Gil Bar-Sela1, Michael J Schultz2, Karima Elshamy3, Maryam Rassouli4, Eran Ben-Arye5, Myrna Doumit6, Nahla Gafer7, Alaa Albashayreh8, Ibtisam Ghrayeb9, Ibrahim Turker10, Gulcin Ozalp10, Sultan Kav11, Rasha Fahmi12, Sophia Nestoros13, Hasanein Ghali14, Layth Mula-Hussain15, Ilana Shazar16, Rana Obeidat17, Rehana Punjwani18, Mohamad Khleif19, Gulbeyaz Can20, Gonca Tuncel10, Haris Charalambous21, Safa Faraj14, Neophyta Keoppi22, Mazin Al-Jadiry14, Sergey Postovsky23, Ma'an Al-Omari24, Samaher Razzaq14, Hani Ayyash25, Khaled Khader26, Rejin Kebudi27, Suha Omran28, Osaid Rasheed29, Mohammed Qadire30, Ahmet Ozet31, Michael Silbermann32. 1. Cancer Center, Emek Medical Center, Afula, Israel. gil_ba@clalit.org.il. 2. Division of Oncology, Rambam Health Care Campus, Haifa, Israel. 3. Faculty of Nursing, Mansoura University, Mansoura, Egypt. 4. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran. 5. The Oncology Service, Lin Medical Center, Haifa, Israel. 6. Alice Ramez Chagoury School of Nursing, Lebanese American University, Beirut, Lebanon. 7. Radiation and Isotope Center, Khartoum, Sudan. 8. College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman. 9. Makassed Charitable Hospital, Bethlehem, West Bank, Palestine. 10. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey. 11. Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey. 12. El-Salam Oncology Center, Cairo, Egypt. 13. Cyprus Anti-Cancer Society, Avodaphnousa Hospice, Nicosia, Cyprus. 14. Children's Welfare Teaching Hospital, Baghdad College of Medicine, Baghdad, Iraq. 15. Cross Cancer Institute, University of Alberta, Edmonton, Canada. 16. Department of Hematology, Rambam Health Care Campus, Haifa, Israel. 17. Faculty of Nursing, Zarqa University, Zarqa, Jordan. 18. Children Cancer Hospital, Karachi, Pakistan. 19. Al-Sadeel Society for Palliative Care, Bethlehem, West Bank, Palestine. 20. Florence Nightingale Faculty of Nursing, Istanbul University, Istanbul, Turkey. 21. Bank of Cyprus Oncology Center, Nicosia, Cyprus. 22. Cyprus Anti-Cancer Society, Nicosia, Cyprus. 23. Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. 24. King Abdullah University Hospital, Irbid, Jordan. 25. European Khan Yunis Hospital, Khan Yunis, Gaza Strip, Palestine. 26. Taif University, Taif, Saudi Arabia. 27. Cerrahpasa Medical Faculty & Oncology Institute, Istanbul University, Istanbul, Turkey. 28. Faculty of Nursing, Jordan University for Science and Technology, Irbid, Jordan. 29. Abu Dis and Al-Ahli Hospital, Al Quds University, Hebron, West Bank, Palestine. 30. Faculty of Nursing, Al-Bayt University, Mafraq, Jordan. 31. Tibbi Onkoloji Bilim Dali, Gazi Universitesi Tip Fakultesi, Ankara, Turkey. 32. Middle East Cancer Consortium and Technion-Israel Institute of Technology, Haifa, Israel.
Abstract
BACKGROUND: Although staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision. METHODS: A cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancer patients. RESULTS: Seven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p < 0.001 to p = 0.01). Even though only 42-45% overall were positively inclined toward praying with patients, respondents in lower HDI countries expressed more positive views (p < 0.001). In interaction analysis, HDI proved to be the single strongest factor associated with five of eight spiritual care examples (p < 0.001 for all). Significantly, the Middle Eastern respondents in our study actually provided actual spiritual care to 47% of their most recent advanced cancer patients, compared to only 27% in a parallel American study, with the key difference identified being HDI. CONCLUSIONS: A country's development level is a key factor influencing attitudes toward spiritual care and its actual provision. Respondents from lower ranking HDI countries proved relatively more likely to provide spiritual care and to have positive attitudes toward praying with patients. In contrast, respondents from countries with higher HDI levels had relatively more positive attitudes toward spiritual care interventions that involved gathering information applicable to patient care.
BACKGROUND: Although staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision. METHODS: A cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancerpatients. RESULTS: Seven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p < 0.001 to p = 0.01). Even though only 42-45% overall were positively inclined toward praying with patients, respondents in lower HDI countries expressed more positive views (p < 0.001). In interaction analysis, HDI proved to be the single strongest factor associated with five of eight spiritual care examples (p < 0.001 for all). Significantly, the Middle Eastern respondents in our study actually provided actual spiritual care to 47% of their most recent advanced cancerpatients, compared to only 27% in a parallel American study, with the key difference identified being HDI. CONCLUSIONS: A country's development level is a key factor influencing attitudes toward spiritual care and its actual provision. Respondents from lower ranking HDI countries proved relatively more likely to provide spiritual care and to have positive attitudes toward praying with patients. In contrast, respondents from countries with higher HDI levels had relatively more positive attitudes toward spiritual care interventions that involved gathering information applicable to patient care.
Entities:
Keywords:
Human Development Index; Middle East; Oncology; Palliative care; Prayer; Spiritual care