title: Palliative care and spiritual care:  the crucial role of spiritual care in the care of patients with advanced illness.
abstract: OBJECTIVE
  Within the hospice and palliative care movement, patients' religion/spirituality (R/S) has been a core component of care incorporated within international and US palliative care guidelines. However, as the discipline of palliative care has been incorporated into the larger biomedical community, the inclusion of spiritual care has become controversial. This review summarizes key empirical research at the intersection of palliative care and R/S in order to assess its validity as a domain of end-of-life care.
  
  
  RESULTS
  Recent research shows that R/S and spiritual care are important components to the care of patients facing advanced illness. Patients - particularly ethnic minorities - rely upon R/S as an important means to interpret and cope with illness. Studies suggest that R/S plays an important role in coping with disease-related symptoms, improves quality of life, and impacts medical decision-making near death. Patients largely desire medical caregivers to take an active role in providing spiritual care, and patients likewise frequently experience multiple spiritual needs arising in the face of life-threatening illness.
  
  
  CONCLUSIONS
  Despite an empirical evidence for spiritual care as part of palliative care, R/S remains insufficiently addressed by the medical system. Further research is required in order to more clearly identify the roles of healthcare providers and standardize the provision of spiritual care within palliative care.
authors.affiliation: Center for Psychosocial Oncology and Palliative Care Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors.forename: Nora M
authors.initials: NM
authors.lastname: El Nawawi
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Balboni
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Balboni
mesh_terms: D005006:Ethnicity / Q000523:psychology; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D012067:Religion; D026443:Spiritual Therapies; D029181:Spirituality