Abstract

BackgroundDecision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients.MethodsA cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one’s perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients’ definitions of spirituality was based on the interpretative phenomenological process.ResultsSpiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one’s decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones’ values and beliefs.ConclusionThe impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients’ spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

Highlights

  • Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions

  • Participants were recruited from palliative outpatient consultations of two Portuguese Institutes of Oncology, namely from the Northern Region (NOI) (n = 53) and Central Region (COI) (n = 42) (Table 3)

  • All patients approached agreed to participate in the study, but two patients interrupted the administration of the questionnaires due to unexpected pain/symptoms

Read more

Summary

Introduction

Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. This study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients. Palliative care is a patient-centred, transcultural and holistic approach that is essential to address the patient as a whole. Spirituality is a significant dimension of quality of life along with physical and psychological wellbeing in palliative care patients [4,5,6]. It is common for end of life patients to explore his or her spirituality [7]. The lack of agreement on the conceptualisation of spirituality in both research and clinical practice often results in a non-systematic and intuitive approach to patients’ spiritual needs [7,8,9,10]

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call