What are the social and spiritual needs of patients in the palliative phase of their illness, a systematic review

Background/aims: People in the palliative phase of their illness have wide-ranging needs throughout all dimensions of care: physical, psychological, social and spiritual. Attention for patients’ social and spiritual needs is still lacking and has proven to be difficult in day to day care. In order to appropriately attend to social and spiritual needs, knowledge on these needs is essential. This study concerns the final results of a systematic review that assesses the empirical evidence describing social and spiritual needs of patients in the palliative phase of their illness from their own perspective.
Methods: A systematic review of original, peer-reviewed research, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed using a thematic analysis approach. Five online databases (PubMed, EMBASE, CINAHL, Scopus and PsycInfo) and additional sources were searched for primary research published between January 1st 2008 to April 2019 reporting patients’ social and spiritual needs. Cochrane was consulted for the search strategy.
Results: After full-text screening, 33 studies were included. We found studies reporting needs across five themes: autonomy, connection, meaning, hope and death and dying. These needs varied across the world. Also, qualitative and quantitative methods of assessment yielded different results in terms of reported needs. Needs reported by patients could be interpreted as either social or spiritual depending on the patient’s point of view.
Conclusions: Studies were heterogeneous and showed a great variability in reported needs. Patients do not distinct between social and spiritual needs themselves. Consequently, these needs show great overlap in our results. Although, patients do not distinct between social and spiritual needs, in daily healthcare practice this is necessary to allocate appropriate patient-tailored care. In order to map patients’ needs, a combination of qualitative and quantitative assessment is advisable.Funding: ZonMW.