Assessment of Spirituality in Cancer Patients Receiving Palliative Care: Qualitative Study
DOI:
https://doi.org/10.32635/2176-9745.RBC.2026v72n4.5508Keywords:
Spirituality, Palliative Care, Oncology, Cancer, FaithAbstract
Introduction: Spirituality is an intrinsic component of human experience, with the manifestation of religious beliefs or experiences often observed in the health context. In palliative care, spiritual assessment seeks to understand the patient’s relationship with these beliefs and the community, in an attempt to identify suffering inherent to the end-of-life condition. Objective: To analyze whether the assessment of spirituality is relevant for patients under oncological palliative care. Method: Observational, cross-sectional, and qualitative study conducted with oncological patients in palliative care, assisted by the Integrated Oncology Center and Home Care Service. Data collection was carried out using a semi-structured questionnaire, utilizing the FICA Spiritual History Tool and the American College of Physicians’ Spiritual History instruments, followed by Thematic Content Analysis as proposed by Bardin. Results: Twelve patients were interviewed, identifying four thematic categories that express the participants’ spiritual experience: faith/belief, importance of faith; community, spiritual history, and therapeutic approach. Conclusion: The results showed heterogeneity in patients’ expectations regarding the approach to spirituality in the SUS, reinforcing the need for individualized care and its role as a coping resource.
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Puchalski CM, Vitillo R, Hull SK, et al. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. 2014;17(6):642-56. doi: https://doi.org/10.1089/jpm.2014.9427 DOI: https://doi.org/10.1089/jpm.2014.9427
Ritz CDA. Pessoas sem religião com crença: a urbanização e a fragilização da herança religiosa. REVER. 2023;23(2):345-64. doi: https://doi.org/10.23925/1677-1222.2023vol23i2a20 DOI: https://doi.org/10.23925/1677-1222.2023vol23i2a20
Cenedesi Júnior MA. Bioética aplicada aos cuidados paliativos: questão de saúde pública. Rev Bioét. 2023;31:e3532PT. doi: https://doi.org/10.1590/1983-803420233532PT DOI: https://doi.org/10.1590/1983-803420233532pt
Batista VM, Menezes TMO, Freitas RA, et al. Cuidado espiritual prestado pela equipe de enfermagem à pessoa em paliação na terapia intensiva. Rev Gaúcha Enferm. 2022;43:e20210330. doi: https://doi.org/10.1590/1983-1447.2022.20210330.pt DOI: https://doi.org/10.1590/1983-1447.2022.20210330.pt
Machado CAM, Marques ACB, Silva LAA, et al. Coping religioso/espiritual e qualidade de vida dos sobreviventes de câncer cinco anos após o transplante de células-tronco hematopoiéticas. Rev Bras Cancerol. 2022;68(4):e-182812. doi: https://doi.org/10.32635/2176-9745.RBC.2022v68n4.2812 DOI: https://doi.org/10.32635/2176-9745.RBC.2022v68n4.2812
Ferreira LF, Freire AP, Silveira ALC, et al. A influência da espiritualidade e da religiosidade na aceitação da doença e no tratamento de pacientes oncológicos: revisão integrativa da literatura. Rev Bras Cancerol. 2020;66(2):e-07422. doi: https://doi.org/10.32635/2176-9745.RBC.2020v66n2.422 DOI: https://doi.org/10.32635/2176-9745.RBC.2020v66n2.422
Nagy DS, Isaic A, Motofelea AC, et al. The role of spirituality and religion in improving quality of life and coping mechanisms in cancer patients: a systematic review. Healthcare (Basel). 2024;12(23):2349. doi: https://doi.org/10.3390/healthcare12232349 DOI: https://doi.org/10.3390/healthcare12232349
Lebowa W, Prusak J, Leśniak M, et al. The influence of religiosity and spirituality on the quality of life of patients with multiple myeloma. Clin Lymphoma Myeloma Leuk. 2023;23(12):889-96. doi: https://doi.org/10.1016/j.clml.2023.08.013 DOI: https://doi.org/10.1016/j.clml.2023.08.013
Majda A, Szul N, Kołodziej K, et al. Influence of spirituality and religiosity of cancer patients on their quality of life. Int J Environ Res Public Health. 2022;19(9):4952. doi: https://doi.org/10.3390/ijerph19094952 DOI: https://doi.org/10.3390/ijerph19094952
Pawlikowski J, Białowolski P, Węziak-Białowolska D, et al. Religious service attendance, health behaviors and well-being: an outcome-wide longitudinal analysis. Eur J Public Health. 2019;29(6):1177-83. doi: https://doi.org/10.1093/eurpub/ckz075 DOI: https://doi.org/10.1093/eurpub/ckz075
Chen Y, Koh HK, Kawachi I, et al. Religious service attendance and deaths related to drugs, alcohol, and suicide among US health care professionals. JAMA Psychiatry. 2020;77(7):737-44. doi: https://doi.org/10.1001/jamapsychiatry.2020.0175 DOI: https://doi.org/10.1001/jamapsychiatry.2020.0175
Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: Evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030-40. doi: https://doi.org/10.1093/ije/dyaa120 DOI: https://doi.org/10.1093/ije/dyaa120
Ramos TH, Silva LS, Carvalho TP, et al. Esperança da Pessoa com Câncer Avançado em Cuidados Paliativos. Rev Bras Cancerol. 2024;70(2):e-074661. doi: https://doi.org/10.32635/2176-9745.rbc.2024v70n2.4661 DOI: https://doi.org/10.32635/2176-9745.RBC.2024v70n2.4661
Fuchs JR, Fuchs JW, Hauser JM, et al. Patient desire for spiritual assessment is unmet in urban and rural primary care settings. BMC Health Serv Res. 2021;21(1):289. doi: https://doi.org/10.1186/s12913-021-06300-y DOI: https://doi.org/10.1186/s12913-021-06300-y
Plauto MSBC, Cavalcanti CCF, Jordán APW, et al. Espiritualidade e qualidade de vida em médicos que convivem com a finitude da vida. Revista Brasileira de Educação Médica. 2022;46(1):e043. doi: https://doi.org/10.1590/1981-5271v46.1-20210322 DOI: https://doi.org/10.1590/1981-5271v46.1-20210322.ing
Balboni TA, VanderWeele TJ, Doan-Soares SD, et al. Spirituality in serious illness and health. JAMA. 2022;328(2):184-97. doi: https://doi.org/10.1001/jama.2022.11086 DOI: https://doi.org/10.1001/jama.2022.11086
World Health Organization. Cancer Pain Relief and Palliative Care: Report of a WHO Expert Committee. Geneva: World Health Organization; 1990. (WHO Technical Report Series; 804).
Santos LL, Barros VS, Haidar AMSCB, et al. Correlação entre capacidade funcional e qualidade de vida em pacientes oncológicos em cuidados paliativos. Rev Bras Cancerol. 2023;69(3):e-203912. doi: https://doi.org/10.32635/2176-9745.RBC.2023v69n3.3912 DOI: https://doi.org/10.32635/2176-9745.RBC.2023v69n3.3912
Bizutti NS, Antunes RF, Melo RNR, et al. Evolução histórica do conforto no cuidado de enfermagem a pacientes oncológicos em fim de vida: revisão integrativa da literatura. Rev Bras Cancerol. 2024;70(1):e-044437. doi: https://doi.org/10.32635/2176-9745.RBC.2024v70n1.4437 DOI: https://doi.org/10.32635/2176-9745.RBC.2024v70n1.4437
Sleeth G, Gottlieb P, Srinivasan A, et al. Evaluation of the HOPE spiritual assessment model: a scoping review of international interest, applications and studies over 20+ years. BMC Palliat Care. 2025;24(1):191. doi: https://doi.org/10.1186/s12904-025-01809-z DOI: https://doi.org/10.1186/s12904-025-01809-z
Jaman-Mewes P, Caetano da Silva de Oliveira M, Mazotti MR, et al. Spiritual care interventions for palliative care patients: a scoping review. Palliat Support Care. 2024;22(5):1449-68. doi: https://doi.org/10.1017/S1478951524000592 DOI: https://doi.org/10.1017/S1478951524000592
Câmara dos Deputados (BR). Lei nº 14.758, de 19 de dezembro de 2023. Institui a Política Nacional de Prevenção e Controle do Câncer no âmbito do Sistema Único de Saúde (SUS) e o Programa Nacional de Navegação da Pessoa com Diagnóstico de Câncer; e altera a Lei nº 8.080, de 19 de setembro de 1990 (Lei Orgânica da Saúde). Diário Oficial da União, Brasília, DF. 2023 dez 20; Seção 1:1.
Ministério da Saúde (BR). Resolução nº 41, de 31 de outubro de 2018. Dispõe sobre as diretrizes para a organização dos cuidados paliativos, à luz dos cuidados continuados integrados, no âmbito Sistema Único de Saúde (SUS). Diário Oficial da União, Brasília, DF. 2018 nov 23.
Ministério da Saúde (BR). Portaria GM/MS nº 3.681, de 7 de maio de 2024. Institui a Política Nacional de Cuidados Paliativos – PNCP no âmbito do Sistema Único de Saúde – SUS, por meio da alteração da Portaria de Consolidação GM/MS nº 2, de 28 de setembro de 2017. Diário Oficial da União, Brasília, DF. 2024 maio 22.
Ministério da Saúde (BR). Portaria nº 825, de 25 de abril de 2016. Redefine a Atenção Domiciliar no âmbito do Sistema Único de Saúde (SUS). Diário Oficial da União. 2016 abr 26; Seção 1.
D’Alessandro MPS, Barbosa LC, Anagusko SS, et al., editores. Manual de cuidados paliativos [Internet]. 2. ed. rev. ampl. São Paulo: Hospital Sírio-Libanês; Ministério da Saúde; 2023 [acesso em 2026 jul 27]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/guias-e-manuais/2023/manual-de-cuidados-paliativos-2a-edicao?utm Brasil.
Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23-42. doi: https://doi.org/10.1002/nur.21768 DOI: https://doi.org/10.1002/nur.21768
Creswell JW, Poth CN. Qualitative inquiry & research design: choosing among five approaches. 4. ed. Los Angeles: Sage Publications; 2018.
O'Brien BC, Harris IB, Beckman TJ, et al. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245-51. doi: https://doi.org/10.1097/ACM.0000000000000388 DOI: https://doi.org/10.1097/ACM.0000000000000388
Puchalski C, Romer AL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med. 2000;3(1):129-37. doi: https://doi.org/10.1089/jpm.2000.3.129 DOI: https://doi.org/10.1089/jpm.2000.3.129
Borneman T, Ferrell B, Puchalski CM. Evaluation of the FICA Tool for Spiritual Assessment. J Pain Symptom Manage. 2010;40(2):163-73. doi: https://doi.org/10.1016/j.jpainsymman.2009.12.019 DOI: https://doi.org/10.1016/j.jpainsymman.2009.12.019
Lo B, Quill T, Tulsky J, et al. Discussing palliative care with patients. Ann Intern Med. 1999;130(9):744-9. DOI: https://doi.org/10.7326/0003-4819-130-9-199905040-00015
Bischoff KE, Patel K, Boscardin WJ, et al. Prognoses associated with Palliative Performance Scale scores in modern palliative care practice. JAMA Netw Open. 2024;7(7):e2420472. doi: https://doi.org/10.1001/jamanetworkopen.2024.20472 DOI: https://doi.org/10.1001/jamanetworkopen.2024.20472
Fillipo R, Leblanc TW, Plyler KE, et al. How do patients interpret and respond to a novel patient-reported Eastern Cooperative Oncology Group performance status (ECOG)? Qual Life Res. 2024;33(9):2375-85. doi: https://doi.org/10.1007/s11136-024-03715-y DOI: https://doi.org/10.1007/s11136-024-03715-y
Allende-Pérez S, Rodríguez-Mayoral O, Peña-Nieves A, et al. Performance status and survival in cancer patients undergoing palliative care: retrospective study. BMJ Support Palliat Care. 2024;14(e1):e1256-62. doi: https://doi.org/10.1136/spcare-2022-003562 DOI: https://doi.org/10.1136/spcare-2022-003562
Bardin L. Análise de conteúdo. 1. ed. São Paulo: Edições 70; 2016.
Assarroudi A, Heshmati Nabavi F, Armat MR, et al. Directed qualitative content analysis: the description and elaboration of its underpinning methods and data analysis process. J Res Nurs. 2018;23(1):42-55. doi: https://doi.org/10.1177/1744987117741667 DOI: https://doi.org/10.1177/1744987117741667
Silva VG, Souza FN, Siqueira ASA, et al. Ressignificação do diagnóstico de câncer e cuidados paliativos: abordagem urgente do cuidado oncológico. Rev Bras Cancerol. 2025;71(2):e-024891. doi: https://doi.org/10.32635/2176-9745.RBC.2025v71n2.4891 DOI: https://doi.org/10.32635/2176-9745.RBC.2025v71n2.4891
Soratto J, Pires DEP, Friese S. Thematic content analysis using ATLAS.ti software: potentialities for research in health. Rev Bras Enferm. 2020;73(3):e20190250. doi: https://doi.org/10.1590/0034-7167-2019-0250 DOI: https://doi.org/10.1590/0034-7167-2019-0250
Conselho Nacional de Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção 1:59.
Dorenbaum-Fastlicht A, Castañeda I, Guevara-López UM, et al. Spirituality and spiritual care in palliative and terminal illness: a systematic review and epistemic meta-analysis from physicians’ hermeneutic and bioethical perspective. BMC Palliat Care. 2025;24(1):301. doi: https://doi.org/10.1186/s12904-025-01916-x DOI: https://doi.org/10.1186/s12904-025-01916-x
Meira GG, Biondo CS, Cunha JXP, et al. A importância atribuída à espiritualidade como estratégia de enfrentamento do tratamento oncológico. Rev Baiana Enferm. 2023;37:e43848. doi: https://doi.org/10.18471/rbe.v37.43848 DOI: https://doi.org/10.18471/rbe.v37.43848
Almeida Filho RF, Trezza MCSF, Comassetto I, et al. Spirituality in the uncertainty of illness: the perspective of oncology patients. Rev Bras Enferm. 2023;76(4):e20220712. doi: https://doi.org/10.1590/0034-7167-2022-0712 DOI: https://doi.org/10.1590/0034-7167-2022-0712
Patrício AC de A, Athayde RAA, Aquino TAA. A influência da espiritualidade e da religiosidade no sentido de vida de pacientes oncológicos. REVER. 2022;22(1):179-96. doi: https://doi.org/10.23925/1677-1222.2021vol22i1a12 DOI: https://doi.org/10.23925/1677-1222.2021vol22i1a12
Quinn B, Connolly M. Spirituality in palliative care. BMC Palliat Care. 2023;22(1):1. doi: https://doi.org/10.1186/s12904-022-01116-x DOI: https://doi.org/10.1186/s12904-022-01116-x
Matos J, Querido A, Laranjeira C. Spiritual care through the lens of Portuguese palliative care professionals: a qualitative thematic analysis. Behav Sci (Basel). 2024;14(2):134. doi: https://doi.org/10.3390/bs14020134 DOI: https://doi.org/10.3390/bs14020134
Costeira C, Querido A, Ventura F, et al. Spiritual care[givers] competence in palliative care: a scoping review. Healthcare (Basel). 2024;12(11):1059. doi: https://doi.org/10.3390/healthcare12111059 DOI: https://doi.org/10.3390/healthcare12111059
Wang W, Yang J, Bai D, et al. Nurses' perceptions and competencies about spirituality and spiritual care: a systematic review and meta-analysis. Nurse Educ Today. 2024;132:106006. doi: https://doi.org/10.1016/j.nedt.2023.106006 DOI: https://doi.org/10.1016/j.nedt.2023.106006
Erden Melikoğlu S, Köktürk Dalcalı B, Güngörmüş E, et al. The relationship between the individualized care perceptions and spiritual care perceptions of nurses. Perspect Psychiatr Care. 2022;58(4):1712-9. doi: https://doi.org/10.1111/ppc.12979 DOI: https://doi.org/10.1111/ppc.12979
Puchalski C, Jafari N, Buller H, et al. Interprofessional spiritual care education curriculum: a milestone toward the provision of spiritual care. J Palliat Med. 2020;23(6):777-84. doi: https://doi.org/10.1089/jpm.2019.0375 DOI: https://doi.org/10.1089/jpm.2019.0375
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