Multiple barriers to spiritual care for family members of critically ill patients were identified in a study on the perceptions of family members of patients who had been discharged from an intensive care unit (ICU), spiritual healthcare practitioners, and clinicians working in the ICU. These findings were published in the Journal of Pastoral Care and Counseling.
This was a qualitative study that used semi-structured individual interviews or focus groups conducted separately for family members, spiritual healthcare practitioners, and clinicians to evaluate participants’ experiences and attitudes regarding spiritual care in the ICU. Transcripts of these sessions were analyzed for thematic content.
Spiritual care was defined in this study as “that which recognizes and responds to the needs of the human spirit, including the need for meaning, purpose, and connection.”
Of the 414 family members, 451 clinicians, and 18 spiritual healthcare providers invited, 18 family members, 32 clinicians, and 10 spiritual healthcare providers participated in the study.
Some of the challenges to providing spiritual care to family members of ICU patients were misconceptions on the part of family members that spiritual care was offered only within the context of specific religious or “new age” practices, and that spiritual health practitioners represented only specific religious faiths. In addition, both family members and clinicians often associated spiritual care only with “end-of-life” care.
Other factors identified as impediments to spiritual care in the ICU included the biomedical focus of the ICU setting, clinician training gaps regarding recognition of spiritual distress in family members, hesitancy on the part of family members to initiate conversations with clinicians regarding spiritual distress, as well as time constraints on the part of clinicians and spiritual healthcare providers.
Furthermore, clinicians’ limitations and misconceptions regarding spiritual care were identified as barriers to discussions between them and family members of ICU patients regarding spirituality and spiritual distress.
A key facilitator of spiritual care was use of “a team approach to supporting family members with spiritual distress, where clinicians could provide general spiritual support and seek specialized expertise from spiritual health practitioners as needed.” In support of this type of interdisciplinary approach, spiritual healthcare providers reported that they perceived clinicians to value their contributions.
Moreover, family members and clinicians identified the importance of providing a continuity of spiritual care, and clinicians noted the value to expanding the scope of spiritual care to encompass the continuum of care, not just at critical junctures.
“Multiple barriers to spiritual care described in our study highlight how clinician discomfort in entering into conversations with family members about spirituality and spiritual distress is related to factors beyond their clinical training,” the study authors commented in their concluding remarks. “How these challenges may be mitigated through education, continuity of care, and interprofessional collaboration will require further research to inform approaches to better integrating spiritual care within ICU settings.”
Roze des Ordons AL, Stelfox HT, Grindrod-Miller K, Sinuff T, Smiechowski J, Sinclair S. Challenges and enablers of spiritual care for family members of patients in the intensive care unit. J Pastoral Care Counsel. 2020;74(1):12-21.