A Qualitative Analysis of a Healthcare Professional's Understanding and Approach to Management of Spiritual Distress in an Acute Care Setting

Objective: The goal of this study was to explore healthcare professionals' (HCPs') perception of their role in provision of spiritual care, in addition to attempting to identify a simple question(s) to help identify spiritual distress. Background: Spirituality is well recognized as important to whole-person care, particularly in those with terminal illnesses. Understanding the role of front-line providers in the identification and management of spiritual distress, however, remains challenging. Methods: Twenty-one HCPs (eight physicians, seven nurses, six social workers) underwent qualitative semi-structured interviews exploring an understanding of spirituality/spiritual distress. HCPs were drawn from inpatient and outpatient settings in a tertiary care facility, and all had experience with patients with terminal illnesses. Interviews were subsequently coded and analyzed for dominant themes. Results: Essentially all participants spoke of the high importance of spirituality and spiritual care, particularly for those facing end of life. However, the majority of HCPs had difficulty in formulating definitions/descriptions of spiritual care and spiritual distress, in marked contradistinction to the importance they ascribed to this aspect of holistic care. Almost universally provision of spiritual care was seen as critical, yet in the domain of chaplaincy/dedicated spiritual care providers. Reasons frequently cited for HCP's reluctance to provide such care themselves included time available, lack of training and expertise, and the sense that others could do a better job. Discussion: Despite spirituality being highlighted as important to care, few HCPs felt able to provide this, raising questions around how such care can be encouraged and developed in busy acute care settings.