Spiritual Care Unveiled - Religious Literacy in Palliative Care

Abstract

Sweden is portrayed as being multicultural and multireligious and at the same time, significantly impacted by secularization and simultaneously highly influenced by secular values. This diversity necessitates that society develop a deeper understanding of these variations. The overall aim of this thesis was to examine variations in place of death in relation to birth country, spiritual care discourses in palliative care research literature, and how healthcare professionals understand, handle and respond to religiosity and spirituality among patients and their family carers in palliative home care settings. The theoretical framework is based on religious literacy, deepened by lived religion and critical religion. Various methods were used: statistical analysis, discourse analysis, focus groups and ethnography. The findings show that foreign-born individuals are more likely to die in hospitals or at home than domestic-born individuals. Region of birth was one of several factors influencing place of death among foreign-born individuals. In the research literature, spirituality was described as enigmatic yet inherently human, with an assumption that every individual has a spiritual dimension. The analysis showed that healthcare professionals are expected to embody specific qualities in order to do spiritual care. Spiritual care was seen as crucial for holistic palliative care, focusing on acts like physical touch, silent presence and listening. In the focus groups, healthcare professionals identified qualities like “providing support” and “being present” as essential for spiritual care. Participants often positioned themselves as secular and non-religious, frequently employing an “us versus them” rhetoric, especially in discussions around truth-telling. In the ethnographic study, religion and culture were ascribed to the ‘Other’, with a notable silence surrounding patients’ religiosity in the encounters. A few professionals challenged these norms by engaging with patients’ spirituality. The study underscores a need for religious literacy in palliative home care, while also recognizing the diverse forms of religious literacy that exist. In conclusion, this thesis highlights the need to move beyond simplistic labels surrounding spirituality and religion, and instead advocates for a dynamic and changing view of religion as practised and contextual. The findings also reveal a gap between the theory and practice of spiritual care. By increasing religious literacy at both individual and organizational levels, healthcare professionals can better approach religious, cultural, and diverse encounters with greater openness and confidence.