Spirituality in palliative home care: a framework for the clinician.
Abstract
PURPOSE:
Spiritual care
at the end of life remains poorly understood despite its promotion by
the World Health Organisation. The purpose of this paper was to develop a
consensus-based framework of the main elements of spiritual care in palliative home care.
METHODS:
Expert
meeting using the nominal group technique, followed by a two-stage
web-based Delphi process, was used. Experts from three stakeholder
groups (physicians, professional spiritual care givers and researchers) representing two countries (Belgium and the Netherlands) participated in this study.
RESULTS:
Fourteen elements of spiritual care
were retained: (1) being sensitive to patient's fear of the dying
process; (2) listening to the patient's expectations and wishes about
the end of life; (3) giving attention to patient's wishes about the
design of the farewell; (4) offering rituals if the patient experiences
them as meaningful; (5) listening to the stories, dreams and passions of
the patient; (6) helping the patient find strength in inner resources;
(7) connecting with the patient in truth, openness and honesty; (8)
supporting communication and quality of relationships; (9) making sure
the patient feels comfortable and safe; (10) seeing spirituality as an interwoven, though specific dimension; (11) caring for your own spirituality;
(12) knowing and accepting your vulnerability; (13) being able to learn
from your patient; and (14) having an interdisciplinary team that is
there when needed.
CONCLUSIONS:
The experts agreed to the 14 main elements of spiritual care in palliative home care.
There were no differences in this regard between the stakeholder
groups. This study provides a first step towards the development of an
interdisciplinary spiritual care model in palliative home care.
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