Article

The Degree to Which Spiritual Needs of Patients Near the End of Life Are Met

Carla P. Hermann

spirituality, quality of life, end-of-life care
ONF 2007, 34(1), 70-78. DOI: 10.1188/07.ONF.70-78

Purpose/Objectives: To determine to what degree the spiritual needs of patients near the end of life are met.

Design: Descriptive.

Setting: One inpatient and five outpatient hospices.

Sample: 62 female and 38 male hospice patients with a mean age of 67 years; 74% were dying from cancer.

Methods: Each subject completed the Spiritual Needs Inventory and rated life satisfaction via the Cantril ladder.

Main Research Variables: Spiritual needs and life satisfaction.

Findings: Women, patients residing in a nursing home or an inpatient hospice unit, and patients with lower levels of education reported a higher number of unmet spiritual needs. Needs that could be met independently by patients and were not related to functional status were met at a higher rate than those that were dependent on others and on functional status.

Conclusions: Spiritual activities are important to patients who are near the end of life, but these patients may have a variety of unmet spiritual needs that depend on many factors, including the care setting.

Implications for Nursing: Nurses must recognize the importance of spirituality to patients near the end of life. Assessment for specific spiritual needs can lead to the development of interventions to meet those needs. Meeting patients' spiritual needs can enhance their quality of life.

Jump to a section

    References

    Aldridge, D. (1993). Is there evidence for spiritual healing? Advances: Journal of Mind-Body Health, 9(4), 4-21.
    Brady, M.J., Peterman, A.H., Fitchett, G., Mo, M., & Cella, D. (1999). A case for including spirituality in quality of life measurement in oncology. Psycho-Oncology, 8, 417-428.
    Bregman, L. (2004). Defining spirituality: Multiple uses and murky meanings of an incredibly popular term. Journal of Pastoral Care and Counseling, 58, 157-167.
    Byock, I. (1997). Dying well: Peace and possibilities at the end of life. New York: Riverhead Books.
    Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press.
    Carson, V.B., & Green, H. (1992). Spiritual well-being: A predictor of hardiness in patients with acquired immunodeficiency syndrome. Journal of Professional Nursing, 8, 209-220.
    Dann, N.J., & Mertens, W.C. (2004). Taking a "leap of faith": Acceptance and value of a cancer program-sponsored spiritual event. Cancer Nursing, 27, 134-141.
    Duggleby, W. (2000). Enduring suffering: A grounded theory analysis of the pain experience of elderly hospice patients with cancer. Oncology Nursing Forum, 27, 825-831.
    Ehman, J.W., Ott, B.B., Short, T.H., Ciampa, R.C., & Hansen-Flaschen, J. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 1803-1806.
    Ellis, M.R., Vinson, D.C., & Ewigman, B. (1999). Addressing spiritual concerns of patients: Family physicians' attitudes and practices. Journal of Family Practice, 48, 105-109.
    Emanuel, L.L., Alpert, H.R., Baldwin, D.C., & Emanuel, E.J. (2000). What terminally ill patients care about: Toward a validated construct of patients' perspectives. Journal of Palliative Medicine, 3, 419-431.
    Fernsler, J.I., Klemm, P., & Miller, M.A. (1999). Spiritual well-being and demands of illness in people with colorectal cancer. Cancer Nursing, 22, 134-140.
    Ferrans, C.E., & Powers, M.J. (1985). Quality of life index: Development and psychometric properties. Advances in Nursing Science, 8(1), 15-24.
    Ferrell, B.R., Smith, S.L., Juarez, G., & Melancon, C. (2003). Meaning of illness and spirituality in ovarian cancer survivors. Oncology Nursing Forum, 30, 249-257.
    Field, M.J., & Cassel, C.K. (Eds.). (1997). Approaching death: Improving care at the end of life. Washington, DC: National Academies Press.
    Flannelly, K.J., Weaver, A.J., & Costa, K.G. (2004). A systematic review of religion and spirituality in three palliative care journals, 1990-1999. Journal of Palliative Care, 20, 50-56.
    Hermann, C.P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28, 67-72.
    Hermann, C.P. (2006). Development and testing of the spiritual needs inventory for patients near the end of life. Oncology Nursing Forum, 33, 737-744.
    Kaczorowski, J.M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer. Hospice Journal, 5(3/4), 105-116.
    Kennedy, C., & Cheston, S.E. (2003). Spiritual distress at life's end: Finding meaning in the maelstrom. Journal of Pastoral Care and Counseling, 57, 131-141.
    Laborde, J.M., & Powers, M.J. (1980). Satisfaction with life for patients undergoing hemodialysis and patients suffering from osteoarthritis. Research in Nursing and Health, 3, 19-24.
    Laubmeier, K.K., Zakowski, S.G., & Bair, J.P. (2004). The role of spirituality in the psychological adjustment to cancer: A test of the transactional model of stress and coping. International Journal of Behavioral Medicine, 11, 48-55.
    Lin, H.R., & Bauer-Wu, S.M. (2003). Psycho-spiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing, 44, 69-80.
    Logan, J., Hackbusch-Pinto, R., & De Grasse, C.E. (2006). Women undergoing breast diagnostics: The lived experience of spirituality. Oncology Nursing Forum, 33, 121-126.
    McMillan, S.C. (1996). The quality of life of patients with cancer receiving hospice care. Oncology Nursing Forum, 23, 1221-1228.
    McMillan, S.C., & Weitzner, M. (2000). How problematic are various aspects of quality of life in patients with cancer at the end of life? Oncology Nursing Forum, 27, 817-823.
    Meraviglia, M.G. (2004). The effects of spiritual well-being of people with lung cancer. Oncology Nursing Forum, 31, 89-94.
    Mickley, J.R., Soeken, K., & Belcher, A. (1992). Spiritual well-being, religiousness and hope among women with breast cancer. Image: Journal of Nursing Scholarship, 24, 267-272.
    Miller, J.F. (1985). Assessment of loneliness and spiritual well-being in chronically ill and healthy adults. Journal of Professional Nursing, 1, 79-85.
    Murray, S.A., Kendall, M., Boyd, K., Worth, A., & Benton, T.F. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39-45.
    O'Gorman, M.L. (2002). Spiritual care at the end of life. Critical Care Nursing Clinics of North America, 14, 171-176.
    Penckofer, S.H., & Holm, K. (1984). Early appraisal of coronary revascularization on quality of life. Nursing Research, 33, 60-63.
    Reed, P.G. (1986). Religiousness among terminally ill and healthy adults. Research in Nursing and Health, 9, 35-41.
    Reed, P.G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing and Health, 10, 335-344.
    Reed, P.G. (1992). An emerging paradigm for the investigation of spirituality in nursing. Research in Nursing and Health, 15, 349-357.
    Sellers, S.C., & Haag, B.A. (1998). Spiritual nursing interventions. Journal of Holistic Nursing, 16, 338-354.
    Spiroch, C.R., Walsh, D., Mazanec, P., & Nelson, K.A. (2000). Ask the patient: A semi-structured interview study of quality of life in advanced cancer. American Journal of Hospice and Palliative Care, 17, 235-240.
    Steinhauser, K.E., Christakis, N.A., Clipp, E.C., McNeilly, M., McIntyre, L., & Tulsky, J.A. (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA, 284, 2476-2482.
    Stranahan, S. (2001). Spiritual perception, attitudes about spiritual care, and spiritual care practices among nurse practitioners. Western Journal of Nursing Research, 23, 90-104.
    Streiner, D.L., & Norman, G.R. (1995). Health measurement scales: A practical guide to their development and use. (2nd ed.). Oxford, United Kingdom: Oxford University Press.
    Sulmasy, D.P. (2002). A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist, 42, 24-33.
    Tan, H.M., Braunack-Mayer, A., & Beilby, J. (2005). The impact of the hospice environment on patient spiritual expression. Oncology Nursing Forum, 32, 1049-1055.
    Taylor, E.J. (2001). Spirituality, culture, and cancer care. Seminars in Oncology Nursing, 17, 197-205.
    Taylor, E.J. (2003). Nurses caring for the spirit: Patients with cancer and family caregiver expectations. Oncology Nursing Forum, 30, 585-590.
    Taylor, E.J., Amenta, M., & Highfield, M. (1995). Spiritual care practices of oncology nurses. Oncology Nursing Forum, 22, 31-39.
    Taylor, E.J., & Mamier, I. (2005). Spiritual care nursing: What cancer patients and family caregivers want. Journal of Advanced Nursing, 49, 260-267.
    Taylor, E.J., Outlaw, F.H., Bernardo, T.R., & Roy, A. (1999). Spiritual conflicts associated with praying about cancer. Psycho-Oncology, 8, 386-394.
    Taylor, V.B., & Ferszt, G.G. (1990). Spiritual healing. Holistic Nursing Practice, 4(4), 32-38.
    Varricchio, C. (2006). Measurement issues in quality-of-life assessments. Oncology Nursing Forum, 33(1, Suppl.), 13-21.
    Vassallo, B.M. (2001). The spiritual aspects of dying at home. Holistic Nursing Practice, 15, 17-29.
    Walter, T. (2002). Spirituality in palliative care: Opportunity or burden? Palliative Medicine, 16, 133-139.
    Wright, K.B. (1998). Professional, ethical, and legal implications for spiritual care in nursing. Image: Journal of Nursing Scholarship, 30, 81-83.