PT - JOURNAL ARTICLE AU - Shane Sinclair AU - Shelley Raffin Bouchal AU - Harvey Chochinov AU - Neil Hagen AU - Susan McClement TI - Spiritual care: how to do it AID - 10.1136/bmjspcare-2011-000191 DP - 2012 Dec 01 TA - BMJ Supportive & Palliative Care PG - 319--327 VI - 2 IP - 4 4099 - http://spcare.bmj.com/content/2/4/319.short 4100 - http://spcare.bmj.com/content/2/4/319.full SO - BMJ Support Palliat Care2012 Dec 01; 2 AB - 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.