Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T05:25:31.954Z Has data issue: false hasContentIssue false
  • English
  • Français

Collective soul: The spirituality of an interdisciplinary palliative care team

Published online by Cambridge University Press:  29 June 2006

SHANE SINCLAIR ,
SHELLEY RAFFIN ,
JOSE PEREIRA  and
NANCY GUEBERT
SHANE SINCLAIR
Affiliation:
Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
SHELLEY RAFFIN
Affiliation:
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
JOSE PEREIRA
Affiliation:
Palliative Medicine, Universities of Lausanne and Geneva, Switzerland; Department of Oncology, University of Calgary, Calgary, Alberta, Canada
NANCY GUEBERT
Affiliation:
Calgary Health Region, Calgary, Alberta, Canada.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals (HCP) experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care.

Methods: A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit (TPCU) in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and/or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.

Results: Initially participants struggled to define spirituality. Concepts of spirituality relating to integrity, wholeness, meaning, and personal journeying emerged. For many, spirituality is inherently relational. Others acknowledged transcendence as an element of spirituality. Spirituality was described as being wrapped in caring and often manifests in small daily acts of kindness and of love, embedded within routine acts of caring. Palliative care served as a catalyst for team members' own spiritual journeys. For some participants, palliative care represented a spiritual calling. A collective spirituality stemming from common goals, values, and belonging surfaced.

Significance of results: This was the first known study that focused specifically on the exploration of a collective spirituality. The culture of palliative care seems to foster spiritual reflection among health care professionals both as individuals and as a whole. While spirituality was difficult to describe, it was a shared experience often tangibly present in the provision of care on all levels.

Keywords

SpiritualityInterdisciplinary teamsPalliativeEnd-of-life carePalliative care unitHospice
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 1 , March 2006 , pp. 13 - 24
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Ajemian, I. (1993). The interdisciplinary team. In Oxford Textbook of Palliative Medicine, Doyle, D., Hanks, G. & MacDonald, N. (eds.), pp. 17–28. Oxford: Oxford University Press.
Astrow, A., Puchalski, C., & Sulmasy, D. (2001). Religion, spirituality and heath care: Social, ethical, and practical considerations. The American Journal of Medicine, 110, 283–287.Google Scholar
Ben-Arye, E., Bar-Sela, G., Frenkel, M., et al. (2005). Is a biopsychosocial-spiritual approach relevant to cancer treatment? A study of patients and oncology staff members on issues of complementary medicine and spirituality. Supportive Care in Cancer, 13, 1–11.Google Scholar
Brock, C. & Salmsky, J. (1993). Empathy: An essential skill for understanding the physician–patient relationship in clinical practice. Family Medicine, 25, 245–248.Google Scholar
Burns, S. (1991). The spirituality of the dying. Health Progress, 72, 48–54.Google Scholar
Byrne, M. (2001). Who cares for the spirit in palliative care? Progress in Palliative Care, 9, 129–130.Google Scholar
Campbell, J. (1982). Myths to Live By. Toronto: Bantam Books.
Cassell, E. (1982). The nature of suffering and the goals of medicine. New England Journal of Medicine, 306, 639–645.Google Scholar
Cawley, N. (1997). An exploration of the concept of spirituality. International Journal of Palliative Care, 3, 31–36.Google Scholar
Cherlin, E., Schulman-Green, D., McCorkle, R., et al. (2004). Family perceptions of clinicians' outstanding practices in end-of-life care. Journal of Palliative Care, 20, 113–116.Google Scholar
Chochinov, H. (2002). Dignity-conserving care. JAMA, 287, 2253–2260.Google Scholar
Cobb, M. (2001). The Dying Soul: Spiritual Care at the End of Life. Buckingham: Oxford University Press.
Daaleman, T. & VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care. JAMA, 284, 2514–2517.Google Scholar
Ehman, J., Ott, B., Short, T., 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, 1803–1806.Google Scholar
Elkins, D., Hedstrom, L., Hughes, L., et al. (1988). Toward a humanistic-phenomenological spirituality: Definition, description, and measurement. Journal of Humanisitc Psychology, 28, 5–18.Google Scholar
Ferguson, S., Wright, D., & Packer, J. (1988). New Dictionary of Theology. Downers Grove: InterVarsity Press.
Fetterman, D. (1983). Ethnography: Step by Step. Newbury Park: Sage.
Fitchett, G. & Handzo, G. (1998). Spiritual assessment, screening, and intervention. In Psycho-Oncology, Holland, J. (ed.), p. 808. New York: Oxford University Press.
Flannelly, K., Weaver, A., & Costa, K. (2004). A systematic review of religion and spirituality in three palliative care journals, 1990–1999. Journal of Palliative Care, 20, 50–56.Google Scholar
George H. Gallup International Institute. (1997). Spiritual beliefs and the dying process: A report on a national survey. Princeton, NJ: Author.
Germain, C. (1993). Ethnography: The method. In Nursing Research: A Qualitative Perspective, Munhall, P. & Oiler Boyd, C. (eds.), pp. 237–268. New York: National League for Nursing.
Grey, A. (1994). The spiritual component of palliative care. Palliative Medicine, 8, 215–221.Google Scholar
Griffin, A. (1983). A philosophical analysis of caring in nursing. Journal of Advanced Nursing, 8, 293.Google Scholar
Guba, E.G. & Lincoln, Y.S. (2000). Competing paradigms in qualitative research. In Handbook of Qualitative Research, 3rd ed. Denzin, N.K. & Lincoln, Y.S. (eds.), pp. 163–188. Thousand Oaks, CA: Sage.
Hegarty, M. (2001). The dynamic of hope: Hoping in the face of death. Progress in Palliative Care, 9, 42–46.Google Scholar
Kearney, M. (2000). A Place of Healing. Oxford: Oxford University Press.
Krikorian, D. & Moser, D. (1985). Satisfactions and stresses experienced by professional nurses in hospice programs. The American Journal of Hospice Care, 2, 25–33.Google Scholar
Kuhl, D. (2002). What Dying People Want. Toronto: Anchor.
Maddix, T. & Pereira, J. (2001). Reflecting on the work of palliative care. Journal of Palliative Medicine, 4, 373–378.Google Scholar
Martsolf, D. & Mickley, J. (1998). The concept of spirituality in nursing theories: Differing world-views and extent of focus. Journal of Advanced Nursing, 27, 294–303.Google Scholar
McCabe, M. (1997). Clinical response to spiritual issues. In Topics in Palliative Care, Portenay, R. & Bruera, E., (eds.), pp. 279–290. New York: Oxford University Press.
McClain, C., Rosenfeld, B., & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. The Lancet, 361, 1603–1607.Google Scholar
McSherry, W. & Draper, P. (1997). The spiritual dimension: Why the absence within nursing curricula? Nurse Education Today, 17, 413–417.Google Scholar
Millison, M. (1988). Spirituality and the caregiver. The American Journal of Hospice Care, 5, 37–44.Google Scholar
Millison, M. & Dudley, J. (1990). The importance of spirituality in hospice work: A study of hospice professionals. The Hospice of Journal, 6, 63–78.Google Scholar
Morse, J. & Richards, L. (2002). Read Me First: For a User's Guide to Qualitative Methods. Thousand Oaks, CA: Sage.
Nagai-Jacobsen, M.G. & Burkhardt, M.A. (1989). Spirituality: Cornerstone of holistic nursing practice. Holistic Nursing Practice, 3, 18–26.Google Scholar
O'Connor, P. & Kaplan, M. (1986). The role of the interdisciplinary team in providing spiritual care: An attitudinal study of hospice workers. In In Quest of the Spiritual Component of Care for the Terminally Ill, Wald, F. (ed.), pp. 51–62. New Haven: Yale University Press.
Prochnau, C., Liu, L., & Boman, J. (2003). Personal-professional connections in palliative care occupational therapy. The American Journal of Occupational Therapy, 57, 196–204.Google Scholar
Puchalski, C. & Romer, A. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Care, 3, 129–137.Google Scholar
Reed, P. (1997). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing & Health, 10, 335–344.Google Scholar
Rose, S. (2001). Is the term ‘spirituality’ a word that everyone uses, but nobody knows what anyone means by it? Journal of Contemporary Religion, 16, 193–207.Google Scholar
Ross, L. (1994). Spiritual care: The nurse's role. Nursing Standard, 8, 35–37.Google Scholar
Ross, L. (1995). The spiritual dimension: Its importance to patients' health, well-being and quality of life and its implications for nursing practice. International Journal of Nursing Studies, 32, 457–468.Google Scholar
Saunders, C. (1988). Spiritual pain. Journal of Palliative Care, 4, 29–32.Google Scholar
Saunders, C. (1993). Introduction—“History and Challenge.” In The Management of Terminal Malignant Diseases, 3rd ed. Saunders, C., Sykes & N. (eds.), pp. 1–15. London: Edward Arnold.
Sloan, R.P., Bagiella, E., & Powell, T. (1999). Religion, spirituality and medicine. The Lancet, 353, 664–667.Google Scholar
Smith, E., Stefanek, M., Joseph, M., et al. (1993). Spiritual awareness, personal perspectives on death, and psychosocial distress among cancer patients: An initial investigation. Journal of Psychosocial Oncology, 11, 89–103.Google Scholar
Spradley, J.P. (1979). The Ethnographic Interview. New York: Holt, Rinehart & Winston.
Taylor, E. & Ersek, M. (1995). Ethical and spiritual dimensions of cancer pain management. In Cancer Pain Management, 2nd ed., McGuire, D., Yarbro, C. & Ferrell, B. (eds.), pp. 41–60. Boston: Jones and Bartlett.
Vincent, P. & Garrison-Peace, H. (1985). Do hospice nurses differ from non-hospice nurses? The American Journal of Hospice Care, 2, 36.Google Scholar
Walter, T. (1997). The idealogy and organization of spiritual care: Three approaches. Palliative Medicine, 11, 21–30.Google Scholar
Weaver, M., Ow, C., Walker, D., et al. (1993). A questionnaire for patients’ evaluations of their physicians humanistic behaviours. Journal of General Internal Medicine, 8, 1235–1239.Google Scholar
White, G. (2000). An inquiry into the concepts of spirituality and spiritual care. International Journal of Palliative Nursing, 6, 479–484.Google Scholar
World Health Organization. (1990). Technical report series 804. Geneva: Author.
Wright, M. (2001). Chaplaincy in hospice and hospital: Findings from a survey in England and Wales. Palliative Medicine, 15, 229–242.Google Scholar
Wright, M.C. (2002). The essence of spiritual care: A phenomenological enquiry. Palliative Medicine, 16, 125–132.Google Scholar
Yates, J., Chalmer, B., St. James, P., et al. (1981). Religion in patients with advanced cancer. Medical and Pediatric Oncology, 9, 121–128.Google Scholar