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BMJ Support Palliat Care 2:319-327 doi:10.1136/bmjspcare-2011-000191
  • Research

Spiritual care: how to do it

  1. Susan McClement5
  1. 1Alberta Health Services, Cancer Care, Spiritual Care Services, Tom Baker Cancer Centre, Calgary Alberta, Canada
  2. 2Department of Nursing, University of Calgary, Calgary Alberta, Canada
  3. 3Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Manitoba, Canada
  4. 4Division of Palliative Medicine, Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
  5. 5Department of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Shane Sinclair, Spiritual Care Services, Tom Baker Cancer Centre, 1331 29 Street NW, Calgary, Alberta T2N 4N2 Canada; shane.sinclair{at}albertahealthservices.ca
  1. Contributors Shane Sinclair; Shelley RaffinBouchal, Neil Hagen; Susan McClement; Harvey Max Chochinov.

Abstract

Objective This study explores the provision of spiritual care by healthcare professionals working at the end of life.

Design Qualitative–ethnographic inquiry.

Setting Phase 1: five Canadian sites; phase 2: a residential hospice in Alberta, Canada.

Participants Phase 1: six palliative care leaders; phase 2: 24 frontline palliative care clinicians.

Results Data were collected over a 12-month period with analysis of findings occurring concurrently. Using semistructured interviews and participant observation, 11 themes, organised under five overarching categories, emerged from the data. Five bedside skills were identified as essential to spiritual care: hearing, sight, speech, touch and presence. The integration of these bedside skills with the intrinsic qualities of healthcare professionals, including their values and spiritual beliefs, appeared to be essential to their application in spiritual care. Spiritual care primarily involved the tacit qualities of healthcare professionals and their effect on patient's spiritual well-being, rather than their explicit technical skill set or expert knowledge base.

Conclusion Participants identified spiritual care as both a specialised care domain and as a philosophy of care that informs and is embedded within physical and psychosocial care. Hearing, sight, speech, touch and presence were identified as the means by which healthcare professionals impacted patients' spiritual well-being regardless of clinician's awareness or intent. An empirical framework is presented providing clinicians with a pragmatic way of incorporating spiritual care into clinical practice.

Footnotes

  • Competing interests None.

  • Ethics approval Approval provided by the Conjoint Health Research Ethics Board of the University of Calgary, the Ottawa Hospital Research Ethics Board and the Fraser Health Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement These data are a subset of a larger ethnographic study investigating the spirituality of palliative care professionals in Canada which was the topic of Dr Shane Sinclair's PhD Thesis. The thesis is available through the University of Calgary.

  • Accepted 24 April 2012.
  • Published Online First 11 July 2012

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