Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T15:30:08.708Z Has data issue: false hasContentIssue false
  • English
  • Français

The physician's role in the assessment and treatment of spiritual distress at the end of life

Published online by Cambridge University Press:  29 June 2006

ANTHONY E. BROWN ,
SIMON N. WHITNEY  and
JAMES D. DUFFY
ANTHONY E. BROWN
Affiliation:
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas
SIMON N. WHITNEY
Affiliation:
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas
JAMES D. DUFFY
Affiliation:
Department of Psychiatry, The Methodist Hospital, Houston, Texas
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Patients at the end of their life typically endure physical, emotional, interpersonal, and spiritual challenges. Although physicians assume a clearly defined role in approaching the physical aspects of terminal illness, the responsibility for helping their patients' spiritual adaptation is also important.

Methods: This article (1) describes the terms and definitions that have clinical utility in assessing the spiritual needs of dying patients, (2) reviews the justifications that support physicians assuming an active role in addressing the spiritual needs of their patients, and (3) reviews clinical tools that provide physicians with a structured approach to the assessment and treatment of spiritual distress.

Results: This review suggests that physicians can and should be equipped to play a key role in relieving suffering at the end of life.

Significance of results: Physicians can help their patients achieve a sense of completed purpose and peace.

Keywords

SpiritualityReligionEnd of lifePalliative careQuality of life
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 1 , March 2006 , pp. 81 - 86
Copyright
© 2006 Cambridge University Press

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

Bessinger, D. & Kuhne, T. (2002). Medical spirituality: Defining domains and boundaries. Southern Medical Journal, 95, 1385–1388.Google Scholar
Block, S.D. (2001). Perspectives on care at the close of life. Psychological considerations, growth, and transcendence at the end of life: The art of the possible. JAMA, 285, 2898–2905.Google Scholar
Born, W., Greiner, K.A., Sylvia, E., et al. (2004). Knowledge, attitudes, and beliefs about end-of-life care among inner-city African Americans and Latinos. Journal of Palliative Medicine, 7, 247–256.Google Scholar
Braun, K.L. & Zir, A. (2001). Roles for the church in improving end-of-life care: Perceptions of Christian clergy and laity. Death Studies, 25, 685–704.Google Scholar
Breitbart, W. (2002). Spirituality and meaning in supportive care: Spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Supportive Care in Cancer, 10, 272–280.Google Scholar
Breitbart, W. (2003). Reframing hope: Meaning-centered care for patients near the end of life. Interview by Karen S. Heller. Journal of Palliative Medicine, 6, 979–988.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.Google Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA, 284, 2907–2911.Google Scholar
Chibnall, J.T., Videen, S.D., Duckro, P.N., et al. (2002). Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16, 331–338.Google Scholar
Davis, C.G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality and Social Psychology, 75, 561–574.Google Scholar
Derrickson, B.S. (1996). The spiritual work of the dying: A framework and case studies. Hospital Journal, 11, 11–30.Google Scholar
Ehman, J.W., Ott, B.B., Short, T.H., et al. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 1803–1806.Google Scholar
Gordon, T. & Mitchell, D. (2004). A competency model for the assessment and delivery of spiritual care. Palliative Medicine, 18, 646–651.Google Scholar
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486–500.Google Scholar
Hardwig, J. (2000). Spiritual issues at the end of life: A call for discussion. Hastings Center Report, 30, 28–30.Google Scholar
Hills, J., Paice, J.A., Cameron, J.R., et al. (2005). Spirituality and distress in palliative care consultation. Journal of Palliative Medicine, 8, 782–788.Google Scholar
Kawa, M., Kayama, M., Maeyama, E., et al. (2003). Distress of inpatients with terminal cancer in Japanese palliative care units: From the viewpoint of spirituality. Supportive Care in Cancer, 11, 481–490.Google Scholar
Kellehear, A. (2000). Spirituality and palliative care: A model of needs. Palliative Medicine, 14, 149–155.Google Scholar
Kristeller, J.L., Zumbrun, C.S., & Schilling, R.F. (1999). “I would if I could”: How oncologists and oncology nurses address spiritual distress in cancer patients. Psycho-Oncology, 8, 451–458.Google Scholar
Levin, J. & Schiller, P.L. (1987). Is there a religious factor in health? Journal of Religion and Health, 26, 9–36.Google Scholar
Lo, B., Ruston, D., Kates, L.W., et al. (2002). Discussing religious and spiritual issues at the end of life: A practical guide for physicians. Journal of the American Medical Association, 287, 749–754.Google Scholar
Marrone, R. (1999). Dying, mourning, and spirituality: A psychological perspective. Death Studies, 23, 495–519.Google 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.Google Scholar
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
McGrath, P. (2003). Religiosity and the challenge of terminal illness. Death Studies, 27, 881–899.Google Scholar
McIllmurray, M.B., Francis, B., Harman, J.C., et al. (2003). Psychosocial needs in cancer patients related to religious belief. Palliative Medicine, 17, 49–54.Google Scholar
McKee, D.D. & Chappel, J.N. (1992). Spirituality and medical practice. Journal of Family Practice, 35, 201, 205–208.Google Scholar
Meador, K.G. (2004). Spiritual care at the end of life: What is it and who does it? North Carolina Medical Journal, 65, 226–228.Google Scholar
Miller, D.K., Chibnall, J.T., Videen, S.D., et al. (2005). Supportive-affective group experience for persons with life-threatening illness: Reducing spiritual, psychological, and death-related distress in dying patients. Journal of Palliative Medicine, 8, 333–343.Google Scholar
Murray, S.A., Kendall, M., Boyd, K., et al. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39–45.Google Scholar
National Consensus Project for Quality Palliative Care: Clinical Practice Guidelines for Quality Palliative Care, Executive Summary. (2004). Journal of Palliative Medicine, 7, 611–627.Google Scholar
Puchalski, C.M. (2002). Spirituality and end-of-life care: A time for listening and caring. Journal of Palliative Medicine, 5, 289–294.Google Scholar
Puchalski, C.M., Dorff, R.E., & Hendi, I.Y. (2004). Spirituality, religion, and healing in palliative care. Clinics in Geriatric Medicine, 20, vi–vii, 689–714.Google Scholar
Rumbold, B.D. (2003). Caring for the spirit: Lessons from working with the dying. Medical Journal of Australia, 179(6 Suppl.), S11–13.Google Scholar
Schwartz, C., Lennes, I., Hammes, B., et al. (2003). Honing an advance care planning intervention using qualitative analysis: The Living Well interview. Journal of Palliative Medicine, 6, 593–603.Google Scholar
Sheehan, M.N. (2000). On dying well: How does one live spiritually in the hope of dying well? America (NY), 183, 12–15.Google Scholar
Sumner, C.H. (1998). Recognizing and responding to spiritual distress. American Journal of Nursing, 98, 26–30; quiz 31.Google Scholar
Thomson, J.E. (2000). The place of spiritual well-being in hospice patients' overall quality of life. Hospital Journal, 15, 13–27.Google Scholar
Villagomeza, L.R. (2005). Spiritual distress in adult cancer patients: Toward conceptual clarity. Holistic Nursing Practice, 19, 285–294.Google Scholar
Walter, T. (2002). Spirituality in palliative care: Opportunity or burden? Palliative Medicine, 16, 133–139.Google Scholar
Wright, M.C. (2002). The essence of spiritual care: A phenomenological enquiry. Palliative Medicine, 16, 125–132.Google Scholar