Spiritual care beneficial, but rare, to patients at end of life
December 28, 2012 | by Hiu Chung So
For terminally ill patients, one of the most important things they can do is to prepare themselves for the inevitable — physically, mentally and spiritually. But according to a study published in the Dec. 17 issue of the Journal of Clinical Oncology, very few of them have their spiritual needs attended to, even when doctors and nurses believe that it should be included as part of end-of-life care.
The findings were based on a survey of more than 400 patients diagnosed with advanced cancers, doctors and nurses. While the majority of all three groups believed that acts of spiritual care, such as asking about the patient’s spiritual beliefs or referring them to a chaplain, were appropriate for patients with advanced cancers, most patients reported never receiving any form of spiritual care from their nurses and doctors (87 and 94 percent, respectively.)
Even by the physicians and nurses’ own responses, only a minority of them – 24 percent of doctors, 31 percent of nurses – said that they have provided spiritual care to patients.
“I think we are realizing we can no longer ignore this aspect of care,” said Betty Ferrell, Ph.D., R.N., professor of nursing research and education at City of Hope. She was quoted in a Reuters article about the study.
However, Ferrell — who was not involved in this study — said “that the tides are changing” and that most doctors and nurses see the importance and benefits of spiritual care.
The survey also found that most physicians and nurses reported a lack of spiritual care training, which the authors cited is the strongest predictor of whether healthcare providers will offer spiritual care to their patients.
According to the data analysis in the study, doctors and nurses who were trained were 7 to 11 times more likely to provide spiritual care to their patients. However, less than 15 percent from each group have received such training.
"We can't practice what we don't know," Ferrell said in the Reuters article. "Physicians and nurses have never been taught to access and respond to spiritual need.”
Ferrell currently heads the End-of-Life Nursing Education Consortium, a training curriculum designed to equip nurses with the knowledge and skills they need to help patients and families through serious illnesses and prepare for the end of life.
Concurring with Ferrell, the study’s authors wrote that more extensive training and research in providing spiritual care is needed, and that such training can potentially “improve patient well-being and medical care quality at the end-of-life.”