J Palliat Med 2014 17: 642–656.Īstrow AB, Wexler A, Texeira K, et al. Improving the spiritual dimension of whole person care: reaching national and international consensus. Spirituality focus groups palliative care pastoral care qualitative research religion and psychology. Findings should inform patient- and caregiver-centred spiritual care provision, education and research. To meet patient and caregiver preferences, healthcare providers should be able to address their spiritual concerns. Caregivers' priorities included staff training, assessment, studying impact, and caregiver's spiritual care needs. Patients' research priorities included understanding the qualities of human connectedness and fostering these skills in staff.

Spiritual care was reportedly lacking, primarily due to staff members' de-prioritisation and lack of time. Participants emphasised the need for staff competence in spiritual care. Spirituality supported coping, but could also result in framing illness as punishment. Participants reported wide-ranging spiritual concerns spanning existential, psychological, religious and social domains. Five themes are described: patients' and caregivers' spiritual concerns, understanding of spirituality and its role in illness, views and experiences of spiritual care, preferences regarding spiritual care, and research priorities. Two-thirds of participants were Christian. In total, 71 caregivers participated: median age 61 years 56 were women. Discussions were transcribed, translated into English and analysed thematically.Ī total of 74 patients participated: median age 62 years 53 had cancer 48 were women. Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers. Evidence to inform spiritual care practices in palliative care is limited. Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. 12 12 Independent Consultant in Palliative Care Research, Kenya.11 11 School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.10 10 The George Washington University's Institute for Spirituality & Health (GWish), School of Medicine & Health Sciences, The George Washington University, Washington, DC, USA.9 9 Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA.8 8 Director of Medical Education, MJHS Institute for Innovation in Palliative Care, New York, NY, USA.7 7 Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań, Poland.6 6 MWAPO Health Development Group, Nairobi, Kenya.5 5 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.4 4 Global Health Programme, Diaconia University of Applied Sciences, Helsinki, Finland.3 3 Faculty of Nursing, University of Calgary, Calgary, AB, Canada.2 2 Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.1 1 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

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