Toward a clinical model for patient spiritual journeys in supportive and palliative care: Testing a concept of human spirituality and associated recursive states

Abstract

Objective In 2015, a Chaplaincy Research Consortium generated a model of human spirituality in the palliative care context to further chaplaincy research. This article investigates the clinical fit of (a) the model's fundamental premise of universal human spirituality and (b) its 4 proposed stage descriptors (Discovery, Dialogue, Struggle, and Arrival). Method First, we collected qualitative data from an interdisciplinary palliative care focus group. Participants (n = 5) shared responses to the statement “the human spirit has essential commonalities across [ … ] groups and [ … ] attributes.” Participants also shared vignettes of spiritual care, and 48 vignettes illustrating patients’ spiritual journeys were subsequently taken from the transcript of that group. Second, we invited different mixed discipline palliative care professionals (n = 9) to individually card sort these vignettes to the model's 4 stage descriptors; we conducted pattern analysis on the results. We then administered a third step, convening six physicians to complete the card sort again, this time allowing designation of cards to one or two of the 4 stage descriptors. Results Focus group participants were supportive of the model's all-encompassing definition of spirituality. The concept of “connectedness” was a shared focus for all participants, connectedness and spirituality appearing almost synonymous. Pattern analysis of assigned 48 vignettes to the 4 stages showed stronger consensus around Discovery and Arrival than Struggle and Dialogue. Results of the additional card sort suggested Struggle and Dialogue involve oscillation and are harder to think of as a steady state as distinct from processes associated with Discovery or Arrival. Significance of results “Connectedness” is a productive concept for modeling human spiritual experience near the end of life. As one healthcare professional said: “this connectedness piece is [ … ] what I always look for … ” Although further work is needed to understand struggle and dialogue elements in peoples’ spiritual journeys, discovery and arrival shared consensus among participants.

Needs for nurses to provide spiritual care and their associated influencing factors among elderly inpatients with stroke in China: A cross-sectional quantitative study

“…Spirituality is derived from the Latin word “Spiritus,” which means breathing, courage, strength, energy and soul, and usually endowed with the spirit of life (Lazenby, 2010). Spiritual care refers to the provision of care measures or activities for individuals according to their culture and beliefs by listening, accompanying or discussing the meaning and value of life with patients according to the assessment results of individual spiritual needs and pains (Ayik et al, 2021; Johnson et al, 2021). At present, the definition of spiritual care needs has not reached a consensus.…”

The Role of Psilocybin-Assisted Psychotherapy to Support Patients With Cancer: A Critical Scoping Review of the Research

“…Anxiety and/or depressive disorders in patients with cancer often include underlying existential components, which can be challenging to address and can even be overlooked in a medicalized approach (Bauereiß et al, 2018; Karlsson et al, 2014). Existential concerns may reflect an individual's struggle to find meaning, purpose, and value with living and may coincide with a loss or lack of spiritual wellbeing (Johnson et al, 2021). It is established that many cancer patients with anxiety and/or depressive disorders derive symptom improvement from traditional psychotherapeutic options, including pharmaceutical agents, cognitive-behavioral interventions, psychotherapy, supportive-existential interventions, and integrative therapies—such as mindfulness meditation (Grassi et al, 2017).…”

“…Spirituality is a unique experience for each individual and has been associated with feelings and experiences that connect the individual to a sacred source, or an awareness of the infinite with awe (Johnson et al, 2021). Spiritual encounters can result in enhanced connection, heightened awareness, acceptance, and capacity to express humanness, and are thus frequently associated with healing (Johnson et al, 2021). When patients are distressed by psychological symptoms, it can be difficult to tap into their spiritual resources.…”

“…For patients with cancer, additional therapeutic approaches are needed that address personalized fears associated with death and dying, and to place the cycle of life in a context that makes sense (Karlsson et al, 2014). Furthermore, therapies that build the capacity for distressed individuals to widen their spiritual lens and that carry the potential to alleviate existential angst may produce mental health benefits beyond established approaches (Johnson et al, 2021). The need for novel treatments for anxiety, depression, and existential distress among people with cancer leads researchers to evaluate the state of the science relative to psychedelic-assisted psychotherapy as a viable intervention.…”

Spiritual care perceptions and empathy of Chinese nursing students: The mediating roles of spiritual well-being

“…Spirituality is derived from the Latin word “Spiritus,” which means breathing, courage, strength, energy, and soul, and usually endowed with the spirit of life, meaning to make life more abundant and vigorous (Lazenby, 2010; Weathers et al, 2016; Green et al, 2020). Spiritual care refers to the provision of care measures or activities for individuals according to their culture and beliefs by listening, accompanying, or discussing the meaning and value of life with patients according to the assessment results of individual spiritual needs and pains (Ayik et al, 2021; Johnson et al, 2021). During spiritual care, nurses can achieve resonance and empathy with patients, help patients explore the value of life and find the meaning of life, and help patients build a healthy body, psychology, and spirituality (Donesky et al, 2020; Musa, 2020).…”