Exploring spirituality in everyday neuro-oncology practice - nurses' and physicians' spiritual care toolbox

Patients with primary malignant brain tumors suffer from symptoms of both neoplastic and neurological disease, resulting in a limited prognosis and high symptomatic burden, including aphasia and mental deterioration. Thus, special spiritual care needs arise for these patients, which may be challenging. We explore spiritual tools that neurological and neurosurgical healthcare workers use when confronted with spiritual distress of their patients.

A vignette-based, cross-sectional, multicenter online survey was conducted to collect qualitative data. In total, 143 nurses and physicians working on 41 neurological and neurosurgical units in Bavarian hospitals participated and their self-reported behavior was analyzed using reflexive thematic analysis.

A total of 5 themes regarding the spiritual tools implemented by nurses and physicians in neuro-oncology were generated: (1) from physical to spiritual care, (2) feeling togetherness between the words, (3) listening to each other: one word at a time, (4) away from the dooming "why"-escaping the thought spirals, and (5) taking life back into one's own hands. These themes represent a spectrum including nonverbal tools like building a physical connection, allowing for emotional connection, and active listening. The verbal approach focuses on conversation strategies to relieve patients of guilt, facilitate spiritual discussions at the end-of-life, and communicate the diagnosis, prognosis, and treatment to strengthen self-efficacy.

Verbal, nonverbal, and holistic approaches to spiritual care in neuro-oncology were identified and can be used to develop a spiritual care toolbox for nurses and physicians in neuro-oncology, given the unique needs of patients with primary malignant brain tumors.