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Spiritual needs and spiritual support preferences of people with end-stage heart failure and their carers: implications for nurse managers


  • Linda Ross BA, RGN, PhD,

    Reader in Spirituality & Healthcare, Corresponding author
    1. Department of Education and Service Delivery, Faculty of Health, Education, Psychology and Sport, University of South Wales, Pontypridd, UK
    • Correspondence

      Linda Ross

      Department of Education and Service Delivery Faculty of Health, Education Psychology and Sport University of South Wales

      Pontypridd CF37 1DL




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  • Jacky Austin MBE, PhD, BSc (Hons), RGN

    Consultant Nurse
    1. Heart Failure and Cardiac Rehabilitation Services, Aneurin Bevan Health Board, South Wales, UK
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Spiritual care is an important element of holistic care but has received little attention within palliative care in end-stage heart failure.


To identify the spiritual needs and spiritual support preferences of end-stage heart failure patients/carers and to develop spiritual support guidelines locally.


Semi-structured interviews (totalling 47) at 3-monthly intervals up to 1 year with 16 end-stage heart failure patients/carers. Focus group/consultation with stakeholders.


Participants were struggling with spiritual/existential concerns alongside the physical and emotional challenges of their illness. These related to: love/belonging; hope; coping; meaning/purpose; faith/belief; and the future. As a patient's condition deteriorated, the emphasis shifted from ‘fighting’ the illness to making the most of the time left. Spiritual concerns could have been addressed by: having someone to talk to; supporting carers; and staff showing sensitivity/taking care to foster hope. A spiritual support home visiting service would be valued.


Our sample experienced significant spiritual needs and would have welcomed spiritual care within the palliative care package.

Implications for nursing management

Nurse managers could play a key role in developing this service and in leading further research to evaluate the provision of such a service in terms of its value to patients and other benefits including improved quality of life, spiritual wellbeing, reduced loneliness/isolation and a possible reduction in hospital admissions.