Organization-level principles and practices to support spiritual care at the end of life: a qualitative study

Paul Holyoke,Barry Stephenson

doi:10.1186/s12904-017-0197-9

Abstract

BackgroundThough most models of palliative care specifically include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. Organizations often leave responsibility for such care with individual care providers, some of whom are comfortable with this role and well supported, others who are not. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that then might be applied in secular healthcare organizations.MethodsForty-six digitally-recorded interviews were conducted with bereaved family members, care providers and administrators associated with four hospice organizations in North America, representing Buddhist, Catholic, Jewish, and Salvation Army faith traditions. The interviews were analyzed iteratively using the constant comparison method within a grounded theory approach.ResultsNine Principles for organizational support for spiritual care emerged from the interviews. Three Principles identify where and how spiritual care fits with the other aspects of palliative care; three Principles guide the organizational approach to spiritual care, including considerations of assessment and of sacred places; and three Principles support the spiritual practice of care providers within the organizations. Organizational practices that illustrate each of the principles were provided by interviewees.ConclusionsThese Principles, and the practices underlying them, could increase the quality of spiritual care offered by secular health care organizations at the end of life.

Highlights

Though most models of palliative care include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families
Quality spiritual care incorporates the spiritual into every other aspect of hospice palliative care such that the spiritual is not merely a part or element of care, but rather a descriptor of the kind, nature, and quality of all care
The hospices visited are rooted in specific religious traditions; in conceptualizing the spiritual dimensions of end of life, these hospices do not view spirituality and religious concerns as an element or component of overall palliative care; rather, spiritual care is embedded throughout the Foundational principles that influence the organization of spiritual care 1

Summary

Introduction

Though most models of palliative care include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that might be applied in secular healthcare organizations. In caring for people with terminal illness, needs, concerns, and questions of a religious, spiritual, or existential nature are usually present [1]. Broadly conceived, is necessary for the person who is dying, and for family members and care providers. Saunders understood, The medical model has been the dominant paradigm in health care for over a century. Health care has become almost exclusively the provenance

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Conclusion