A study conducted among advanced cancer patients in Soweto has found that most patients who received palliative care and are at the end of life, have spiritual needs beyond regular prayers from spiritual leaders. Furthermore, patients who received religious or spiritual care had less physical pain, used less morphine and had higher odds of dying where they wish than those who did not.
The study involving 233 participants was conducted by a team of local and international experts led by Wits researchers.
Lead researcher Dr Mpho Ratshikana-Moloko from the Centre for Palliative Care in the Faculty of Health Sciences at Wits University says that previous research has shown that religion and spirituality are important to most patients facing life-threatening illnesses. However, this study probed further.
Using the African Palliative Care Association Palliative Outcome Scale, the research confirmed previous international findings that nearly 98% of the participants had a religious or spiritual need.
The most common spiritual need expressed by patients in Soweto was “seeking a closer connection with their God” and “forgiveness for sins”, says Ratshikana-Moloko. This finding is of significance because it calls on faith leaders to provide relevant support that responds to the needs of patients. This research-led intervention empowers leaders to move beyond prayer, explains Ratshikana-Moloko.
“This is the first study to assess the spiritual and religious needs, and religious and spirituality care provided to advanced cancer patients who received palliative care in Soweto,” says Ratshikana-Moloko.
Since the study was concluded in 2018, Wits University has developed a course in Spiritual and Chaplaincy in Palliative Care. The first cohort of faith leaders from all religious backgrounds completed in September 2023.
Palliative care to increase
Palliative care is one of the key pillars in illness management among terminally ill patients who are judged by a specialist physician as unlikely to benefit from curative-intent therapy. Often, patients are unlikely to survive beyond six months.
The South African National Policy Framework and Strategy for Palliative Care (2017–2022) incorporates spirituality into health care. However, palliative care services in South and southern Africa and elsewhere, rarely address these needs, despite available policies, guidelines and evidence.
“We have to implement what we know. The integration of spiritual care within the clinical care setting is recommended,” Ratshikana-Moloko.
South Africa faces a heavy burden of communicable and non-communicable diseases. One in six deaths globally is due to cancer, and cancer diagnoses are expected to increase by 70% in the next two decades, especially in low- and middle-income countries.
“Failure to identify and address the religious and spiritual needs of terminally-ill patients may increase distress and suffering,” Ratshikana-Moloko.