Examining spiritual needs, spiritual practices, ritual, and coping in palliative care: An Australian cohort study

This study aimed to examine religious and post-Christian spiritual orientations, types of spiritual and ritual activities, coping strategies of patients with advanced illness and explore associations between spiritual needs, practices, well-being, quality of life, and coping styles.

One hundred and two patients completed validated instruments: Post-Christian Spirituality Scale, Spiritual Needs Questionnaire, Spiritual Practices Questionnaire, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Global Quality of Life Scale, and Brief-COPE Questionnaire. Descriptive statistics summarized participant characteristics and scale distributions. Spearman correlations (Bonferroni-adjusted) examined associations between spiritual needs, practices, and coping modes. Multivariate regression analyses assessed whether ritual practices predicted spiritual needs.

Inner peace (median, 1.4; IQR, 1, 2) and humanistic/prosocial practices (median, 66.6; IQR, 44.4, 83.2) were prominent spiritual needs and frequently used rituals, respectively. Strong correlations were observed between religious needs and religious rituals (rho = 0.87). Existential, inner peace, and giving/generativity needs correlated moderately with existentialistic practices (rho = 0.56-0.69). Humanistic/prosocial spiritual practices were moderately associated with giving/generativity (rho = 0.52) and inner peace needs (rho = 0.42). Emotion-focused coping, particularly acceptance and emotional support, was most consistently associated with spiritual needs and practices, reinforcing the centrality of relational and embodied forms of spirituality at the end of life. Regression analyses confirmed existentialistic practices predicted existential and inner peace needs, while humanistic practices predicted generativity needs.

Findings demonstrate strong alignment between spiritual needs and ritual activity, supporting development of personalized, ritual-based spiritual care frameworks. Determining individual orientations toward embodied, relational, and humanistic practices may offer an adaptable means of addressing spiritual suffering.