Spiritual care and pain in cancer

Abstract

Cancer pain is a multidimensional phenomenon in which meaning is a central element. Therefore, pain treatment should focus on the whole ­person, and be given by caregivers who are aware of the healing impact of their role. Spiritual care focuses on the aspect of meaning, purpose, and connectedness in cancer pain. Spiritual care may be religious of nature, but not ­necessarily so. In the normal development of the spiritual process of ­cancer patients, six phases can be distinguished: sense of finiteness and mortality, loss of grip, loss of meaning, grief, experience of new meaning, and ­integration of old and new meaningfulness. According to a consensus-based guideline on spiritual care published in 2010 in the Netherlands, three levels of spiritual care are distinguished. Spiritual care starts with attention, openness, and attentiveness. Although this is the basis of good care in general, it can become spiritual care if there is trust and willingness to engage with one another on an existential level. Attention may develop into accompaniment which may take different forms, depending on one’s personality, background, and profession. Sometimes patients can have a spiritual crisis. Then, ­referral and intervention by a chaplain of trained psychosocial caregiver is needed.