Spirituality and religiosity in a palliative medicine population: mixed-methods study

2020 ◽  
pp. bmjspcare-2020-002261
Author(s):  
Clare C O'Callaghan ◽  
Ekavi Georgousopoulou ◽  
Davinia Seah ◽  
Josephine M Clayton ◽  
David Kissane ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Religious Affiliation ◽  
Religious Faith ◽  
Mixed Methods Study ◽  
Religious Support ◽  
Spiritual Support ◽  
Religious Activities ◽  
Care Needs ◽  
Chronic Illness Therapy ◽  
Time Strength

BackgroundSpiritual care allows palliative care patients to gain a sense of purpose, meaning and connectedness to the sacred or important while experiencing a serious illness. This study examined how Australian patients conceptualise their spirituality/religiosity, the associations between diagnosis and spiritual/religious activities, and views on the amount of spiritual support received.MethodsThis mixed-methods study used anonymous semistructured questionnaires, which included the Functional Assessment of Chronic Illness Therapy-Spiritual Scale-12 (FACIT-SP-12) and adapted and developed questions examining religion/spirituality’s role and support.ResultsParticipants numbered 261, with a 50.9% response rate. Sixty-two per cent were affiliated with Christianity and 24.2% with no religion. The mean total FACIT-SP-12 score was 31.9 (SD 8.6). Patients with Christian affiliation reported a higher total FACIT-SP-12 score compared with no religious affiliation (p=0.003). Those with Christian and Buddhist affiliations had higher faith subscale scores compared with those with no religious affiliation (p<0.001). Spirituality was very important to 39.9% and religiosity to 31.7% of patients, and unimportant to 30.6% and 39.5%, respectively. Following diagnosis, patients prayed (p<0.001) and meditated (p<0.001) more, seeking more time, strength and acceptance. Attendance at religious services decreased with frailty (p<0.001), while engagement in other religious activities increased (p=0.017). Patients who received some level of spiritual/religious support from external religious/faith communities and moderate to complete spiritual/religious needs met by the hospitals reported greater total FACIT-SP-12 spirituality scores (p<0.001).ConclusionRespectful inquiry into patients spiritual/religious needs in hospitals allows for an attuned approach to addressing such care needs while considerately accommodating those disinterested in such support.

Palliative Caregivers’ Spirituality, Views About Spiritual Care, and Associations With Spiritual Well-Being: A Mixed Methods Study

2019 ◽  
Vol 37 (4) ◽  
pp. 305-313 ◽  
Author(s):  
Clare O’Callaghan ◽  
Davinia Seah ◽  
Josephine M. Clayton ◽  
Martina Welz ◽  
David Kissane ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Spiritual Care ◽  
Religious Affiliation ◽  
Religious Faith ◽  
Well Being ◽  
Mixed Methods Study ◽  
Spiritual Needs ◽  
Religious Support ◽  
Care Providers ◽  
Spiritual Well Being

Background: Spiritual care is integral to palliative care. It engenders a sense of purpose, meaning, and connectedness to the sacred or important and may support caregiver well-being. Aim: To examine caregivers’ spirituality, religiosity, spiritual well-being, and views on spiritual/religious support. Design: A mixed-methods study across 4 Australian sites, recruiting caregivers of patients with a life expectancy of under 12 months. The anonymous semistructured questionnaire used included research team developed and adapted questions examining religion/spirituality’s role and support and views on hospitals supporting spiritual/religious requirements. It additionally included the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12). Results: One hundred nine caregivers participated (47.4% responded). Median spiritual well-being was 30.5 on FACIT-Sp-12. Religious affiliation was associated with higher Faith subscores ( P < .001). Spirituality was very important to 24.5%, religiosity to 28.2%, and unimportant to 31.4% and 35.9%, respectively. Caregivers prayed ( P = .005) and meditated ( P = .006) more following patients’ diagnoses, gaining comfort, guidance, and strength. Caregivers whose spiritual/religious needs were met to moderate/full extent by external religious/faith communities (23.8%) reported greater spiritual well-being ( P < .001). Hospitals supported moderate/full caregiver spiritual needs in 19.3%. Pastoral care visits comforted 84.4% of those who received them (n = 32) but elicited discomfort in 15.6%. Caregivers also emphasized the importance of humane staff and organizational tone in supporting spiritual care. Conclusions: Hospital-based spiritual care providers should seek to identify those who seek pastoral or religiously orientated care. Genuine hospitality of showing concern for the other ensures the varied yet inevitably humanist requirements of the caregiver community are met.

scholarly journals A mixed-methods study of the Care Needs of individuals with idiopathic Pulmonary fibrosis and their carers—CaNoPy: a study protocol: Table 1

BMJ Open ◽  
2013 ◽  
Vol 3 (8) ◽  
pp. e003537 ◽  
Author(s):  
Anthony Byrne ◽  
Cathy Sampson ◽  
Jessica Baillie ◽  
Kim Harrison ◽  
Ben Hope-Gill ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Study Protocol ◽  
Mixed Methods Study ◽  
Care Needs

Health care Needs of Women Immediately Post-Incarceration: A Mixed Methods Study

2013 ◽  
Vol 30 (5) ◽  
pp. 409-419 ◽  
Author(s):  
Alison M. Colbert ◽  
L. Kathleen Sekula ◽  
Rick Zoucha ◽  
Susan M. Cohen
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Health Care Needs ◽  
Care Needs

scholarly journals Needs-based provision of medical care to nursing home residents: protocol for a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025614 ◽  
Author(s):  
Jonas Czwikla ◽  
Maike Schulz ◽  
Franziska Heinze ◽  
Thomas Kalwitzki ◽  
Daniel Gand ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mixed Methods ◽  
Nursing Homes ◽  
Medical Care ◽  
Delphi Study ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Care Needs ◽  
Term Care

IntroductionNursing home residents typically have greater needs for medical care than community-dwelling elderly. However, restricted cognitive abilities and limited mobility may impede their access to general practitioners and medical specialists. The provision of medical care in nursing homes may therefore be inappropriate in some areas of medical care. The purpose of this mixed-methods study is to systematically assess, evaluate and explain met and unmet medical care needs in German nursing homes and to develop solutions where medical care is found to be inappropriate.Methods and analysisFirst, statutory health insurance claims data are analysed to identify differences in the utilisation of medical care between nursing home residents and community-dwelling elderly with and without need for long-term care. Second, the health status and medical care of 500 nursing home residents are assessed and evaluated to quantify met and unmet medical care needs. Third, qualitative expert interviews and case conferences and, fourth, quantitative analyses of linked data are used to provide structural, case-specific and generalisable explanations of inappropriate medical care among nursing home residents. Fifth, a modified Delphi study is employed to develop pilot projects aiming to improve medical care in nursing homes.Ethics and disseminationThis study was approved by the Ethics Committee of the University of Bremen on 23 November 2017. Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.Trial registration numberDRKS00012383.

A Mixed-Methods Study of Unmet Supportive Care Needs Among Head and Neck Cancer Survivors

2019 ◽  
Vol 42 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Winnie K.W. So ◽  
Cho-Lee Wong ◽  
Kai-Chow Choi ◽  
Carmen W.H. Chan ◽  
Joanne C.Y. Chan ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Mixed Methods ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Head And Neck ◽  
Neck Cancer ◽  
Mixed Methods Study ◽  
Supportive Care Needs ◽  
Care Needs

scholarly journals “I don’t take for granted that I am doing well today”: a mixed methods study on well-being, impact of cancer, and supportive needs in long-term childhood cancer survivors

2021 ◽  
Author(s):  
Manya Jerina Hendriks ◽  
Nathalie Hartmann ◽  
Erika Harju ◽  
Katharina Roser ◽  
Gisela Michel
Keyword(s):  
Psychological Distress ◽  
Mixed Methods ◽  
Supportive Care ◽  
Childhood Cancer ◽  
Unmet Needs ◽  
Qualitative Interviews ◽  
Childhood Cancer Survivors ◽  
Mixed Methods Study ◽  
Care Needs

Abstract Purpose With increasing numbers of childhood cancer survivors (CCS), it is important to identify the impact of cancer and CCS’ needs for support services that can mitigate the long-term impact on psychosocial wellbeing, including health-related quality of life (HRQOL). We aimed (1) to describe survivors’ wellbeing, impact of cancer, and supportive care needs and (2) to determine how socio-demographic or clinical characteristics and impact of cancer relate to survivors’ unmet needs. Method In this mixed methods study, a quantitative survey was used to assess HRQOL, psychological distress, impact of cancer, and supportive care needs. Qualitative interviews were conducted to explore the meaning of wellbeing, health, and impact of cancer. Results Overall, 69 CCS participated in the survey of which 28 participated in qualitative interviews (aged ≥ 18 years, diagnosed with cancer ≤ 18 years). Few CCS (13%) reported poor physical HRQOL, but almost half reported poor mental HRQOL (49%) and psychological distress (42%). Health was considered to encompass both: physical and emotional aspects of wellbeing. Cancer positively impacted CCS’ ability to care and attitude towards life, whereas relationships and insurance were negatively impacted. Risks for unmet needs increased in CCS with self-reported low health status, late effects, psychological distress, with older age at study or longer time since end of treatment. Conclusion In our study, many CCS experienced various psychosocial, psychological and informational unmet needs, indicating that survivors’ needs are currently not duly addressed. Current efforts to provide supportive psychosocial care in Switzerland should be further operationalized to provide adequate support.

scholarly journals Home Alone or Not? A Mixed Methods Study of Different Perceptions of Social Isolation between Care Managers and Older Housebound Adults

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Social Isolation ◽  
Well Being ◽  
Mixed Methods Study ◽  
Assessment Process ◽  
Older Person ◽  
Care Needs ◽  
Care Manager ◽  
Care Managers

Purpose: This paper aims to discuss whether the level of social isolation and loneliness as assessed by care managers corresponds to the level of social isolation and loneliness as perceived by the older persons whose care needs are being assessed. Design/methodology/approach: This mixed methods study followed up the assessment of 40 older people by 20 care managers with a focus on the accuracy of the care manager’s assessment on the level of social isolation experienced by the service user. In order for this to be achieved structured interviews were conducted with both the older person and the care manager assessing their needs, with a specific focus on the assessment of loneliness and social isolation. Following these initial interviews two focus groups were then undertaken with the care manager to discuss the findings and unpack the assessment process. Findings: The key issues were that the true level of social isolation and loneliness was under assessed by the care manager completing the assessment. That the care manager’s assessment was predominantly focused on the physical well-being of the older person and heavily influenced by the assessment paperwork. Originality/value: This provides lessons for professionals about the lack of effectiveness of their assessment of social isolation and loneliness in older people, and the potential impact this has on the older person’s quality of life.

What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program

2017 ◽  
Vol 35 (2) ◽  
pp. 236-243 ◽  
Author(s):  
Claire K. Ankuda ◽  
Kaileen Kersting ◽  
Timothy C. Guetterman ◽  
Jessica Haefner ◽  
Evan Fonger ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Social Services ◽  
Functional Disability ◽  
Symptom Burden ◽  
Mixed Methods Study ◽  
Spiritual Support ◽  
Medical Monitoring ◽  
Home Based ◽  
The Impact

Background: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. Aim: To identify what services are critical and why they matter to patients in a home-based palliative program. Setting/Participants: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan. Measurements: Two semistructured interviews were conducted for each participant, one while enrolled in AHS and another 3 months after the program ended to elicit the impact of AHS on their care. Qualitative theme data were merged with quantitative data on demographics, social and financial resources, symptoms, medical conditions, functional status, and utilization of health care while in AHS. Results: Four major themes of critical services reported by distinct populations of participants were described—medical support, endorsed by nearly every participant; emotional and spiritual support, endorsed by those with serious illness and symptom burden; practical assistance, endorsed by those with functional disability and isolation; and social services, endorsed by those in poverty. Medical monitoring was also described as critical but only by healthier participants. Conclusion: This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.

scholarly journals Regional differences in the patient population of general practices in northern Germany: results of a mixed-methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041762
Author(s):  
Heike Hansen ◽  
Ingmar Schäfer ◽  
Nadine Janis Pohontsch ◽  
Agata Kazek ◽  
Hanna Hardt ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Rural Areas ◽  
Urban Areas ◽  
Regional Differences ◽  
Medical Training ◽  
Qualitative Content Analysis ◽  
Mixed Methods Study ◽  
Northern Germany ◽  
Care Needs

ObjectivesThe aim of our study was to explore patient types in general practitioner (GP) practices and to quantify the regional differences of the frequencies of these patient types in northern Germany.Design and settingWe conducted a mixed-methods study based on focus groups and standardised interviews with GPs. All counties and independent cities within a radius of 120 km around Hamburg were assigned one of three regional categories (urban areas, environs, rural areas). The focus groups were analysed using qualitative content analysis. Relative frequencies of consultations by patient types and differences between the regions were calculated. Logistic regression analyses were used to identify differences among regions.ParticipantsNine focus groups with 65 GPs (67.7% male). From the 280 initially recruited GPs 211 (65.4% male) could be personally interviewed.ResultsFour themes with 27 patient types were derived from the focus groups: patients classified by morbidity, sociodemographic characteristics, special care needs and patient behaviour. Five patient characteristics were significantly more prevalent in urban areas than rural areas: patients with migration background and culturally different disease concepts (OR 1.23; 95% CI 1.06 to 1.42), privately insured patients (OR 1.17; 95% CI 1.05 to 1.31), educationally disadvantaged patients with low health literacy (OR 1.11; 95% CI 1.04 to 1.19), patients with psychiatric disorders (OR 1.07; 95% CI 1.02 to 1.12) and senior citizens living on their own without caregivers (OR 1.05; 95% CI 1.05 to 1.31). Three patient types were significantly less prevalent in urban areas: minors accompanied by their parents (OR 0.71; 95% CI 0.61 to 0.83), patients with poor therapy adherence (OR 0.87, 95% CI 0.80 to 0.95) and patients with dementia (OR 0.90; 95% CI 0.82 to 0.99).ConclusionsGPs could compensate the specific needs of their patients with medical training aligned with the requirements of their region. Urban GPs need skills treating patients with psychiatric, social and cultural problems, rural GPs regarding the care for children or noncompliant patients.Trial registration numberNCT02558322

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