Spiritual Care: An Essential Aspect of Cancer Care
Spirituality is a universal part of the end-of-life experience. Spirituality is considered a primary part of hospice and palliative care. The meaning of spirituality and how it affects the quality of the end of life and dying are explored.
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Spiritual Care: An Essential Aspect of Cancer Care Kenneth J. Doka
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Introduction
As an enduring gift of the hospice movement, led by openly spiritual Dame Cicely Saunders, spirituality re-emerged as a critical aspect of medical care. In recent years, varied initiatives such as the National Consensus Project emphasizing the value of spirituality as an aspect of palliative care, The ACE (Achieving Clinical Excellence) project offering training in palliative care to chaplains and psychosocial professionals, and The Hospice Foundation of America’s Teleconference on Spirituality at the End-of-Life all stressed the importance of spiritual care in death and bereavement. Spiritual care is particularly important in cancer care – as cancer has long been viewed as a dreaded disease – one that carries, in many cases, a sense of moral opprobrium and spiritual abandonment. For much of its long history, cancer was an unspoken disease – the big “C” – a fearful disease dreaded for its mysterious causation slow and painful, sometimes disfiguring progression. Even now with far better treatment, diagnosis, and survival rates, cancer still is viewed as a spiritual curse. And it still carries a sense, at least in some sites of the disease, of opprobrium. Tell someone of another’s death by lung cancer and a likely question is “how long did the victim smoke?” A question that implies the individual with the disease is less deserving of sympathy or support. This chapter explores the nature of spirituality both during the course of illness, and should death occur, in bereavement. It begins by defining spirituality and exploring the ways that spirituality may affect health care. It then addresses the spiritual issues that may be experienced throughout the course of an illness – from diagnosis to chronic care, recovery, or death as well as the spiritual issues that arise in grief. Finally, the chapter focuses on both spiritual assessment and intervention.
K.J. Doka, PhD The Graduate School of The College of New Rochelle, New Rochelle, NY, USA The Hospice Foundation of America, Washington, DC, USA e-mail: [email protected] © Springer International Publishing Switzerland 2017 L. Berk (ed.), Dying and Death in Oncology, DOI 10.1007/978-3-319-41861-2_6
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K.J. Doka
6.2
Defining Spirituality
Religion and spirituality are often elusive concepts that are difficult to define and differentiate. A Consensus Conference funded by the Archstone Foundation brought together scholars and practitioners from a broad range of fields and disciplines in 2009. The agreed upon definition emerging from the Consensus Conference was that: Spirituality is the aspect of humanity that refers to the ways that individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred (Puchalski et al. 2009, p. 887). The International Workgroup on Dying, Death and Bereavement defines spirituality as “concerned with the transcendental, inspirational, and existenti
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