Spiritual history taking in palliative home care: A cluster randomized controlled trial

Abstract

Background: Many health-care providers experience barriers to addressing spiritual needs, such as not having the right vocabulary. The ars moriendi model might be a feasible tool for spiritual history taking in palliative care. Aim: To investigate the effect of a structured spiritual history taking on the spiritual well-being of palliative patients in home care. Design: Cluster randomized controlled trial, conducted between February and October 2013. Patients and methods: Registered nurses and general practitioners approached eligible patients with an incurable, life-threatening disease for study participation. Health-care providers allocated to the intervention arm of the study took a spiritual history on the basis of the ars moriendi model. Health-care providers in the control arm provided care as usual. Patient-reported outcomes on spiritual well-being, quality of life, pain, and patient–provider trust were assessed at two points in time. Results: A total of 245 health-care providers participated in the study (204 nurses and 41 physicians). In all, 49 patient–provider dyads completed the entire study protocol. The median age of the patients was 75 years (range: 41–95 years), and 55% of the patients were female. There were no significant differences at any point in time in the scores on spiritual well-being, quality of life, pain, or patient–provider trust between the intervention and the control group. Conclusion: This cluster randomized controlled trial showed no demonstrable effect of spiritual history taking on patient scores for spiritual well-being, quality of life, health-care relationship trust, or pain. Further research is needed to develop instruments that accurately assess the effectiveness of spiritual interventions in palliative care populations.