Article2019

Spiritual Distress in Family Members of Critically Ill Patients: Perceptions and Experiences

Amanda Roze des Ordons · Henry T. Stelfox · Tasnim Sinuff · Kathleen Grindrod-Millar · Jennifer Smiechowski · Shane Sinclair

22 citations0/0 files storedJournal of Palliative Medicine

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Religion, Spirituality, and Psychology Palliative Care and End-of-Life Issues Family and Patient Care in Intensive Care Units

Abstract

Background: Spiritual distress among family members of patients in the intensive care unit (ICU) has not been well characterized. This limits clinicians' understanding of how to best offer support. Objective: To explore how family members experience spiritual distress, and how it is recognized and support offered within the ICU context. Design: A qualitative study involving interviews and focus groups between May 2016 and April 2017. Setting/Subjects: Family members of ICU patients ( n = 18), spiritual health practitioners ( n = 10), and an interprofessional group of clinicians who work in the ICU ( n = 32). Measurements: Transcribed data were analyzed using interpretive description. Results: The experience of spiritual distress was variably described by all three groups through concepts, modulators, expressions and manifestations, and ways in which spiritual distress was addressed. Concepts included loss of meaning, purpose and connection, tension in beliefs, and interconnected distress. Modulators were related to the patient and family context, the ICU context, and the relational context. Expressions and manifestations were unique and individual, involving verbal expressions of thoughts and emotions, as well as behavioral manifestations of coping. Clinical strategies for addressing spiritual distress were described through general principles, specific strategies for discussing spiritual distress, and ways in which spiritual support can be offered. Conclusions: Our study provides a rich description of how spiritual distress is experienced by family members of ICU patients, and how spiritual health practitioners and clinicians recognize spiritual distress and offer support. These findings will help inform clinician education and initiatives to better support families of critically ill patients.

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References

2009Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference 2011Support of cancer patients' spiritual needs and associations with medical care costs at the end of life 1958THE CHARACTERISTICS OF A HELPING RELATIONSHIP 2012Addressing Spirituality Within the Care of Patients at the End of Life: Perspectives of Patients With Advanced Cancer, Oncologists, and Oncology Nurses 1999‘I would if I could’: how oncologists and oncology nurses address spiritual distress in cancer patients 2015“The Patient Is Dying, Please Call the Chaplain”: The Activities of Chaplains in One Medical Center's Intensive Care Units 2015What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care 2007Spiritual care of families in the intensive care unit*

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2021Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes 2021Vicarious spiritual distress in intensive care unit healthcare providers: A qualitative study 2020Exploring spiritual health practitioners’ roles and activities in critical care contexts

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