The adequate provision of care, the quality of patients’ lives, and their satisfaction depend on numerous factors that should be considered when selecting the cooperation model. However, the problem becomes more complex speaking about critical or end-of-life care. Spirituality can be viewed as one of the factors relevant to the issue. Patients’ visions and beliefs can contribute to the acceptance of their condition and the absence of fear because of death and the afterlife. However, there is still a lack of attention devoted to the issue, and numerous barriers should be considered when touching upon the given theme. Spiritual care has multiple ethical concerns surrounding it and has lacked adequate laws, and it is a significant aspect of care that most helps the more vulnerable population transition from the end of life to the afterlife.
Ethical Concerns Surrounding Treatment of Patients with Spirituality Beliefs in Critical Care or End of Life Care
Treatment of patients with specific spiritual beliefs might require additional attention, effort, and reconsideration of the existing practices. For instance, the patients’ autonomy might be overlooked during spiritual care because of several factors. First of all, it is linked to the fact that there are hundreds of religious affiliations peculiar to various patients. For instance, indigenous people’s needs might differ from others as they might have specific visions impacting their vision of death and end-of-life care (Terpstra et al., 2020). Applying the ideas of patients’ autonomy, it is vital to ensure patients can make decisions about their conditions and whether the provided treatment meets their ideas of spirituality and death (Mogan et al., 2022). It would help to improve the quality of provided care and guarantee that clients are supported during the most challenging period of their lives.
In such a way, healthcare providers must take into consideration the religious beliefs of their patients and respect their wishes and decisions while under their care. Research shows that staff in nursing homes have close relations with patients when delivering palliative care (Molloy & Phelan, 2022). It means they are also informed about the wishes and desires of their clients. For this reason, they can become significant change agents promoting the use of spiritual practices and helping patients to acquire the needed assistance. It might help decrease the fear among individuals who face death and guarantee their peaceful transition into the afterlife.
At the same time, healthcare providers must keep professionalism and not cross boundaries with their patients during spiritual treatment. It is vital to remain within the ethical field and guarantee that patients will not be offended because of the health workers’ assumptions regarding their spirituality or religious views (Terpstra et al., 2020). Spirituality treatment will, for the most part, require the healthcare team to get involved and interact with their patients at a personal level. It helps to differentiate social from spiritual needs and ensure the provision of the necessary care and interventions. Moreover, there is a high risk of misunderstanding and crossing borders because of too close cooperation. For this reason, professionalism remains the primary factor used to align spiritual care.
However, in some cases, personal information and a deep sense of empathy and care might exceed professional boundaries. It means that specialists providing end-of-life care face a high risk of developing deep attachments to residents when delivering care (Molloy & Phelan, 2022). It might impact the quality of treatment and decisions made by the staff regarding further interventions and assistance. This specific bond requires an in-depth investigation to acquire a better vision of the role these relations play in delivering spiritual care to patients (Molloy & Phelan, 2022). However, the acquired personal information might also be used to select the best possible supportive practices, meaning that it remains valuable and can be used to guarantee patients’ peaceful transition into the afterlife, which is one of the major goals of spiritual care.
Benefits of Spirituality Treatment of Patients in Critical Care and End of Life Care
The significance of considering the spiritual needs of patients in critical an end-of-life care can also be evidenced by specific benefits associated with it. Thus, spirituality treatments assist patients in coping with anxiety and stress appropriately. It can be viewed regarding the principles of a good death or residents’ ability to pass away fearless and without deep spiritual pain (Duru Aşiret et al., 2020). The reduced level of stress positively influences individuals’ perception of the afterlife. At the same time, this approach has some more benefits that should be considered while selecting the appropriate model and providing care to patients.
Thus, spirituality treatment helps patients in the critical care stage of their disease to manage and cope with their terminal diagnosis and reach peace with the creator whom we call God, and transition gracefully to the afterlife. It is one of the critical advantages of the discussed model as the central goal of the healthcare sector is the reduction of suffering. Practicing spirituality care can guarantee that patients are less scared and feel better (Molloy & Phelan, 2022). These practices can promote inner peace and coping strength, which is one of the desired conditions (Terpstra et al.,2020). As a result, there is a chance to avoid severe moral suffering at this stage and the impossibility of accepting the condition. It should be viewed as one of the critical advantages of this model of care.
In evidence-based practice, studies indicate that health care providers embrace the opportunity to incorporate spiritual care in the late stages of end-of-life care. Research shows that most nursing students have positive attitudes towards caring for dying patients (Zahran et al., 2022). They view death as one of the strongest emotional experiences; however, for nurses meeting it daily, it implies the responsibility to meet holistic patients’ needs (Zahran et al., 2022). Using the major ideas of spiritual care, health workers acquire the chance to reduce emotional suffering and pain and ensure patients feel better because of close cooperation with their care provider.
Speaking about benefits, it is also vital to admit that spiritual treatment of patients in critical and end-of-life care potentially improves the quality of life at the end of care. The ability to guarantee a peaceful transition to the afterlife and a comparatively high life quality during the last phases is one of the significant tasks of palliative care (Washington et al., 2021). Under these conditions, using spiritual practices accepted by patients, care providers acquire the chance to accomplish the task and increase the level of residents’ satisfaction.
Moreover, patients come to terms with their impending death and might potentially want to resolve old issues and grudges with someone from their past. Using the available spiritual practices, nurses might help to resolve old conflicts and accept the sins or errors of the past. Thus, social and spiritual needs might overlap, meaning they should be explored in depth through the socio-spiritual approach (Lormans et al., 2021). It will help to resolve the existing issues and promote patients’ readiness to enter the last phases of their lives.
Finally, spiritual care allows patients to say their last goodbyes to their loved ones. The inability to see close people at the end of life is one of the biggest fears (Terpstra et al., 2020). For this reason, the spiritual approach considers this need and ensures residents have a chance to interact with people who are important to them. Moreover, the last rituals or practices helping to reduce stress might be an essential part of such meetings (Terpstra et al., 2020). These actions might be critical for working with patients in palliative care.
Lack of laws, Standards, and Legislation Relevant to Spirituality and End of Life Treatments and Care
However, the failure to set standards for disseminating spiritual care might impact the role of the caregiver to perform their role effectively. Currently, the problem remains underresearched, and there is no clear framework for preparing and educating nursing students on how to meet the needs of patients who are close to death (Estrada et al., 2021). Most health care professionals do not get the training to provide spiritual care and lack the skill (Duru Aşiret et al., 2020). It can be viewed as a systemic problem emerging due to the drawback in the curriculum and work of the educational establishments (Duru Aşiret et al., 2020). At the same time, nursing students show readiness to acquire this sort of training and information to assist this group of patients (Zahran et al., 2022). It means that there is a need to introduce an appropriate framework to prepare health workers in the discussed paradigm. The possible approaches might include social and integrative models of shared decision-making (Washington et al., 2022). They might help to eliminate the barriers to the involvement of patients and better cooperation with nurses.
Another problem is that health care professionals have large caseloads and, for the most part, do not set aside time appropriately to provide spiritual treatment care accordingly to the patients in need. It can be linked to the lack of policies regulating their work and giving time devoted to working with these clients, understanding their needs, and preparing the appropriate intervention (Mogan et al., 2022). As a result, the delivery of spiritual care might be complicated because of the current flaws in standards and regulations. For this reason, it is vital to resolve these issues and ensure that the patients can enjoy the benefits mentioned above.
Altogether, spiritual care is a significant element in healthcare that should be incorporated to improve the quality of care for end-of-life patients so that they can have a dignified transition and peaceful passing to the afterlife. The existing research evidences that it might be associated with numerous benefits, such as reduced fear and stress, ability to communicate with close people, and resolve old issues. However, there is a lack of legislation, regulation, and training linked to the idea of spiritual care. Caregivers do not get training to perform their tasks in terms of the model, which impacts their effectiveness. For this reason, it is critical to continue investigating the question to eliminate flaws and create a practical framework for cooperation between patients and nurses.
Duru Aşiret, G., Yılmaz, C. K., & Gökşin, İ. (2020). Relationship between the nursing students’ attitudes towards spiritual care and the principles of a good death. Perspectives in Psychiatric Care, 56(4), 913-919.
Estrada, L. V., Cohen, C. C., Shang, J., & Stone, P. W. (2021). Community-based advance care planning interventions for minority older adults: A systematic review. Journal of Gerontological Nursing, 47(5), 26-36.
Lormans, T., de Graaf, E., van de Geer, J., van der Baan, F., Leget, C., & Teunissen, S. (2021). Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness. Palliative medicine, 35(6), 1071–1098.
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Washington, K. T., Demiris, G., White, P., Mathis, H. C., Forsythe, J. E., & Parker, O. D. (2022). A goal-directed model of collaborative decision making in hospice and palliative care. Journal of Palliative Care, 37(2), 120-124.
Zahran, Z., Hamdan, K. M., Ayman M. Hamdan‐Mansour, Allari, R. S., Alzayyat, A. A., & Shaheen, A. M. (2022). Nursing students’ attitudes towards death and caring for dying patients. Nursing Open, 9(1), 614-623.