The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

Autores da FMUP
Participantes de fora da FMUP
- Gonçalves, F
- Moutinho, S
- Castro, M.
Unidades de investigação
Abstract
Background Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients. Methods A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one's perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients' definitions of spirituality was based on the interpretative phenomenological process. Results Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one's decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones' values and beliefs. Conclusion The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients' spiritual needs is essential for promoting patient empowerment, autonomy and dignity.
Dados da publicação
- ISSN/ISSNe:
- 1472-684X, 1472-684X
- Tipo:
- Article
- Páginas:
- 22-22
- Link para outro recurso:
- www.scopus.com
BMC Palliative Care BioMed Central Ltd.
Citações Recebidas na Web of Science: 28
Citações Recebidas na Scopus: 49
Documentos
- Não há documentos
Filiações
Keywords
- Autonomy; Decision-making; Decisional conflict; Palliative care; Spirituality; Spiritual wellbeing
Proyectos asociados
Ameaça aos princípios bioéticos na pratica médica no Brasil: Duas Décadas dos Processos ético-profissionais (1988-2008)
Investigador Principal: Rui Manuel Lopes Nunes
Estudo Clínico Académico . 2019
Citar a publicação
Rego M,Gonçalves F,Moutinho S,Castro M,Nunes R. The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study. BMC Palliative Care. 2020. 19. (1):p. 22-22. IF:3,234. (2).