title: Patient and healthcare perspectives on the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic: a qualitative study.
abstract: OBJECTIVE
  The purpose of this study was to use a qualitative approach to better understand the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic from the perspectives of patients and healthcare providers.
  
  
  METHODS
  Participants were recruited from the bone marrow transplant clinic of a large urban outpatient cancer care centre in western Canada.
  
  
  METHODS
  Focus groups were conducted with patients (n=7) and healthcare providers (n=9) to explore the importance of addressing spiritual issues across the treatment trajectory and to identify factors associated with effectively addressing these needs.
  
  
  RESULTS
  Data were analysed using the qualitative approach of latent content analysis. Addressing spiritual issues was understood by patients and healthcare providers, as a core, yet under addressed, component of comprehensive care. Both sets of participants felt that addressing basic spiritual issues was the responsibility of all members of the interdisciplinary team, while recognising the need for specialised and embedded support from a spiritual care professional. While healthcare providers felt that the impact of the illness and treatment had a negative effect on patients' spiritual well-being, patients felt the opposite. Skills, challenges, key time points and clinical indicators associated with addressing spiritual issues were identified.
  
  
  CONCLUSIONS
  Despite a number of conceptual and clinical challenges associated with addressing spiritual issues patients and their healthcare providers emphasised the importance of an integrated approach whereby basic spiritual issues are addressed by members of the interdisciplinary team and by an embedded spiritual care professional, who in addition also provides specialised support. The identification of clinical issues associated with addressing spiritual needs provides healthcare providers with clinical guidance on how to better integrate this aspect of care into their clinical practice, while also identifying acute incidences when a more targeted and specialised approach may be of benefit.
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shane
authors.initials: S
authors.lastname: Sinclair
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shelagh
authors.initials: S
authors.lastname: McConnell
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Raffin Bouchal
authors.affiliation: Alberta Health Services, Cancer Control, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Naree
authors.initials: N
authors.lastname: Ager
authors.affiliation: Alberta Health Services, Cancer Control, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Reanne
authors.initials: R
authors.lastname: Booker
authors.affiliation: Alberta Health Services, Cancer Control, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Bert
authors.initials: B
authors.lastname: Enns
authors.affiliation: Research Consulting Services, Information Technologies, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Tak
authors.initials: T
authors.lastname: Fung
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016026:Bone Marrow Transplantation; D002170:Canada; D003191:Comprehensive Health Care; D003695:Delivery of Health Care; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D010348:Patient Care Team; D036301:Qualitative Research; D029181:Spirituality; D055815:Young Adult
keywords: bone marrow transplant; cancer; psychosocial; qualitative; spiritual care; spirituality