Do We Provide Spiritual Care to Terminally Ill Patients? Should We?

Betty R. Ferrell, PhD, RN


January 29, 2015


This study is a model of the gap between what patients with serious illness want and what professionals are able to provide. The provision of spiritual care is a strong recommendation by the World Health Organization, National Consensus Project, Joint Commission, and many other organizations.[1,2,3,4] This study and others have established the link between spiritual support and key quality-of-life outcomes.[5,6]

One of the most interesting findings was the "desire to provide spiritual care." Balboni and colleagues reported that 74% of nurses and 60% of physicians desire to "at least occasionally" provide spiritual care. This means that 26% of nurses and 40% of physicians did not, which is a concerning finding given that spiritual care is an essential domain of palliative care and patient-centered care. The perceived barriers are also interesting; among them are lack of time, inadequate training, lack of privacy, and the belief that spiritual care is better offered by others.

The last factor—believing that "others" should provide this care—was endorsed by 50% of the sample. This is unfortunate because although hospital chaplains and ordained clergy are the specialists and experts in spiritual care, it is not uncommon for hospitals to have only a few chaplains for several hundred patients, even in settings with predominantly seriously ill or critically ill patients.

It is important to recognize that this study surveyed professionals caring for advanced cancer patients, thus raising the bar as to what should be expected in spiritual care. A lack of training in spiritual care was a concern of both nurses and physicians. This study provides clear direction for work that is needed to break down barriers to quality spiritual care.



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