title: Former palliative caregivers who identify that additional spiritual support would have been helpful in a population survey.
abstract: BACKGROUND
  Palliative care encompasses physical, psychosocial and spiritual care for patients and caregivers. No population data are available on bereaved people who subsequently report that additional spiritual support would have been helpful.
  
  
  METHODS
  In a population survey, a respondent-defined question was asked regarding 'additional spiritual support' that would have been helpful if someone 'close to them had died' an expected death in the previous five years. Data (socio-demographic [respondent]); clinical [deceased]) directly standardized to the whole population were analysed.
  
  
  RESULTS
  There were 14,902 participants in this study (71.6% participation rate), of whom 31% (4665) experienced such a death and 1084 (23.2%) provided active hands-on (day-to-day or intermittent) care. Fifty-one of the 1084 (4.7%) active caregivers identified that additional spiritual support would have been helpful. The predictors in a regression analysis were: other domains where additional support would have been helpful (OR 1.69; 95% CI 1.46-1.94; p<0.001); and being female (OR 3.23; 95% CI 1.23 to 8.33; p=0.017). 'Additional spiritual support being helpful' was strongly associated with higher rates where additional support in other domains would also have been helpful in: all bereaved people (2.7 vs 0.6; p<0.0001); and in active caregivers (3.7 vs 0.8; p<0.0001).
  
  
  CONCLUSIONS
  People who identify that additional spiritual support would have been helpful have specific demographic characteristics. There is also a strong association with the likelihood of identifying that a number of other additional supports would have been helpful. Clinically, the need for additional spiritual support should open a conversation about other areas where the need for further support may be identified.
authors.affiliation: Palliative and Supportive Services, Flinders University, Adelaide, Australia.
authors.forename: Meg M
authors.initials: MM
authors.lastname: Hegarty
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Ian
authors.initials: I
authors.lastname: Olver
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
mesh_terms: D001315:Australia; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010166:Palliative Care / Q000523:psychology*; D029181:Spirituality; D011795:Surveys and Questionnaires