On spiritual health and spiritual care: Care of the spirit as everyone’s business

Spirituality represents an important sphere of health and healthcare practice, with elements of meaning, purpose, and transcendence common to most definitions found in the literature. Compassionate attention to this sphere is perhaps most critical when caring for those living with dying, and or grieving in response to loss – whether experienced in the past, present or future. What then, is spiritual health?

As defined within an educational context, spiritual health is ‘a fundamental dimension of people's overall health and wellbeing, permeating and integrating all the other dimensions of health (i.e. the physical, mental, emotional, social and vocational) … a dynamic state of being, shown by the extent to which people live in harmony within relationships in the (personal, communal, environmental, and global) domains of spiritual wellbeing'.¹

Understanding spiritual health and wellbeing is vital, given many patients may find themselves contemplating the nature of their existence (perhaps for the first time), or questioning their faith, if they belong to a particular community of faith. Indeed, Haberecht and Prior describe the interplay of grief dynamics within a form of spiritual chaos.² As part of a positive education approach to spiritual health and wellbeing in palliative care contexts,³ spiritual care can promote health and wellbeing in ways that contribute to a sense of ‘positive dying’, where patients and families face illness and death with holistic healing, in the absence of medical cure.

Care of the spirit in palliative and end-of-life care is arguably a clinical practice area least understood and developed within multidisciplinary healthcare teams. While spiritual care has traditionally been the sole domain of chaplaincy and clinical pastoral care practitioners, the need for spiritual care responsibilities to be recognized and shared across multi-disciplinary teams is increasingly recognized. To support this ideal, however, targeted education is necessary to address the training limitations inherent to discipline-specific preparation for practice programs.

The Essence of Spiritual Care⁴ represents one example of an educational resource designed to address this gap in spiritual care training. Developed by Palliative Care Australia, in collaboration with the Spiritual Health Association, this is the first in a series of four online education modules (freely accessible) developed to support health professionals in developing their understanding of spiritual care. As highlighted in research by Jones and colleagues,⁵ spirituality is everyone’s business, and this is reflected in the practice reality of clinical case studies.⁶

Understanding spirituality and spiritual health is key to the provision of spiritual care to promote holistic quality of life. And spiritual care is an essential element of palliative and end-of-life care. While significant progress has been made, greater access to spiritual care training and educational resources can empower clinicians in caring for the spirit.