Exploring religiosity's impact on end-of-life care: A call for nursing inquiry

Abstract

End-of-life care (EOLC) remains a pivotal aspect of nursing practice, yet its delivery often varies due to numerous influencing factors. Religiosity emerges as a significant but understudied determinant affecting EOLC provision. Religiosity is an all-encompassing term defining a person’s public or private involvement in religious groups or activities. This opinion piece delves into the nexus between religiosity and nursing practice, emphasizing the need for empirical inquiry to elucidate its role in shaping care dynamics. Drawing upon existing literature, it describes religiosity's multifaceted influence on nursing behaviours and decision-making in EOLC settings. The piece advocates for research efforts aimed at understanding its impact on care quality and equity. By fostering a deeper comprehension of how religiosity interacts with nursing practice, healthcare systems can strive towards delivering more personalized, equitable, and dignified EOLC experiences for patients and families.

Keywords

Religiosity / End-of-life care / Nursing Ethics / Patient-centered care

References

[1] Sikkema D, Casagrande M. End-of-life care: Toward a new beginning in Ontario. [Internet]. Cardus; 2018. Available from: https://www.cardus.ca/research/health/reports/end-of-life-care-toward-a-new-beginning-in-ontario/

[2] Bjarnason D. Nurse religiosity and end-of-life care. Journal of Research in Nursing. 2012 Jan; 17(1): 78-91. https://doi.org/10.1177/1744987110372046

[3] Heyland DK. What matters most in end-of-life care: perceptions of seriously ill patients and their family members. Canadian Medical Association Journal. 2006 Feb 28; 174(5): 627-33. PMid:16505458 https://doi.org/10.1503/cmaj.050626

[4] McCourt R, Power JJ, Glackin M. General nurses’ experiences of end-of-life care in the acute hospital setting: a literature review. Int J Palliat Nurs. 2013 Oct; 19(10): 510-6. PMid:24162282 https://doi.org/10.12968/ijpn.2013.19.10.510

[5] Festic E, Wilson ME, Gajic O, et al. Perspectives of Physicians and Nurses Regarding End-of-Life Care in the Intensive Care Unit. J Intensive Care Med. 2012 Feb; 27(1): 45-54. PMid:21257636 https://doi.org/10.1177/0885066610393465

[6] Mendola A, Grace PJ, Milliken A. Cultural, Religious, Language and Personal Experiences: Influences in Ethical Deliberations. In: Grace P, Milliken A, editors. Clinical Ethics Handbook for Nurses [Internet]. Dordrecht: Springer Netherlands; 2022 [cited 2024 Oct 21]. p. 115-32. (The International Library of Bioethics; vol. 93). https://doi.org/10.1007/978-94-024-2155-2_6

[7] White JH, Peirce AG, Jacobowitz W. The relationship amongst ethical position, religiosity and self-identified culture in student nurses. Nurs Ethics. 2019 Nov; 26(7-8): 2398-412. PMid:30336765 https://doi.org/10.1177/0969733018792738

[8] Taylor EJ, Park CG, Pfeiffer JB. Nurse religiosity and spiritual care. Journal of Advanced Nursing. 2014 Nov; 70(11): 2612-21. PMid:24806098 https://doi.org/10.1111/jan.12446

[9] Hubbell SL, Woodard EK, Barksdale-Brown DJ, et al. Spiritual care practices of nurse practitioners in federally designated nonmetropolitan areas of North Carolina. Journal of the American Academy of Nurse Practitioners. 2006 Aug; 18(8): 379-85. PMid:16907700 https://doi.org/10.1111/j.1745-7599.2006.00151.x

[10] Moberg DO. Spirituality and Aging: Research and Implications: Sociology. Journal of Religion, Spirituality & Aging. 2008 Mar 27; 20(1-2): 95-134. https://doi.org/10.1080/15528030801922038

[11] Ravari A, Bazargan M, Vanaki Z, et al. Job satisfaction among Iranian hospital-based practicing nurses: examining the influence of self-expectation, social interaction and organisational situations: Job satisfaction among Iranian hospital-based nurses. Journal of Nursing Management. 2012 May; 20(4): 522-33. PMid:22591154 https://doi.org/10.1111/j.1365-2834.2010.01188.x

[12] Gómez-Vírseda C, De Maeseneer Y, Gastmans C. Relational autonomy: what does it mean and how is it used in end-of-life care? A systematic review of argument-based ethics literature. BMC Med Ethics. 2019 Dec; 20(1): 76. PMid:31655573 https://doi.org/10.1186/s12910-019-0417-3

[13] Miracle VA.National Nurses Week and the Nightingale Pledge: Dimensions of Critical Care Nursing. 2009 May; 28(3): 145-6. PMid:19387283 https://doi.org/10.1097/DCC.0b013e31819aef4e

[14] Chandler C. Exploring How Nurse Beliefs and Attitudes Influence End-of-Life-Care Practice [Internet]. University of Massachusetts Amherst; 2018 [cited 2025 Mar 16]. Available from: https://scholarworks.umass.edu/entities/publication/f54a482b-d9bc-4949-805c-9b85ccff6f72

[15] Pugh E, Song R, Whittaker V, et al. A profile of the belief system and attitudes to end-of-life decisions of senior clinicians working in a National Health Service Hospital in the United Kingdom. Palliat Med. 2009 Mar; 23(2): 158-64. PMid:19073784 https://doi.org/10.1177/0269216308100248

[16] Alshehry AS, Almazan JU, Alquwez N. Influence of Religiosity on the Saudi Nursing Students’ Attitudes Toward Older People and Perceptions on Elderly Care. J Relig Health. 2020 Dec; 59(6): 2701-14. PMid:31190273 https://doi.org/10.1007/s10943-019-00857-z

[17] Juranić B, Včev A, Vuletić S, et al. (Dis)Agreement with Dysthanasia, Religiosity and Spiritual Experience as Factors Related to Nurses’ Workload during End-of-Life Care. IJERPH. 2023 Jan 5; 20(2): 955. PMid:36673711 https://doi.org/10.3390/ijerph20020955

[18] Winter-Pfändler U, Flannelly KJ, Morgenthaler C. Referrals to Health Care Chaplaincy by Head Nurses: Situations and Influencing Factors. Holistic Nursing Practice. 2011 Jan; 25(1): 26-32. PMid:21150502 https://doi.org/10.1097/HNP.0b013e3181fe266c

[19] Minton ME, Isaacson MJ, Varilek BM, et al. A willingness to go there: Nurses and spiritual care. Journal of Clinical Nursing. 2018 Jan; 27(1-2): 173-81. PMid:28474751 https://doi.org/10.1111/jocn.13867

[20] Watt S, Sword W, Krueger P. Implementation of a health care policy: An analysis of barriers and facilitators to practice change. BMC Health Serv Res. 2005 Dec; 5(1): 53. PMid:16102173 https://doi.org/10.1186/1472-6963-5-53

[21] Isaacson MJ, Minton ME. End-of-Life Communication: Nurses Cocreating the Closing Composition With Patients and Families. Advances in Nursing Science. 2018 Jan; 41(1): 2-17. PMid:29389725 https://doi.org/10.1097/ANS.0000000000000186

[22] Abbasi M, Farahani-Nia M, Mehrdad N, et al. Nursing students’ spiritual well-being, spirituality and spiritual care. Iran J Nurs Midwifery Res. 2014 May; 19(3): 242-7.

[23] Timmins F, Neill F. Teaching nursing students about spiritual care - A review of the literature. Nurse Education in Practice. 2013 Nov; 13(6): 499-505. PMid:23491611 https://doi.org/10.1016/j.nepr.2013.01.011

[24] Hubbell SL, Kauschinger E, Oermann M. Development and Implementation of an Educational Module to Increase Nurses’ Comfort With Spiritual Care in an Inpatient Setting. J Contin Educ Nurs. 2017 Aug; 48(8): 358-64. PMid:28759693 https://doi.org/10.3928/00220124-20170712-07

[25] Conner NE, Loerzel VW, Uddin N.Nursing Student End-of-Life Care Attitudes After an Online Death and Dying Course: Journal of Hospice & Palliative Nursing. 2014 Aug; 16(6): 374-82. https://doi.org/10.1097/NJH.0000000000000080

[26] Chiang YC, Lee HC, Chu TL, et al. A spiritual education course to enhance nursing students’ spiritual competencies. Nurse Education in Practice. 2020 Nov; 49: 102907. PMid:33220574 https://doi.org/10.1016/j.nepr.2020.102907