Monday, 9 November 2015
Joanne K. Olson, PhD, RN, FAAN
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
Suzette Brémault-Phillips, PhD, OT
Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
Pamela Brett-MacLean, PhD, MA, BA
Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
Doreen Oneschuk, MEd, MD
Division of Palliative Medicine, Department of Oncology, Univeristy of Alberta, Edmonton, AB, Canada
Shane Sinclair, PhD, MDiv, BA
Faculty of Nursing, Univeristy of Calgary, Calgary, AB, Canada
Background:Care of advanced cancer patients and other patients with life limiting illnesses frequently focuses on the physical aspects of disease management. Individuals are inconsistently invited to share their spiritual and psychosocial needs, or discuss how their lives have changed as a result of their circumstance. And yet, seriously ill patients have indicated that the possibility of continued spiritual suffering adds to the distress associated with their illness. Spirituality, broadly defined as that which gives meaning and purpose to life, often is a central issue for patients at the end of life or those dealing with cancer and chronic illness. Growing evidence has demonstrated that spirituality, whether expressed through religious or secular means, is an important component of patient care that affects patient healthcare decision making and healthcare outcomes. Despite a strong evidence base that spirituality is important to patients, clinicians are sometimes reluctant to make spiritual care a core component of patient care. Some healthcare professionals are concerned that such discussions require a substantial time commitment and others feel ill prepared to address spiritual needs.
Purpose: This research aimed to (1) explore the value of including spiritual conversations in routine patient care; (2) identify facilitators and barriers to incorporating spirituality into person-centred care; and (3) determine ways healthcare professionals can effectively incorporate spirituality into person-centered care.
Setting: Three inpatient hospital units in Alberta, Canada served as the setting for this research: a hospice unit, a tertiary palliative care unit, and a geriatric assessment unit.
Methods: Healthcare professionals (physicians, registered nurses, nurse practitioners, social workers, occupational therapists, and physical therapists) were invited to participate in this descriptive exploratory research project. Nine (9) health care professionals (1 physician, 4 registered nurses, 1 nurse practitioner, 1 social worker, 1 occupational therapist and 1 physical therapist) agreed to participate. After a half-day educational event, they intentionally integrated spirituality into their care of 24 patients who had consented to be part of the project. Data regarding the experiences of the healthcare professionals and the outcomes of their care were gathered during focus groups and chart reviews.
Results:Findings indicate positive impacts at the organizational, clinical/unit, professional/personal and patient levels when healthcare professionals include spirituality in patient care. The findings specifically focus on strengths, challenges, and opportunities regarding the inclusion of spirituality in patient care at the various levels within the healthcare organization. Recommendations for practice and further research are offered and the challenges of conducting this research will be discussed to inform future research projects in this area.
Funded by:Covenant Health, Edmonton, Alberta.