Palliative and Supportive Care Research Department, Cabrini Health, Melbourne, Victoria, Australia.
Institute of Ethics and Society, University of Notre Dame Australia, Sydney, New South Wales, Australia.
BMJ Support Palliat Care. 2022 Sep;12(3):316-323. doi: 10.1136/bmjspcare-2020-002261. Epub 2020 Jun 4.
Spiritual care allows palliative care patients to gain a sense of purpose, meaning and connectedness to the sacred or important while experiencing a serious illness. This study examined how Australian patients conceptualise their spirituality/religiosity, the associations between diagnosis and spiritual/religious activities, and views on the amount of spiritual support received.
This mixed-methods study used anonymous semistructured questionnaires, which included the Functional Assessment of Chronic Illness Therapy-Spiritual Scale-12 (FACIT-SP-12) and adapted and developed questions examining religion/spirituality's role and support.
Participants numbered 261, with a 50.9% response rate. Sixty-two per cent were affiliated with Christianity and 24.2% with no religion. The mean total FACIT-SP-12 score was 31.9 (SD 8.6). Patients with Christian affiliation reported a higher total FACIT-SP-12 score compared with no religious affiliation (p=0.003). Those with Christian and Buddhist affiliations had higher faith subscale scores compared with those with no religious affiliation (p<0.001). Spirituality was very important to 39.9% and religiosity to 31.7% of patients, and unimportant to 30.6% and 39.5%, respectively. Following diagnosis, patients prayed (p<0.001) and meditated (p<0.001) more, seeking more time, strength and acceptance. Attendance at religious services decreased with frailty (p<0.001), while engagement in other religious activities increased (p=0.017). Patients who received some level of spiritual/religious support from external religious/faith communities and moderate to complete spiritual/religious needs met by the hospitals reported greater total FACIT-SP-12 spirituality scores (p<0.001).
Respectful inquiry into patients spiritual/religious needs in hospitals allows for an attuned approach to addressing such care needs while considerately accommodating those disinterested in such support.
精神关怀使姑息治疗患者在罹患重病时能够获得目标感、意义感和与神圣或重要事物的联系感。本研究旨在探讨澳大利亚患者如何理解自己的灵性/宗教信仰、诊断与精神/宗教活动之间的关联，以及他们对所获得的精神支持程度的看法。
本混合方法研究采用匿名半结构式问卷，其中包括慢性疾病治疗功能评估-精神量表 12 项（FACIT-SP-12）以及经过改编和开发的问题，以考察宗教/精神信仰的作用和支持。
共有 261 名参与者，应答率为 50.9%。62%的参与者隶属于基督教，24.2%的参与者没有宗教信仰。平均总 FACIT-SP-12 得分为 31.9（SD 8.6）。与无宗教信仰者相比，基督教信仰者的总 FACIT-SP-12 评分更高（p=0.003）。与无宗教信仰者相比，基督教和佛教信仰者的信仰子量表得分更高（p<0.001）。39.9%的患者认为灵性非常重要，31.7%的患者认为宗教非常重要，30.6%的患者认为灵性不重要，39.5%的患者认为宗教不重要。诊断后，患者更多地祈祷（p<0.001）和冥想（p<0.001），寻求更多的时间、力量和接受。随着虚弱程度的增加，参加宗教仪式的人数减少（p<0.001），而参与其他宗教活动的人数增加（p=0.017）。从外部宗教/信仰团体获得一定程度的精神/宗教支持，以及医院满足患者中度至完全的精神/宗教需求的患者报告称，他们的总 FACIT-SP-12 精神评分更高（p<0.001）。
在医院中尊重地询问患者的精神/宗教需求，可以使医院以一种恰当的方式满足这些护理需求，同时也考虑到那些对这种支持不感兴趣的患者。
