Objective: Health care professionals and policy makers
acknowledge that spiritual needs are important for many patients with
life-limiting illnesses. We asked such patients to describe their
spiritual needs and how these needs may impinge on their physical,
psychological, and social well-being. Patients were also encouraged to
explain in what ways their spiritual needs, if they had any, could be
Methods: We conducted two qualitative interviews, 3 months
apart, with 20 patients in their last year of life: 13 patients with
advanced cancer and 7 with advanced nonmalignant illness. We also
interviewed each patient's general practitioner. Sixty-six interviews
were tape-recorded, transcribed, and analyzed.
Results: Patients' spiritual needs centered around their
loss of roles and self-identity and their fear of dying. Many sought to
make sense of life in relation to a nonvisible or sacred world. They
associated anxiety, sleeplessness, and despair with such issues, which at
times resulted in them seeking support from health professionals. Patients
were best able to engage their personal resources to meet these needs when
affirmed and valued by health professionals.
Significance of results: Enabling patients to deal with their
spiritual needs through affirmative relationships with health
professionals may improve quality of life and reduce use of health
resources. Further research to explore the relationship between spiritual
distress and health service utilization is indicated.