Deconstructing spiritual care: Discursive underpinnings within palliative care research.

Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care.

Navigating Complexity: Spiritual Care Discourses Among Swedish Palliative Care Professionals.

Through discourse analysis of focus groups, this study investigates how palliative care professionals in Sweden engage with "spiritual care," "religion" and "spirituality." Our results reveal a common assumption that religion is "visible," but at the same time private. Furthermore, we observed a secular and nonreligious positioning, marked by frequent "us versus them" rhetoric, especially in discussions about truth telling. The findings illustrate a view of belonging to a secular society in which a discourse of static understanding of religion dominated, indicating a vague religious literacy. This study indicates a need among healthcare professionals to discern, understand and relate to non-visible forms of religion.

Understanding the needs for support and coping strategies in grief following the loss of a significant other: insights from a cross-sectional survey in Sweden.

Background: Grief has previously been described in pathological terms, characterized by several stages. In the past three decades, new perspectives on grief as a reaction to the loss of a significant other have emerged. It shows that grief is an individual process based on circumstances surrounding the death and the bereaved person's life situation, rather than being predetermined. Objective: The aim of the study was to show how grief is perceived by people who have lost a significant other, and it focuses on bereavement support, how the death affects the bereaved person's living conditions, how the bereaved person deals with grief, and if grief is expressed differently depending on whether it was an expected death (ED) or an unexpected death (UED). Design: A cross-sectional design was used with data collected anonymously using an online survey with semi-structured answers and options for participants to add their own comments, and it was analyzed descriptively. Result: Support in grief was mainly given by family and friends, and the perceived need was primarily for emotional support or emotional support combined with practical support, and to a greater extent for UEDs and women. For some bereaved persons, health caregivers and religious institutions provided support outside their own network. Grief can affect how people socialize with others and change social relationships. People can deal with grief in social as well as religious ways in the company of friends, through everyday conversations, spending time in nature, and having a spiritual outlook on life, and with the help of pets. Conclusion: The results can contribute to an increased understanding of grief after the loss of a significant other and how grief affects the bereaved person's life depending on whether it is an ED or a UED. There was a difference between the genders, with women perceiving a need for and receiving different forms of support and to a greater extent than men.

Understanding support and coping in grief Grief has long been described as a mental health disorder and characterized by multiple stages. In the last three decades, research has shown new perspectives on grief as a normal reaction to the loss of a significant other. It has shown that grief is an individual process based on the circumstances surrounding the death, the bereaved person's social life situation, different forms of support and how the bereaved person deals with their changed life situation. The aim of this study was to investigate what support in grief can look like and the coping strategies that are used. The grieving process can vary depending on how the death affects the bereaved person's living conditions, how they deal with grief, and whether it was perceived as an expected death (ED) or an unexpected death (UED). The study took the form of an online survey with data collected as anonymous semi-structured answers, with options for participants to add their own comments, and it was analysed descriptively. The results showed that support in grief was mainly provided by family and friends, regardless of whether it was an ED or a UED. For some bereaved persons, health caregivers and religious institutions provided support outside their own network. The participants mainly reported a need for emotional support and emotional support combined with practical support. Grief can influence how people socialize with others and lead to changes in social relationships. People can cope with grief in social and religious ways, by socializing with friends, and through everyday conversations, spending time in nature and having a spiritual outlook on life, and with the help of pets. The conclusions drawn from the results can contribute to a greater understanding of the bereavement of a significant other and how grief influences the life circumstances of a bereaved person in many ways.

Balancing hope at the end of life organisational conditions for spiritual care in palliative homecare in Sweden.

The aim of this article is to examine how norms and values related to culture, religion, and spirituality were experienced and expressed by healthcare professionals caring for patients at the end of life in Advanced Care at Home (ACH) in Sweden, with a focus on how organisational aspects enabled or hindered spiritual care. Founded on participant observation with physicians and exploratory short-term fieldwork conducted between June and December 2019, findings show that physicians experienced communication problems relating to both religion and culture, yet were skilled in balancing hope and existential needs, medically and practically. However, all healthcare encompassed a secular bias complicating abilities to "read" religious and spiritual needs, reflecting a general lack of religious literacy among healthcare providers. ACH physicians and the palliative care team were facilitated by several organisational and structural conditions necessary for person-centred and spiritual care, including the non-hierarchical and interprofessional composition of care teams, continuity of care, space for physicians' reflection, and engagement in dialogue with patients and their relatives. Furthermore, the 6S palliative care ideology was promoted within the team, as was a creative outlook in supporting patients and their relatives' hope at the end of life. Nevertheless, interest varied. Some physicians were more skilled in dialogue, creativity and including the patient in medical decisions. Others were less focused on the person and maintained a strong emphasis on medicine, practicalities, and biomedical testing. Further, structural and organisational hindrances to person-centred and spiritual care were illuminated, including a lack of routines surrounding protecting the patient's needs in transitions from hospital to ACH. Even though the organisation of care in ACH provided conditions for person-centredness, the lack of religious literacy caused further hindrances to spiritual care. We conclude that, without religious literacy, and the ability to holistically meet patients' spiritual needs, care cannot be truly person-centred.