Relationships is the pivotal point around which spiritual care needs to be given to terminally ill patients, claim researchers.
However, researchers have pinpointed a mismatch between patients' expectations and understanding when it comes to spirituality, and what medical and family caregivers offer.
And now researchers have offered new recommendations to improve this situation.
Using the definition of spirituality 'a personal search for meaning and purpose in life, which may or may not be related to religion,' Cardiff University's Adrian Edwards together with Hong Kong based researchers Naomi Pang, Vicky Shiu and Cecelia Chan scoured the palliative care literature to create a systematic meta-study of spirituality.
They incorporated qualitative data from 19 studies on 178 patients and 116 healthcare providers in their analysis.
Edwards' team found that although policy organizations advocate integrating physical, psychosocial and spiritual aspects within palliative care, not all patients understand the term 'spirituality.'
Besides, according to quantitative studies, 87 percent of patients consider spirituality important in their lives, while 51 to 77 percent of patients specifically consider religion important.
The initial challenge is to clarify what spirituality means in healthcare, and to reduce the gap between policy and patient expectations.
In literature searches, the investigators found that spirituality principally focused on relationships, rather than just meaning making.
Some other conclusions include that the division between the terms 'spirituality' and 'spiritual care' in the literature was artificial, and in fact the terms were used interchangeably.
'Relationships' surfaced as crucial factors all areas-relationships formed an integral part of spirituality; were a spiritual need; caused spiritual distress when they were broken; and were the way through which spiritual care was given.
The best caregivers practiced self-reflection and awareness.
Stumbling blocks to trust included social, religious or cultural discordance, inappropriateness, judgement or proselytising.
The way around this was to avoid religion but instead share common humanity - a 'spirit-to-spirit' relationship.
"A 'spirit to spirit' framework for spiritual care-giving respects individual personhood. This was achieved in the way physical care was given, by focusing on presence, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing," said Edwards.
The study appears in the journal Palliative Medicine, published by SAGE.