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Spiritual Beliefs and End of Life Care



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Mar 22, 2009 01:28 PM

Spiritual Beliefs and End of Life Care

by tnbutterfly Staff

What role do spiritual beliefs play in a “good death”? How can the nurse in her/his role as patient advocate be equipped to assist the patient and family in honoring their spiritual beliefs when considering end of life treatment?

According to a study published this week in the Journal of the American Medical Association, “cancer patients who rely on their faith to handle the stresses of serious illness and approaching death are more likely to receive aggressive care when they die”. In this study, nearly 80 percent of the 345 patients with advanced stages of various cancers said religion helped them cope, and about 32 percent reported that their faith was "the most important thing that keeps you going."

“Cancer patients who relied heavily on religious coping were less likely to understand a do-not-resuscitate order and felt that such an order was morally wrong. These patients were less likely to have advanced planning such as having a living will (29 percent, versus 68 percent who were less religious) or medical power of attorney, which is the ability to act on someone else's behalf (34 percent, versus 64 percent who relied less on religion).”

In interpreting the results, study lead author Andrea Phelps, MD says "beyond the significance of religious faith in coping with the emotional challenge of incurable cancer, it is important to recognize how religious coping factors into extremely difficult decisions confronting patients as their cancer progresses and death appears imminent. Beyond turning to doctors for advice, patients often look to God for guidance in these times of crisis."

Holly Prigerson, associate professor of psychiatry at Harvard Medical School says, "Our results highlight how patients' ways of coping, particularly their use of religious coping, factor prominently into the ultimate medical care patients receive. This suggests that clinicians should be attentive to terminally ill patients' religious views as they discuss prognosis and treatment options with them. A greater understanding of the basis of patients' medical choices can go a long way toward achieving shared goals of care.”

In the face of serious illness and/or impending death, a person’s spiritual and religious beliefs will influence the choices and decisions regarding treatment. During these times of health crisis, patients and families may not be sure what is ethical or appropriate. They may not have enough knowledge about their medical condition or understand the scope and meaning of the potential treatments. Nurses play a vital role in communicating with family, educating them and assisting them to make decisions that are congruent with their beliefs.

What are your experiences in dealing with spiritual issues during end of life care?


http://www.cnn.com/2009/HEALTH/03/18/cancer.God.religion/

http://www.sciencedaily.com/releases/2009/03/090317162842.htm


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3 Comments
No. 1
from shrinky
Old Apr 17, 2009, 11:18 AM

Default Re: Spiritual Beliefs and End of Life Care
This is really a deep subject and I'm sure there will be different thoughts and perspectives. My experiences have been different here in SC because there are so many different types of religions, churches, beliefs. The people who really live their faith accept that death comes to everyone, and that God makes that decision. People who have religion may not necessarily do more than go to church on Sunday and believe that they are good Christians simply because of that. I have had the pleasure of having several dying patients that were missionaries or reverands and really had a more difficult time accepting death than others did. So I don't think that we can generalize and say that patients who rely on their religion seek treatment more than not. There are some that accept death as an opportunity to go Home and be cancer free and out of pain, who seek quality rather than quantity. Others don't want to leave their families and friends even though it is inevitable. I'm sure that I am rambling as any older person tends to do at times, but I hope that this is clearer than mud. My Hospice peers told me that I should be the Chaplain but I'm the nurse until the end.
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No. 2
from thenry
Old May 13, 2009, 11:10 PM

Default Re: Spiritual Beliefs and End of Life Care
It makes sense who are we to say how people will react to facing death...even christians who know were they are going want to feel like they have accomplished what they needed to and some just simple want to know the loved ones they are leaving behind are going to be ok.
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No. 3
Old May 15, 2009, 12:42 PM

Default Re: Spiritual Beliefs and End of Life Care
Originally Posted by shrinky View Post
This is really a deep subject and I'm sure there will be different thoughts and perspectives. My experiences have been different here in SC because there are so many different types of religions, churches, beliefs. The people who really live their faith accept that death comes to everyone, and that God makes that decision. People who have religion may not necessarily do more than go to church on Sunday and believe that they are good Christians simply because of that. I have had the pleasure of having several dying patients that were missionaries or reverands and really had a more difficult time accepting death than others did. So I don't think that we can generalize and say that patients who rely on their religion seek treatment more than not. There are some that accept death as an opportunity to go Home and be cancer free and out of pain, who seek quality rather than quantity. Others don't want to leave their families and friends even though it is inevitable. I'm sure that I am rambling as any older person tends to do at times, but I hope that this is clearer than mud. My Hospice peers told me that I should be the Chaplain but I'm the nurse until the end.

Oh I whole-heartedly agree........we can't and shouldn't generalize. Everyone is unique with different needs, expectations, beliefs, backgrounds, etc. Those are the things we must take into account when making nursing assessments. It is not a "one size fits all" approach.

Since your peers say you should be the chaplain, I'm sure it is because they have witnessed the compassionate care you give to your patients.
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