| Type | Journal Article |
|---|---|
| Author | S. Q. Abbas |
| Author | S. Dein |
| Abstract | This paper reports on a focus group study aimed at exploring the difficulties that palliative care healthcare professionals encounter while assessing the spiritual distress of their patients. Three focus groups were conducted in a hospice (n = 15). Participants were all healthcare professionals working in the hospice in-patient unit. Interviews were taped and later transcribed. The data was analysed through content analysis. Emergent themes included: lack of vocabulary around spiritual issues, personal issues surrounding death and dying, training issues, fear of being unable to resolve spiritual problems, time constraints and difficulty separating spiritual and religious needs. Participants provided a number of recommendations for improving care. This pilot study has generated useful data in relation to how spiritual care of patients might be improved. Despite the abundance of academic publications and policies on spirituality, this area is not integrated well into palliative care. [ABSTRACT FROM AUTHOR] |
| Publication | Mental Health, Religion & Culture |
| Volume | 14 |
| Issue | 4 |
| Pages | 341-352 |
| Date | April 2011 |
| DOI | 10.1080/13674671003716780 |
| ISSN | 13674676 |
| Short Title | The difficulties assessing spiritual distress in palliative care patients |
| Library Catalog | EBSCOhost |
| Date Added | Thu Sep 29 08:55:49 2011 |
| Modified | Thu Sep 29 08:55:49 2011 |
| Type | Journal Article |
|---|---|
| Author | Amy L Ai |
| Author | Crystal L Park |
| Author | Marshall Shearer |
| Abstract | Settling one's end-of-life affairs in the face of coronary artery bypass graft surgery (CABG) can be both distressing and beneficial for individuals who are facing imminent threat of death. Religious thoughts, common in this context, may offer some comfort and support for facing this process. However, few empirical studies have addressed the role of religious or spiritual involvement in the settling of one's end-of-life affairs in cardiac patients. This prospective study investigated the effect of religious and spiritual factors on whether decisions regarding end-of-life had been made in a sample of middle-aged and older patients undergoing CABG. In particular, we expected faith factors of an intrinsic nature would promote this decision. Two weeks pre-operatively, patients (mean age = 65 years) were recruited for interviews. One hundred seventy-seven CABG patients completed the pre-operative and post-operative follow-up one month after surgery, while 96 offered information regarding their engagement in settling end-of-life affairs. Cardiac indicators were obtained from the computerized Society of Thoracic Surgeons' Adult Cardiac Database (STS). Multiple regression analyses revealed that private religiousness increased the likelihood of having engaged in end-of-life decision planning by nearly half again (OR = .1.47, 95% CI = 1.10, 1.96, p < .05) and that experiencing reverence in secular contexts nearly doubled the likelihood (OR = .1.99, 95% CI = 1.16, 3.44, p < .05). The reduced likelihood of having made plans was observed among those who scored higher on experiencing reverence in religious contexts (OR = .44, 95% CI = .23, .87, p < .05) and among patients using petitionary prayer (OR = .21, 95% CI = .04, .98,p < .05). These effects manifested after controlling for age, impacted functioning, and number of diseased arteries. Therefore, faith factors appear to have independent but complex effects on end-of-life decision making in middle-aged and older cardiac patients. |
| Publication | International Journal of Psychiatry in Medicine |
| Volume | 38 |
| Issue | 1 |
| Pages | 113-132 |
| Date | 2008 |
| Journal Abbr | Int J Psychiatry Med |
| ISSN | 0091-2174 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/18624023 |
| Accessed | Fri Nov 13 19:04:07 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 18624023 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
This prospective study investigated the effect of religious and spiritual factors on whether decisions regarding end-of-life had been made in a sample of middle-aged and older patients undergoing CABG. In particular, we expected faith factors of an intrinsic nature would promote this decision.
| Type | Journal Article |
|---|---|
| Author | Gwenda Albers |
| Author | Michael A. Echteld |
| Author | Henrica C.W. de Vet |
| Author | Bregje D. Onwuteaka-Philipsen |
| Author | Mecheline H.M. van der Linden |
| Author | Luc Deliens |
| Publication | Journal of Pain and Symptom Management |
| Volume | 40 |
| Issue | 2 |
| Pages | 290-300 |
| Date | August 2010 |
| DOI | 10.1016/j.jpainsymman.2009.12.012 |
| ISSN | 0885-3924 |
| Short Title | Content and Spiritual Items of Quality-of-Life Instruments Appropriate for Use in Palliative Care |
| Accessed | Mon Sep 13 20:46:53 2010 |
| Library Catalog | ScienceDirect |
| Date Added | Thu Sep 29 09:03:07 2011 |
| Modified | Thu Sep 29 09:03:07 2011 |
| Type | Journal Article |
|---|---|
| Author | Jonathan Bergman |
| Author | Arlene Fink |
| Author | Lorna Kwan |
| Author | Sally Maliski |
| Author | Mark S Litwin |
| Abstract | Despite the positive influence of spiritual coping on the acceptance of a cancer diagnosis, higher spirituality is associated with receipt of more high intensity care at the end of life. The purpose of our study was to assess the association between spirituality and type of end-of-life care received by disadvantaged men with prostate cancer. We studied low-income, uninsured men in IMPACT, a state-funded public assistance program, who had died since its inception in 2001. Of the 60 men who died, we included the 35 who completed a spirituality questionnaire at program enrollment. We abstracted sociodemographic and clinical information as well as treatment within IMPACT, including zolendroic acid, chemotherapy, hospice use, and palliative radiation therapy. We measured spirituality with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being questionnaire (FACIT-Sp) and compared end-of-life care received between subjects with low and high FACIT-Sp scores using chi-squared analyses. A higher proportion of men with high (33%) versus low (13%) spirituality scores enrolled in hospice, although our analysis was not adequately powered to demonstrate statistical significance. Likewise, we saw a trend toward increased receipt of palliative radiation among those with higher spirituality (37% vs. 25%, P=0.69). The differences in end-of-life care received among those with low and high spirituality varied little by the FACIT-Sp peace and faith subscales. Conclusions: End-of-life care was similar between men with lower and higher spirituality. Men with higher spirituality trended toward greater hospice use, suggesting that they redirected the focus of their care from curative to palliative goals. |
| Publication | World Journal of Urology |
| Volume | 29 |
| Issue | 1 |
| Pages | 43-49 |
| Date | Feb 2011 |
| Journal Abbr | World J Urol |
| DOI | 10.1007/s00345-010-0610-y |
| ISSN | 1433-8726 |
| Accessed | Tue Mar 15 14:29:35 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 21170717 |
| Date Added | Thu Sep 29 08:56:57 2011 |
| Modified | Thu Sep 29 08:56:57 2011 |
| Type | Journal Article |
|---|---|
| Author | Co-Shi Chantal Chao |
| Author | Ching-Huey Chen |
| Author | Miaofen Yen |
| Abstract | The purpose of this hermeneutic study was to investigate the essence of spirituality of terminally ill patients. In-depth unstructured interviews were used as the method for data collection. In the six-month period of data collection, the researcher was in the role of a hospice palliative care consultant who directly took care of the subject patients in a hospice ward of a teaching hospital. The six subjects were selected purposively according to various demographic backgrounds. Interview transcripts provided the data for analysis. The results were composed of four constitutive patterns and ten themes. The first constitutive pattern was "Communion with Self" which included three themes: (1) Self-identity--spirituality is the discovery of the authentic self. (2) Wholeness--a human being is full of contradictions but still in wholeness. (3) Inner peace--spirituality is negotiating conflicts for self-reconciliation. The second constitutive pattern was "Communion with others" which included two themes: (1) Love--spirituality is a caring relationship but not an over-attachment to others. (2) Reconciliation--spirituality is to forgive and to be forgiven. The third constitutive pattern was "Communion with Nature" which included two themes: (1) Inspiration from the nature--spirituality is the resonance of the marvelous beauty of nature. (2) Creativity--spirituality is conceiving imaginatively. The fourth constitutive pattern was "Communion with Higher Being" which included three themes: (1) Faithfulness--spirituality is keeping the trust dependably. (2) Hope--spirituality is claiming possibilities. (3) Gratitude--spirituality is giving thanks and embracing grace. The scientific rigor of this qualitative research as well as the strength and limitations of the study are reported. Implications for hospice palliative care and future research are recommended. |
| Publication | The Journal of Nursing Research: JNR |
| Volume | 10 |
| Issue | 4 |
| Pages | 237-245 |
| Date | Dec 2002 |
| Journal Abbr | J Nurs Res |
| ISSN | 1682-3141 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/12522736 |
| Accessed | Thu Nov 12 23:04:34 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 12522736 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
The purpose of this hermeneutic study was to investigate the essence of spirituality of terminally ill patients. In-depth unstructured interviews were used as the method for data collection.
| Type | Journal Article |
|---|---|
| Author | John T Chibnall |
| Author | Susan D Videen |
| Author | Paul N Duckro |
| Author | Douglas K Miller |
| Abstract | The purpose of this study was to identify demographic, disease, health care, and psychosocial-spiritual factors associated with death distress (death-related depression and anxiety). Cross-sectional baseline data from a randomized controlled trial were used. Outpatients (n=70) were recruited from an urban academic medical centre and proprietary hospital. All patients had life-threatening medical conditions, including cancer; pulmonary, cardiac, liver, or kidney disease; HIV/AIDS; or geriatric frailty. Measures of death distress, physical symptom severity, depression and anxiety symptoms, spiritual well-being, social support, patient-perceived physician communication, and patient-perceived quality of health care experiences were administered. In a hierarchical multiple regression model, higher death distress was significantly associated with living alone, greater physical symptom severity, more severe depression symptoms, lower spiritual well-being, and less physician communication as perceived by the patient. Death distress as a unique experiential construct was discriminable among younger patients with specific, diagnosable life-threatening conditions, but less so among geriatric frailty patients. The findings suggest that the experience of death distress among patients with life-threatening medical conditions is associated with the psychosocial-spiritual dimensions of the patient's life. Attention to these dimensions may buffer the negative affects of death distress. |
| Publication | Palliative Medicine |
| Volume | 16 |
| Issue | 4 |
| Pages | 331-338 |
| Date | Jul 2002 |
| Journal Abbr | Palliat Med |
| ISSN | 0269-2163 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/12132546 |
| Accessed | Thu Nov 12 21:49:11 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 12132546 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
The purpose of this study was to identify demographic, disease, health care, and psychosocial-spiritual factors associated with death distress (death-related depression and anxiety). Death distress as a unique experiential construct was discriminable among younger patients with specific, diagnosable life-threatening conditions, but less so among geriatric frailty patients. The findings suggest that the experience of death distress among patients with life-threatening medical conditions is associated with the psychosocial-spiritual dimensions of the patient’s life.
| Type | Journal Article |
|---|---|
| Author | Ana Catarina de Araújo Elias |
| Author | Joel Sales Giglio |
| Author | Cibele Andrucioli de Mattos Pimenta |
| Author | Linda Gentry El-Dash |
| Abstract | Therapeutic intervention involving the technique of Relaxation, Mental Images, and Spirituality (RIME) can foster the redefinition of spiritual pain in terminal patients. A training course was developed to instruct health care professionals in its use, and the results were followed up by evaluating reactions of professionals to its use in intervention with patients. Six subjects (a nurse, a doctor, three psychologists, and an alternative therapist), all skilled in palliative care, were invited to take part in the experience. They worked with 11 terminal patients in public hospitals of the cities of Campinas, Piracicaba, and São Paulo, located in Brazil. The theoretical basis for the study involves action research and phenomenology, and the results were analyzed using both qualitative and quantitative methods. The analysis of the experience of the professionals revealed 5 categories and 15 subcategories. The analysis of the nature of spiritual pain revealed 6 categories and 11 subcategories. The administration of RIME revealed statistically significant differences (p < 0.0001), i.e., patients reported a greater level of well-being at the end than at the beginning of sessions, which suggests that RIME led to the redefinition of spiritual pain for these terminal patients. The training program proposed has shown itself to be effective in preparing health care professionals for the use of RIME intervention. |
| Publication | TheScientificWorldJournal |
| Volume | 6 |
| Pages | 2158-2169 |
| Date | 2006 |
| Journal Abbr | ScientificWorldJournal |
| DOI | 10.1100/tsw.2006.345 |
| ISSN | 1537-744X |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/17370011 |
| Accessed | Fri Nov 13 17:30:08 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 17370011 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
Therapeutic intervention involving the technique of Relaxation, Mental Images, and Spirituality (RIME) can foster the redefinition of spiritual pain in terminal patients. A training course was developed to instruct health care professionals in its use, and the results were followed up by evaluating reactions of professionals to its use in intervention with patients.
| Type | Journal Article |
|---|---|
| Author | Lois Downey |
| Author | Ruth A Engelberg |
| Author | Leanna J Standish |
| Author | Leila Kozak |
| Author | William E Lafferty |
| Abstract | Improving end-of-life care is a priority in the United States, but assigning priorities for standard care services requires evaluations using appropriate study design and appropriate outcome indicators. A recent randomized controlled trial with terminally ill patients produced no evidence of benefit from massage or guided meditation, when evaluated with measures of global quality of life or pain distress over the course of patient participation. However, reanalysis using a more targeted outcome, surrogates' assessment of patients' benefit from the study intervention, suggested significant gains from massage-the treatment patients gave their highest preassignment preference ratings. The authors conclude that adding a menu of complementary therapies as part of standard end-of-life care may yield significant benefit, that patient preference is an important predictor of outcome, and that modifications in trial design may be appropriate for end-of-life studies. |
| Publication | The American Journal of Hospice & Palliative Care |
| Volume | 26 |
| Issue | 4 |
| Pages | 246-253 |
| Date | 2009 Aug-Sep |
| Journal Abbr | Am J Hosp Palliat Care |
| DOI | 10.1177/1049909109331887 |
| ISSN | 1938-2715 |
| Short Title | Three lessons from a randomized trial of massage and meditation at end of life |
| URL | http://www.ncbi.nlm.nih.gov.ezproxy.bu.edu/pubmed/19395701 |
| Accessed | Sat Sep 26 15:38:25 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 19395701 |
| Date Added | Thu Sep 29 09:05:38 2011 |
| Modified | Thu Sep 29 09:05:38 2011 |
| Type | Journal Article |
|---|---|
| Author | Lois Downey |
| Author | Paula Diehr |
| Author | Leanna J. Standish |
| Author | Donald L. Patrick |
| Author | Leila Kozak |
| Author | Douglass Fisher |
| Author | Sean Congdon |
| Author | William E. Lafferty |
| Abstract | This article reports findings from a randomized controlled trial of massage and guided meditation with patients at the end of life. Using data from 167 randomized patients, the authors consider patient outcomes through 10 weeks post-enrollment, as well as next-of-kin ratings of the quality of the final week of life for 106 patients who died during study participation. Multiple regression models demonstrated no significant treatment effects of either massage or guided meditation, delivered up to twice a week, when compared with outcomes of an active control group that received visits from hospice-trained volunteers on a schedule similar to that of the active treatment arms. The authors discuss the implications of their findings for integration of these complementary and alternative medicine therapies into standard hospice care. |
| Publication | Journal of palliative care |
| Volume | 25 |
| Issue | 2 |
| Pages | 100-108 |
| Date | 2009 |
| Journal Abbr | J Palliat Care |
| ISSN | 0825-8597 |
| Short Title | Might Massage or Guided Meditation Provide “Means to a Better End”? |
| Library Catalog | PubMed Central |
| Extra | PMID: 19678461 PMCID: 2858762 |
| Date Added | Thu Sep 29 09:05:38 2011 |
| Modified | Thu Sep 29 09:05:38 2011 |
| Type | Journal Article |
|---|---|
| Author | A Edwards |
| Author | N Pang |
| Author | V Shiu |
| Author | C Chan |
| Abstract | Spirituality and spiritual care are gaining increasing attention but their potential contribution to palliative care remains unclear. The aim of this study was to synthesize qualitative literature on spirituality and spiritual care at the end of life using a systematic ('meta-study') review. Eleven patient articles and eight with healthcare providers were included, incorporating data from 178 patients and 116 healthcare providers, mainly from elderly White and Judaeo-Christian origin patients with cancer. Spirituality principally focused on relationships, rather than just meaning making, and was given as a relationship. Spirituality was a broader term that may or may not encompass religion. A 'spirit to spirit' framework for spiritual care-giving respects individual personhood. This was achieved in the way physical care was given, by focusing on presence, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing. Affirmative relationships supported patients, enabling them to respond to their spiritual needs. The engagement of family caregivers in spiritual care appears underutilized. Relationships formed an integral part of spirituality as they were a spiritual need, caused spiritual distress when broken and were the way spiritual care was given. Barriers to spiritual care include lack of time, personal, cultural or institutional factors, and professional educational needs. By addressing these, we may make an important contribution to the improvement of patient care towards the end of life. |
| Publication | Palliative Medicine |
| Volume | 24 |
| Issue | 8 |
| Pages | 753-770 |
| Date | Dec 2010 |
| Journal Abbr | Palliat Med |
| DOI | 10.1177/0269216310375860 |
| ISSN | 1477-030X |
| Short Title | The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care |
| URL | http://www.ncbi.nlm.nih.gov.ezproxy.bu.edu/pubmed/20659977 |
| Accessed | Tue Jan 18 19:05:13 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 20659977 |
| Date Added | Thu Sep 29 08:58:27 2011 |
| Modified | Thu Sep 29 08:58:27 2011 |
| Type | Journal Article |
|---|---|
| Author | Eva Jeppsson Grassman |
| Author | Anna Whitaker |
| Abstract | This article addresses the role of the Church of Sweden in spiritual care for parishioners in their end-of-life phase. The frame of reference is a new geography of dying that implies that a majority of Swedes today, particularly older people, die in their local neighborhood of belonging, in fact in their parishes. Findings from a study of all parishes in two Swedish communities are presented that indicate support for dying parishioners is surprisingly uncommon, although most parishes offer support for the bereaved. A possible interpretation of these contrasting patterns is discussed. The findings indicate that divergent forms of care logic motivated the different types of support offered by the Church. Long-standing relationships with aging parishioners seemed to be at the heart of the matte |
| Publication | Journal of Religion, Spirituality & Aging |
| Volume | 21 |
| Issue | 4 |
| Pages | 344-360 |
| Date | 2009 October |
| DOI | 10.1080/15528030903158192 |
| ISSN | 1552-8030 |
| Short Title | Divergent Logics of Spiritual Care |
| URL | http://www.informaworld.com.ezproxy.bu.edu/10.1080/15528030903158192 |
| Accessed | Mon Nov 2 20:35:45 2009 |
| Library Catalog | Informaworld |
| Date Added | Thu Sep 29 09:05:21 2011 |
| Modified | Thu Sep 29 09:05:21 2011 |
| Type | Journal Article |
|---|---|
| Author | Meg M. Hegarty |
| Author | Amy P. Abernethy |
| Author | Ian Olver |
| Author | David C. Currow |
| Abstract | BACKGROUND Palliative care encompasses physical, psychosocial and spiritual care for patients and caregivers. No population data are available on bereaved people who subsequently report that additional spiritual support would have been helpful. METHODS In a population survey, a respondent-defined question was asked regarding 'additional spiritual support' that would have been helpful if someone 'close to them had died' an expected death in the previous five years. Data (socio-demographic [respondent]); clinical [deceased]) directly standardized to the whole population were analysed. RESULTS There were 14,902 participants in this study (71.6% participation rate), of whom 31% (4665) experienced such a death and 1084 (23.2%) provided active hands-on (day-to-day or intermittent) care. Fifty-one of the 1084 (4.7%) active caregivers identified that additional spiritual support would have been helpful. The predictors in a regression analysis were: other domains where additional support would have been helpful (OR 1.69; 95% CI 1.46-1.94; p < 0.001); and being female (OR 3.23; 95% CI 1.23 to 8.33; p = 0.017). 'Additional spiritual support being helpful' was strongly associated with higher rates where additional support in other domains would also have been helpful in: all bereaved people (2.7 vs 0.6; p < 0.0001); and in active caregivers (3.7 vs 0.8; p < 0.0001). CONCLUSION People who identify that additional spiritual support would have been helpful have specific demographic characteristics. There is also a strong association with the likelihood of identifying that a number of other additional supports would have been helpful. Clinically, the need for additional spiritual support should open a conversation about other areas where the need for further support may be identified. |
| Publication | Palliative Medicine |
| Volume | 25 |
| Issue | 3 |
| Pages | 266-277 |
| Date | Apr 2011 |
| Journal Abbr | Palliat Med |
| DOI | 10.1177/0269216310389225 |
| ISSN | 1477-030X |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/21228089 |
| Accessed | Mon May 9 19:04:27 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 21228089 |
| Date Added | Thu Sep 29 08:55:49 2011 |
| Modified | Thu Sep 29 08:55:49 2011 |
| Type | Journal Article |
|---|---|
| Author | Paul L Kimmel |
| Author | Seth L Emont |
| Author | John M Newmann |
| Author | Helen Danko |
| Author | Alvin H Moss |
| Abstract | BACKGROUND: Recent research suggests that patients' perceptions may be more important than objective clinical assessments in determining quality of life (QOL) for patients with end-stage renal disease (ESRD). METHODS: We interviewed 165 hemodialysis patients from 3 sites using a QOL questionnaire that included the Satisfaction With Life Scale (SWLS) and the McGill QOL (MQOL) scale, which includes a single-item global measure of QOL (Single-Item QOL Scale [SIS]). The MQOL scale asks patients to report their most troublesome symptoms. We also initiated the use of a Support Network Scale and a Spiritual Beliefs Scale. RESULTS: Mean patient age was 60.9 years, 52% were men, 63% were white, and 33% were African American. Patients had a mean treatment time for ESRD of 44 months, mean hemoglobin level of 11.8 g/dL (118 g/L), mean albumin level of 3.7 g/dL (37 g/L), and mean Kt/V of 1.6. Forty-five percent of patients reported symptoms. Pain was the most common symptom (21% of patients). There was an inverse relationship between reported number of symptoms and SWLS (P < 0.01), MQOL scale score (P < 0.001), and SIS (P < 0.001). The Spiritual Beliefs Scale correlated with the MQOL scale score, SWLS (both P < 0.01), and SIS (P < 0.05). The Support Network Scale score correlated with the MQOL Existential (P = 0.01) and MQOL Support (P < 0.01) subscales. No clinical parameter correlated with any measure of QOL, spiritual beliefs, or social support. CONCLUSION: Symptoms, especially pain, along with psychosocial and spiritual factors, are important determinants of QOL of patients with ESRD. Additional studies, particularly a longitudinal trial, are needed to determine the reproducibility and utility of these QOL measures in assessing patient long-term outcome and their association with other QOL indices in larger and more diverse patient populations. |
| Publication | American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation |
| Volume | 42 |
| Issue | 4 |
| Pages | 713-721 |
| Date | Oct 2003 |
| Journal Abbr | Am. J. Kidney Dis |
| ISSN | 1523-6838 |
| Short Title | ESRD patient quality of life |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/14520621 |
| Accessed | Thu Nov 12 23:39:17 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 14520621 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
Recent research suggests that patients’ perceptions may be more important than objective clinical assessments in determining quality of life (QOL) for patients with end-stage renal disease (ESRD). We interviewed 165 hemodialysis patients from 3 sites using a QOL questionnaire that included the Satisfaction With Life Scale (SWLS) and the McGill QOL (MQOL) scale, which includes a single-item global measure of QOL (Single-Item QOL Scale [SIS]).
| Type | Journal Article |
|---|---|
| Author | Esther Mok |
| Author | Frances Wong |
| Author | Daniel Wong |
| Abstract | AIM: This paper is a report of a study conducted to explore the phenomenon of spirituality and spiritual care among terminally ill Chinese patients. BACKGROUND: Meeting a patient's spiritual needs is a fundamental part of holistic nursing care. In the Western literature, spirituality is related to connectedness, faith, and hope. Contemporary scholars in the West suggest that spirituality is a broader term than religion. METHOD: Phenomenological interviews were conducted with a convenience sample of 15 terminally ill Chinese patients in 2007. FINDINGS: Participants found the term spirituality an abstract concept and described it as a unique personal belief which gives strength and relates to meaning of life. Spirituality is integrated with the body and mind and is a multidimensional concept. The acceptance of death as a process in life and 'letting go' leads to serenity and peace of mind. Other important themes include how the meaning of life is derived through relationships and connectedness, self-reflection of responsibilities, and obligations fulfilled. Inner spiritual well-being is attained from having faith and knowing possibilities in life and after death. Participants did not expect nurses to provide spiritual care, but when quality interpersonal care was given it gave them strength and spiritually supportive. CONCLUSION: If healthcare professionals can provide a compassionate and loving environment that facilitates acceptance and hope, the spiritual life of patients is enhanced. For dying individuals to experience love and for them to be understood as valuable even when no longer economically productive are both experiences of healing. |
| Publication | Journal of Advanced Nursing |
| Volume | 66 |
| Issue | 2 |
| Pages | 360-370 |
| Date | Feb 2010 |
| Journal Abbr | J Adv Nurs |
| DOI | 10.1111/j.1365-2648.2009.05193.x |
| ISSN | 1365-2648 |
| Accessed | Fri May 7 14:43:14 2010 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 20423419 |
| Date Added | Thu Sep 29 09:04:35 2011 |
| Modified | Thu Sep 29 09:04:35 2011 |
| Type | Journal Article |
|---|---|
| Author | Scott A Murray |
| Author | Marilyn Kendall |
| Author | Elizabeth Grant |
| Author | Kirsty Boyd |
| Author | Stephen Barclay |
| Author | Aziz Sheikh |
| Abstract | Typical trajectories of physical decline have been described for people with end-stage disease. It is possible that social, psychological, and spiritual levels of distress may also follow characteristic patterns. We sought to identify and compare changes in the psychological, social, and spiritual needs of people with end-stage disease during their last year of life by synthesizing data from two longitudinal, qualitative, in-depth interview studies investigating the experiences and needs of people with advanced illnesses. The subjects were 48 patients with advanced lung cancer (n=24) and heart failure (n=24) who gave a total of 112 in-depth interviews. Data were analyzed within individual case studies and then cross-sectionally according to the stage of physical illness. Characteristic social, psychological, and spiritual end-of-life trajectories were discernible. In lung cancer, the social trajectory mirrored physical decline, while psychological and spiritual well-being decreased together at four key transitions: diagnosis, discharge after treatment, disease progression, and the terminal stage. In advanced heart failure, social and psychological decline both tended to track the physical decline, while spiritual distress exhibited background fluctuations. Holistic end-of-life care needs to encompass all these dimensions. An appreciation of common patterns of social, psychological, and spiritual well-being may assist clinicians as they discuss the likely course of events with patients and carers and try to minimize distress as the disease progresses. |
| Publication | Journal of Pain and Symptom Management |
| Volume | 34 |
| Issue | 4 |
| Pages | 393-402 |
| Date | Oct 2007 |
| Journal Abbr | J Pain Symptom Manage |
| DOI | 10.1016/j.jpainsymman.2006.12.009 |
| ISSN | 0885-3924 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/17616334 |
| Accessed | Fri Nov 13 17:49:11 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 17616334 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
We sought to identify and compare changes in the psychological, social, and spiritual needs of people with end-stage disease during their last year of life by synthesizing data from two longitudinal, qualitative, in-depth interview studies investigating the experiences and needs of people with advanced illnesses.
| Type | Journal Article |
|---|---|
| Author | Christina Puchalski |
| Author | Betty Ferrell |
| Author | Rose Virani |
| Author | Shirley Otis-Green |
| Author | Pamela Baird |
| Author | Janet Bull |
| Author | Harvey Chochinov |
| Author | George Handzo |
| Author | Holly Nelson-Becker |
| Author | Maryjo Prince-Paul |
| Author | Karen Pugliese |
| Author | Daniel Sulmasy |
| Abstract | A Consensus Conference sponsored by the Archstone Foundation of Long Beach, California, was held February 17-18, 2009, in Pasadena, California. The Conference was based on the belief that spiritual care is a fundamental component of quality palliative care. This document and the conference recommendations it includes builds upon prior literature, the National Consensus Project Guidelines, and the National Quality Forum Preferred Practices and Conference proceedings. |
| Publication | Journal of Palliative Medicine |
| Volume | 12 |
| Issue | 10 |
| Pages | 885-904 |
| Date | Oct 2009 |
| Journal Abbr | J Palliat Med |
| DOI | 10.1089/jpm.2009.0142 |
| ISSN | 1557-7740 |
| Short Title | Improving the quality of spiritual care as a dimension of palliative care |
| URL | http://www.ncbi.nlm.nih.gov.ezproxy.bu.edu/pubmed/19807235 |
| Accessed | Mon Oct 19 20:07:09 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 19807235 |
| Date Added | Thu Sep 29 09:05:21 2011 |
| Modified | Thu Sep 29 09:05:21 2011 |
| Type | Journal Article |
|---|---|
| Author | E J Pugh |
| Author | R Song |
| Author | V Whittaker |
| Author | J Blenkinsopp |
| Abstract | There is evidence from outside the United Kingdom to show that physicians' religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers and specialist registrars and their attitudes to decisions which commonly must be taken when caring for individuals who are dying. All consultants (N = 119), nurse key workers (N = 36) and specialist registrars (N = 44) working in an acute hospital in the north-east of England were asked to complete a postal questionnaire. In all, 65% of consultants, 67% of nurse key workers and 41% of specialist registrars responded. Results showed that consultants' religion and belief systems differed from those of nurses and the population they served. Consultants and nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration and not withdraw treatment. Nurses were more sympathetic to the idea of physician-assisted suicide for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. This may have practical implications for the clinical care given and the place of care. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or physician-assisted suicide. |
| Publication | Palliative Medicine |
| Volume | 23 |
| Issue | 2 |
| Pages | 158-164 |
| Date | Mar 2009 |
| Journal Abbr | Palliat Med |
| DOI | 10.1177/0269216308100248 |
| ISSN | 1477-030X |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/19073784 |
| Accessed | Mon Mar 28 18:18:24 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 19073784 |
| Date Added | Thu Sep 29 09:07:00 2011 |
| Modified | Thu Sep 29 09:07:00 2011 |
| Type | Journal Article |
|---|---|
| Author | Dori Seccareccia |
| Author | Judith Belle Brown |
| Abstract | BACKGROUND: Modern palliative care defines four key domains fundamental to a patients' holistic care: physical, emotional, social, and spiritual. Regardless of the symptom being addressed, all four domains of care may need to be addressed to reduce suffering and encourage healing. Yet, despite the spiritual domain consistently being asserted as an integral part of palliative care, more is written on how to provide the physical, emotional, and social aspects of care than on how to provide spiritual care. OBJECTIVE: The objective of this study was to explore the perspectives and experiences of palliative care physicians regarding the spiritual domain of care and to identify the role of this domain both personally and professionally. DESIGN: This study recruited a purposeful sample of palliative care physicians and utilized the qualitative method of phenomenology to elicit palliative care physician's perspectives and experiences regarding the importance of spirituality in providing palliative care to patients. RESULTS: Themes that emerged from the study in relation to palliative care physicians' perspectives and experiences regarding the spiritual domain of care included the concept of spirituality and the difference between spirituality and religion. The overarching theme was the concept of how the participant's own spirituality impacted their practice and their practice impacted their spirituality. These were inextricably woven together. CONCLUSION: Addressing spirituality was fundamental to a palliative care physician providing compassionate and holistic care. The impact of a physician's personal spirituality on practice and practice on spirituality were inextricably woven together. |
| Publication | Journal of Palliative Medicine |
| Volume | 12 |
| Issue | 9 |
| Pages | 805-809 |
| Date | Sep 2009 |
| Journal Abbr | J Palliat Med |
| DOI | 10.1089/jpm.2009.0038 |
| ISSN | 1557-7740 |
| Short Title | Impact of spirituality on palliative care physicians |
| URL | http://www.ncbi.nlm.nih.gov.ezproxy.bu.edu/pubmed/19624268 |
| Accessed | Fri Sep 18 18:31:36 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 19624268 |
| Date Added | Thu Sep 29 09:06:02 2011 |
| Modified | Thu Sep 29 09:06:02 2011 |
| Type | Journal Article |
|---|---|
| Author | Lucy Selman |
| Author | Richard Harding |
| Author | Marjolein Gysels |
| Author | Peter Speck |
| Author | Irene J Higginson |
| Abstract | CONTEXT Despite the need to assess spiritual outcomes in palliative care, little is known about the properties of the tools currently used to do so. In addition, measures of spirituality have been criticized in the literature for cultural bias, and it is unclear which tools have been validated cross-culturally. OBJECTIVES This systematic review aimed to identify and categorize spiritual outcome measures validated in advanced cancer, human immunodeficiency virus (HIV), or palliative care populations; to assess the tools' cross-cultural applicability; and for those measures validated cross-culturally, to determine and categorize the concepts used to measure spirituality. METHODS Eight databases were searched to identify relevant validation and research studies. An extensive search strategy included search terms in three categories: palliative care, spirituality, and outcome measurement. Tools were evaluated according to two criteria: 1) validation in advanced cancer, HIV, or palliative care and 2) validation in an ethnically diverse context. Tools that met Criterion 1 were categorized by type; tools that also met Criterion 2 were subjected to content analysis to identify and categorize the spiritual concepts they use. RESULTS One hundred ninety-one articles were identified, yielding 85 tools. Fifty different tools had been reported in research studies; however, 30 of these had not been validated in palliative care populations. Thirty-eight tools met Criterion 1: general multidimensional measures (n=21), functional measures (n=11), and substantive measures (n=6). Nine measures met Criterion 2; these used spiritual concepts relating to six themes: Beliefs, practices, and experiences; Relationships; Spiritual resources; Outlook on life/self; Outlook on death/dying; and Indicators of spiritual well-being. A conceptual model of spirituality is presented on the basis of the content analysis. Recommendations include consideration of both the clinical and cultural population in which spiritual instruments have been validated when selecting an appropriate measure for research purposes. Areas in need of further research are identified. CONCLUSION The nine tools identified in this review are those that have currently been validated in cross-cultural palliative care populations and, subject to appraisal of their psychometric properties, may be suitable for cross-cultural research. |
| Publication | Journal of Pain and Symptom Management |
| Volume | 41 |
| Issue | 4 |
| Pages | 728-753 |
| Date | Apr 2011 |
| Journal Abbr | J Pain Symptom Manage |
| DOI | 10.1016/j.jpainsymman.2010.06.023 |
| ISSN | 1873-6513 |
| Short Title | The measurement of spirituality in palliative care and the content of tools validated cross-culturally |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/21306866 |
| Accessed | Mon May 9 19:04:27 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 21306866 |
| Date Added | Thu Sep 29 08:55:49 2011 |
| Modified | Thu Sep 29 08:55:49 2011 |
| Type | Journal Article |
|---|---|
| Author | Margaret L Stuber |
| Author | Beth M Houskamp |
| Abstract | This article uses a developmental framework to consider common spiritual issues raised by children and adolescents who are confronting death. The literature exploring the role of children's spirituality in addressing death is used to illustrate specific areas of concern and topics deserving further research. Clinical examples are offered to illustrate the types of situations encountered by mental health professionals dealing with seriously ill children and their families. Recommendations are offered for concrete approaches for mental health professionals dealing with families confronting the death of a child. |
| Publication | Child and Adolescent Psychiatric Clinics of North America |
| Volume | 13 |
| Issue | 1 |
| Pages | 127-136, viii |
| Date | Jan 2004 |
| Journal Abbr | Child Adolesc Psychiatr Clin N Am |
| ISSN | 1056-4993 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/14723304 |
| Accessed | Fri Nov 13 12:35:21 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 14723304 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
This article uses a developmental framework to consider common spiritual issues raised by children and adolescents who are confronting death. The literature exploring the role of children’s spirituality in addressing death is used to illustrate specific areas of concern and topics deserving further research. Clinical examples are offered to illustrate the types of situations encountered by mental health professionals dealing with seriously ill children and their families.
| Type | Journal Article |
|---|---|
| Author | Daniel P Sulmasy |
| Abstract | PURPOSE: This article presents a model for research and practice that expands on the biopsychosocial model to include the spiritual concerns of patients. DESIGNS AND METHODS: Literature review and philosophical inquiry were used. RESULTS: The healing professions should serve the needs of patients as whole persons. Persons can be considered beings-in-relationship, and illness can be considered a disruption in biological relationships that in turn affects all the other relational aspects of a person. Spirituality concerns a person's relationship with transcendence. Therefore, genuinely holistic health care must address the totality of the patient's relational existence-physical, psychological, social, and spiritual. The literature suggests that many patients would like health professionals to attend to their spiritual needs, but health professionals must be morally cautious and eschew proselytizing in any form. Four general domains for measuring various aspects of spirituality are distinguished: religiosity, religious coping and support, spiritual well-being, and spiritual need. A framework for understanding the interactions between these domains is presented. Available instruments are reviewed and critiqued. An agenda for research in the spiritual aspects of illness and care at the end of life is proposed. IMPLICATIONS: Spiritual concerns are important to many patients, particularly at the end of life. Much work remains to be done in understanding the spiritual aspects of patient care and how to address spirituality in research and practice. |
| Publication | The Gerontologist |
| Volume | 42 Spec No 3 |
| Pages | 24-33 |
| Date | Oct 2002 |
| Journal Abbr | Gerontologist |
| ISSN | 0016-9013 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/12415130 |
| Accessed | Thu Nov 12 22:05:25 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 12415130 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
This article presents a model for research and practice that expands on the biopsychosocial model to include the spiritual concerns of patients.
| Type | Journal Article |
|---|---|
| Author | Mélanie Vachon |
| Author | Lise Fillion |
| Author | Marie Achille |
| Abstract | The definition of spirituality is the subject of endless debates in the empirical literature. This content analysis sought to: (1) exhaustively review the empirical literature on end-of-life spirituality to extract definitional elements of this concept and (2) elaborate on these definitional elements to create an integrative and inclusive definition of end-of-life spirituality based on the items retrieved. A search of the literature on spirituality published in the last 10 years was conducted via the the PsychINFO and MEDLINE databases. Seventy-one articles were selected based on specific inclusion criteria. A qualitative thematic analysis yielded 11 dimensions for the concept of end-of-life spirituality, namely: (1) meaning and purpose in life, (2) self-transcendence, (3) transcendence with a higher being, (4) feelings of communion and mutuality, (5) beliefs and faith, (6) hope, (7) attitude toward death, (8) appreciation of life, (9) reflection upon fundamental values, (10) the developmental nature of spirituality, and (11) its conscious aspect. The definition derived from this concept analysis, after being tested empirically, may be useful in informing the development of new measures of spirituality and new protocols to assess spirituality in clinical settings. |
| Publication | Journal of Palliative Medicine |
| Volume | 12 |
| Issue | 1 |
| Pages | 53-59 |
| Date | Jan 2009 |
| Journal Abbr | J Palliat Med |
| DOI | 10.1089/jpm.2008.0189 |
| ISSN | 1557-7740 |
| Accessed | Tue Feb 22 19:38:06 2011 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 19284263 |
| Date Added | Thu Sep 29 09:06:18 2011 |
| Modified | Thu Sep 29 09:06:18 2011 |
| Type | Journal Article |
|---|---|
| Author | Peter H Van Ness |
| Author | Virginia R Towle |
| Author | John R O'Leary |
| Author | Terri R Fried |
| Abstract | OBJECTIVE: The purpose of this study is to present empirical evidence about whether religious patients are more or less willing to undergo the risks associated with potentially life-sustaining treatment. METHODS: At least every 4 months 226 older community-dwelling persons with advanced cancer, congestive heart failure, or chronic obstructive pulmonary disease were asked questions about several dimensions of religiousness and about their willingness to accept potentially life-sustaining treatment. RESULTS: Results were mixed but persons who said that during their illness they grew closer to God (odds ratio [OR] = 1.79; 95% confidence intervals [CI] = 1.15, 2.78) or those grew spiritually (OR = 1.61; 95% CI = 1.03, 2.52) were more willing to accept risk associated with potentially life-sustaining treatment than were persons who did not report such growth. DISCUSSION: Not all dimensions of religiousness have the same association with willingness to undergo potentially life-sustaining treatment. Seriously ill older, religious patients are not especially predisposed to avoid risk and resist treatment. |
| Publication | Journal of Aging and Health |
| Volume | 20 |
| Issue | 5 |
| Pages | 545-559 |
| Date | Aug 2008 |
| Journal Abbr | J Aging Health |
| DOI | 10.1177/0898264308317538 |
| ISSN | 0898-2643 |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/18443144 |
| Accessed | Fri Nov 13 18:54:05 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 18443144 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
The purpose of this study is to present empirical evidence about whether religious patients are more or less willing to undergo the risks associated with potentially life-sustaining treatment. Results: Results were mixed but persons who said that during their illness they grew closer to God (odds ratio [OR] = 1.79; 95% confidence intervals [CI] = 1.15, 2.78) or those grew spiritually (OR = 1.61; 95% CI = 1.03, 2.52) were more willing to accept risk associated with potentially life-sustaining treatment than were persons who did not report such growth.
| Type | Journal Article |
|---|---|
| Author | Anna-Leila Williams |
| Abstract | OBJECTIVE: A meta-summary of the qualitative literature on spiritual perspectives of adults who are at the end of life was undertaken to summarily analyze the research to date and identify areas for future research on the relationship of spirituality with physical, functional, and psychosocial outcomes in the health care setting. METHODS: Included were all English language reports from 1966 to the present catalogued in PubMed, Medline, PsycInfo, and CINAHL, identifiable as qualitative investigations of the spiritual perspectives of adults at the end of life. The final sample includes 11 articles, collectively representing data from 217 adults. RESULTS: The preponderance of participants had a diagnosis of cancer; those with HIV/AIDS, cardiovascular disease, and ALS were also represented. Approximately half the studies were conducted in the United States; others were performed in Australia, Finland, Scotland, and Taiwan. Following a process of theme extraction and abstraction, thematic patterns emerged and effect sizes were calculated. A spectrum of spirituality at the end of life encompassing spiritual despair (alienation, loss of self, dissonance), spiritual work (forgiveness, self-exploration, search for balance), and spiritual well-being (connection, self-actualization, consonance) emerged. SIGNIFICANCE: The findings from this meta-summary confirm the fundamental importance of spirituality at the end of life and highlight the shifts in spiritual health that are possible when a terminally ill person is able to do the necessary spiritual work. Existing end-of-life frameworks neglect spiritual work and consequently may be deficient in guiding research. The area of spiritual work is fertile ground for further investigation, especially interventions aimed at improving spiritual health and general quality of life among the dying. |
| Publication | Palliative & Supportive Care |
| Volume | 4 |
| Issue | 4 |
| Pages | 407-417 |
| Date | Dec 2006 |
| Journal Abbr | Palliat Support Care |
| ISSN | 1478-9515 |
| Short Title | Perspectives on spirituality at the end of life |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/17133899 |
| Accessed | Fri Nov 13 17:03:21 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 17133899 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
Objective: A meta-summary of the qualitative literature on spiritual perspectives of adults who are at the end of life was undertaken to summarily analyze the research to date and identify areas for future research on the relationship of spirituality with physical, functional, and psychosocial outcomes in the health care setting. Results: A spectrum of spirituality at the end of life encompassing spiritual despair (alienation, loss of self, dissonance), spiritual work (forgiveness, self-exploration, search for balance), and spiritual well-being (connection, self-actualization, consonance) emerged.
| Type | Journal Article |
|---|---|
| Author | Laraine Winter |
| Author | Marie P Dennis |
| Author | Barbara Parker |
| Abstract | Research on end-of-life treatment preferences has documented robust racial differences, with African-Americans preferring more life-prolonging treatment than Whites. Although little research has attempted to explain these racial differences systematically, speculation has centered on religiosity. We examined a dimension of religiosity frequently invoked in end-of-life research-guidance by God's will-as a potential mediator of racial differences in such treatment preferences. Three hundred African-American and White men and women aged 60 or older participated in a 35-minute telephone interview that elicited preferences for four common life-prolonging treatments in each of nine health scenarios. The questionnaire included the five-item God's will (GW) scale, a health conditions checklist, a depression measure, and sociodemographic questions. GW mediated racial differences at least partially for most treatments and in most health scenarios. Implications are discussed for understanding end-of-life treatment preferences and why races tend to differ. |
| Publication | Omega |
| Volume | 56 |
| Issue | 3 |
| Pages | 273-288 |
| Date | 2007-2008 |
| Journal Abbr | Omega (Westport) |
| ISSN | 0030-2228 |
| Short Title | Religiosity and preferences for life-prolonging medical treatments in African-American and white elders |
| URL | http://www.ncbi.nlm.nih.gov/pubmed/18300651 |
| Accessed | Fri Nov 13 18:44:17 2009 |
| Library Catalog | NCBI PubMed |
| Extra | PMID: 18300651 |
| Date Added | Sat Oct 1 16:55:15 2011 |
| Modified | Sat Oct 1 16:55:15 2011 |
Research on end-of-life treatment preferences has documented robust racial differences, with African-Americans preferring more life-prolonging treatment than Whites. Although little research has attempted to explain these racial differences systematically, speculation has centered on religiosity. We examined a dimension of religiosity frequently invoked in end-of-life research-guidance by God’s will-as a potential mediator of racial differences in such treatment preferences.