DOI QR코드

DOI QR Code

Spiritual Care in Hospice and Palliative Care

  • Ferrell, Betty R. (Division of Nursing Research and Education, City of Hope Comprehensive Cancer Center)
  • Received : 2017.08.16
  • Accepted : 2017.11.14
  • Published : 2017.12.01

Abstract

Spiritual care is at the center of hospice and palliative care. Patients facing serious and life-threatening illness have important needs in regard to faith, hope, and existential concerns. The purpose of this article is to review the key aspects of this care, including the definitions of spirituality, spiritual assessment, and spiritual care interventions. A review of the current literature was conducted to identify content related to spiritual care in hospice and palliative care. A growing body of evidence supports the importance of spiritual care as a key domain of quality palliative care. The literature supports the importance of spiritual assessment as a key aspect of comprehensive patient and family assessment. Spirituality encompasses religious concerns as well as other existential issues. Future research and clinical practice should test models of best support to provide spiritual care.

영적간호는 호스피스 완화의료의 중심에 있다. 심각하고 생명을 위협하는 질병에 직면한 환자는 신앙, 희망 및 실존적 관심과 관련하여 중요한 요구를 가지고 있다. 이 논문의 목적은 영성, 영적 평가 및 영적간호 중재의 정의를 포함하여 이러한 간호의 핵심 측면들을 검토하는 것이다. 호스피스 완화의료에서 영적간호와 관련된 내용을 파악하기 위해 현재의 문헌 자료들을 조사했다. 점점 더 많은 증거들이 양질의 완화의료의 핵심 영역으로서 영적간호의 중요성을 뒷받침하고 있다. 문헌은 포괄적인 환자 및 가족 평가의 핵심 측면으로서 영적 평가의 중요성을 뒷받침한다. 영성은 다른 실존적 문제들뿐만 아니라 종교적인 관심도 포함한다. 향후 연구 및 임상시험은 영적간호를 제공하기 위한 최선의 지원 모델을 검증해야 한다.

Keywords

References

  1. Puchalski CM, Ferrell B. Making health care whole: integrating spirituality into health care. West Conshohocken, PA:Templeton Press;2010.
  2. WHO: Definition of Palliative Care [Internet]. Geneva: World Health Organization; c2017 [cited by 2016 Oct 28]. Available from: http://www.who.int/cancer/palliative/definition/en/.
  3. National Consensus Project for Quality Palliative Care [Internet]. Clinical practice guidelines for quality palliative care. 3rd ed. Pittsburgh, PA: National Consensus Project for Quality Palliative Care; 2013 [cited by 2016 Oct 28]. Available from: http://www.nationalconsensusproject.org.
  4. prc.coh.org [Internet]. Duarte, CA: City of Hope Pain Resource Center; 2017 [cited by 2016 Oct 28]. Available from: http://prc.coh.org.
  5. Ferrell B, Sun V, Hurria A, Cristea M, Raz DJ, Kim JY, et al. Interdisciplinary palliative care for patients with lung cancer. J Pain Symptom Manage 2015;50:758-67. https://doi.org/10.1016/j.jpainsymman.2015.07.005
  6. Jim HS, Pustejovsky JE, Park CL, Danhauer SC, Sherman AC, Fitchett G, et al. Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer 2015;121:3760-8. https://doi.org/10.1002/cncr.29353
  7. Bultz BD, Groff SL, Fitch M, Blais MC, Howes J, Levy K, et al. Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology 2015;20:463-9.
  8. Whitford HS, Olver IN, Peterson MJ. Spirituality as a core domain in the assessment of quality of life in oncology. Psychooncology 2008;17:1121-8. https://doi.org/10.1002/pon.1322
  9. Salsman JM, Pustejovsky JE, Jim HS, Munoz AR, Merluzzi TV, George L, et al. A meta-analytic approach to examining the correlation between religion/spirituality and mental health in cancer. Cancer 2015;121:3769-78. https://doi.org/10.1002/cncr.29350
  10. Sun V, Kim JY, Irish TL, Borneman T, Sidhu RK, Klein L, et al. Palliative care and spiritual well-being in lung cancer patients and family caregivers. Psychooncology 2015;25:1448-55.
  11. Sun V, Grant M, Koczywas M, Freeman B, Zachariah F, Fujinami R, et al. Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer. Cancer 2015:121:3737-45. https://doi.org/10.1002/cncr.29567
  12. Sherman AC, Merluzzi TV, Pustejovsky JE, Park CL, George L, Fitchett G, et al. A meta-analytic review of religious or spiritual involvement and social health among cancer patients. Cancer 2015;121:3779-88. https://doi.org/10.1002/cncr.29352
  13. Vallurupalli M, Lauderdale K, Balboni MJ, Phelps AC, Block SD, Ng AK, et al. The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. J Support Oncol 2012;10:81-7. https://doi.org/10.1016/j.suponc.2011.09.003
  14. Wang CW, Chan CL, Ng SM, Ho AH. The impact of spirituality on health-related quality of life among Chinese older adults with vision impairment. Aging Ment Health 2007;12: 267-75.
  15. Bekelman DB, Dy SM, Becker DM, Wittstein IS, Hendricks DE, Yamashita TE, et al. Spiritual well-being and depression in patients with heart failure. J Gen Intern Med 2007;22:470-7. https://doi.org/10.1007/s11606-006-0044-9
  16. Winkelman WD, Lauderdale K, Balboni MJ, Phelps AC, Peteet JR, Block SD, et al. The relationship of spiritual concerns to the quality of life of advanced cancer patients: preliminary findings. J Palliat Med 2011;14:1022-8. https://doi.org/10.1089/jpm.2010.0536
  17. Puchalski C, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, et al. Improving the quality of spiritual care as a dimension of palliative care: the report of the Consensus Conference. J Palliat Med 2009;12:885-904. https://doi.org/10.1089/jpm.2009.0142
  18. Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, et al. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 2007;25: 555-60. https://doi.org/10.1200/JCO.2006.07.9046
  19. Puchalski CM, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med 2014;17:642-56. https://doi.org/10.1089/jpm.2014.9427
  20. Stephenson PS, Berry DM. Describing spirituality at the end of life. West J Nurs Res 2015;37:1229-47. https://doi.org/10.1177/0193945914535509
  21. Nolan S, Saltmarsh P, Leget C. Spiritual care in palliative care: working towards an EAPC Task Force. Eur J Palliat Care 2011:18:86-9.
  22. National Comprehensive Cancer Network. NCCN Clinical practice guidelines in oncology: palliat care. Rockledge, PA: National Comprehensive Cancer Network;2016.
  23. Candy B, Jones L, Varagunam M, Speck P, Tookman A, King M. Spiritual and religious interventions for well-being of adults in the terminal phase of disease. Cochrane Database Syst Rev 2012;(5):CD007544.
  24. Mako C, Galek K, Poppito SR. Spiritual pain among patients with advanced cancer in palliative care. J Palliat Med 2006; 9:1106-13. https://doi.org/10.1089/jpm.2006.9.1106
  25. Puchalski C, Romer AL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med 2000;3:129-37. https://doi.org/10.1089/jpm.2000.3.129
  26. Hui D, de la Cruz M, Thorney S, Parsons HA, Delgado-Guay M, Bruera E. The frequency and correlates of spiritual distress among patients with advanced cancer admitted to an acute palliative care unit. Am J Hosp Palliat Care 2011;28:264-70. https://doi.org/10.1177/1049909110385917
  27. Koenig HG. Spirituality & health research: methods, measurements, statistics, and resources. West Conshohocken, PA: Tempelton Press;2011.
  28. Selman L, Siegert R, Harding R, Gysels M, Speck P, Higginson IJ. A psychometric evaluation of measures of spirituality validated in culturally diverse palliative care populations. J Pain Symptom Manage 2011;42:604-22. https://doi.org/10.1016/j.jpainsymman.2011.01.015
  29. Steinhauser KE, Alexander SC, Byock IR, George LK, Tulsky JA. Seriously ill patients' discussions of preparation and life completion: an intervention to assist with transition at the end of life. Palliat Support Care 2009;7:393-404. https://doi.org/10.1017/S147895150999040X
  30. Borneman T, Ferrell B, Puchalski CM. Evaluation of the FICA tool for spiritual assessment. J Pain Symptom Manage 2010; 40:163-73. https://doi.org/10.1016/j.jpainsymman.2009.12.019
  31. Taylor EJ. Spiritual assessment. In: Ferrell BR, Coyle N, Paice JA, eds. Oxford textbook of palliative nursing. 4th ed. New York:Oxford University Press;2015. p. 531-45.
  32. Monod S, Brennan M, Rochat E, Martin E, Rochat S, Bula CJ. Instruments measuring spirituality in clinical research: a systematic review. J Gen Intern Med 2011;26:1345-57. https://doi.org/10.1007/s11606-011-1769-7
  33. Balboni TA, Maciejewski PK, Balboni MJ, Enzinger AC, Paulk ME, Munoz F, et al. Racial/ethnic differences in end-of-life treatment preferences: The role of religious beliefs about care, Abstract 6529. J Clin Oncol 2013;31:18 Supplement.
  34. King M, Llewellyn H, Leurent B, Owen F, Leavey G, Tookman A, et al. Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care. Psychooncology 2013;22:2505-12. https://doi.org/10.1002/pon.3313
  35. Baird RP. Spiritual care intervention. In: Ferrell BR, Coyle N, Paice JA, eds. Oxford textbook of palliative nursing. 4th ed. New York:Oxford University Press;2015. p. 546-53.
  36. Ferrell, BR. The role of the advanced practice registered nurse in spiritual care. In: Dahlin C, Coyne PJ, Ferrell BR, eds. Advanced practice palliative nursing. New York, New York:Oxford University Press;2016.
  37. Higginson IJ, Evans CJ, Grande G, Preston N, Morgan M, McCrone P, et al. Evaluating complex interventions in end of life care: the MORECare statement on good practice generated by a synthesis of transparent expert consultations and systematic reviews. BMC Med 2013;11:111. https://doi.org/10.1186/1741-7015-11-111
  38. Vachon M, Fillion L, Achille M. A conceptual analysis of spirituality at the end of life. J Palliat Med 2009;12:53-9. https://doi.org/10.1089/jpm.2008.0189
  39. Alcorn SR, Balboni MJ, Prigerson HG, Reynolds A, Phelps AC, Wright AA, et al. "If God wanted me yesterday, I wouldn't be here today": religious and spiritual themes in patients' experiences of advanced cancer. J Palliat Med 2010;13:581-8. https://doi.org/10.1089/jpm.2009.0343
  40. Breitbart W, Poppito S, Rosenfeld B, Vickers AJ, Li Y, Abbey J, et al. Pilot randomized controlled trial of individual meaningcentered psychotherapy for patients with advanced cancer. J Clin Oncol 2012;30:1304-9. https://doi.org/10.1200/JCO.2011.36.2517
  41. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol 2005;23:5520-5. https://doi.org/10.1200/JCO.2005.08.391
  42. Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, et al. Effect of dignity therapy on distress and end-of life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol 2011;12:753-62. https://doi.org/10.1016/S1470-2045(11)70153-X
  43. AACN. ELNEC [Internet]. Washington, DC; American Association of Colleges of Nursing: c2017 [cited by 2016 Oct 28]. Available from: http://www.aacn.nche.edu/elnec.
  44. GWISH.org [Internet]. Washington, DC: The George Washington Institute for Spirituality and Health; c2017 [cited by 2016 Oct 28]. Available from: http://www.GWISH.org
  45. Selman L, Young T, Vermandere M, Stirling I, Leget C; Research Subgroup of European Association for Palliative Care Spiritual Care Taskforce. Research priorities in spiritual care: an international survey of palliative care researchers and clinicians. J Pain Symptom Manage 2014;48:518-31. https://doi.org/10.1016/j.jpainsymman.2013.10.020
  46. Delgado-Guay MO, Parsons HA, Hui D, De la Cruz MG, Thorney S, Bruera E. Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. Am J Hosp Palliat Care 2013;30:455-61. https://doi.org/10.1177/1049909112458030
  47. Ferrell B, Coyle N. The nature of suffering and the goals of nursing. New York, NY:Oxford University Press;2008.
  48. Balboni MJ, Sullivan A, Amobi A, Phelps AC, Gorman DP, Zollfrank A, et al. Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. J Clin Oncol 2013;31:461-7.
  49. Borneman T, Brown-Saltzman K. Meaning in Illness. In: Ferrell BR, Coyle N, Paice JA, eds. Oxford Textbook of Palliative Nursing. 4th ed. New York:Oxford University Press;2015. p. 554-66.

Cited by

  1. Models for Spiritual Care in Hospice and Palliative Care vol.21, pp.2, 2018, https://doi.org/10.14475/kjhpc.2018.21.2.41
  2. Validation of a Korean Version of the Spiritual Care Competence Scale : Focused on the Hospice and Palliative Care Setting vol.21, pp.5, 2017, https://doi.org/10.1097/njh.0000000000000589
  3. Effectiveness of Education Program on Nursing Knowledge and Attitude toward Pain Management vol.7, pp.4, 2020, https://doi.org/10.4103/apjon.apjon_17_20