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Spiritual Care through the Lens of Portuguese Palliative Care Professionals: A Qualitative Thematic Analysis
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Abstract(s)
Professionals in palliative care (PC) are often challenged by the suffering of the people
they care for, throughout the latter stages of life. Spiritual care requires understanding
the suffering and experiences of the sick person, recognizing their resources and their
spiritual needs. Providing spiritual care is paramount to person-centered care. Despite
the increase in data and its recognized importance in palliative care, spiritual care
continues to be the least advanced and most overlooked aspect. This study aims to
explore the perceptions and experiences of spiritual care from the perspective of PC
professionals and identify their strategies to address spiritual care issues.
To respond to these objectives, a qualitative, descriptive, and exploratory study was
designed, in which fifteen PC professionals participated. Data were collected between
September and October 2023, through semi-structured personal interviews and
managed using the WebQDA software (University of Aveiro, Aveiro, Portugal). All data
were analyzed using thematic content analysis.
The study included 15 palliative care professionals with an average age of 38.51±5.71
years, with the majority being female (93.3%). Regarding the professional category,
the majority of participants were nurses (n=9), with an average of 13.6 years of
professional experience and 3.3 years working in palliative care. Most of the
participants identified themselves as having no specific training in spiritual care.
Thematic analysis spawned three main themes: (1) spiritual care as key to palliative
care, (2) floating between “shadows” and “light” in providing spiritual care, and (3)
strategies for competent and spiritual-centered care. Three sub-themes were identified
under the first theme: "We are all spiritual beings" - an ontological condition; spiritual
awakening at the end of life; and relational spirituality. In the second theme, two subthemes
were identified: barriers and facilitators of spiritual care. Finally, in the third
theme, we found three sub-themes: assessment centred on the spiritual needs of the
sick person; effective spiritual accompaniment; and developing self-knowledge and
interpersonal relationships in the work environments.
Spiritual care was considered challenging by its very nature and given the individual,
relational, and organizational constraints lived by professionals working in palliative
care. With support from healthcare institutions, spiritual care can and should become a defining feature of the type, nature, and quality of palliative care provision. Care
providers should be sensitive to spiritual needs and highly skilled and capable of an inthe-
moment approach to respond to these needs. Further research on educating and
training in spiritual care competence is a priority.
Description
Keywords
Cuidado espiritual Estudo qualitativo Cuidados paliativos Profissionais Sofrimento Fim de vida