Author, Year of Publication and Country

Design

Data Collection / Study Conduction

Settings

Sample Size and Participants

Methods/Instruments

Aim

Findings

Themes

Analysis

Siler et al. (2019) USA [16]

Descriptive qualitative study

not mentioned

Practitioners in three outpatient Kaiser Permanente sites in California that provides palliative care and oncology services that had provided care for patients with lung cancer; purposive sampling

19 oncology and palliative care clinicians

Focus group and key informant interviews

to explore palliative care and oncology clinician's perspective on current challenges and facilitating factors in meeting the spiritual needs of patients with lung cancer

Clinicians described facilitating factors and challenges they encountered when addressing patient and caregiver spiritual needs

1. Factors That Facilitate Addressing Spiritual Needs 2. Challenges in Providing Culturally Respectful Care

The study demonstrated the need to provide nurses with practical tools, education, and a supportive environment to address patients' and family caregiver's spiritual concerns

Dong et al. (2015) China [17]

Phenomenological Qualitative Study

not mentioned

Practitioners were recruited from a cancer center in Mainland China; the participants had to have worked with and been exposed to dying cancer patients for at least half a year; to be more than 18 years old

participate; and to be a Chinese speaker.

15 physicians and 22 nurses

semi-structured face to face interview

To explore the experiences of Chinese physicians and nurses who care for dying cancer patients in their practical work.

physicians and nurses described strong ambitions to give dying cancer patients high-quality care, and they emphasized the importance of maintaining dying patients' hopes in the death-denying cultural context

(1) strong senses of obligation and crisis; (2) hope and spirit maintenance; (3) improvement of quality of life; (4) promotion of family function; (5) dilemmas during EOL stage

The study involves Chinese physicians and nurses experience a challenge when caring for dying cancer patients in the Chinese cultural context. Flexible and specific education and training in EOL cancer care are required to meet the needs of Chinese physicians and nurses at the cancer center studied.

Siller et al. (2018) USA [18]?

Descriptive qualitative stud

not mentioned

Purposive sampling that represents nurses, physicians, social workers, chaplains, and nurse administrators in three outpatient sites in Southwesteren United States that provided care to lung cancer patients

19 clinicians

Focus group and key informant interviews

To explore palliative care and oncology clinician's perspective on the perceived facilitators and challenges in meeting the quality of life needs of lung cancer patients and family caregivers in community based-settings

Clinicians addressed usueful practices and challenges like tining and staffing constraints, need for clinician education on palliative care, and education in providing spiritual support for patients and caregivers

(1) early palliative care (2) interdisciplinary care planning (3) symptom management (4) addressing psychological and social needs (5) providing culturally respectful care, including spiritual care

The research explained the perception of clinicians as they integrate palliative care in their sin community based settings

Zumstein-Shaha et al. (2020) USA [19]

Descriptive qualitative stud

July 2019

The survey was distributed to nurses attending an End-of-Life Nursing Educational Consortium (ELNEC) Summit held in San Diego, California on July 30–31, 2019 as well as to nurse practitioner students attending the first nurse practitioner Master of Science in nursing program at the Bern University of Applied Sciences (BUAS).

registered nurses (n=62)

Narrative survey

to explore nurses' recounting of patients' spiritual needs. To describe how nurses responds to patients' spiritual needs

Nurses concluded that religious, faith, and spiritual issues were important yet they found it difficult or uncomfortable to talk to patients about spirituality. Also stated is the importance of asking about religious, faith, or spiritual issues throughout the care process.

(1) Trying to make sense of the situation (2) Listening and acknowledging

With experience, nurses developed ways of talking with patients about spirituality/religion, which profoundly impacted their own lives and resulted in personal growth. Nurses felt a lack of spiritual competency

Zheng et al. (2015) China [20]

Descriptive qualitative stud

November 2012–February 2013

This study was conducted in Northern China at a 2400-bed cancer hospital, which has anationwidee reputation in cancer treatment and provides medical, surgical, radiologic, biological and palliative care services to patients from all parts of mainland China.

28 nurses who have been taking care of terminally ill patients in a cancer hospital in Tianjin, mainland China

semi-structured interviews

To elucidate Chinese oncology nurses’ experience of caring for dying cancer patients

Nurses in current study pointed out that oncology nurses’ sensitivity to dying patients’ religious background is essential and that spirituality plays a positive role in coping with imminent death for dying patients.

(1) end-of life care for dying cancer patients, (2) end-of-life care for family members, (3) cultural sensitivity and communication, (4) moral distress and self-limitations, (5) self-reflection and benefit-finding

Chinese nurses reported suffering but also benefiting from their experiences. End-of-life cancer care training is needed by Chinese oncology nurses, especially for those who are younger and less experienced.

Kesbakhi & Rohani (2021) Australia [21]

Mixed-methods sequential explanatory design

Not mentioned

At a time and location agreed upon, nurses were interviewed in a private room within the hospitals.

15 oncology nurses between the ages of 24 and 50 (6 men and 9 women) took part.

Semi-structured face-to-face interviews - lasting between 17 and 45 minutes

Examining how oncology nurses view the effects of clinical empathy in patients and nurses, as well as the variables that affect it.

This study highlights the integral role of existential

and spiritual issues in IM and AM cancer care.

(1) organizational factors (2) contextual elements.

The scientific focus on and treatment recommendations for spiritual and existential needs and care increase significantly every year. Spiritual care, affirmation, and relief of despair are particularly important for palliative and end-of-life situations: Supporting patients

emotional, existential, and spiritual needs indicate high-quality oncological health care.

Kienle et al. (2018) Germany [22]

Descriptive qualitative stud

Between 2009 and 2012

All interviews were conducted in person, and anonymity and confidentiality were ensured, enabling open communication. All but one of the physicians consented to digital audio recording; that physician’s interview consisted of field notes.

35 purposively sampled doctors

In-depth, semi-structured interviews

To better understand integrative cancer care and particularly the approach to psychological and spiritual needs of patients

Most of the doctors who were contacted underlined the importance of spirituality. Given its crucial significance for cancer patients, as well as the fact that this?occasionally their main justification for using IM.

(1)reducing emotional and spiritual suffering?(2) supporting the reduction of fear.

Psychological, biographical, and spiritual factors are important issues in integrative cancer care.

Best et al. (2016) Australia [23]

Qualitative Study, Grounded Theory

Not mentioned

Questions aimed at eliciting doctors’ familiarity with the concept of patient spirituality and with current practices regarding discussing (or not discussing) patient spirituality, as well as their perceptions of the challenges and outcomes of this type of discussion.

23 physicians

Semi-structured interview lasting 20 to 45 minutes via telephone.

To understand how experienced practitioners discuss spirituality

Doctors with considerable experience in discussing spirituality with advanced cancer

patients described a delicate and individualized process directed by the patient.

(1) developing the self (2) developing one’s attitude (3) approaching the patient (4) what makes it easier (5) what makes it harder (6) an important and effective intervention

Those who desire to develop expertise in this area need to take steps to develop their own spirituality as well as practice the recommended techniques to maximize the impact of such discussions.

Hamooleh et al. (2013) Iran [24]

Descriptive qualitative stud

Not mentioned

The research field at Tehran University of Medical Sciences such as Cancer Institute, Palliative Medical Center and Valieasr Hospital.

14 Nurses Participants 10 Females and 4 males ages ranging from 27 to 48

Deep semi-structured and face-to-face interviews 30 to 45 mins

Identify the perception of Iranian nurses regarding ethics-based palliative care in cancer patients

Nurses’ points of view, human dignity, professional truthfulness and altruism all have important roles in ethics-based palliative care in cancer.

(1) human dignity (2) professional truthfulness (3)altruism

ethics-based palliative care from the viewpoint of the nurses and showed that ethical concepts have a pivotal role in palliative care.

Kim et al. (2017) USA [25]

Descriptive qualitative study

January 2013 and May 2013.

Academic Medical center in a northeastern metropolitan area

31 nurses Participants in the 8 ICUs at the medical center, including the adult neurological, surgical oncologic, general surgical, cardiac surgical, and medical ICUs and the neonatal ICUs

In-depth interviews

Nurses are pivotal in the process of spiritual caregiving, spiritual care is now seen as the responsibility of another important member of the healthcare team: chaplains

Good critical care implies not only caring for physical ailments but also diagnosing and addressing spiritual distress among patients, their

family members, and even the ICU clinician team itself

(1) when nurses encounter patients and their families who need spiritual care; (2) what nurses consider caring for patients and their families who require spiritual support (3) how nurses perceive the role of chaplains(4) what nurses recommend for improving spiritual care in the ICU

nurses’ perceptions of chaplains and their role have grown to include duties such as listening, spending time with patients, providing aid during crises, facilitating end-of-life discussions, providing care and support to hospital staff, providing emotional support and rituals for families and staff, and acting as liaisons between patients’ families and medical staff

Bakitas et al. (2012) United Kingdom [26]

Descriptive qualitative study

September and December 2007

National Cancer Institute (NCI)-designated cancer center in Lebanon, New Hampshire

35 oncology clinicians

Semi-structured Interview

To understand oncology clinicians’ perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model

Oncology clinicians appreciated the extra time that palliative care was able to provide to medically or socially complex patients and families. They also recognized the importance of appropriately timed conversations

(1) treating the whole patient, (2) focusing on quality versus quantity of life, (3) some patients just want to fight (4) helping with transitions; timing is everything

Successful integration of palliative care research and clinical services requires the close involvement of the practicing oncologist.