Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-25T06:16:03.478Z Has data issue: false hasContentIssue false
  • English
  • Français

Spiritual beliefs, practices, and needs at the end of life: Results from a New Zealand national hospice study

Published online by Cambridge University Press:  30 August 2016

Richard Egan ,
Rod MacLeod ,
Chrystal Jaye ,
Rob McGee ,
Joanne Baxter ,
Peter Herbison  and
Sarah Wood
Richard Egan*
Affiliation:
Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Rod MacLeod
Affiliation:
HammondCare and the University of Sydney, Sydney, Australia
Chrystal Jaye
Affiliation:
Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Rob McGee
Affiliation:
Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Joanne Baxter
Affiliation:
Dunedin School of Medicine, Division of Health Sciences and Māori Health Workforce Development Unit, Dunedin, New Zealand
Peter Herbison
Affiliation:
Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Sarah Wood
Affiliation:
Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
*
Address correspondence and reprint requests to: Richard Egan, Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, P.O. Box 56, Dunedin 9054, New Zealand. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

International studies have shown that patients want their spiritual needs attended to at the end of life. The present authors developed a project to investigate people's understanding of spirituality and spiritual care practices in New Zealand (NZ) hospices.

Method:

A mixed-methods approach included 52 semistructured interviews and a survey of 642 patients, family members, and staff from 25 (78%) of NZ's hospices. We employed a generic qualitative design and analysis to capture the experiences and understandings of participants' spirituality and spiritual care, while a cross-sectional survey yielded population level information.

Results:

Our findings suggest that spirituality is broadly understood and considered important for all three of the populations studied. The patient and family populations had high spiritual needs that included a search for (1) meaning, (2) peace of mind, and (3) a degree of certainty in an uncertain world. The healthcare professionals in the hospices surveyed seldom explicitly met the needs of patients and families. Staff had spiritual needs, but organizational support was sometimes lacking in attending to these needs.

Significance of results:

As a result of our study, which was the first nationwide study in NZ to examine spirituality in hospice care, Hospice New Zealand has developed a spirituality professional development program. Given that spirituality was found to be important to the majority of our participants, it is hoped that the adoption of such an approach will impact on spiritual care for patients and families in NZ hospices.

Keywords

SpiritualityHospice carePalliative careExistentialPatient needs
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 2 , April 2017 , pp. 223 - 230
Copyright
Copyright © Cambridge University Press 2016 

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.)

Footnotes

*

All authors contributed equally to this work

References

REFERENCES

Adams, R.N., Mosher, C.E., Cannady, R.S., et al. (2014). Caregiving experiences predict changes in spiritual well-being among family caregivers of cancer patients. Psycho-Oncology, 23(10), 1178–1184. Epub ahead of print May 17.CrossRefGoogle ScholarPubMed
Astrow, A.B., Wexler, A., Texeira, K., et al. (2007). Is failure to meet spiritual needs associated with cancer patients' perceptions of quality of care and their satisfaction with care? Journal of Clinical Oncology, 25(36), 5753–5757.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(5), 555–560.Google Scholar
Bregman, L. (2006). Spirituality: A glowing and useful term in search of a meaning. Omega, 53(1–2), 15–26. Abstract available from http://ome.sagepub.com/content/53/1/5.abstract.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(4), 272–280. Epub ahead of print Aug 28, 2001.Google Scholar
Cobb, M. (2003). Spiritual care. In Psychological issues in palliative care. Lloyd-Williams, M. (ed.), pp. 135–147. New York: Oxford University Press.Google Scholar
Cobb, M., Dowrick, C. & Lloyd-Williams, M. (2012). What can we learn about the spiritual needs of palliative care patients from the research literature? Journal of Pain and Symptom Management, 43(6), 1105–1119. Epub ahead of print May 9.Google Scholar
Doyle, D. & Woodruff, R. (2004). The IAHPC manual of palliative care, 3rd ed. Chicago: International Association for Hospice & Palliative Care. Available from http://www.pacificcancer.org/pacp-resources/palliative-care-cancer-survivorship/iahpc-manual-palliative-care.pdf.Google Scholar
Doyle, D., Hanks, G., Cherny, N.I., et al. (eds.) (2004). Oxford textbook of palliative medicine, 3rd ed.. New York: Oxford University Press.Google Scholar
Egan, R., MacLeod, R., Jaye, C., et al. (2011). What is spirituality? Evidence from a New Zealand hospice study. Mortality, 16(4), 307–324. Available from http://www.tandfonline.com/doi/abs/10.1080/13576275.2011.613267.CrossRefGoogle Scholar
Hanson, L.C., Dobbs, D., Usher, B.M., et al. (2008). Providers and types of spiritual care during serious illness. Journal of Palliative Medicine, 11(6), 907–914.CrossRefGoogle ScholarPubMed
Jim, H., Purnell, J., Richardson, S., et al. (2006). Measuring meaning in life following cancer. Quality of Life Research, 15(8), 1355–1371. Epub ahead of print Jul 13.Google Scholar
Joint Commission on Accreditation of Healthcare Organizations (2005). The source: Evaluating your spiritual assessment process, Vol. 3, pp. 6–7. Washington, DC: Joint Commission on Accreditation of Healthcare Organizations.Google Scholar
Kellehear, A. (2000). Spirituality and palliative care: A model of needs. Palliative Medicine, 14(2), 149–155.Google Scholar
Kernohan, W.G., Mary, W., Caroline, M., et al. (2007). An evidence base for a palliative care chaplaincy service in Northern Ireland. Palliative Medicine, 21(6), 519–525.Google Scholar
Lambie, D., Egan, R., Walker, S., et al. (2015). How spirituality is understood and taught in New Zealand medical schools. Palliative & Supportive Care, 13(1), 53–58. Epub ahead of print Oct 29, 2013.CrossRefGoogle ScholarPubMed
Lin, H.-R. & Bauer-Wu, S.M. (2003). Psycho-spiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing, 44(1), 69–80.CrossRefGoogle ScholarPubMed
MacLeod, R. (2003). Psychosocial care for non-malignant disease. In Psychological issues in palliative care. Lloyd-Williams, M. (ed.), pp. 119–135. New York: Oxford University Press.Google Scholar
MacLeod, R.D., Thompson, R., Fisher, J.W., et al. (2012). New Zealanders' knowledge of palliative care and hospice services. The New Zealand Medical Journal, 125(1348), 51–60.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(6), 521–528.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(9369), 1603–1607.Google Scholar
McCord, G., Gilchrist, V.J., Grossman, S.D., et al. (2004). Discussing spirituality with patients: A rational and ethical approach. Annals of Family Medicine, 2(4), 356–361.Google Scholar
McGrath, P. (2003). Spiritual pain: A comparison of findings from survivors and hospice patients. The American Journal of Hospice & Palliative Care, 20(1), 23–33.Google Scholar
Milstein, J.M. (2008). Introducing spirituality in medical care: Transition from hopelessness to wholeness. The Journal of the American Medical Association, 299(20), 2440–2441.Google Scholar
Moadel, A., Morgan, C., Fatone, A., et al. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically diverse cancer patient population. Psycho-Oncology, 8(5), 378–385.Google Scholar
Morgan, A., MacLeod, R., Schumacher, M., et al. (2015). How do we best meet the spiritual needs of people we care for? European Journal of Palliative Care, 22(3), 130–132.Google Scholar
Morgan, D. (2008). Paradigms lost and pragmatism regained: Methodological implications of combing qualitative and quantitative methods. Journal of Mixed Methods Research, 1(1), 48–76.Google Scholar
Murata, H. (2003). Spiritual pain and its care in patients with terminal cancer: Construction of a conceptual framework by philosophical approach. Palliative & Supportive Care, 1(01), 15–21.Google Scholar
Murray, S. (2010). The quality of death: Ranking end-of-life care across the world. Available from http://graphics.eiu.com/upload/eb/qualityofdeath.pdf.Google Scholar
Murray, S., 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(1), 39–45.Google Scholar
Naylor, W. (2011). National health needs assessment for palliative care. Phase 1 report: Assessment of palliative care need. Wellington: Cancer Control New Zealand. Available from https://www.health.govt.nz/system/files/documents/publications/national-health-needs-assessment-for-palliative-care-jun11.pdf.Google Scholar
Nursing Council of New Zealand (2012). New Zealand nursing workforce: A profile of nurse practitioners, registered nurses and enrolled nurses 2011. Wellington: Nursing Council of New Zealand. Available from www.nursingcouncil.org.nz/Publications/Reports.Google Scholar
Patton, M.Q. (2002). Qualitative research and evaluation methods, 3rd ed. Thousand Oaks, CA: Sage.Google Scholar
Perkins, C. (2015). Promoting spiritual care for older people in New Zealand: The Selwyn Centre for Ageing and Spirituality. Working with Older People, 19(3), 107–113. Available from https://billionbooksbaby.org/pdf-selwyn-churches-of-auckland.html.CrossRefGoogle Scholar
Phelps, A.C., Lauderdale, K.E., Alcorn, S., et al. (2012). Addressing spirituality within the care of patients at the end of life: Perspectives of patients with advanced cancer, oncologists, and oncology nurses. Journal of Clinical Oncology, 30(20), 2538–2544. Epub ahead of print May 21.CrossRefGoogle ScholarPubMed
Puchalski, C.M. (2012). Spirituality in the cancer trajectory. Annals of Oncology, 23(Suppl. 3), 49–55. Available from http://annonc.oxfordjournals.org/content/23/suppl_3/49.full.pdf+html.Google Scholar
Puchalski, C.M., Lunsford, B., Harris, M.H., et al. (2006). Interdisciplinary spiritual care for seriously ill and dying patients: A collaborative model. Cancer Journal, 12(5), 398–416.Google Scholar
Puchalski, C.M., Vitillo, R., Hull, S.K., et al. (2014). Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine, 17(6), 642–656. Epub ahead of print May 19.Google Scholar
Rumbold, B. (2002). From religion to spirituality. In Spirituality and palliative care: Social and pastoral perspectives. Rumbold, B. (ed.), pp. 5–21. Melbourne: Oxford University Press.Google Scholar
Rumbold, B. (2007). A review of spiritual assessment in health care practice. The Medical Journal of Australia, 186(10 Suppl.), S60–S62.Google Scholar
Sinclair, S., Pereira, J. & Raffin, S. (2006). A thematic review of the spirituality literature within palliative care. Journal of Palliative Medicine, 9(2), 464–479.Google Scholar
Statistics New Zealand (2006). QuickStats about culture and identity. Available from http://www.stats.govt.nz/Census/2006CensusHomePage/QuickStats/quickstats-about-a-subject/culture-and-identity/religious-affiliation.aspx.Google Scholar
Steinhauser, K., Christakis, N., Clipp, E., et al. (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. The Journal of the American Medical Association, 284(19), 2476–2482.Google Scholar
Sulmasy, D. (2002). A biopsychosocial–spiritual model for the care of patients at the end of life. The Gerontologist, 42(3, Spec. Iss.), 24–33.CrossRefGoogle ScholarPubMed
Taylor, E.J. & Brander, P. (2013). Hospice patient and family carer perspectives on nurse spiritual assessment. Journal of Hospice & Palliative Nursing, 15(6), 347–354.CrossRefGoogle Scholar
Walsh, K., King, M., Jones, L., et al. (2002). Spiritual beliefs may affect outcome of bereavement: Prospective study. British Medical Journal, 324(7353), 1551.Google Scholar