Spiritual suffering in palliative care: a concept analysis

PURPOSE: The concept of spiritual suffering in palliative care lacks clarity, which hinders appropriate therapeutic response. This study aims to clarify and define the concept of spiritual suffering within the context of palliative care. The research questions guiding this study are: What are the attributes, antecedents, and consequences of spiritual suffering in palliative care? How is it defined within that setting?

METHODS: A concept analysis was conducted using Walker and Avant's eight-step approach: (1) selecting the concept; (2) determining the aim; (3) identifying all uses of the concept; (4) defining attributes; (5) constructing a model case; (6) identifying borderline, related, and contrary cases; (7) specifying antecedents and consequences; and (8) identifying empirical referents.

RESULTS: Spiritual suffering in palliative care is a personal and transcendental phenomenon, marked by a profound disruption in existential meaning, personal identity, and deterioration of relational connection. This experience may include internal conflict within belief systems, hopelessness, existential questioning, multiple concerns, and significant difficulty accepting circumstances that threaten one's sense of integrity. Emotional responses are also present and may intensify distress, hindering the pursuit of inner peace.

CONCLUSION: This analysis offers a clear and operational definition of spiritual suffering in the context of palliative care and identifies its core components. It can assist professionals in recognising and addressing this form of suffering, fostering more compassionate, person-centred care. These findings offer valuable insights for ongoing efforts to integrate spiritual care into holistic palliative care practice and for future research on development of effective spiritual care interventions.