Challenges and opportunities for spiritual care practice in hospices in a middle-income country

摘要

Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet. We explored spiritual care practices, and training needs, through a national quantitative online study of palliative care organisations in South Africa registered with the Hospice Palliative Care Association of South Africa. A survey was sent to representatives of all member organisations listed on the national database of Hospice Palliative Care Association of South Africa. Viable data from 41% (n?=?40) member organisations were analysed through the use of simple statistics. An expressed need (75%; n?=?30) was recorded for the development of a national spiritual care curriculum. Although 48% (n?=?20) of the member organisations were willing to participate in the development of a spiritual care curriculum, 37% (n?=?14) could not participate, citing financial (n?=?27), time (n?=?31) and expertise constraints (n?=?22). A set of hard and soft skills were suggested to suit the diverse South African context. Spiritual care was seen by participants as a key component of palliative care. International curricula in spiritual care, while useful, do not offer easy adaptation to the diversities of South Africa. A bespoke spiritual care curriculum was called for, for diverse South Africa.