Skip to main content
×
Home

The physician's role in the assessment and treatment of spiritual distress at the end of life

  • ANTHONY E. BROWN (a1), SIMON N. WHITNEY (a1) and JAMES D. DUFFY (a2)
Abstract

Objective: Patients at the end of their life typically endure physical, emotional, interpersonal, and spiritual challenges. Although physicians assume a clearly defined role in approaching the physical aspects of terminal illness, the responsibility for helping their patients' spiritual adaptation is also important.

Methods: This article (1) describes the terms and definitions that have clinical utility in assessing the spiritual needs of dying patients, (2) reviews the justifications that support physicians assuming an active role in addressing the spiritual needs of their patients, and (3) reviews clinical tools that provide physicians with a structured approach to the assessment and treatment of spiritual distress.

Results: This review suggests that physicians can and should be equipped to play a key role in relieving suffering at the end of life.

Significance of results: Physicians can help their patients achieve a sense of completed purpose and peace.

Copyright
Corresponding author
Corresponding author: Anthony E. Brown, M.D., M.P.H., Baylor College of Medicine, Department of Family and Community Medicine, 3701 Kirby Dr., Suite 600, Houston, TX 77098, USA. E-mail: anthonyb@bcm.tmc.edu
References
Hide All

REFERENCES

Bessinger, D. & Kuhne, T. (2002). Medical spirituality: Defining domains and boundaries. Southern Medical Journal, 95, 13851388.
Block, S.D. (2001). Perspectives on care at the close of life. Psychological considerations, growth, and transcendence at the end of life: The art of the possible. JAMA, 285, 28982905.
Born, W., Greiner, K.A., Sylvia, E., et al. (2004). Knowledge, attitudes, and beliefs about end-of-life care among inner-city African Americans and Latinos. Journal of Palliative Medicine, 7, 247256.
Braun, K.L. & Zir, A. (2001). Roles for the church in improving end-of-life care: Perceptions of Christian clergy and laity. Death Studies, 25, 685704.
Breitbart, W. (2002). Spirituality and meaning in supportive care: Spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Supportive Care in Cancer, 10, 272280.
Breitbart, W. (2003). Reframing hope: Meaning-centered care for patients near the end of life. Interview by Karen S. Heller. Journal of Palliative Medicine, 6, 979988.
Breitbart, W., Gibson, C., Poppito, S.R., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49, 366372.
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA, 284, 29072911.
Chibnall, J.T., Videen, S.D., Duckro, P.N., et al. (2002). Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16, 331338.
Davis, C.G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality and Social Psychology, 75, 561574.
Derrickson, B.S. (1996). The spiritual work of the dying: A framework and case studies. Hospital Journal, 11, 1130.
Ehman, J.W., Ott, B.B., Short, T.H., et al. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 18031806.
Gordon, T. & Mitchell, D. (2004). A competency model for the assessment and delivery of spiritual care. Palliative Medicine, 18, 646651.
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486500.
Hardwig, J. (2000). Spiritual issues at the end of life: A call for discussion. Hastings Center Report, 30, 2830.
Hills, J., Paice, J.A., Cameron, J.R., et al. (2005). Spirituality and distress in palliative care consultation. Journal of Palliative Medicine, 8, 782788.
Kawa, M., Kayama, M., Maeyama, E., et al. (2003). Distress of inpatients with terminal cancer in Japanese palliative care units: From the viewpoint of spirituality. Supportive Care in Cancer, 11, 481490.
Kellehear, A. (2000). Spirituality and palliative care: A model of needs. Palliative Medicine, 14, 149155.
Kristeller, J.L., Zumbrun, C.S., & Schilling, R.F. (1999). “I would if I could”: How oncologists and oncology nurses address spiritual distress in cancer patients. Psycho-Oncology, 8, 451458.
Levin, J. & Schiller, P.L. (1987). Is there a religious factor in health? Journal of Religion and Health, 26, 936.
Lo, B., Ruston, D., Kates, L.W., et al. (2002). Discussing religious and spiritual issues at the end of life: A practical guide for physicians. Journal of the American Medical Association, 287, 749754.
Marrone, R. (1999). Dying, mourning, and spirituality: A psychological perspective. Death Studies, 23, 495519.
McClain, C.S., Rosenfeld, B., & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet, 361, 16031607.
McClain-Jacobson, C., Rosenfeld, B., Kosinski, A., et al. (2004). Belief in an afterlife, spiritual well-being and end-of-life despair in patients with advanced cancer. General Hospital Psychiatry, 26, 484486.
McGrath, P. (2003). Religiosity and the challenge of terminal illness. Death Studies, 27, 881899.
McIllmurray, M.B., Francis, B., Harman, J.C., et al. (2003). Psychosocial needs in cancer patients related to religious belief. Palliative Medicine, 17, 4954.
McKee, D.D. & Chappel, J.N. (1992). Spirituality and medical practice. Journal of Family Practice, 35, 201, 205–208.
Meador, K.G. (2004). Spiritual care at the end of life: What is it and who does it? North Carolina Medical Journal, 65, 226228.
Miller, D.K., Chibnall, J.T., Videen, S.D., et al. (2005). Supportive-affective group experience for persons with life-threatening illness: Reducing spiritual, psychological, and death-related distress in dying patients. Journal of Palliative Medicine, 8, 333343.
Murray, S.A., Kendall, M., Boyd, K., et al. (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, 3945.
National Consensus Project for Quality Palliative Care: Clinical Practice Guidelines for Quality Palliative Care, Executive Summary. (2004). Journal of Palliative Medicine, 7, 611627.
Puchalski, C.M. (2002). Spirituality and end-of-life care: A time for listening and caring. Journal of Palliative Medicine, 5, 289294.
Puchalski, C.M., Dorff, R.E., & Hendi, I.Y. (2004). Spirituality, religion, and healing in palliative care. Clinics in Geriatric Medicine, 20, vi–vii, 689–714.
Rumbold, B.D. (2003). Caring for the spirit: Lessons from working with the dying. Medical Journal of Australia, 179(6 Suppl.), S1113.
Schwartz, C., Lennes, I., Hammes, B., et al. (2003). Honing an advance care planning intervention using qualitative analysis: The Living Well interview. Journal of Palliative Medicine, 6, 593603.
Sheehan, M.N. (2000). On dying well: How does one live spiritually in the hope of dying well? America (NY), 183, 1215.
Sumner, C.H. (1998). Recognizing and responding to spiritual distress. American Journal of Nursing, 98, 2630; quiz 31.
Thomson, J.E. (2000). The place of spiritual well-being in hospice patients' overall quality of life. Hospital Journal, 15, 1327.
Villagomeza, L.R. (2005). Spiritual distress in adult cancer patients: Toward conceptual clarity. Holistic Nursing Practice, 19, 285294.
Walter, T. (2002). Spirituality in palliative care: Opportunity or burden? Palliative Medicine, 16, 133139.
Wright, M.C. (2002). The essence of spiritual care: A phenomenological enquiry. Palliative Medicine, 16, 125132.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
  • URL: /core/journals/palliative-and-supportive-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 19 *
Loading metrics...

Abstract views

Total abstract views: 94 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th November 2017. This data will be updated every 24 hours.