Spiritual needs among hospitalized patients at a public hospital in Brazil
a cross-sectional study
Keywords:
Palliative care, Spirituality, Religion, BrazilAbstract
BACKGROUND: The relationship between spirituality and health has been the object of growing discussion. There is a lack of data on spiritual needs assessments in Brazil. OBJECTIVE: This study aimed to assess the spiritual needs of patients admitted to a public tertiary hospital and perform a comparative analysis between patients with and without indications for palliative care. DESIGN AND SETTING: A cross-sectional observational study included patients hospitalized between August and December 2020 in Hospital do Servidor Publico Municipal, Sao Paulo, Brazil. METHODS: The included patients answered a questionnaire consisting of sociodemographic data, the Duke religiosity scale, and the Spiritual Needs Assessment for Patients (SNAP) tool for a spiritual needs assessment. The World Health Organization Palliative Needs tool (NECPAL) was used to evaluate the indications for palliative care. The level of significance adopted was 5%. RESULTS: A total of 66 patients were included in this study. Most participants (97%) declared themselves as belonging to a religion. The group without indication for palliative care by the NECPAL showed greater spiritual (P = 0.043) and psychosocial needs (P = 0.004). No statistically significant difference was observed in the religious needs domain (P = 0.176). There were no statistically significant differences in the Duke scale scores between the two groups. CONCLUSION: Spiritual, psychosocial, and religious needs are prevalent among hospitalized patients, and multidisciplinary teams must consider these needs in their management approach. In addition, this study suggests that psychosocial and spiritual needs can be even higher in patients who do not receive palliative care.
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References
Monod SM, Rochat E, Büla CJ, et al. The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons. BMC Geriatr. 2010;10:88; PMID: 21144024; https://doi.org/10.1186/1471-2318-10-88.
Steinhauser KE, Fitchett G, Handzo GF, et al. State of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes. J Pain Symptom Manage. 2017; PMID: 28733252; https://doi.org/10.1016/j.jpainsymman.2017.07.028.
Guimarães HP, Avezum A. O impacto da espiritualidade na saúde física. Arch Clin Psychiatry (São Paulo). 2007;34(Suppl 1):88-94. https://doi.org/10.1590/S0101-60832007000700012.
Koenig HG. Religion, spirituality and psychotic disorders. Arch Clin Psychiatry (São Paulo). 2007;34(Suppl 1):95-104. https://doi.org/10.1590/S0101-60832007000700013.
Canada AL, Fitchett G, Murphy PE, et al. Racial/ethnic differences in spiritual well-being among cancer survivors. J Behav Med. 2013;36(5):441-53. PMID: 22752250; https://doi.org/10.1007/s10865-012-9439-8.
Gudenkauf LM, Clark MM, Novotny PJ, et al. Spirituality and Emotional Distress among Lung Cancer Survivors. Clin Lung Cancer. 2019;20(6):e661-6. PMID: 31378618; https://doi.org/10.1016/j.cllc.2019.06.015.
Lyon ME, D’Angelo LJ, Cheng YI, et al. The influence of religious beliefs and practices on health care decision-making among HIV positive adolescents. AIDS Care. 2020;32(7):896-900. PMID: 31535560; https://doi.org/10.1080/09540121.2019.1668523.
Taheri-Kharameh Z, Zamanian H, Montazeri A, Asgarian A, Esbiri R. Negative Religious Coping, Positive Religious Coping, and Quality of Life Among Hemodialysis Patients. Nephrourol Mon. 2016;8(6):e38009. PMID: 27896237; https://doi.org/10.5812/numonthly.38009.
Park CL, Lee SY. Unique effects of religiousness/spirituality and social support on mental and physical well-being in people living with congestive heart failure. J Behav Med. 2020;43(4):630-7. PMID: 31522357; https://doi.org/10.1007/s10865-019-00101-9.
Proserpio T, Pagani Bagliacca E, Sironi G, et al. Spirituality and Sustaining Hope in Adolescents with Cancer: The Patients’ View. J Adolesc Young Adult Oncol. 2020;9(1):36-40. PMID: 31539288; https://doi.org/10.1089/jayao.2019.0058.
Pearce MJ, Coan AD, Herndon JE 2nd, Koenig HG, Abernethy AP. Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer. 2012;20(10):2269-76. PMID: 22124529; https://doi.org/10.1007/s00520-011-1335-1.
Scherer JS, Milazzo KC, Hebert PL, et al. Association Between Self-reported Importance of Religious or Spiritual Beliefs and End-of-Life Care Preferences Among People Receiving Dialysis. JAMA Netw Open. 2021;4(8):e2119355. PMID: 34347059; https://doi.org/10.1001/jamanetworkopen.2021.19355.
Seddigh R, Keshavarz-Akhlaghi AA, Azarnik S. Questionnaires Measuring Patients’ Spiritual Needs: A Narrative Literature Review. Iran J Psychiatry Behav Sci. 2016;10(1):e4011. PMID: 27284281; https://doi.org/10.17795/ijpbs-4011.
Sharma RK, Astrow AB, Texeira K, Sulmasy DP. The Spiritual Needs Assessment for Patients (SNAP): Development and Validation of a Comprehensive Instrument to Assess Unmet Spiritual Needs. J Pain Symptom Manage. 2012;44(1):44-51. PMID: 22658473; https://doi.org/10.1016/j.jpainsymman.2011.07.008.
de Araujo Toloi D, Uema D, Matsushita F, et al. Validation of questionnaire on the Spiritual Needs Assessment for Patients (SNAP) questionnaire in Brazilian Portuguese. Ecancermedicalscience. 2016;10:694. PMID: 28101137; https://soi.org/10.3332/ecancer.2016.694.
Esperandio M, Leget, C. Spirituality in palliative care: a public health issue? Rev Bioet. 2020;28(3):543-53. https://doi.org/10.1590/1983-80422020283419.
Taunay TCD, Gondim FAA, Macêdo DS, et al. Validação da versão brasileira da escala de religiosidade de Duke (DUREL). Arch Clin Psychiatry São Paulo. 2012;39(4):130-5. https://doi.org/10.1590/S0101-60832012000400003.
Santana MTEA, Gómez-Batiste X, Silva LMGD, Gutiérrez MGR. Cross-cultural adaptation and semantic validation of an instrument to identify palliative requirements in Portuguese. Einstein (Sao Paulo). 2020;18:eAO5539. PMID: 33053019; https://doi.org/10.31744/einstein_journal/2020AO5539.
Gómez-Batiste X, Martínez-Muñoz M, Blay C, et al. Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia. BMJ Support Palliat Care. 2013;3(3):300-8. PMID: 24644748; https://doi.org/10.1136/bmjspcare-2012-000211.
Menegatti-Chequini MC, Maraldi EO, Peres MFP, Leão FC, Vallada H. How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil. Braz J Psychiatry. 2019;41(1):58-65. PMID: 30427386; https://doi.org/10.1590/1516-4446-2017-2447.
Cheng Q, Xu X, Liu X, Mao T, Chen Y. Spiritual needs and their associated factors among cancer patients in China: a cross-sectional study. Support Care Cancer. 2018;26(10):3405-12. PMID: 29663138; https://doi.org/10.1007/s00520-018-4119-z.
Frick E, Büssing A, Rodrigues Recchia D, et al. Spirituelle Bedürfnisse von Patienten eines Notfallzentrums. [Spiritual needs of patients in an emergency room]. Med Klin Intensivmed Notfmed. 2021;116(3):245-53. PMID: 32034431; https://doi.org/10.1007/s00063-020-00653-8.
Best M, Leget C, Goodhead A, Paal P. An EAPC white paper on multidisciplinary education for spiritual care in palliative care. BMC Palliat Care. 2020;19(1):9. PMID: 31941486; https://doi.org/10.1186/s12904-019-0508-4.
Dezorzi LW, Raymundo MM, Goldim JR, de Oliveira CAV de. Spirituality in the continuing education of healthcare professionals: An approach to palliative care. Palliat Support Care. 2019;17(6):662-7. PMID: 30862320; https://doi.org10.1017/S1478951519000117.
Vilalta A, Valls J, Porta J, Viñas J. Evaluation of Spiritual Needs of Patients with Advanced Cancer in a Palliative Care Unit. J Palliat Med. 2014;17(5):592-600. PMID: 24745870; https://doi.org/10.1089/jpm.2013.0569.
