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Spiritual conversation model for patients and loved ones in palliative care: a validation study


Objectives In palliative care, validated tools for professionals that facilitate day-to-day spiritual conversations with patients and loved ones are scarce. The objective of this study was to validate the Diamond spiritual conversation model across different palliative care settings as well as professional and educational levels.

Methods An online survey was filled in by 387 professionals providing palliative care for patients in hospice, home care, hospital and nursing home settings. The five polarities of the Diamond model: holding on–letting go, doing–undergoing, remembering–forgetting, me–the other and believing–knowing were operationalised and evaluated on reported occurrence.

Results In conversations with patients, palliative care professionals reported letting go of loved ones (81.8%), dealing with pain and suffering (88.1%), dealing with issues from the past (67.2%), dealing with own versus loved one’s wishes (69.4%) and giving meaning to death (66.7%) as themes occurring regularly to very often. In conversations with loved ones, this was 70.8%, 78.5%, 55.4%, 68,8% and 62%, respectively. Respondents working in hospices reported these themes significantly more than those working in home care settings, nursing homes or hospitals. Nurse assistant respondents reported the themes significantly less than nurses or chaplains.

Conclusion From the perspective of professionals providing palliative care in different palliative care settings, the Diamond model offers a validated framework for addressing relevant spiritual themes for patients and loved ones.

  • End of life care
  • Spiritual care
  • Communication

Data availability statement

Data are available upon reasonable request. Data sharing application for use of the survey data can be made for up to 10 years, and will be considered on a case-by-case basis on receipt of a methodological sound proposal to achieve aims of a non-commercial nature. All requests for data access should be addressed to the Chief Investigator via and will be reviewed by him and the data intelligence group of the University for Humanistic Studies.

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