Spirituality Is An Important Part of Cancer Care, But Nurses Need More Support

A qualitative study assessed a unique role of oncology nurses: addressing needs pertaining to spirituality and religion in their patients.

A survey with two main questions was completed by 62 nurses (mean [range] age, 37.62 [26–74] years) in the U.S. (n=58) and Switzerland (n=4). The first question pertained to their patients’ spirituality at the start of their cancer journey. The second question pertained to the nurses’ experiences with patients’ spirituality and how they responded.

The cohort was primary female (n=34). The mean (range) number of years in nursing was 17.86 (3–47). Stories shared in the survey discussed end-of-life situations (n=29), disease progression (n=20), new cancer diagnosis (n=8), and general views on spirituality and religion (n=5).

Spirituality Benefits Patients … And Nurses

Two main themes emerged from the results: (1) trying to make sense of the situation, and (2) listening and acknowledging.

In the theme of “trying to make sense of the situation,” four subthemes were identified:

  1. Use of religion/spirituality or rituals: “Patients turned to spirituality and/or religion and/or spirituality due to their disease.”
  2. Struggling with the disease: “Frequently, patients blamed God for their illness. Many patients were angry or experienced despair. … For some patients, spirituality or religion provided a rationale for not taking medications or continuing treatment.”
  3. Finding meaning: “Patients sought to understand the reasons for falling ill or to find a way of dealing with the disease in order to make sense of their lives and illness before death.”
  4. Acceptance of the disease: “Spirituality was one factor that helped some patients accept their disease.”

In the theme of “listening and acknowledging,” four separate subthemes were uncovered:

  1. Challenge of addressing spirituality and/or religion: “Nurses acknowledged that it can be difficult to talk about religious and spiritual issues with patients, especially since this is not part of routine care and is not performed regularly. … Some nurses acknowledged that their own lack of confidence in discussing spirituality or religion contributed to a hesitancy to engage in spiritual care.”
  2. Finding a way to talk about spirituality/religion: “Nurses who were trained to address spiritual and religious issues did so more regularly.”
  3. Providing spiritual care: “When patients asked to exercise their religious faith-based practices, nurses were generally supportive. In these instances, nurses called for representatives of the respective faith community or arranged time for the patient to pray or engage in faith or ritual practices.”
  4. Personal reflections on spirituality/religion: “Reflecting on religion and spirituality and engaging in spiritual care did affect the nurses, as they reported that they had been personally touched by specific situations … The peace patients obtained was compensation.”

The study was published in the October issue of the European Journal of Oncology Nursing.

The researchers concluded that discussions on spirituality/religion appeared to benefit both the patients and the nurses.

“For nurses to provide spiritual care, institutional acknowledgement of the importance of spiritual care is needed. Nurses have highlighted the lack of adequate settings to address spirituality. Spiritual care needs to be a part of the institutional vision to enable the provision of this care to become relevant and accountable by institutions,” they wrote.