Little information is available about HF patients’ desires regarding having their healthcare providers address their spiritual concerns, feeling constrained in doing so, and the extent to which their spiritual needs go unmet | Psychology, Health & Medicine
Nearly half of our sample reported high levels of unmet spiritual needs and reported moderately strong desires to have their doctor or other healthcare professional attend to their spiritual needs, and moderately strong feelings of constraint in doing so. Spiritual constraint and unmet spiritual needs were associated with poorer spiritual, psychological and physical well-being, but these effects varied, depending on patients’ desire to discuss spiritual needs. These findings have important implications for clinical management of HF patients.
Full reference: Park, C.L. & Sacco, S.J. (2017)Heart failure patients’ desires for spiritual care, perceived constraints, and unmet spiritual needs: relations with well-being and health-related quality of life. Psychology, Health & Medicine. Vol. 22 (no.9) pp. 1011-1020
The aim of this study was to assess the opinion of intensive care unit (ICU) personnel and the impact of their personality and religious beliefs on decisions to forego life-sustaining treatments (DFLSTs) | BMJ Open
Results: The participation rate was 65.7%. Significant differences in DFLSTs between doctors and nurses were identified. 71.4% of doctors and 59.8% of nurses stated that the family was not properly informed about DFLST and the main reason was the family’s inability to understand medical details. 51% of doctors expressed fear of litigation and 47% of them declared that this concern influenced the information given to family and nursing staff. 7.5% of the nurses considered DFLSTs dangerous, criminal or illegal. Multivariate logistic regression identified that to be a nurse and to have a high neuroticism score were independent predictors for preferring the term ‘passive euthanasia’ over ‘futile care’ (OR 4.41, 95% CI 2.21 to 8.82, p<0.001, and OR 1.59, 95% CI 1.03 to 2.72, p<0.05, respectively). Furthermore, to be a nurse and to have a high-trust religious profile were related to unwillingness to withdraw mechanical ventilation. Fear of litigation and non-disclosure of the information to the family in case of DFLST were associated with a psychoticism personality trait (OR 2.45, 95% CI 1.25 to 4.80, p<0.05).
Conclusion: We demonstrate that fear of litigation is a major barrier to properly informing a patient’s relatives and nursing staff. Furthermore, aspects of personality and religious beliefs influence the attitudes of ICU personnel when making decisions to forego life-sustaining treatments.
Full reference: Ntantana, A, et al. (2017) The impact of healthcare professionals’ personality and religious beliefs on the decisions to forego life sustaining treatments: an observational, multicentre, cross-sectional study in Greek intensive care units. BMJ Open. 7:e013916.
Spiritual care can be an important source of support for patients dealing with chronic or terminal illnesses, and it is a key component of palliative care | BMJ Supportive & Palliative Care
Studies have shown that patients would like more frequent discussions on religion and spirituality (R/S) while in the hospital, but many patients do not have the chance to do so. One way to ensure that R/S is addressed during a hospital stay is via chaplain referrals. One study showed that chaplain visits are associated with increased patient satisfaction, and patients more often endorsed that staff met their emotional and spiritual needs, although research shows differences among professionals in chaplaincy referral rates; nurses have been shown to have higher likelihood of referring than physicians and social workers (SWs).
With the advent of the electronic health record (EHR), we felt it was important to explore whether or not healthcare professionals (HCPs) are interested in technology for requesting chaplains, and therefore improve access to spiritual care for patients. In fact, some initial research shows potential benefits of using electronic means to better identify and target patients in need of a chaplain visit, and one innovative palliative care service using pagers for referrals was reported as highly valuable by nurses to patients and the clinical team.
Here, we report results from a quality improvement (QI) project aimed at improving chaplaincy referrals, and therefore spiritual care, at a major academic centre in New York City, with a focus on gauging interest in technology-driven means for chaplain referrals.
Full reference: Rhee, J.Y. et al. (2017) Integrating chaplaincy into healthcare: a survey shows providers are interested in technology-based options. BMJ Supportive & Palliative Care. Published Online First: 7th July 2017.
Holyoke, P. & Stephenson, B. BMC Palliative Care | Published online: 11 April 2017
Background: Though most models of palliative care specifically include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. Organizations often leave responsibility for such care with individual care providers, some of whom are comfortable with this role and well supported, others who are not. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that then might be applied in secular healthcare organizations.
Conclusions: These Principles, and the practices underlying them, could increase the quality of spiritual care offered by secular health care organizations at the end of life.
Read the article here
NICE has published new guidance calling on healthcare professionals to ask adults in the final days of life about their religious or spiritual beliefs.
Cultural preferences and spiritual beliefs should be included in discussions about the care a person, and those close to them, want to receive, says NICE.
Knowing if someone holds a religious belief can be important for providing the care they desire. For example, someone who is Catholic may wish to receive the last prayers and ministrations.
The 2016 End of Life Care Audit reported nearly half of all deaths in England occurred in hospital. Spiritual wishes were only documented for one in 7 people who were able to communicate their desires.
Read the full overview here
Read the full guidance here