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“…This finding is consistent with prior studies in non-ICU settings that have shown many patients find spiritual care to be the single most important factor enabling them to cope with a serious illness (20)(21)(22). More than half of participants rated their spiritual pain greater than or equal to 5 on a 0 to 10 integer scale, and higher spiritual pain scores have been shown to be associated with lower spiritual quality of life and adverse physical and emotional symptoms (32). The desired chaplain interventions that a patient selected, whether or not religious, focused on comforting the patient and improving his or her wellbeing in the context of both his or her spiritual pain and critical illness.…”

Section: Original Researchsupporting

confidence: 89%

“…He is a member of the Association of Professional Chaplains, has a Master's of Divinity, and completed six units of Clinical Pastoral Education accredited by the Association for Clinical Pastoral Education. He developed the illustrated spiritual care communication card with four sections that reflect the domains of a spiritual assessment that would be typically assessed by a chaplain through conversation but instead can be assessed by having the user point to pictures and words to: (1) identify spiritual or religious affiliations; (2) identify a range of feelings; (3) rate spiritual pain (32); and (4) select a desired religious, spiritual, or nonspiritual intervention that a chaplain can offer ( Figure 1). He developed the range of feelings a patient could identify based first on the four classes of feelings that he was trained to assess when caring for someone: anger, happiness, sadness, and fear (33).…”

Section: Picture-guided Spiritual Carementioning

confidence: 99%

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A Novel Picture Guide to Improve Spiritual Care and Reduce Anxiety in Mechanically Ventilated Adults in the Intensive Care Unit

et al. 2016

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Rationale: Hospital chaplains provide spiritual care that helps patients facing serious illness cope with their symptoms and prognosis, yet because mechanically ventilated patients cannot speak, spiritual care of these patients has been limited. Objectives:To determine the feasibility and measure the effects of chaplain-led picture-guided spiritual care for mechanically ventilated adults in the intensive care unit (ICU). Methods:We conducted a quasi-experimental study at a tertiary care hospital between March 2014 and July 2015. Fifty mechanically ventilated adults in medical or surgical ICUs without delirium or dementia received spiritual care by a hospital chaplain using an illustrated communication card to assess their spiritual affiliations, emotions, and needs and were followed until hospital discharge. Feasibility was assessed as the proportion of participants able to identify spiritual affiliations, emotions, and needs using the card. Among the first 25 participants, we performed semistructured interviews with 8 ICU survivors to identify how spiritual care helped them. For the subsequent 25 participants, we measured anxiety (on 100-mm visual analog scales [VAS]) immediately before and after the first chaplain visit, and we performed semistructured interviews with 18 ICU survivors with added measurements of pain and stress (on 6100-mm VAS). Measurements and Main Results:The mean (SD) age was 59 (616) years, median mechanical ventilation days was 19.5 (interquartile range, 7-29 d), and 15 (30%) died in-hospital. Using the card, 50 (100%) identified a spiritual affiliation, 47 (94%) identified one or more emotions, 45 (90%) rated their spiritual pain, and 36 (72%) selected a chaplain intervention. Anxiety after the first visit decreased 31% (mean score change, 220; 95% confidence interval, 233 to 27). Among 28 ICU survivors, 26 (93%) remembered the intervention and underwent semistructured interviews, of whom 81% felt more capable of dealing with their hospitalization and 0% felt worse. The 18 ICU survivors who underwent additional VAS testing during semistructured follow-up interviews reported a 49-point reduction in stress (95% confidence interval, 272 to 224) and no significant change in physical pain that they attributed to picture-guided spiritual care.Conclusions: Chaplain-led picture-guided spiritual care is feasible among mechanically ventilated adults and shows potential for reducing anxiety during and stress after an ICU admission.

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Section: Original Researchsupporting

confidence: 89%

Section: Picture-guided Spiritual Carementioning

confidence: 99%

A Novel Picture Guide to Improve Spiritual Care and Reduce Anxiety in Mechanically Ventilated Adults in the Intensive Care Unit

et al. 2016

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“…Challenges such as these arise when a person is facing death (3). These issues, including spirituality and religiosity, are well recognised as factors that affect patients' quality of life, quality of care and satisfaction (4), and need to be addressed by those close to the afflicted person, i.e. relatives or healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

Training Intervention for Health Care Staff in the Provision of Existential Support to Patients With Cancer: A Randomized, Controlled Study

Henoch

Danielson

Strang

et al. 2013

Journal of Pain and Symptom Management

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Context: When a patient receives a cancer diagnosis, existential issues become more compelling.Throughout the illness trajectory, cancer patients could be cared for on oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.Objectives: To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude towards caring for dying patients.Methods: This was a randomised, controlled trial with a training intervention consisting of theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses on oncology wards and hospice wards and in palliative home care teams were randomised to a training group or non-training group. Primary outcomes, confidence in communication and attitude towards the care of dying patients were measured at baseline, immediately after the training and five to six months after.Results: Confidence in communication improved significantly in the training group from baselinebefore the training -to both the first and second follow-up, i.e. immediately after the training and five months after. The attitude towards caring for the dying did not improve in the training group.Conclusion: This study shows that short-term training with reflection improves the confidence of healthcare staff when communicating, which is important for healthcare managers with limited resources. Further studies are needed to explore how patients experience the communication skills of healthcare staff after such training.

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“…13 Patients of many cultures consider spirituality to be important by the end of their lives, 4,5,14-16 and palliative-care patients who consider themselves to be more spiritually-oriented also tend to report less spiritual pain, depression, and anxiety. 17,18 Therefore, we should overcome our perceived awkwardness in approaching the subject of death and provide the spiritual balm our patients need.…”

Section: Question 4: Do We Respect the Cultural Taboo Which Shuns Spementioning

confidence: 99%

Death in a Mission Hospital

Ritchie

2017

han-j-cjgh

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Medical missionaries may struggle with the proper understanding of their roles in the death of their patients. To better grasp a biblical concept of death, medical missionaries should understand God's plan for death and also understand both God's sovereignty and their own free will. Missionaries should prepare patients and their families for impending death while observing cultural sensitivity. Cultural objections to discussing impending death may be addressed by emphasizing the Christian understanding of earthly death and eternal life, and by honoring the passing of the believing patient.

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Spirituality, Religiosity, and Spiritual Pain in Advanced Cancer Patients

Abstract: A vast majority of advanced cancer patients receiving palliative care considered themselves spiritual and religious. Spiritual pain was common and was associated with lower self-perceived religiosity and spiritual quality of life.

Cited by 221 publications

References 36 publications

A Novel Picture Guide to Improve Spiritual Care and Reduce Anxiety in Mechanically Ventilated Adults in the Intensive Care Unit

A Novel Picture Guide to Improve Spiritual Care and Reduce Anxiety in Mechanically Ventilated Adults in the Intensive Care Unit

Training Intervention for Health Care Staff in the Provision of Existential Support to Patients With Cancer: A Randomized, Controlled Study

Death in a Mission Hospital

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