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Spirituality and religiosity in a palliative medicine population: mixed-methods study
  1. Clare C O'Callaghan1,2,
  2. Ekavi Georgousopoulou3,
  3. Davinia Seah3,4,
  4. Josephine M Clayton5,6,
  5. David Kissane3,4 and
  6. Natasha Michael1,3
  1. 1Palliative and Supportive Care Research Department, Cabrini Health, Melbourne, Victoria, Australia
  2. 2Institute of Ethics and Society, University of Notre Dame Australia, Sydney, New South Wales, Australia
  3. 3School of Medicine Sydney Campus, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
  4. 4Sacred Heart Health Service, St. Vincent’s Hospital, Sydney, New South Wales, Australia
  5. 5Hammond Care, Sydney, New South Wales, Australia
  6. 6Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Natasha Michael, Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia; nmichael{at}


Background Spiritual care allows palliative care patients to gain a sense of purpose, meaning and connectedness to the sacred or important while experiencing a serious illness. This study examined how Australian patients conceptualise their spirituality/religiosity, the associations between diagnosis and spiritual/religious activities, and views on the amount of spiritual support received.

Methods This mixed-methods study used anonymous semistructured questionnaires, which included the Functional Assessment of Chronic Illness Therapy-Spiritual Scale-12 (FACIT-SP-12) and adapted and developed questions examining religion/spirituality’s role and support.

Results Participants numbered 261, with a 50.9% response rate. Sixty-two per cent were affiliated with Christianity and 24.2% with no religion. The mean total FACIT-SP-12 score was 31.9 (SD 8.6). Patients with Christian affiliation reported a higher total FACIT-SP-12 score compared with no religious affiliation (p=0.003). Those with Christian and Buddhist affiliations had higher faith subscale scores compared with those with no religious affiliation (p<0.001). Spirituality was very important to 39.9% and religiosity to 31.7% of patients, and unimportant to 30.6% and 39.5%, respectively. Following diagnosis, patients prayed (p<0.001) and meditated (p<0.001) more, seeking more time, strength and acceptance. Attendance at religious services decreased with frailty (p<0.001), while engagement in other religious activities increased (p=0.017). Patients who received some level of spiritual/religious support from external religious/faith communities and moderate to complete spiritual/religious needs met by the hospitals reported greater total FACIT-SP-12 spirituality scores (p<0.001).

Conclusion Respectful inquiry into patients spiritual/religious needs in hospitals allows for an attuned approach to addressing such care needs while considerately accommodating those disinterested in such support.

  • spiritual care
  • terminal care
  • communication
  • psychological care
  • supportive care

Statistics from


  • Contributors COC, NM and DK designed the initial study; JC and DS assisted in piloting and modification; NM, JC and DS led recruitment across sites; EG conducted the statistical analysis and COC the qualitative analysis; all authors interpreted data; COC, DK, EG and NM wrote the initial manuscript. All authors approved the final manuscript. NM is responsible for the overall content as guarantor.

  • Funding This study was funded by grants from the Cabrini Foundation Sambor Family Clinical Research Grant, St Vincent’s Curran Foundation Grant, University of Notre Dame Australia SoMS Research Support Grant.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval for the study was granted by the Clinical Research Ethics Committee of Cabrini Health (07-12-09-16) and HammondCare Hospital / St. Vincent’s Hospital (LNR/17/SVH/279).

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

  • Data availability statement Data are available upon reasonable request. Deidentified patient data are available from the Palliative and Supportive Care Research Department at Cabrini Health. The data are available via the corresponding author (orcid ID and reuse is only permitted following further consent from the research team and ethics approval.

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