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Collective soul: the spirituality of an interdisciplinary palliative care team.

https://arctichealth.org/en/permalink/ahliterature168024
Source
Palliat Support Care. 2006 Mar;4(1):13-24
Publication Type
Article
Date
Mar-2006
Author
Shane Sinclair
Shelley Raffin
Jose Pereira
Nancy Guebert
Author Affiliation
Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada. shane.sinclair@calgaryhealthregion.ca
Source
Palliat Support Care. 2006 Mar;4(1):13-24
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult
Alberta
Attitude of Health Personnel
Female
Humans
Interprofessional Relations
Male
Middle Aged
Palliative Care
Patient care team
Professional-Patient Relations
Spirituality
Abstract
Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals (HCP) experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care.
A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit (TPCU) in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and/or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.
Initially participants struggled to define spirituality. Concepts of spirituality relating to integrity, wholeness, meaning, and personal journeying emerged. For many, spirituality is inherently relational. Others acknowledged transcendence as an element of spirituality. Spirituality was described as being wrapped in caring and often manifests in small daily acts of kindness and of love, embedded within routine acts of caring. Palliative care served as a catalyst for team members' own spiritual journeys. For some participants, palliative care represented a spiritual calling. A collective spirituality stemming from common goals, values, and belonging surfaced.
This was the first known study that focused specifically on the exploration of a collective spirituality. The culture of palliative care seems to foster spiritual reflection among health care professionals both as individuals and as a whole. While spirituality was difficult to describe, it was a shared experience often tangibly present in the provision of care on all levels.
PubMed ID
16889320 View in PubMed
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Health care provider communication: an empirical model of therapeutic effectiveness.

https://arctichealth.org/en/permalink/ahliterature117011
Source
Cancer. 2013 May 1;119(9):1706-13
Publication Type
Article
Date
May-1-2013
Author
Harvey M Chochinov
Susan E McClement
Thomas F Hack
Nancy A McKeen
Amanda M Rach
Pierre Gagnon
Shane Sinclair
Jill Taylor-Brown
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. harvey.chochinov@cancercare.mb.ca
Source
Cancer. 2013 May 1;119(9):1706-13
Date
May-1-2013
Language
English
Publication Type
Article
Keywords
Canada
Cancer Care Facilities - manpower
Communication
Empirical Research
Female
Focus Groups
Humans
Male
Neoplasms - therapy
Professional-Patient Relations
Abstract
Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the setting of cancer-related distress with the objective of understanding its constituent parts.
Seventy-eight experienced psychosocial oncology clinicians from 24 health care centers across Canada were invited to participate in 3 focus groups each. In total, 29 focus groups were held over 2 years, during which clinicians articulated the therapeutic factors deemed most helpful in mitigating patient psychosocial distress. The content of each focus group was summarized into major themes and was reviewed with participants to confirm their accuracy. Upon completion of the focus groups, workshops were held in various centers, eliciting participant feedback on an empirical model of therapeutic effectiveness based on the qualitative analysis of focus group data.
Three primary, interrelated therapeutic domains emerged from the data, forming a model of optimal therapeutic effectiveness: 1) personal growth and self-care (domain A), 2) therapeutic approaches (domain B), and 3) creation of a safe space (domain C). Areas of domain overlap were identified and labeled accordingly: domain AB, therapeutic humility; domain BC, therapeutic pacing; and domain AC, therapeutic presence.
This empirical model provides detailed insights regarding the elements and pedagogy of effective communication and psychosocial care for patients who are experiencing cancer-related distress.
Notes
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Comment In: Cancer. 2013 May 1;119(9):1609-1023341022
PubMed ID
23341092 View in PubMed
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Impact of death and dying on the personal lives and practices of palliative and hospice care professionals.

https://arctichealth.org/en/permalink/ahliterature138814
Source
CMAJ. 2011 Feb 8;183(2):180-7
Publication Type
Article
Date
Feb-8-2011
Author
Shane Sinclair
Author Affiliation
Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Manitoba, Canada. shane.sinclair@albertahealthservices.ca
Source
CMAJ. 2011 Feb 8;183(2):180-7
Date
Feb-8-2011
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Anthropology, Cultural
Attitude to Death
Canada
Health Personnel - psychology
Hospice Care
Humans
Palliative Care
Personal Satisfaction
Professional-Patient Relations
Spirituality
Abstract
Background Working within the landscape of death and dying, professionals in palliative and hospice care provide insight into the nature of mortality that may be of benefit to individuals facing the end of life. Much less is known about how these professionals incorporate these experiences into their personal lives and clinical practices. Methods This ethnographic inquiry used semi-structured interviews and participant observation to elicit an in-depth understanding of the impact of death and dying on the personal lives of national key leaders (n = 6) and frontline clinicians (n = 24) involved in end-of-life care in Canada. Analysis of findings occurred in the field through constant comparative method and member checking, with more formal levels of analysis occurring after the data-collection phase. Results Eleven specific themes, organized under three overarching categories (past, present and future), were discovered. Early life experiences with death were a common and prominent feature, serving as a major motivator in participants' career path of end-of-life care. Clinical exposure to death and dying taught participants to live in the present, cultivate a spiritual life, reflect on their own mortality and reflect deeply on the continuity of life. Interpretation Participants reported that their work provided a unique opportunity for them to discover meaning in life through the lessons of their patients, and an opportunity to incorporate these teachings in their own lives. Although Western society has been described as a "death-denying" culture, the participants felt that their frequent exposure to death and dying was largely positive, fostering meaning in the present and curiosity about the continuity of life.
Notes
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Cites: J Pain Symptom Manage. 2006 Jul;32(1):13-2616824981
Cites: Palliat Support Care. 2006 Mar;4(1):13-2416889320
Cites: Int J Palliat Nurs. 2007 Jun;13(6):291-30017851385
Cites: J Palliat Med. 2007 Dec;10(6):1321-818095811
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Cites: J Pain Symptom Manage. 2008 Dec;36(6):559-7118579340
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Comment In: CMAJ. 2011 Feb 8;183(2):169-7021135080
PubMed ID
21135081 View in PubMed
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The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.

https://arctichealth.org/en/permalink/ahliterature156482
Source
J Pain Symptom Manage. 2008 Dec;36(6):559-71
Publication Type
Article
Date
Dec-2008
Author
Harvey Max Chochinov
Thomas Hassard
Susan McClement
Thomas Hack
Linda J Kristjanson
Mike Harlos
Shane Sinclair
Alison Murray
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Pain Symptom Manage. 2008 Dec;36(6):559-71
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Death
Canada - epidemiology
Female
Humans
Male
Palliative Care - psychology
Psychometrics - methods
Questionnaires
Reproducibility of Results
Right to Die
Self-Assessment
Sensitivity and specificity
Spirituality
Stress, Psychological - diagnosis - epidemiology - psychology
Terminally Ill - psychology
Abstract
Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test-retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.
PubMed ID
18579340 View in PubMed
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The Patient Dignity Inventory: applications in the oncology setting.

https://arctichealth.org/en/permalink/ahliterature121035
Source
J Palliat Med. 2012 Sep;15(9):998-1005
Publication Type
Article
Date
Sep-2012
Author
Harvey Max Chochinov
Susan E McClement
Thomas F Hack
Nancy A McKeen
Amanda M Rach
Pierre Gagnon
Shane Sinclair
Jill Taylor-Brown
Author Affiliation
Department of Psychiatry, Manitoba Palliative Care Research Unit, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Palliat Med. 2012 Sep;15(9):998-1005
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Female
Humans
Male
Manitoba
Medical Oncology - manpower - methods
Neoplasms - psychology
Palliative Care - psychology
Psychometrics - instrumentation
Reproducibility of Results
Right to Die
Stress, Psychological - diagnosis - psychology
Terminally Ill - psychology
Abstract
The Patient Dignity Inventory (PDI) is a novel 25-item psychometric instrument, designed to identify multiple sources of distress (physical, functional, psychosocial, existential, and spiritual) commonly seen in patients who are terminally ill. It was also designed to help guide psychosocial clinicians in their work with patients. While its validity and reliability have been studied within the context of palliative care, its utility in clinical settings has not as yet been examined.
The purpose of this study was to determine how psychosocial oncology professionals would use the PDI with within their practice and what utility it might have across the broad spectrum of cancer.
Between October 2008 and January 2009, psychosocial oncology clinicians from across Canada were invited to use the PDI to determine their impressions of this approach in identifying distress and informing their practice.
Ninety participants used the PDI and submitted a total of 429 feedback questionnaires detailing their experience with individual patients. In 76% of instances, the PDI revealed one or more previously unreported concerns; in 81% of instances, clinicians reported that the PDI facilitated their work. While it was used in a wide range of circumstances, clinicians were more inclined to apply the PDI to patients engaged in active treatment or palliation, rather than those in remission, having recently relapsed, or newly diagnosed. Besides its utility in identifying distress, the PDI enabled clinicians to provide more targeted therapeutic responses to areas of patient concern.
While this study suggests various clinical applications of the PDI, it also provides an ideal forerunner for research that will directly engage patients living with cancer.
PubMed ID
22946576 View in PubMed
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Patients' and caregivers' needs, experiences, preferences and research priorities in spiritual care: A focus group study across nine countries.

https://arctichealth.org/en/permalink/ahliterature299387
Source
Palliat Med. 2018 01; 32(1):216-230
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2018
Author
Lucy Ellen Selman
Lisa Jane Brighton
Shane Sinclair
Ikali Karvinen
Richard Egan
Peter Speck
Richard A Powell
Ewa Deskur-Smielecka
Myra Glajchen
Shelly Adler
Christina Puchalski
Joy Hunter
Nancy Gikaara
Jonathon Hope
Author Affiliation
1 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Source
Palliat Med. 2018 01; 32(1):216-230
Date
01-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Belgium
Canada
Caregivers - psychology
Female
Finland
Focus Groups
Humans
Kenya
Male
Middle Aged
Neoplasms - nursing
Palliative Care - psychology
Poland
Quality of Life - psychology
Republic of Korea
South Africa
Spirituality
Stress, Psychological - psychology
Terminally Ill - psychology
United Kingdom
United States
Abstract
Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited.
To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers.
Focus group study.
Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. Discussions were transcribed, translated into English and analysed thematically.
A total of 74 patients participated: median age 62 years; 53 had cancer; 48 were women. In total, 71 caregivers participated: median age 61 years; 56 were women. Two-thirds of participants were Christian. Five themes are described: patients' and caregivers' spiritual concerns, understanding of spirituality and its role in illness, views and experiences of spiritual care, preferences regarding spiritual care, and research priorities. Participants reported wide-ranging spiritual concerns spanning existential, psychological, religious and social domains. Spirituality supported coping, but could also result in framing illness as punishment. Participants emphasised the need for staff competence in spiritual care. Spiritual care was reportedly lacking, primarily due to staff members' de-prioritisation and lack of time. Patients' research priorities included understanding the qualities of human connectedness and fostering these skills in staff. Caregivers' priorities included staff training, assessment, studying impact, and caregiver's spiritual care needs.
To meet patient and caregiver preferences, healthcare providers should be able to address their spiritual concerns. Findings should inform patient- and caregiver-centred spiritual care provision, education and research.
PubMed ID
29020846 View in PubMed
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A thematic review of the spirituality literature within palliative care.

https://arctichealth.org/en/permalink/ahliterature169650
Source
J Palliat Med. 2006 Apr;9(2):464-79
Publication Type
Article
Date
Apr-2006
Author
Shane Sinclair
Jose Pereira
Shelley Raffin
Author Affiliation
Foothills Medical Centre, Calgary, University of Calgary, Canada. shane.sinclair@calgaryhealthregion.ca
Source
J Palliat Med. 2006 Apr;9(2):464-79
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Alberta
Humans
Palliative Care
Spirituality
Abstract
Research related to spirituality and health has developed from relative obscurity to a thriving field of study over the last 20 years both within palliative care and within health care in general. This paper provides a descriptive review of the literature related to spirituality and health, with a special focus on spirituality within palliative and end-of-life care. CINAHL and MEDLINE were searched under the keywords "spirituality" and "palliative." The review revealed five overarching themes in the general spirituality and health literature: (1) conceptual difficulties related to the term spirituality and proposed solutions; (2) the relationship between spirituality and religion; (3) the effects of spirituality on health; (4) the subjects enrolled in spirituality-related research; and (5) the provision of spiritual care. While the spirituality literature within palliative care shared these overarching characteristics of the broader spirituality and health literature, six specific thematic areas transpired: (1) general discussions of spirituality in palliative care; (2) the spiritual needs of palliative care patients; (3) the nature of hope in palliative care; (4) tools and therapies related to spirituality; (5) effects of religion in palliative care; and (6) spirituality and palliative care professionals. The literature as it relates to these themes is summarized in this review. Spirituality is emerging largely as a concept void of religion, an instrument to be utilized in improving or maintaining health and quality of life, and focussed predominantly on the "self" largely in the form of the patient. While representing an important beginning, the authors suggest that a more integral approach needs to be developed that elicits the experiential nature of spirituality that is shared by patients, family members, and health care professionals alike.
PubMed ID
16629575 View in PubMed
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7 records – page 1 of 1.