Spiritual assessment in palliative care: multicentre study (original) (raw)
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Indian Journal of Palliative Care, 2016
Introduction: There are only a few studies on spirituality among palliative care patients in India. This gap in research may be caused by the absence of relevant questionnaires and scales specifically designed for Indian palliative care populations. In this study, we describe the development of such a questionnaire and explain its psychometric characteristics. Methods: We designed a questionnaire on the basis of a systematic review of the literature. After a review of the questionnaire by specialists and a subsequent pilot study, the questionnaire was amended. The final questionnaire consisted of a list of 36 spirituality items. It was administered to a sample of 300 cancer patients attending the pain clinic of a tertiary hospital in New Delhi. Results: A factor analysis led to four factors explaining 54.6% of variance: Shifting moral and religious values (Factor 1), support from religious relationship (Factor 2), existential blame (Factor 3), and spiritual trust (Factor 4). The skewness and kurtosis for Factors 1, 3, and 4 were within a tolerable range for assuming a normal distribution, but Factor 2 was skewed. The alphas showed that the four factors have an acceptable internal consistency. Statistically significant associations were observed for age and Factor 3 (P = 0.004), gender and Factor 4 (P = 0.014), marital status and Factors 3 (P = 0.002) and 4 (P = 0.001), educational level and Factors 3 (P < 0.001) and 4 (P < 0.001), and pain scores and Factors 1 (P < 0.001), 2 (P < 0.001), and 3 (P = 0.001). Conclusion: The questionnaire offers promising prospects for the study of spirituality among palliative care patients in India.
Investigation of Spiritual Well-Being Palliative Care of Patients
Innovative Journal of Medical Health Science, 2019
Background: One of the indispensable aspects of the philosophy of holistic care, and negative situations such as life-threatening illness, spiritual well-being, which is defined as the search for a relationship with a divine soul, is a requirement that must be met in order to maintain the existence of the individual. The patient's need for social and spiritual well-being increases even more in cases of long-term treatment, such as cancer, that reduce the quality of life. Determining and meeting the spiritual needs of the individual in the difficult times of the crisis can be realized by determining the spiritual well-being levels of the individuals and by providing the individual spiritual care. This study was conducted to determine the level of the spiritual well-being of palliative care patients diagnosed with cancer. Methods: This is a descriptive study. The population of the study consisted of 124 patients diagnosed with cancer who were hospitalized in the palliative unit between January and August 2018 and were treated in two state hospitals operating on the European side of Istanbul. The sample consisted of 111 people with voluntary participation and communication. Personal Information Form and Spiritual Well-being Scale were used to collect data. Data were evaluated by one-way analysis of variance (one- way anova) and significance (t-test) of the difference between the two means. Results: The total score averages from the spiritual good scale of individuals participating in the Study were determined to be good with x = 4,15. In terms of the level of education of Scale scores, only "Anomi" is significantly differentiated between groups of age, with a total score of the scale, In the sub-dimension of transcendity and the subdimension of "Harmony with Nature" according to the variable metastasis (p > 0.05). Conclusion: Spiritual Well-being has a positive effect on the healing process of individuals with impaired health. It helps individuals who have a crisis in life threatening diseases such as Cancer to cope with this crisis and to provide spiritual well-being in the sense of life. In This process, spiritual care initiatives by healthcare professionals can be transformed into a part of the healing process and the spiritual goodness of the individual can be increased. Further research in This area is projected to contribute to the richening of the relevant literature in Turkey. Key words: Spiritual, spiritual well-being, palliative care, palliative care unit
Spirituality and its Relevance in Assistance to Patients under Palliative Care According to Experts
Hospice and Palliative Medicine International Journal, 2017
Background: Palliative care and spirituality are still very little discussed, but when studied and applied they become capable of alleviating some of the dimensions of suffering of man. Objective: To evaluate the understanding of health professionals about the concept of assistance to patients under palliative care and spirituality, as well as the application of techniques to alleviate the spiritual suffering for these patients. Method: This study used questionnaires in 91 professionals that work in the palliative care area (doctors, nurses and psychologists, chaplains), with at least three years of experience, regardless of gender. Results: The study shows a divergence in the work of professionals of the multidisciplinary staff, as well as the difficulty in addressing issues of spirituality. Conclusion: The palliative care and spirituality provide relief to many suffering patients, it is important to have health professionals aligned in concepts and prepared to use it in clinical practice.
Heliyon, 2024
Spiritual wellbeing (SWB) is one of the crucial components of holistic care for patients with terminal illnesses. The use of a validated instrument can help health professionals approach this difficult and subjective topic. There is no validated Bengali tool to measure this domain. Our study aimed to translate the EORTC QLQ SWB32 tool into Bengali, validate it among advanced cancer patients in Bangladesh, and compare the study's findings to international validation studies to determine its suitability as a measurement and intervention tool for these patients. Methods The original English version of the tool was translated in Bengali and back-translated by four independent translators with good command in both languages. After approval from the EORTC translation team and linguistic validation, the tool was further validated among 163 advanced cancer patients from oncology and palliative care units of three tertiary-level hospitals in Bangladesh. Reliability was tested with Cronbach's alpha, and construct validity was determined by exploratory factor analysis. Known group comparisons were performed by the Kruskal-Wallis H test and the Mann-Whitney U test. Result Ten adult cancer patients (two female and eight male, three Hindu and seven Muslim) participated in the linguistic validation. Six out of ten participants found the measure understandable and acceptable. A total of 163 advanced cancer patients participated in the psychometric validation phase. The majority of those participants were Muslims (94 %), with a slight male predominance. The internal consistency of each scale was satisfactory (0.7). Exploratory factor analysis also showed similarity to the original scale except item 12 (able to forgive others), which was loaded in both the EX and RO components (0.813 and 0.544, respectively). Older patients had a better relationship with themselves and a lower level of existential fulfilment than the younger group. Patients who tried to find comfort in their religion or spiritual faith, actively performed religious rituals, and had affiliations with religious or spiritual communities showed significantly higher global SWB. Conclusion The Bengali version of the EORTC QLQ-SWB32 is a reliable and valid tool for measuring the spiritual wellbeing of advanced cancer patients receiving palliative care.
Spirituality and religiosity in the approach to patients under palliative care
Revista Bioética
The development of the care plan for patients under palliative care must be unique and comprehensive, seeking to meet, as far as possible, the patient’s needs. Within this plan, the spiritual and religious axis stands out. To analyze the importance of this type of approach, we carried out an integrative review study. The articles analyzed should answer the guiding question “what does the literature say about spirituality and religiosity in the approach to patients under palliative care?”. The sample comprised 15 articles that show the multidisciplinary nature of the theme and point out the benefits of combining the spiritual and religious axis with care plans. We observed, however, that some practices and religious aspects can negatively influence the individual and the professional team feels unprepared to address and develop this issue with its patients.
Evaluation of Spiritual Needs of Patients with Advanced Cancer in a Palliative Care Unit
Journal of Palliative Medicine, 2014
Introduction: Spiritual needs play an important role in palliative care as both a clinical dimension and a therapeutic strategy. However, recent studies have shown that the management of this dimension still remains a challenge at the clinical level of palliative care. Goals: Our goal was to evaluate the spiritual needs of patients diagnosed with advanced and terminal cancer by the palliative care unit of a hospital in Barcelona, Spain. Methods: An observational study was conducted that involved 50 patients who were recruited between May 2007 and January 2008. A questionnaire was used which included 28 items selected from a review of the literature; the responses were analyzed using a five-point Lickert scale. The results were grouped in 11 categories corresponding to different spiritual needs. Results: Two spiritual needs emerged as the most relevant for the patients: their need to be recognized as a person until the end of their life and their need to know the truth about their illness. The least important spiritual needs were identified as those: for continuity and an afterlife; to get rid of obsessions; to achieve freedom from blame and to be able to forgive others; and the need for reconciliation and to feel forgiven by others. Conclusions: When patients knew the truth about their illnesses and they were treated with dignity, their most important needs were likely to be covered. These results suggest that patients receiving palliative care wish to live for the present with as much normality as possible and show only minor concern for their past and future.
Spirituality in Palliative Patients: A literature Review
2014
Introduction : Spirituality is important for palliative patients. Studies on spirituality in palliative patients were found differently in terms of the importance and the assessment. The purpose of the study : To describe the importance of spirituality and identify the most appropriate tool for spirituality assessment used in palliative patients. Methodology : Searching were conducted from PubMed and ProQuest during 2005-2014. A total 15 studies were analyzed for this review. Result : Spirituality was important for palliative patients in reducing distress, anxiety, depression and also improving quality of life. There were numerous measurements have been used to measure spirituality in palliative patients which showed good psychometric properties and can be used in multicultural palliative patients population such as MQOL, QUAL-E and POS. Conclusion : Spirituality was reported having a pivotal role for palliative patients. The 8items of GES as a new measurement seems have a feasible and valid in measuring spirituality for palliative patients. However, the measurement still requires further testing.
Signs of spiritual distress and its implications for practice in Indian Palliative Care
Indian Journal of Palliative Care
Given the particularity of spirituality in the Indian context, models and tools for spiritual care that have been developed in Western countries may not be applicable to Indian palliative care patients. Therefore, we intended to describe the most common signs of spiritual distress in Indian palliative care patients, assess differences between male and female participants, and formulate contextually appropriate recommendations for spiritual care based on this data. Methods: Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. We calculated frequencies and percentages, and we compared responses of male and female participants using Chi-squared tests. Results: Most participants believed in God or a higher power who somehow supports them. Signs of potential spiritual distress were evident in the participants' strong agreement with existential explanations of suffering that directly or indirectly put the blame for the illness on the patient, the persistence of the "Why me?" question, and feelings of unfairness and anger. Women were more likely to consider illness their fate, be worried about the future of their children or spouse and be angry about what was happening to them. They were less likely than men to blame themselves for their illness. The observations on spirituality enabled us to formulate recommendations for spiritual history taking in Indian palliative care. Conclusion: Our recommendations may help clinicians to provide appropriate spiritual care based on the latest evidence on spirituality in Indian palliative care. Unfortunately, this evidence is limited and more research is required.
OPINION Spirituality and religiosity in supportive and palliative care
To provide an updated overview about the role of spirituality and religiosity in the way patients with lifethreatening illnesses cope, and the importance of providing a comprehensive spiritual assessment and spiritual care in an interdisciplinary team work setting, such as supportive and palliative care.