Spiritual care: What do cancer patients and their family members want? A co-design project

ABSTRACT

Purpose: Through active participant engagement, this project aimed to better comprehend the spiritual care needs of New Zealand cancer patients and their families and friends, and to gain further insight from others, including healthcare practitioners. Methods: A co-design process was undertaken, which involved presentations and interactive group workshops on the topic of spirituality and spiritual care. A facilitated, semi-structured discussion centred around three main topic areas: the meaning of spirituality; the documentation of spirituality in healthcare settings; current spiritual care development needs; and areas for improvement. The Framework Method was used to undertake an inductive analysis of the qualitative data in order to develop key themes according to topic area. Results: Key concepts constructed from our analysis of the three main topic areas include: Participants broadly understood spiritualty to be characterized by core values, expressions of love and kindness, and connectedness with others and/or with the environment; participants felt as if documentation of spiritual beliefs had the potential to inform others about their needs and wishes participants also recommended that opportunities be created for people to engage in conversation about spirituality, and that this should be undertaken purposefully. Importantly, responses often alluded to the great diversity of need when it comes to spiritual care. Conclusions: Integration of spiritual care into health system policies, intake and assessment processes, care plans, and training and professional development opportunities, are all required in order to reflect relevant national guidelines and strategies more effectively.

KEYWORDS:

• Spirituality
• spiritual care
• cancer
• supportive care
• health
• wellbeing

Acknowledgements

We would like to extend a sincere thankyou to all who participated in our workshops, and who provided project feedback. We would also like to acknowledge and thank the Mid-Central District Health Board Spiritual Care Advisory Group for their on-going support. Finally, we would like to thank Jonathan Drew, medical student at the University of Otago, for designing our graphical abstract.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Richard Egan is co-director of the Cancer Society Social and Behavioural Research Unit, Dunedin School of Medicine, University of Otago, New Zealand. His Master’s thesis examined spirituality in New Zealand state schools; his PhD explored spirituality in end-of-life care. Richard is a past President of the New Zealand Public Health Association and is currently Vice-Chair on the Board of the Health Promotion Forum of New Zealand. He is an Honorary Research Consultant for Meaningful Aging Australia, a member of the Global Network for Spirituality & Health, and a Board member of the Selwyn Institute for Aging and Spirituality. He works with Hospice NZ on spirituality matters.

Anna Graham-DeMello is from Nova Scotia, Canada. Her background is in human nutrition, public health, and health promotion. She currently works at the University of Otago, Dunedin, both in the Department of Medicine and the Department of Preventive and Social Medicine on various public-health-related projects.

Sande Ramage has a background in health promotion and change management in health and welfare, plus experience in school, military, and health chaplaincy. She is Spiritual Care Coordinator at MidCentral District Health Board, New Zealand and is involved in implementing the Transforming Spiritual Care Strategy that seeks to embed spirituality as an integral part of health care.

Barry Keane is the Nurse Director for Mental Health and Addiction Services at MidCentral DHB, New Zealand. He is Chair of the Spiritual Care Advisory Group at MidCentral and has been involved in a number of initiatives to promote the development of an effective systems-based approach to meeting spiritual care needs in an acute hospital setting. He is a past chair of the Ministry of Health Palliative Care Advisory Group and has been involved in other national initiatives in end-of-life care.

Notes

1 Whanau is the term used to refer to a family group or extended family in the Māori language.

2 See: https://www.health.govt.nz/our-work/populations/maori-health/maori-health-models/maori-health-models-te-whare-tapa-wha (Accessed 03/09/2018).

Additional information

Funding

This work was supported by the Cancer Society of New Zealand, Central District Division.