Spiritual health care : an enquiry into the spiritual care of patients with cancer within the acute hospital and the specialist inpatient palliative care unit in England and Wales

Question: What are
the features of the spiritual care of patients with cancer within
hospice and
the acute hospital?
Objectives: To identify: guidelines relating
to spiritual care, the means whereby spiritual needs are assessed key features of spiritual care, perceptions of spiritual care stakeholders, perceptions of health professionals, patients and relatives. Methods: A mixed method design incorporating three phases. Phase I-a survey of the
views of chaplains
in 151 hospices and 195 trusts. Phase II
-a phenomenological
enquiry
into the perceptions of spiritual care amongst 16 stakeholders. Phase III
-a
multiple case study
in 4 health settings.
Data handling: Phase I data: collected
by postal questionnaire; analysed using SPSS.
Phase II data: collected by
recorded
interviews; analysed using NUD*IST software.
Phase III data: collected
from case studies
involving observation,
documentation and
recorded
interviews; analysed using NUD*IST software and biographical and
documentary techniques.
Conclusions: Spiritual care
is founded on the assumption
that all people are
spiritual beings. It affirms
the value of each person and acknowledges
the search
for meaning
in the big questions of
life and death. Institutions determine the
spiritual needs of patients using both formal and
informal means. Such needs are
met
through the provision of physical resources and human
resources. Chaplains
figure prominently, although a broad view of spirituality
is currently attracting a
wider ownership. Within both settings, chaplaincy
is almost exclusively Christian.
Hospices with
funded chaplaincy provide a higher level of service
than hospices
with voluntary chaplaincy. There is a greater demand for
religious care
in
hospitals
rather
than hospices. Illness may prompt a patient's spiritual
(re-) awakening, articulated
through religious
imagery possibly stretching
back to
childhood. Patients' non-religious needs
include someone
to listen and to 'be
there'. Religious (Christian) needs centre around holy communion, prayer and
worship.