Challenges and opportunities for spiritual care practice in hospices in a middle-income country

Ronita Mahilall,Leslie Swartz

doi:10.1186/s12904-021-00756-9

Abstract

BackgroundSpiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet.MethodsWe explored spiritual care practices, and training needs, through a national quantitative online study of palliative care organisations in South Africa registered with the Hospice Palliative Care Association of South Africa. A survey was sent to representatives of all member organisations listed on the national database of Hospice Palliative Care Association of South Africa. Viable data from 41% (n = 40) member organisations were analysed through the use of simple statistics.ResultsAn expressed need (75%; n = 30) was recorded for the development of a national spiritual care curriculum. Although 48% (n = 20) of the member organisations were willing to participate in the development of a spiritual care curriculum, 37% (n = 14) could not participate, citing financial (n = 27), time (n = 31) and expertise constraints (n = 22). A set of hard and soft skills were suggested to suit the diverse South African context.ConclusionsSpiritual care was seen by participants as a key component of palliative care. International curricula in spiritual care, while useful, do not offer easy adaptation to the diversities of South Africa. A bespoke spiritual care curriculum was called for, for diverse South Africa.

Highlights

Spiritual care is recognised as an essential element of holistic palliative care [1,2,3]
In Africa, though spiritual care has been deemed important in the Global South [17,18,19,20], despite the spiritual diversity on the continent and the limitations on amassing meaningful national health care data [21], studies and protocols for the development of palliative care have tended not to focus on spiritual care, but rather on issues such as pain management protocols, for which there are clear indicators [22,23,24,25]
This mapping highlights the maldistribution of hospices in South Africa (SA), not an unfamiliar reality given SA’s apartheid past

Summary

Introduction

Spiritual care is recognised as an essential element of holistic palliative care [1,2,3]. There is a plethora of studies in the Global North that support the need to have spiritual care training programmes in place for hospice staff [14,15,16]. Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet

Methods

Results

Conclusion