title: Effect of a spiritual care training program for staff on patient outcomes.
abstract: Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being.
  
  
  
  This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses. Three of seven clinical teams (clusters) received the intervention, while the other four served as controls. Included patients were newly referred to the palliative care service, had an estimated survival of more than one month, and were aware of their diagnosis and prognosis. The primary outcome measure was the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) patient-reported questionnaire, which patients completed at two timepoints. Total FACIT-Sp score includes the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, which measures overall quality of life, as well as a spiritual well-being score.
  
  
  
  Some 144 patients completed the FACIT-Sp at both timepoints-74 in the control group and 70 in the intervention group. The change in overall quality of life, measured by change in FACT-G scores, was 3.89 points (95% confidence interval [CI 95%] = -0.42 to 8.19, p = 0.076) higher in the intervention group than in the control group. The difference between the intervention and control groups in terms of change in spiritual well-being was 0.32 (CI 95% = -2.23 to 2.88, p = 0.804).
  
  
  
  A brief spiritual care training program can possibly help bring about enhanced improvement of global patient QoL, but the effect on patients' spiritual well-being was not as evident in our participants. Further study with larger sample sizes is needed to allow for more definite conclusions to be drawn.
authors.affiliation: National Cancer Centre Singapore,Singapore.
authors.forename: Grace Meijuan
authors.initials: GM
authors.lastname: Yang
authors.affiliation: National Cancer Centre Singapore,Singapore.
authors.forename: Yung Ying
authors.initials: YY
authors.lastname: Tan
authors.affiliation: Duke-National University of Singapore Graduate Medical School,Singapore.
authors.forename: Yin Bun
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: Duke-National University of Singapore Graduate Medical School,Singapore.
authors.forename: Weng Kit
authors.initials: WK
authors.lastname: Lye
authors.affiliation: HCA Hospice Care,Singapore.
authors.forename: Sock Hui Amy
authors.initials: SHA
authors.lastname: Lim
authors.affiliation: HCA Hospice Care,Singapore.
authors.forename: Wan Ru
authors.initials: WR
authors.lastname: Ng
authors.affiliation: George Washington University,Washington, DC.
authors.forename: Christina
authors.initials: C
authors.lastname: Puchalski
authors.affiliation: National Cancer Centre Singapore,Singapore.
authors.forename: Patricia Soek Hui
authors.initials: PSH
authors.lastname: Neo
mesh_terms: D000368:Aged; D005260:Female; D006282:Health Personnel / Q000193:education*; D018574:Home Care Agencies / Q000458:organization & administration / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000639:trends; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D012846:Singapore; D029181:Spirituality; D011795:Surveys and Questionnaires; D013663:Teaching / Q000592:standards* / Q000639:trends
keywords: Palliative care; Quality of life; Spirituality; Training