The well-being of patients, particularly those in palliative care, is influenced not only by medical and scientific factors but also by how effectively healthcare professionals address their spiritual needs. Despite the World Health Organization and the German Charter for the Care of the Severely Ill and Dying acknowledging spirituality as a fundamental aspect alongside physical, psychological, and social dimensions, the practical implementation in hospitals often falls short.
According to Arndt Büssing, MD, a professor specializing in quality of life, spirituality, and coping at the University of Witten/Herdecke in Germany, many doctors and nurses struggle to address patients’ spiritual needs due to a lack of time, knowledge, or confidence. Speaking at a Diakonie conference, Büssing noted that spiritual concerns are seldom discussed in clinical settings, and there is ambiguity about who should be responsible for this aspect of care—be it pastors, psychologists, nurses, or doctors. The high stress levels in hospital wards further impede the provision of spiritual care.
To address this gap, Büssing evaluated a training program with a curriculum developed by Diakonie and Caritas in 2020. The program trained 91 nurses from diaconal institutions and included input from 774 patients and 356 relatives. The 40-hour interdisciplinary curriculum, “Spiritual/Existential Care Interprofessional” (SpECi), was designed to help healthcare providers meet the spiritual needs of seriously ill patients and their families.
Tested at seven locations, the SpECi curriculum consists of 10 modules covering topics like “Coping with Loss and Grief,” “Spiritual Resources and Sources of Strength,” and “Helpful Rituals.” The goal is to enable hospice and palliative care staff to better understand and respond to their patients’ spiritual needs.
The training has shown promising results. “Participants now have a deeper understanding of their own spirituality, which enhances their ability to listen to and resonate with patients,” Büssing told Medscape’s German edition. Post-training, 85% of respondents reported addressing patients’ spiritual needs more frequently, and 87% expressed a desire for more time to discuss spiritual topics. However, the training did not significantly impact perceived workload or team satisfaction, and team spirit remained low.
Data from American cancer patients revealed that 72% feel their spiritual needs are inadequately supported. In Germany, 20% of outpatients with pain reported having no one to discuss their spiritual needs with, and only 23% spoke with their pastor about these concerns. Notably, 37% of patients with pain preferred discussing their spiritual questions with their doctors, though doctors often refer them to hospital chaplaincy.
Büssing observed that the search for meaning or forgiveness is surprisingly uncommon among patients, raising questions about whether the dying have reconciled with their lives or have different expectations. However, the desire for generativity—sharing life experiences and affirming personal significance—remains strong, alongside the need for emotional peace and encounters with nature.
Büssing concluded that addressing spiritual needs in healthcare is not optional but “indispensable.” He emphasized that neglecting this aspect violates patients’ dignity and compromises the quality of care.
- : public
