Spirituality and Care at the End of Life

How should spiritual care be provided to ill patients within a medical context?

This project aims to empirically characterize how spirituality and religion interact with life-threatening illness, and develop and test new spiritual care interventions within targeted patient populations. Key areas of study include describing the multi-layered role that religion/spirituality holds within the experience of illness, understanding how social and institutional structures shape expressions and perceptions of spirituality, and developing and testing new models of spiritual care within healthcare with particular sensitivity to a variety of epidemiological outcomes. The project also attempts to engage key ethical and policy questions concerning the provision of spiritual care within a secular healthcare setting. Finally, the project evaluates the roles and interplay between physicians, nurses, social workers, chaplains, and clergy as they care for patients facing serious illness. (See prior publications)

Faculty: Michael BalboniTracy Balboni, Susan Block, Andrea Enzinger, Arthur Kleinman, John PeteetAlexandra ShieldsTyler VanderWeele

CURRENT PROJECTS
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Religion and Spirituality in Cancer Care Study 

The Religion and Spirituality in Cancer Care Study is a multi-institution, cross-sectional study of patients with advanced cancer, oncology physicians, and nurses that examines perceptions of spiritual care and uses mixed qualitative and quantitative methods. This study aims include:  (1) Determining how oncology nurses and physicians should perform spiritual care when caring for advanced, incurable cancer patients; (2) Characterizing oncology nurse and physician current spiritual care practices;  and (3) Characterizing the spiritual care needs of advanced, incurable cancer patients. This study has provided a foundation of knowledge upon which to base future spiritual care training interventions for medical professionals.  Funded in part by the Agency for Healthcare Research & Quality and the Conquer Cancer Foundation.

 

Examining How Religiousness and Spiritual Care Influence Quality of Life and Medical Care of Cancer Patients Near Death

The Coping with Cancer II study is a NCI/NIH-funded prospective, cohort study of advanced cancer patients (PI, Holly Prigerson).  It examines end of life communication and its associations with end of life outcomes during the final month of life among 600 Black, Latino, and White patients. As part of this study, the project aims 1) To determine whether specific religious/spiritual (R/S) beliefs and attitudes (e.g., belief in miracles) are prospectively related to patient quality of life (QOL) at the end-of-life (EOL) and EOL medical care in the last month of life; 2) To determine whether specific content of spiritual care provided by the medical system (e.g., physicians, nurses, chaplains) and R/S communities prospectively influences advanced cancer patient QOL and EOL medical care in the last month of life. The study hypothesizes that as terminally-ill cancer patients encounter the EOL, specific R/S beliefs and attitudes shape acceptance and well-being in the face of progressive illness.  Specific R/S beliefs are also hypothesized to shape patients’ medical decision-making and ultimate medical care received at the EOL.  Possible patient R/S beliefs and attitudes that have been proposed include personal attitudes related to a moral law, the role of miracles, belief in an afterlife, and viewpoints related to the goals of suffering. This proposal also hypothesizes that specific spiritual care relationships (R/S communities and medical team) and content influence advanced cancer patients QOL, medical decision-making and EOL care.  Funded in part by the American Society of Clinical Oncology and the National Cancer Institute.