title: Research priorities in spiritual care: an international survey of palliative care researchers and clinicians.
abstract: BACKGROUND
  Spiritual distress, including meaninglessness and hopelessness, is common in advanced disease. Spiritual care is a core component of palliative care, yet often neglected by health care professionals owing to the dearth of robust evidence to guide practice.
  
  
  OBJECTIVE
  To determine research priorities of clinicians/researchers and thus inform future research in spiritual care in palliative care.
  
  
  METHODS
  An online, cross-sectional, mixed-methods survey was conducted. Respondents were asked whether there is a need for more research in spiritual care, and if so, to select the five most important research priorities from a list of 15 topics. Free-text questions were asked about additional research priorities and respondents' single most important research question, with data analyzed thematically.
  
  
  RESULTS
  In total, 971 responses, including 293 from palliative care physicians, 112 from nurses, and 111 from chaplains, were received from 87 countries. Mean age was 48.5 years (standard deviation, 10.7), 64% were women, and 65% were Christian. Fifty-three percent reported their work as "mainly clinical," and less than 2.5% stated that no further research was needed. Integrating quantitative and qualitative data demonstrated three priority areas for research: 1) development and evaluation of conversation models and overcoming barriers to spiritual care in staff attitudes, 2) screening and assessment, and 3) development and evaluation of spiritual care interventions and determining the effectiveness of spiritual care.
  
  
  CONCLUSIONS
  In this first international survey exploring researchers' and clinicians' research priorities in spiritual care, we found international support for research in this domain. Findings provide an evidence base to direct future research and highlight the particular need for methodologically rigorous evaluation studies.
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom. Electronic address: lucy.selman@kcl.ac.uk.
authors.forename: Lucy
authors.initials: L
authors.lastname: Selman
authors.affiliation: Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Northwood, United Kingdom.
authors.forename: Teresa
authors.initials: T
authors.lastname: Young
authors.affiliation: Department of General Practice, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: Vermandere
authors.affiliation: Ayrshire Hospice, Ayr, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Stirling
authors.affiliation: Department of Ethics of Care, University of Humanistic Studies, Utrecht, The Netherlands.
authors.forename: Carlo
authors.initials: C
authors.lastname: Leget
mesh_terms: D002835:Christianity; D002977:Clergy / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006292:Health Priorities / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment; D009726:Nurses / Q000706:statistics & numerical data; D010166:Palliative Care / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data; D011159:Population Surveillance; D012108:Research Personnel / Q000706:statistics & numerical data*; D026443:Spiritual Therapies / Q000706:statistics & numerical data*
keywords: Europe; Spiritual care; international; palliative care; research priorities; spirituality; survey