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Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses

Published online by Cambridge University Press:  06 September 2018

Gil Bar-Sela Open the ORCID record for Gil Bar-Sela [Opens in a new window] ,
Michael J. Schultz ,
Karima Elshamy ,
Maryam Rassouli ,
Eran Ben-Arye ,
Myrna Doumit ,
Nahla Gafer ,
Alaa Albashayreh ,
Ibtisam Ghrayeb  and
Ibrahim Turker
...Show all authors
Gil Bar-Sela*
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Michael J. Schultz
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Karima Elshamy
Affiliation:
Faculty of Nursing, Mansoura University, Mansoura, Egypt
Maryam Rassouli
Affiliation:
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Teheran, Islamic Republic of Iran
Eran Ben-Arye
Affiliation:
The Oncology Service, Lin Medical Center, Haifa, Israel
Myrna Doumit
Affiliation:
Alice Ramez Chagoury School of Nursing, Lebanese American University, Beirut, Lebanon
Nahla Gafer
Affiliation:
Radiation and Isotope Center, Khartoum, Sudan
Alaa Albashayreh
Affiliation:
College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
Ibtisam Ghrayeb
Affiliation:
Makassed Charitable Hospital, East Jerusalem
Ibrahim Turker
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Gulcin Ozalp
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Sultan Kav
Affiliation:
Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
Rasha Fahmi
Affiliation:
El-Salam Oncology Center, Cairo, Egypt
Sophia Nestoros
Affiliation:
Cyprus Anti-Cancer Society, Avodaphnousa Hospice, Nicosia, Cyprus
Hasanein Ghali
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Layth Mula-Hussain
Affiliation:
Cross Cancer Institute - University of Alberta, Edmonton, Canada
Ilana Shazar
Affiliation:
Department of Hematology, Rambam Health Care Campus, Haifa, Israel
Rana Obeidat
Affiliation:
Faculty of Nursing, Zarqa University, Zarqa, Jordan
Rehana Punjwani
Affiliation:
Children Cancer Hospital, Karachi, Pakistan
Mohamad Khleif
Affiliation:
Al-Sadeel Society for Palliative Care, Bethlehem, West Bank, Palestinian Authority
Gulbeyaz Can
Affiliation:
Florence Nightingale Faculty of Nursing, Istanbul University, Istanbul, Turkey
Gonca Tuncel
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Haris Charalambous
Affiliation:
Bank of Cyprus Oncology Center, Nicosia, Cyprus
Safa Faraj
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Neophyta Keoppi
Affiliation:
Cyprus Anti-Cancer Society, Nicosia, Cyprus
Mazin Al-Jadiry
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Sergey Postovsky
Affiliation:
Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
Ma'an Al-Omari
Affiliation:
King Abdullah University Hospital, Irbid, Jordan
Samaher Razzaq
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Hani Ayyash
Affiliation:
European Khan Yunis Hospital, Khan Yunis, Gaza Strip, Palestine
Khaled Khader
Affiliation:
Taif University, Taif, Saudi Arabia
Rejin Kebudi
Affiliation:
Cerrahpaşa Medical Faculty & Oncology Institute, Istanbul University, Istanbul, Turkey
Suha Omran
Affiliation:
Faculty of Nursing, Jordan University for Science and Technology, Irbid, Jordan
Osaid Rasheed
Affiliation:
Al Quds University, Abu Dis and Al-Ahli Hospital, Hebron, West Bank, Palestinian Authority
Mohammed Qadire
Affiliation:
Faculty of Nursing, Al-Bayt University, Mafraq, Jordan
Ahmet Ozet
Affiliation:
Gazi Universitesi Tip Fakultesi, Tibbi Onkoloji Bilim Dali, Ankara, Turkey
Michael Silbermann
Affiliation:
Middle East Cancer Consortium and Technion–Israel Institute of Technology, Haifa, Israel
*
Author for correspondence: Gil Bar-Sela, Integrated Oncology and Palliative Care Unit, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel. Email: g_barsela@rambam.health.gov.il
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Abstract

Objective

When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with “unrealized potential” for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.

Method

We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.

Result

We had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How “developed” a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.

Significance of results

Despite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.

Keywords

CancerHuman development indexMiddle EastPalliative careSpiritual careSpirituality
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 3 , June 2019 , pp. 345 - 352
Copyright
Copyright © Cambridge University Press 2018 

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References

Abu-Ras, W, Laird, L (2011) How Muslim and non-Muslim chaplains serve Muslim patients? Does the interfaith chaplaincy model have room for Muslims' experiences? Journal of Religion and Health 50, 46–61.CrossRefGoogle ScholarPubMed
Anandarajah, G, Roseman, J, Lee, D, et al. (2016) A 10-Year longitudinal study of effects of a multifaceted residency spiritual care curriculum: Clinical ability, professional formation, end of life, and culture. Journal of Pain and Symptom Management 52, 859–872.10.1016/j.jpainsymman.2016.06.006CrossRefGoogle ScholarPubMed
Astrow, AB, 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, 5753–5757.CrossRefGoogle ScholarPubMed
Balboni, TA, Paulk, ME, Balboni, MJ, et al. (2010) Provision of spiritual care to patients with advanced cancer: Associations with medical care and quality of life near death. Journal of Clinical Oncology 28, 445–452.10.1200/JCO.2009.24.8005CrossRefGoogle ScholarPubMed
Balboni, T, Balboni, M, Paulk, ME, et al. (2011) Support of cancer patients' spiritual needs and associations with medical care costs at the end of life. Cancer 117, 5383–5391.10.1002/cncr.26221CrossRefGoogle ScholarPubMed
Balboni, MJ, Sullivan, A, Amobi, A, et al. (2013) Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. Journal of Clinical Oncology 31, 461–467.CrossRefGoogle Scholar
Balboni, MJ, Sullivan, A, Enzinger, AC, et al. (2014) Nurse and physician barriers to spiritual care provision at the end of life. Journal of Pain and Symptom Management 48, 400–410.10.1016/j.jpainsymman.2013.09.020CrossRefGoogle ScholarPubMed
Baldacchino, D (2015) Spiritual care education of health care professionals. Religions 6, 594–613.CrossRefGoogle Scholar
Ben-Arye, E, Bar-Sela, G, Frenkel, M, et al. (2006) Is a biopsychosocial-spiritual approach relevant to cancer treatment? A study of patients and oncology staff members on issues of complementary medicine and spirituality. Support Care Cancer 14, 147–152.10.1007/s00520-005-0866-8CrossRefGoogle ScholarPubMed
Chibnall, JT, Bennett, ML, Videen, SD, et al. (2004) Identifying barriers to psychosocial spiritual care at the end of life: A physician group study. American Journal of Hospital and Palliative Care 21, 419–426.10.1177/104990910402100607CrossRefGoogle ScholarPubMed
Ehman, JW, Ott, BB, Short, TH, et al. (1999) Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine 159, 1803–1806.CrossRefGoogle ScholarPubMed
Epstein-Peterson, ZD, Sullivan, AJ, Enzinger, AC, et al. (2015) Examining forms of spiritual care provided in the advanced cancer setting. American Journal of Hospital and Palliative Care 32, 750–757.CrossRefGoogle ScholarPubMed
Gallison, BS, Xu, Y, Jurgens, CY, et al. (2013) Acute care nurses' spiritual care practices. Journal of Holistic Nursing 31, 95–103.10.1177/0898010112464121CrossRefGoogle ScholarPubMed
Heydari, A, Meshkinyazd, A and Soudmand, P (2017) The effect of spiritual intelligence training on job satisfaction of psychiatric nurses. Iran Journal of Psychiatry 12, 128–133.Google ScholarPubMed
King, SD, Dimmers, MA, Langer, S, et al. (2013) Doctors' attentiveness to the spirituality/religion of their patients in pediatric and oncology settings in the Northwest USA. Journal of Health Care Chaplains 19, 140–164.10.1080/08854726.2013.829692CrossRefGoogle ScholarPubMed
Lemmer, CM (2010) Reflections on teaching “spirituality in the healthcare environment”. Journal of Holistic Nursing 28: 145–149.CrossRefGoogle Scholar
Lundmark, M (2006) Attitudes to spiritual care among nursing staff in a Swedish oncology clinic. Journal of Clinical Nursing 15, 863–874.CrossRefGoogle Scholar
Marom, D (2015) Expanding professional identity and practice: A report on an experiment in intra/inter professional spiritual study. Jerusalem, Israel: Mandel Leadership Institute.Google Scholar
McBrien, B (2010) Nurses' provision of spiritual care in the emergency setting--an Irish perspective. International Emergency Nursing 18, 119–126.CrossRefGoogle Scholar
McCord, G, Gilchrist, VJ, Grossman, SD, et al. (2004) Discussing spirituality with patients: A rational and ethical approach. Annals of Family Medicine 2, 356–361.10.1370/afm.71CrossRefGoogle ScholarPubMed
Mitchell, CM, Epstein-Peterson, ZD, Bandini, J, et al. (2016) Developing a medical school curriculum for psychological, moral, and spiritual wellness: Student and faculty perspectives. Journal of Pain and Symptom Management 52, 727–736.10.1016/j.jpainsymman.2016.05.018CrossRefGoogle ScholarPubMed
Mitchell, DL, Bennett, MJ and Manfrin-Ledet, L (2006) Spiritual development of nursing students: Developing competence to provide spiritual care to patients at the end of life. Journal of Nursing Educators 45, 365–370.Google ScholarPubMed
National Consensus Project (2013) Clinical practice guidelines for quality palliative care. 3rd ed. Pittsburgh: National Consensus Project for Quality Palliative Care Available from http://www.nationalconsensusproject.org/NCP_Clinical_Practice_Guidelines_3rd_Edition.pdf.Google Scholar
Paal, P, Helo, Y and Frick, E (2015) Spiritual care training provided to healthcare professionals: A systematic review. Journal of Pastoral Care and Counseling 69, 19–30.10.1177/1542305015572955CrossRefGoogle ScholarPubMed
Phelps, A, Lauderdale, KE, 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, 2538–2544.CrossRefGoogle ScholarPubMed
Puchalski, C, Ferrell, B, Virani, R, et al. (2009) Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. Journal of Palliative Medicine 12, 885–904.10.1089/jpm.2009.0142CrossRefGoogle Scholar
Puchalski, CM (2013) Integrating spirituality into patient care: An essential element of person-centered care. Polskie Archiwun Medycyny Wewnertznej 123, 491–497.Google Scholar
Puchalski, C, Vitillo, R, Hull, SK, et al. (2014) Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine 17, 642–656.CrossRefGoogle ScholarPubMed
Rassoulian, A, Seidman, C and Löffler-Stastka, H (2016) Transcendence, religion and spirituality in medicine: Medical students' point of view. Medicine (Baltimore) 95, e4953.10.1097/MD.0000000000004953CrossRefGoogle ScholarPubMed
Ronaldson, S, Hayes, L, Aggar, C, et al. (2012) Spirituality and spiritual caring: Nurses' perspectives and practice in palliative and acute care environments. Journal of Clinical Nursing 21, 2126–2135.10.1111/j.1365-2702.2012.04180.xCrossRefGoogle ScholarPubMed
Selby, D, Seccaraccia, D, Huth, J, et al. (2016) A qualitative analysis of a healthcare professional's understanding and approach to management of spiritual distress in an acute care setting. Journal of Palliative Medicine 19, 1197–1204.10.1089/jpm.2016.0135CrossRefGoogle Scholar
Selman, L, Harding, R, Gysels, M, et al. (2011) The measurement of spirituality in palliative care and the content of tools validated cross-culturally: A systematic review. Journal of Pain and Symptom Management 41, 728–753.10.1016/j.jpainsymman.2010.06.023CrossRefGoogle ScholarPubMed
Sulmasy, DP (2002) A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist 42, 24–33.10.1093/geront/42.suppl_3.24CrossRefGoogle ScholarPubMed
Tanyi, RA, McKenzie, M and Chapek, C (2009) How family practice physicians, nurse practitioners, and physician assistants incorporate spiritual care in practice. Journal of the American Academy of Nurse Practitioners 21, 690–697.10.1111/j.1745-7599.2009.00459.xCrossRefGoogle ScholarPubMed
Turan, T and Yavuz Karamanoğlu, A (2013) Determining intensive care unit nurses' perceptions and practice levels of spiritual care in Turkey. Nursing in Critical Care 18, 70–78.CrossRefGoogle ScholarPubMed
van de Geer, J, Groot, M, Andela, R, et al. (2017) Training hospital staff on spiritual care in palliative care influences patient-reported outcomes: Results of a quasi-experimental study. Palliative Medicine 31, 743–753.CrossRefGoogle ScholarPubMed
Vanderwerker, LC, Flannelly, KJ, Galek, K, et al. (2008) What do chaplains really do? III. Referrals in the New York Chaplaincy Study. Journal of Health Care Chaplains 14, 57–73.CrossRefGoogle ScholarPubMed
Vlasblom, JP, van der Steen, JT, Knol, DL, et al. (2011) Effects of a spiritual care training for nurses. Nurse Education Today 31, 790–796.10.1016/j.nedt.2010.11.010CrossRefGoogle ScholarPubMed
Williams, JA, Meltzer, D, Arora, V, et al. (2011) Attention to inpatients' religious and spiritual concerns: Predictors and association with patient satisfaction. Journal of General Internal Medicine 26, 1265–1271.10.1007/s11606-011-1781-yCrossRefGoogle ScholarPubMed
Zollfrank, AA, Trevino, KM, Cadge, W, et al. (2015) Teaching health care providers to provide spiritual care: A pilot study. Journal of Palliative Medicine 18, 408–414.CrossRefGoogle ScholarPubMed