Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T12:13:28.024Z Has data issue: false hasContentIssue false
  • English
  • Français

“All my saints are within me”: Expressions of end-of-life spirituality

Published online by Cambridge University Press:  10 October 2012

Marjorie C. Dobratz
Marjorie C. Dobratz*
Affiliation:
University of Washington Tacoma - Nursing Program, Tacoma, Washington
*
Address correspondence and reprint requests to: Marjorie C. Dobratz, University of Washington Tacoma - Nursing Program, 1900 Commerce St. Campus Box 358421, Tacoma, WA 98402. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

With spirituality being one of the most important components of end-of-life (EOL) care, this study explored the oral responses of 44 dying persons who expressed spirituality.

Method:

Four identified spiritual themes: religious systems of beliefs and values, life meaning, purpose and connections with others, nonreligious systems of beliefs and values, and metaphysical or transcendental phenomena served as a framework for a content analysis of 91 spiritual references.

Results:

From the content analysis, eight interrelated and separate themes emerged. Although the highest number of responses centered on religious beliefs and values, nonreligious beliefs and values that included reason, dignity, mental discipline, and communion were expressed. The themes of life meaning, purpose, and connections with others also surfaced as important aspects of EOL spirituality.

Significance of results:

The findings support the need for hospice/palliative care professionals to approach spirituality from other than a Judeo-Christian viewpoint, help dying persons create meaning and purpose within the context of their lives, and assist them in their desire for connectedness to faith communities and other significant individuals in their lives.

Keywords

SpiritualityHospicePalliative CareDeath and dyingEnd of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 3 , June 2013 , pp. 191 - 198
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alcorn, S.R., Balboni, M.J., Prigerson, H.G., et al. (2010). “If God wanted me yesterday, I wouldn't be here today”: Religious and spiritual themes in patients' experiences of advanced cancer. Journal of Palliative Medicine, 13, 581–588.Google Scholar
Balboni, T.A., Vanderwerker, L.C., Block, S.D., et al. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25, 555–560.Google Scholar
Breitbart, W., Gibson, C., Poppito, S.R., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49, 366–372.CrossRefGoogle ScholarPubMed
Bryson, K.A. (2004). Spirituality, meaning, and transcendence. Palliative and Supportive Care, 2, 321–328.Google Scholar
Chibnall, J.T., Videen, S.D., Duckro, P.N., et al. (2002). Psychosocial correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16, 331–338.Google Scholar
Chiu, L., Emblen, J.D., Van Hofwegen, L., et al. (2004). An integrative review of the concept of spirituality in the health sciences. Western Journal of Nursing Research, 26, 405–428.Google Scholar
Chochinov, H.M. (2004). Dignity and the eye of the beholder. Journal of Clinical Oncology, 7, 1336–1340.Google Scholar
Chochinov, H.M., Hack, T., McClement, S., et al. (2002). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54, 433–443.Google Scholar
Delgado–Guay, M.O., Hui, D., Parsons, H.A., et al. (2011). Spirituality, religiosity, and spiritual pain in advanced cancer patients. Journal of Pain and Symptom Management, 41, 986–994.CrossRefGoogle ScholarPubMed
Dobratz, M.C. (1990). The life closure scale: A measure of psychological adaptation in death and dying. The Hospice Journal, 6, 1–15.CrossRefGoogle Scholar
Dobratz, M.C. (2002–2003). The self-transacting dying: Patterns of social-psychological adaptation in home hospice patients. Omega: The Journal of Death and Dying, 46, 151–167.Google Scholar
Dobratz, M.C. (2004). The life closure scale: Additional psychometric testing of a tool to measure psychological adaptation in death and dying. Research in Nursing & Health, 27, 52–62.Google Scholar
Grant, E., Murray, S.A., Kendall, M., et al. (2004). Spiritual issues and needs: Perspectives from patients with advanced cancer and nonmalignant disease. A qualitative study. Palliative and Supportive Care, 2, 371–378.CrossRefGoogle ScholarPubMed
Hall, B.A. (1998). Patterns of spirituality in persons with advanced HIV disease. Research in Nursing & Health, 21, 143–153.Google Scholar
Hampton, D.M., Hollis, D.E., Lloyd, D.A., et al. (2007). Spiritual needs of persons with advanced cancer. American Journal of Hospice and Palliative Medicine, 24, 42–48.Google Scholar
Hermann, C.P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28, 67–72.Google Scholar
Kudel, I., Cotton, S., Szaflarski, M., et al. (2011). Spirituality and religiosity in patients with HIV: A test and expansion of a model. Annals of Behavioral Medicine, 41, 92–103.Google Scholar
Laubmeier, K.K., Zakowski, S.G. & Bair, J.P. (2004). The role of spirituality in the psychological adjustment to cancer: A test of the transactional model of stress and coping. International Journal of Behavioral Medicine, 11, 48–55.CrossRefGoogle Scholar
McClain, C.S., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet, 361, 1603–1607.CrossRefGoogle ScholarPubMed
McClain–Jacobson, C., Rosenfeld, B., Kosinski, A., et al. (2004). Belief in an afterlife, spiritual well-being and end-of-life despair in patients with advanced cancer. General Hospital Psychiatry, 26, 484–486.Google Scholar
Mahoney, M.J. & Graci, G.M. (1999). The meanings and correlates of spirituality: Suggestions from an exploratory survey of experts. Death Studies, 23, 521–528.Google Scholar
Meraviglia, M.G. (1999). Critical analysis of spirituality and its empirical indicators. Journal of Holistic Nursing, 17, 18–33.Google Scholar
Murata, H. (2003). Spiritual pain and its care in patients with terminal cancer: Construction of a conceptual framework by philosophical approach. Palliative and Supportive Care, 1, 15–21.Google Scholar
Puchalski, C.M., Kilpatrick, S.D., McCullough, M.E., et al. (2003). A systematic review of spiritual and religious variables in Palliative Medicine, American Journal of Hospice and Palliative Care, Hospice Journal, Journal of Palliative Care, and Journal of Pain and Symptom Management. Palliative and Supportive Care, 1, 7–13.Google Scholar
Reed, P.G. (1991). Self-transcendence and mental health in oldest-old adults. Nursing Research, 40, 5–11.Google Scholar
Sandelowski, M. (2011). When a cigar is not just a cigar: Alternative takes on data and data analysis. Research in Nursing & Health, 34, 342–352.Google Scholar
Selman, L., Harding, R., Gysels, M., et al. (2011). The measurement of spirituality in palliative care and the content of tools validated cross-culturally: A systematic review. Journal of Pain and Symptom Management, 41, 728–753.CrossRefGoogle ScholarPubMed
Sessanna, L., Finnell, D. & Jezewski, M.A. (2007). Spirituality in nursing and health-related literature. Journal of Holistic Nursing, 25 (4), 252–262.Google Scholar
Sinclair, S., Pereira, J. & Raffin, S. (2006). A thematic review of the spirituality literature within palliative care. Journal of Palliative Medicine, 9, 464–479.Google Scholar
Tanyi, R. (2002). Towards clarification of the meaning of spirituality. Journal of Advanced Nursing, 39, 500–509.Google Scholar
Tarakeshwar, N., Vanderwerker, L.C., Paulk, E., et al. (2006). Religious coping is associated with quality of life of patients with advanced cancer. Journal of Palliative Medicine, 9, 646–657.CrossRefGoogle ScholarPubMed
Thomas, J. & Retsas, A. (1999). Transacting self-preservation: A grounded theory of the spiritual dimensions of people with terminal cancer. International Journal of Nursing Studies, 36, 191–201.Google Scholar
Vachon, M., Fillion, L. & Achille, M. (2009). A conceptual analysis of spirituality at the end of life. Journal of Palliative Medicine, 12, 53–59.Google Scholar
Williams, A-L. (2006). Perspectives on spirituality at the end of life: A meta-summary. Palliative and Supportive Care, 4, 407–417.Google Scholar