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Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses

Published online by Cambridge University Press:  06 September 2018

Gil Bar-Sela Open the ORCID record for Gil Bar-Sela [Opens in a new window] ,
Michael J. Schultz ,
Karima Elshamy ,
Maryam Rassouli ,
Eran Ben-Arye ,
Myrna Doumit ,
Nahla Gafer ,
Alaa Albashayreh ,
Ibtisam Ghrayeb  and
Ibrahim Turker
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Gil Bar-Sela*
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Michael J. Schultz
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Karima Elshamy
Affiliation:
Faculty of Nursing, Mansoura University, Mansoura, Egypt
Maryam Rassouli
Affiliation:
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Teheran, Islamic Republic of Iran
Eran Ben-Arye
Affiliation:
The Oncology Service, Lin Medical Center, Haifa, Israel
Myrna Doumit
Affiliation:
Alice Ramez Chagoury School of Nursing, Lebanese American University, Beirut, Lebanon
Nahla Gafer
Affiliation:
Radiation and Isotope Center, Khartoum, Sudan
Alaa Albashayreh
Affiliation:
College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
Ibtisam Ghrayeb
Affiliation:
Makassed Charitable Hospital, East Jerusalem
Ibrahim Turker
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Gulcin Ozalp
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Sultan Kav
Affiliation:
Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
Rasha Fahmi
Affiliation:
El-Salam Oncology Center, Cairo, Egypt
Sophia Nestoros
Affiliation:
Cyprus Anti-Cancer Society, Avodaphnousa Hospice, Nicosia, Cyprus
Hasanein Ghali
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Layth Mula-Hussain
Affiliation:
Cross Cancer Institute - University of Alberta, Edmonton, Canada
Ilana Shazar
Affiliation:
Department of Hematology, Rambam Health Care Campus, Haifa, Israel
Rana Obeidat
Affiliation:
Faculty of Nursing, Zarqa University, Zarqa, Jordan
Rehana Punjwani
Affiliation:
Children Cancer Hospital, Karachi, Pakistan
Mohamad Khleif
Affiliation:
Al-Sadeel Society for Palliative Care, Bethlehem, West Bank, Palestinian Authority
Gulbeyaz Can
Affiliation:
Florence Nightingale Faculty of Nursing, Istanbul University, Istanbul, Turkey
Gonca Tuncel
Affiliation:
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Haris Charalambous
Affiliation:
Bank of Cyprus Oncology Center, Nicosia, Cyprus
Safa Faraj
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Neophyta Keoppi
Affiliation:
Cyprus Anti-Cancer Society, Nicosia, Cyprus
Mazin Al-Jadiry
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Sergey Postovsky
Affiliation:
Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
Ma'an Al-Omari
Affiliation:
King Abdullah University Hospital, Irbid, Jordan
Samaher Razzaq
Affiliation:
Children’s Welfare Teaching Hospital, Medical City, Baghdad, Iraq
Hani Ayyash
Affiliation:
European Khan Yunis Hospital, Khan Yunis, Gaza Strip, Palestine
Khaled Khader
Affiliation:
Taif University, Taif, Saudi Arabia
Rejin Kebudi
Affiliation:
Cerrahpaşa Medical Faculty & Oncology Institute, Istanbul University, Istanbul, Turkey
Suha Omran
Affiliation:
Faculty of Nursing, Jordan University for Science and Technology, Irbid, Jordan
Osaid Rasheed
Affiliation:
Al Quds University, Abu Dis and Al-Ahli Hospital, Hebron, West Bank, Palestinian Authority
Mohammed Qadire
Affiliation:
Faculty of Nursing, Al-Bayt University, Mafraq, Jordan
Ahmet Ozet
Affiliation:
Gazi Universitesi Tip Fakultesi, Tibbi Onkoloji Bilim Dali, Ankara, Turkey
Michael Silbermann
Affiliation:
Middle East Cancer Consortium and Technion–Israel Institute of Technology, Haifa, Israel
*
Author for correspondence: Gil Bar-Sela, Integrated Oncology and Palliative Care Unit, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel. Email: g_barsela@rambam.health.gov.il
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Abstract

Objective

When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with “unrealized potential” for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.

Method

We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.

Result

We had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How “developed” a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.

Significance of results

Despite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.

Keywords

CancerHuman development indexMiddle EastPalliative careSpiritual careSpirituality
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 3 , June 2019 , pp. 345 - 352
Copyright
Copyright © Cambridge University Press 2018 

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