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Spirituality in the context of life-threatening illness and life-transforming change

Published online by Cambridge University Press:  28 April 2014

William C. Young
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
Sheeba R. Nadarajah
Department of Nursing, Bowie State University, Bowie, Maryland
Perry R. Skeath
Arizona Center for Integrative Medicine, University of Arizona, Tucson, Arizona
Ann M. Berger*
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
Address correspondence and reprint requests to: Ann M. Berger, Pain and Palliative Care Service, National Institutes of Health Clinical Center, 10 Center Drive, Building 10, Room 2-1733, Bethesda, Maryland 20892. E-mail:



Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care.


A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality.


Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses.

Significance of results:

Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.

Original Articles
Copyright © Cambridge University Press 2014 

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